Fighting the ‘midlife fat attack’

Posted on 18 April 2017

One of the main health concerns for those over 40 (midlife) is that hormonal changes will cause weight gain. A Mediclinic gynaecologist and obstetrician explains that while hormonal changes can indirectly cause weight gain, it’s not as simple as that.

‘Midlife obesity tends to be more prevalent in women than in men,’ says Dr Tobie de Villiers, a gynaecologist and obstetrician practising from Mediclinic Panorama. ‘While studies show that weight gain and age are unrelated, menopause does play a role in the body’s compositional changes. But this time in a woman’s life is more complex than weight-gain alone.

‘While obesity is indeed a major health concern, it is not directly related to menopause,’ Dr De Villiers explains. ‘At the same time, hormonal deficiencies such as low oestrogen levels don’t contribute to actual weight gain. Rather, it is the increased accumulation of fat in the abdominal and hip areas that roughly coincides with the time of menopause, owing to lifestyle choices in response to an altered mood.’ And hormonal changes are known to have a direct effect on a person’s mood.

Midlife hormones and mood

The onset of menopause sees a reduction in oestrogen, as well as other sex hormones like progesterone and testosterone. The time in a woman’s life immediately prior to menopause tends to coincide with a marked spike in fat mass and body fat percentages in general. Known as perimenopause, it is the redistribution of fat during this time that causes wider waistlines, the cumulative effects lingering into the postmenopausal phase.

‘Essentially, perimenopause opens the door for depression,’ says Dr De Villiers. ‘Comfort eating and sugar cravings are the hallmarks of low self-esteem and anxiety – two symptoms prevalent in any hormonal change,’ he explains.

Does medication play a role?

‘Yes,’ says Dr De Villiers. Various antidepressant medications have a water-retaining and bloating effect. Contrary to popular belief, however, menopausal hormone therapy (MHT) does not cause weight gain. Evidence suggests that MHT therapy actually protects against excess body fat production and leads to a slimmer waistline. Added benefits include reduced insulin sensitivity and a lowered risk of diabetes.

Get active and eat right

So with all of this in mind, what sort of preventative measures can assist in beating the dreaded ‘midlife flab’?

‘Get active,’ says Dr De Villiers. ‘Daily low-level exercise goes a long way in safeguarding against obesity. Some form of resistance training also preserves lean muscle mass.

‘A nutritious diet complements a basic exercise programme. Avoid processed foods, caffeine and sugar. Timing of meals is important, so as not to interfere with the body’s natural rhythm. Making good lifestyle decisions is key in combating obesity at any stage of life.’

Published in Endocrinology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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