Have you ever turned around and suddenly caught sight of yourself in an unfamiliar mirror or a shop window and wondered who that woman was reflected back at you?
She looks nothing like the way you imagine yourself to look. When did your body change so much? When did you lose your waist? Or gain those inches on your thighs? And what has happened to your upper arms?
Many women in midlife have so much on their plate that they lose sight of their body for several years. They then ‘suddenly’ register the changes, as if their body had transformed overnight. So you go on a diet for a fortnight, but, well, nothing happens.
Well-meaning friends tell you to ‘just eat less and exercise more’, but for some reason it’s stopped being that simple. A two-week diet that got you back in shape in your 20s now achieves a weight loss that barely registers on the scales. Perhaps you lose a fraction of a single pound. What is going on?
Drs Suzann Kirschner-Brouns and Susanne Esche-Belke (pictured) have penned a book sharing advice for getting in shape in midlife
One of the major reasons is fluctuating hormones. Most women don’t know that up to ten years before menopause, during what is known as perimenopause, their hormones begin to become unbalanced in a way that directly affects their weight.
That’s because our monthly cycles take energy — ovulation is hard work — and from the age of 35 onwards, anovulatory cycles, where no ovulation occurs, become more frequent. Normally, in the second half of a woman’s cycle, our temperature goes up by around 0.5 degrees and if this rise in temperature fails to take place, then the energy otherwise required for heat production is not used up.
Women don’t notice any of this, but after menopause they burn an astonishing 300 fewer calories per day. That all adds up, and quickly.
There are other ways in which hormones conspire to affect our weight at this age, too.
The tongue-twisting hormone dehydroepiandrosterone (DHEA) — a form of oestrogen sometimes known as the ‘fountain of youth’ for its libido-enhancing and age-slowing properties — also starts to fall in midlife.
Lower levels of DHEA inhibit the build-up of muscle, and since muscle is the best fat-burner we have, that’s another tick in the weight-gaining column. Resistance to the hunger-relating hormone leptin often develops at this time of life, too, which makes you feel constantly hungry. So that’s where your snacking problem might come from.
And oestrogen dominance, one of the hallmarks of perimenopause (also responsible for mood swings and headaches, among many other symptoms) leads to water retention and the dreaded redistribution of fat towards the abdominal area.
Bang, there’s the midlife midriff.
Drs Suzann Kirschner-Brouns and Susanne Esche-Belke recommend eating three large meals rather than ten small ones (file image)
If all that makes you want to pull the covers over your head and stay under the duvet, well, we’re here to tell you we can control our weight at this age. Hormones play a part, but so does lifestyle — and that’s the bit we can influence.
We are two doctors who, between us, have spent decades both in general medicine and as specialists in female health and hormones. But, most of all, we are women who have been through this.
We know what it’s like to feel overburdened and overwhelmed in midlife. Overwhelmed by work and motherhood, by our fluctuating hormones, by changes in our metabolism and by those extra pounds.
In our new book, we’ve sifted through the scientific papers, talked to the psychologists and studied the myriad experiences of our own patients. And here is what we’ve learned — not only about surviving the hormonal roller coaster, but using these findings to get into your best shape ever …
Use your newfound selfishness!
In many cases, the reason why women don’t notice their bodies changing until that fateful glance in the unfamiliar mirror is that they’ve been frantically busy playing so many roles.
As a daughter, partner, lover, professional, parent and home-maker, women give Oscar-worthy performances every day of the year, until they’re not quite sure who they were to begin with.
Many women have been culturally conditioned to be extremely good at putting everyone else’s needs above their own.
We’re overwhelmed by fluctuating hormones, by changes in our metabolism and those extra pounds
But as hormones change, almost all women start to re-think those roles. With the hormone rollercoaster comes a feeling that they’ve had enough playing the caregiver within the family, in their community and even at work.
If you suddenly realise you’re no longer the first to put up your hand to volunteer for the parent–teacher association or to organise the office social, this may have something to do with your evolutionary ‘provider hormones’ decreasing.
