5 Steps To Avoiding Midlife Weight Gain: An Ob/Gyn’s Advice


Dr. Greg Banks, Birmingham, AL

In today’s post, Dr. Greg Banks answers a Family Savvy reader’s question about how to avoid midlife weight gain.

QUESTION: Dr. Banks, I am 41 and have never had a weight problem, but I can tell that things are changing. I now have to watch what I eat, and my body shape seems to be changing.  Can you tell me how to avoid gaining weight as I enter midlife?

Dr. Greg Banks, MD, FACOG, FACS

This is a very common question and one that I hear regularly from patients. There are 5 steps to avoiding midlife weight gain that all women should know.

  1. Diagnose and correct any hormonal imbalance. This is time consuming in the physician’s office and poorly understood by most women who are sitting on the exam table. The hormonal balance in the body is intrinsically complex. What women need to know about hormones is not to be found in books written by a former actress (no name necessary) who dispenses medical advice as if she were a physician. To be blunt, self-appointed medical advisors who say “doctors didn’t learn about hormones in med school” didn’t attend one. The truth is, the issue of hormones is not limited to estrogen and progesterone. Women do not revolve around their ovaries the way men revolve around … well you know.  Joking aside, there are two kingpins where hormones are concerned: the thyroid gland and the adrenal gland. When the thyroid is out of sync, the body’s metabolism is lost. If the thyroid is functioning normally, the adrenal must be addressed. It releases DHEAS, which declines after 35 and is in a vicious circle in the production line of steroids including testosterone and estrogen. Adrenal fatigue, which is increased with stress, will result in an underproduction of DHEAS that can be replaced with compounded medication. The ovary can be supplemented with progesterone cream for sleep and well-being and estrogen added in the menopause. This balance is not complete without testosterone. The loss of this hormone in women can lead to the unpleasant loss of libido and gain of abdominal fat–like a male over 50. Hormone replacement is necessary, and if estrogen was truly a killer we would not give out birth control pills.
  2. Decrease simple carbs. Complex carbs are much better than simple carbs, an overconsumption of which can result in midlife weight gain.  Bottom line: if it is white, don’t eat it. The problem lies with sweets, pasta, rice, and other foods loaded with white flour and sugar.  You don’t have to eliminate carbs– just reduce them. You can subtract fiber from the carb count when monitoring carbs. Proteins take longer to digest and keep hunger to a minimum.
  3. Consider going gluten free. If you have symptoms of irritable bowel and continue to gain weight with the low-carb approach, eliminating processed foods and wheat germ may be the ticket. Gluten free diets are easily found on the internet but not much fun to follow.
  4. Avoid fad diets. Rapid weight loss by starvation turns the body into storage mode. You prepare for famine, and the body stores everything you eat after the diet episode is broken. Avoid hunger, and keep the metabolic engine running by eating small amounts multiple times during the day.
  5. Exercise. Women over 40 need 45 minutes of aerobic exercise daily to lose or even maintain weight. Walking slowly, playing one game of tennis, or weight training without aerobics does not offer the calorie burn necessary for those in perimenopause and menopause. This amount of exercise does take time, but it assists in weight loss and increases endorphins and enkephalins. It also brings about a feeling of well being that greatly assists with weight loss.

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