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    by Ngozi Osuagwu, MD | February 26th, 2023


    When I went out this past Sunday morning, my car had frost. I was tempted to forget about doing the Chilly Mile race, and then I remembered the virtual lecture given by Dr. Kapoor. The lecture was on midlife weight gain. I warmed the car, scraped the ice, and drove to the race site.

    Regardless of whether you are average weight, overweight or obese when you reach midlife, the body fat distribution changes. Most of the weight you gain will be around your waist. The average weight gain is about 1.5 pounds a year. This change in fat distribution puts us at risk of type 2 diabetes, problems with cholesterol, and high blood pressure.

    The lecture addressed the cause of the weight gain and why there is a change in fat distribution. It is due to aging and menopause.

    Weight gain due to aging is due to a decreased lean body mass or what medical professionals call sarcopenia. As one gets older, there is a decrease in physical activity. We do not move as much as we do when we are older. We also have a reduction in resting and total energy expenditure. This means we do not need as many calories to perform our daily functions. Adding up all of these changes leads to a positive energy balance, which leads to weight gain.

    When it comes to menopause, we gain weight because we have low estrogen. We have estrogen receptors in cells all over our body, including fat cells. When estrogen attaches to the fat cells in the abdomen, it causes the fat cells to break down and prevents fat cells from sticking to the waistline. When there is a decrease in estrogen, nothing adheres to the receptor, and the fat cells remain in the area. This leads to an increase in fat cells, wherever the fats cells are, especially in the waistline area.  You then add the hot flushes that might prevent us from sleeping, a stressful and busy life that prevents us from exercising, and you can see how we can gain weight, especially in areas where we have fat cells.



    • We have to understand that with increasing age and becoming menopausal contributes to weight gain.
    • Embrace where you are
    • We have to be aware that if we do the same things we did when we were younger – the same amount of eating, the same amount of exercise – WE WILL GAIN WEIGHT
    • As my friend has always said – when you turn 50, you might have to eat 50% less and work out 50% more to maintain weight.
    • Understand that not gaining weight during this time is a significant accomplishment.


    • No diet is the perfect diet. What is important is doing something sustainable. YOLO. I do not believe one should deprive oneself of what brings them joy. I think what goes in your body at this age should be nourishing.
    • You will have to cut down on your calories.
    • I love the seven-word diet I read from one of Michael Pollan’s books –EAT FOOD, MOSTLY PLANTS, NOT TOO MUCH. The goal is to eat real food. When you look at your plate, you should be able to imagine the origin of the food. If I have spinach on my plate, I know it came from a plant. I will not be having hot dogs on my plate because I do not know of any animal with a part called the hot dog.


    • In general, you will not lose weight exercising. Exercise helps to maintain your weight.
    • There are four components of exercise – aerobic, strength training, flexibility, and balance.
    • To eliminate abdominal fat, you must watch what you eat and add strength training to your regimen at least twice a week.

    I did not write this particular blog to discourage anyone. I wanted all to be aware that fat redistribution is a normal part of aging but one we can control if we are ready to change our lifestyle. This will include being mindful of our diet and regular exercise. It takes work, but it is doable. The hope is that as we age, we are the best we are at the age we are.

    For the young ones reading this particular blog, I believe the earlier you develop good habits, the easier it becomes as you get older.

    4 Responses to “MIDLIFE WEIGHT GAIN IS REAL”

    1. Linda K. Jackson says:

      Oh goodness! This was soooo good! I love rowing & walking, for cardio; now I need to add some strength training to try to lose this mid-life weight gain. Your statement about hot dogs caused me to literally laugh out loud! (How about plant-based hot dogs? Lol. Same difference! Lol).

      • Ngozi Osuagwu, MD says:

        Strength training is very important. Regarding plants shaped in meat – I am not a big fan. Read the ingredients, and you will know why.

    2. Angela Eddings says:

      I’m 51 and the eating 50% less and working out 50% more quote is real!. Thanks for the info. Doc, I’m trying my best.
      See ya soon.

    Leave a Reply

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