Don’t feel guilty about it: it might be nature’s way of letting you know that you need to conserve your energy instead of giving it all away.
Looked at like this, menopause is the next exciting act in the development of your own personality.
The stage is set for the wonderful opportunity to take your own needs seriously and to think about what you want. The storms and crises of the midlife phase are real and should not be underestimated, but they provide a huge opportunity to finally tackle your health, your relationships and, yes, your diet.
Don’t fast if you want to lose midlife midriff
The holy grail of midlife dieting is the flat tummy. The dreaded midlife midriff — that stubborn belly fat that appears from nowhere and will not shift — is often hormonal in origin. Specifically, it’s caused first by an imbalance of hormones and then by their slow retreat.
While it’s become fashionable to practice fasting, we don’t advocate long fasts for weight loss. Instead, we recommend eating regularly but not constantly. Eat three large meals rather than ten small ones.
Drs Suzann Kirschner-Brouns and Susanne Esche-Belke (pictured) said during the menopause, it’s realistic to lose a stone and a half within 12 months
One of the reasons for not undertaking long fasts is because the microbiome — the flora in the gut that we now know plays a big role in regulating body weight — has a biorhythm, or an internal clock, and if breakfast or dinner keeps getting cancelled, it gets grumpy.
For years now, this highly individual collection of microscopic bacteria, yeasts and fungi has been the focus of international science. Each of us has 100 trillion little creatures in the gut — more than there are stars in the Milky Way. Our microbiome can affect our personality, our oestrogen levels and certainly our weight. Indeed, there is a fascinating interaction between our microbiome, our hormones and our metabolism.
A really damaged intestinal flora — say, after a course of antibiotics — can scupper all your attempts at weight loss. So feed it regularly and feed it well. Fermented foods like soy and yoghurt products, kombucha, kefir and kimchi, plus probiotics and prebiotics, ensure a balanced microbiome.
Go slowly — and enjoy the odd treat
Don’t be too impatient or too ambitious when you try to lose weight during the menopause.
A scientifically proven realistic goal — one that’s unlikely to lead to a long-term yoyo effect — is to lose a stone and a half within 12 months.
This rate of weight loss is healthy and can be measured in significantly lowered blood sugar, blood fat and blood pressure values.
A study conducted by the University of Massachusetts was able to show that diets containing less than 1,000 calories per day cause bad moods, concentration issues and hunger attacks, and this then leads people to abandon their diets.
A slow diet is much more likely to reset habits for good and thwart that hormonal weight gain. We deliberately don’t recommend a regimented diet, but argue for long-term dietary changes.
Research shows a diet of less than 1,000 calories per day causes bad moods, concentration issues and hunger attacks (file image)
That means moving towards a way of eating that consists mainly of fresh vegetables, fibre-rich produce, and calorie-free drinks such as water and tea.
We’re not going to judge you if you slip. In fact, sometimes it’s the right thing to do to eat the muffin or the ice cream. Enjoy it and let it make you feel good! Just not every day.
And don’t give up healthy eating because of it. Try saying something kind and loving to yourself, then set yourself back on course with a plate of lovely bright veg.
Often it helps to set yourself a feel-good limit. At what point do you start to feel uncomfortable or angry with yourself, or for health reasons say it’s time to stop? Acknowledging this doesn’t mean you’re weak or have failed. It’s the same for everyone.
Don’t stop walking when lockdown lifts
You already know that exercise is good for you on just about every level. But did you know it’s been proven to protect against almost all symptoms that are associated with oestrogen deficiency during perimenopause?
Just one hour of daily walking reduces the risk of hot flushes, insomnia and weight gain. And it’s especially important for women because it promotes bone formation, helps prevent osteoporosis and reduces the risk of breast cancer.
Set an early alarm
Late risers eat 250 more calories per day than those who wake up early, largely because they’re eating more, and later in the evening. They also give themselves less time to exercise.
So what is the best sleep pattern for weight loss in midlife? Researchers in Canada found that eight hours of sleep promotes optimal weight regulation.
