Mid-Life: What Crisis?

The many perspectives of mid-life

Weight, Weight: Don't Tell Me!

Many of us are more conflicted than ever about mid-life weight gain

Many of us worry about our weight by the time we hit mid-life. We may have always been “a little plump,” but now it’s getting out of hand. Or we may have been slim—until we hit a certain age. And right now, in the throes of the holiday season, many of us feel more conflicted than ever about our weight and how we manage (or don’t manage) our eating and physical fitness.

Menopause seems to be a point of demarcation for weight and metabolism for women. Our bodies burn calories and fat somewhat more slowly as we age, so that we require fewer calories than before, in part because we naturally lose muscle mass and bone mass along the way. In addition, menopausal women’s bodies start to cling to their fat in order to maintain our estrogen levels. One study reported that the average woman gained 12 pounds from just prior to menopause to one year after, a gain of about a pound per month.

The experts tell us that weight also redistributes itself in our bodies as we age. For women, those who were more pear-shaped often become less so, and the mid-section of both males and females is the area of most gain. Thus, the waistline can be an area of concern even for slender middle-aged people. How we gain and how much we gain depends on both genetics and lifestyle factors.

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Meanwhile, a number of other things can start to happen in mid-life that may contribute to added weight. Thyroid issues become more common during our 40s and beyond, especially for women. And the thyroid is instrumental in controlling our metabolism, so if it is sluggish (i.e., we have hypothyroidism), we will not burn calories as well. Another symptom of hypothyroidism is fluid retention, a big culprit in weight gain among older women.

By the time we reach 50, many of us have at least one chronic illness. Pain and weakness from arthritic joints can make it harder to get the exercise we once did. Grip strength may be weaker, and painful knees, feet, or hips may make many types of exercise uncomfortable. Simply meeting the demands of our jobs and other responsibilities, and stress—from caring for aging parents, worrying about kids, relationships, money, work, even our health—make it difficult for some of us to eat well, control our eating, or exercise the way we should.

So that’s the bad news: Just business as usual will not allow most of us to maintain our young adult weight or shape.

The second piece of bad news is that we receive constant messages from the media, the diet and fitness industry, and even well-intentioned sources like our physicians, that can add up to shame and distress associated with our size, the way we look, and how we eat—effectively “super-sizing” our concerns about mid-life weight gain. Our internal fat-shaming joins our internal age-shaming as we spend our time worrying about how we look “so old” and “so fat.”

As a result, many of us in our 40’s and 50’s, especially women, may develop a love-hate relationship with eating—lots of fuss and self-scolding, lots of sense of deprivation, but we still find it difficult to stick to a healthy eating plan or to lose weight.

And yet…there’s some good news. Recent research (Zheng, Tumin & Qian, 2013) has suggested that a little extra weight as we age is not necessarily a bad thing, that in fact, a BMI (body mass index) above the “normal” range may be healthy for people in their 50’s. Researchers using from the Health and Retirement Study examined longitudinal data on people aged 51-61 over 17 years and found that those with BMI’s of 26-29 had the lowest mortality—a BMI that is currently considered “overweight.”

The researchers caution that obesity (a BMI over 30 is considered “obese” and over 35, “severely obese) is still not healthy at this age, particularly for those who continue to gain weight. Nevertheless, some experts have suggested that it may be time to recognize that a BMI which would be considered overweight for a younger adult might need to be recast as perfectly normal for someone in their 50’s.

Taking all this into account, an important question that many of us struggle with is: How much should we alter our lifestyle to keep weight gain at bay or take off weight we have gained? In order to help answer this question, I propose a few additional questions to consider.

1. Do you have health concerns that are directly affected by your weight (Type II diabetes, high cholesterol, trouble with knees and feet, etc.)? If this is a “yes,” then it is important for you to work on avoiding more weight gain and finding a way to up how much you move, strengthen your muscles, and tweak your eating, in order to slowly lose a little bit of weight. We’ve all heard it before, but it’s true: strive for a “lifelong” approach, rather than a quick fix, which usually backfires with re-gaining the weight quickly.

2. Could you make one small dietary change? In keeping with the goal of making lifestyle changes you can live with, making small changes is key. For instance, can you work on increasing fruit, vegetables and lean protein in your diet? That’s one way to start…just that. Focus on those three areas and not on what you CANNOT eat. Other ways to improve diet that don’t require Herculean changes might include practicing better portion control at dinner, or cutting out one “regular” snack or drink per day.

3. Do you get some cardio exercise (walking, biking, dancing, moving around the house, walking up and down stairs, etc.) most days? For prevention of breast cancer, Type II diabetes, for good brain and mental health, and for weight control, 20 minutes or more about 5 days a week is really good for us. If you are not doing this, try to start with 5-10 minutes at a time.

4. Are you engaged in strength training and/or “core strengthening” activity on a regular basis (usually twice per week)? Ideally, this should be a “yes.” It would be a good idea to consult your health care professional, join a gym and get instruction on strength training, or seek ideas for this type of exercise online that you can do at home. As a bonus, muscle mass burns more calories than fat, so keeping one’s muscles toned assists in keeping metabolism going.

Recent research demonstrates that even frail elders over 80 years old can benefit from strength training!! (Chou, Huang & Wu, 2012, is just one example.) Apparently, any time we start, strength training has the potential to bring back muscle and reduce the muscle wasting that occurs due to aging.

If you are especially out of condition because of obesity, joint issues, recent surgery, or illness, seek out physical therapy before trying to start an exercise plan. Physical therapists specialize in helping out-of-condition people with pain and weakness to regain their strength and flexibility.

If you don’t need physical therapy, getting a personal trainer or just arranging with a friend to help keep you doing your exercise or making those food decisions can make a big difference.

It’s true that we will feel and look our best if we eat a diet with more fruit, vegetables, and lean protein sources in place of less healthy fats and sugars, and if we work on strengthening our muscles and get up and move around, go out for a walk, or try a few minutes on the bike every day. This simple two-pronged approach may not be enough to return us to the size we wore in our 20s or 30s, or to our young-adult weight, but it can be our mid-life mantra to help curb further weight gain and maintain our best health and strength.

And what if, in addition, we were to wholeheartedly, radically, accept the middle-aged and older versions of our bodies…even with some extra pounds or a little flab here and there? In Cognitive Behavioral Therapy, we learn that sometimes you have to “fake it till you make it.” While in the process of trying to adopt some healthier behaviors, we can try to turn off the fat-shaming, age-shaming comments that run through our heads and come out of our mouths so often. Just imagine: we accept the version of our body we have now and look on it with kindness and appreciation! We might feel a whole lot better and get on with the business of living!

 

References 

Chou, C. H., Hwang, C. L., & Wu, Y. T. (2012). Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Archives of physical medicine and rehabilitation, 93(2), 237-244.

Zheng, H., Tumin, D., & Qian, Z. (2013). Obesity and Mortality Risk: New Findings From Body Mass Index Trajectories. American journal of epidemiology; doi:10.1093/aje/kwt179.

 

 

Kathryn Betts Adams, PhD, MSW, is a former associate professor of social work at Case Western Reserve University. Now living near San Diego, she writes and consults about mid-life and aging.

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