Middle age and weight gain: When does it start and what role do hormones play?

Ways to help lessen the effect hormones can have on midsection weight gain for men and women.

Author: Joyce Retz

Published: January 2, 2019 | Updated: March 10, 2023

I’m 46. Well, my friend is 46. She doesn’t have kids. She works out regularly and has an active life. She eats well most of the time, yet with every year that passes the scale keeps creeping up, despite maintaining the usual routine that has kept her fit for years. And the extra weight is concentrated in her midsection.

Is she experiencing what we all fear — midlife midsection spread? Doesn’t that happen only to women who have had babies? Or women in menopause?

“As a woman gets older, she might notice that maintaining her usual weight becomes more challenging, especially around the time of menopause,” said Jeanne M. Thompson, M.D., internal medicine. “Hormonal changes might make her more likely to gain weight around the abdomen, and these changes can start happening years before menopause.”

Women can take steps to limit weight gain, though. Remaining active is key. You’ll naturally lose muscle mass, so you won’t need as many calories in your diet.

“If you continue to eat as you always have and don’t increase physical activity, you’ll likely gain weight,” Dr. Thompson said.

Hormone changes also can affect sleep, and studies show that not getting enough sleep leads to more snacking and more calories consumed.

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Men gain weight, too

Men aren’t exempt from midsection spread. In middle age, metabolism slows, muscle mass decreases and testosterone levels go down — all contributing to weight gain.

“Just like women, men also must make changes to their diet and activity level as they age,” Dr. Thompson said. “Men and women should also do regular weight training to raise their resting metabolic rate. A pound of muscle burns at least two times more calories at rest than a pound of fat.”

Tips for men and women to avoid midsection weight gain

  • Move more; use an activity tracker for motivation.
  • Take in about 200 fewer calories per day; consider using an app (such as My Fitness Pal) to track calories.
  • Pay attention to calories in drinks, including alcohol.
  • Check nutrition labels for added sugar, and try to avoid foods that contain it.
  • Team up with a buddy to make healthy lifestyle changes.

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