Those who’ve been getting too little sleep for several years have an almost 30 per cent higher risk of piling on the pounds.
Late risers eat 250 more calories per day than those who wake up early, largely because they eat later at night
Levels of leptin, known as the ‘satiety hormone’, which tells you when you’re full, drop if you suffer from sleep deprivation, while too much of the appetite-stimulating hormone ghrelin is formed. Who hasn’t experienced the munchies after a late-night party?
One personal point. After eating salad in the evenings, Susanne noticed that she was sleeping badly — restlessly and too lightly. So now, instead, she often has something that’s easier to digest, like soup.
Raw food is out completely in the evenings — she doesn’t even nibble on a carrot stick — because it lodges heavily in the bowel overnight and causes that poor sleep. She also only allows herself something sweet on the weekends.
Know why you are doing this
Why do you want to lose weight? Why forgo the delicious pasta, creamy sauce and glass of red wine in the evenings?
It’s not just a good question to ask yourself: it’s the crucial question to ask if you want to maintain a balanced diet and cut out the sugary, high-calorie food you know you shouldn’t eat. Why should you make yourself suffer without a good reason?
Do you want to lose weight because it will lower your blood pressure and you will no longer feel dizzy? Or because it will help you deal with your menopausal symptoms better? Or perhaps it’s because you will be able to play sport again with your children or go jogging with your friend without getting out of breath?
Find the very best reason. Write it down on a sticky note and put it on the bathroom mirror or on the fridge. Making uncomfortable changes is impossible without a good reason to motivate you.
Find a way to refuel — but not with food
Chronic stress can lead to significant weight gain.
When stress causes levels of the fight or flight hormone cortisol to rise, so too does our blood sugar. At the same time, our brains demand more energy, demonstrating that need through a decline in concentration, a queasy feeling or hands that shake.
Study in The American Journal of Clinical Nutrition suggests those who take vitamin D as part of their weight-loss regime lose more weight (file image)
Say we have an argument with a colleague or family member and feel those stress levels rising. The best idea to calm down would be to run three circuits around the office or park, but instead we often make a beeline for the fridge.
Refuel in ways that won’t go straight onto the thighs. When everything becomes too much for you, find a comfortable room where you can close the door, or a favourite place outside, like a lake or under a tree or a particular park bench, and rest there for half an hour — or as long as you can.
Give yourself a boost of vitamin D
A recent study in The American Journal of Clinical Nutrition showed that women who were given vitamin D as part of their weight-loss regime lost more weight than those who weren’t. Scientists suspect that vitamin D sends out signals for fat burning, deciding whether fat will be burned for energy or not by directing special vitamin D receptors on the fat cells. If it is not used for energy, it’s stored on the hips!
And the bonus is … a better sex life
A well-loved body is a more relaxed body, and relaxation is crucial to health and to good decision-making around food and exercise.
Being happy with your body is clearly good for your sex life, too. If society persuades older women to think they’re no longer desirable or beautiful, this can nip sexual desire in the bud.
Take a bold look at your sexual needs. Do you still feel desire and, if so, are your desires being met?
We know — and this isn’t only through research — that women’s sexuality is a complex matter.
It’s also true that women in peri-menopause and menopause today feel significantly younger than previous generations did. They’re often more educated about sex and more willing to experiment, daring to express their desires and try out things that previously only took place in their imagination.
When you catch sight of your reflection in the shop window, don’t be too hard on yourself. In your 40s and 50s, you don’t need to look like you did in your 20s or be as slim as your daughter.
Love your body, look after it by embracing a nutritious, healthy diet, and you’ll grasp everything midlife has in store for you with energy and joy.
Adapted by Alison Roberts from Our Hormones, Our Health: How To Understand Your Hormones And Transform Your Life, by Dr Susanne Esche-Belke and Dr Suzann Kirschner-Brouns (£16.99, Scribe). © Susanne Esche-Belke & Suzann Kirschner-Brouns 2021. To order a copy for £14.95 (offer valid to March 30, 2021; free UK p&p on orders over £20), go to mailshop.co.uk/books or call 020 3308 9193.