Just Eat Less, and Other Myths About Managing your Weight after 40

I have some version of the same conversation nearly every day, sometimes more than once a day.  A friend, a colleague or a patient in her 40s or 50s mentions that she weighs more than she ever has in her life.  She points out that she weighed less when she was pregnant.  Paradoxically, she is healthier than she was in her 20s and 30s.  She exercises more, eats better, sleeps more.  And this new and stubborn 5, 10 or 20 pounds is always centered around her waist, or at least where her waist used to be.  

She is frustrated and ready to give up on her healthy lifestyle and pour herself another glass of rosé. “I don’t need to be a size 2,” she cries, “I just want to see some results for all my hard work!”

Worst of all, she has been told by her mother, her friends, maybe even her doctor that she just needs to eat less.  “I don’t think I can eat less or exercise more.  I am not eating cookies all day!”

There is a reason this experience is so universal to women in their 40s, 50s and beyond–insulin resistance.  And understanding insulin resistance is the key to seeing the results of your healthy lifestyle.  

What is insulin resistance?  Put simply, insulin resistance is the need for your pancreas to produce more insulin to maintain a normal sugar level in the blood.  

Why does it plague women in their 40s and 50s? In a word, Hormones.   

During the late reproductive years (Usually early 40s), perimenopausal years (usually late 40s) and menopausal years (typically around age 51) changes in our estrogen and progesterone levels lead to changes in our body composition–the balance of fat and muscle in our bodies. We gain fat in the midsection (also called visceral fat) and visceral fat is known to be the key driver of insulin resistance.  

But why is visceral fat so difficult to get rid of? Insulin is a hormone.  It helps our muscles and fat take up sugar from our blood.  But insulin acts on nearly every tissue in the body and having too much insulin can increase appetite and make us crave sugar and starch, and increase the storage of fat in fat cells and in the liver.  

In essence high insulin levels cause us to store fat which makes us even more insulin resistant–a vicious cycle.

What, then, is a woman of a certain age to do? We will talk concrete solutions tomorrow.