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deborahwaters@iectskin.com · 2021-02-14T21:53:53Z

BY HEATHER RUPE, DOBoard-certified OB/GYNJANUARY 29, 2021 “I’ve gained 10 pounds in the last 2 years! Something must be wrong! Please check my hormones!” I hear this often from patients in their 40s. Each time, I brace myself as I tell them some answers that they are probably not going to like. When you get more mature (a much better term than "aging"), your metabolism begins to decrease. So if your diet and exercise look the same in your 30s as they did in your 20s, you will likely begin to gain weight. This happens a little more drastically as you enter perimenopause, usually around your mid-40s. With the decreasing levels of estrogen in perimenopause, you begin to lose muscle mass, and muscle has a much higher metabolism than fat. When menopause officially arrives (diagnosed as no period for a year), weight gain begins to happen disproportionally in the belly. If the weight gain is associated with changing hormone levels, then why not prescribe some hormones to prevent it? Sadly, it’s not quite that easy or I would be wearing seven estrogen patches right now. While postmenopausal hormone replacement has been associated with less abdominal fat distribution, it doesn’t prevent weight gain and has many other risks, so it is not used for weight control. Perimenopausal hormone therapy has not been shown to reduce weight gain. But it’s not all bad news. With healthy diet choices and tweaking your exercise regimen, you can maintain a healthy weight through perimenopause and menopause. Here’s what I tell my patients: Get a Physical The first step would be to get a full physical. In your 40s, you need to have a checkup every 2-3 years with your primary care doctor to check for conditions like high cholesterol and heart disease. Weight gain could be related to metabolic issues such as thyroid issues or diabetes, which your doctor will usually check for with routine blood work. Move Your Body AND Pump Some Iron We should all be moving our body at least body 30 minutes a day. Walking, Zumba, biking, spin, aerobics, running, or whatever works for you. Exercise helps your heart, mood, sex drive, and prevents osteoporosis. However, if you are only doing cardio, you will likely begin to lose muscle as you approach menopause, so you need to add some type of weight training to your routine to build muscle and improve your metabolism. If the thought of lifting traditional weights seems boring, intimidating, or not feasible in your schedule, there are many other options. I personally recommend a high-intensity interval training (HIIT) workout that uses weights because it combines your cardio and weight training. While it might seem intimidating at first, it can be scalable to all ages and fitness levels. Or yoga may be more your style. Types of yoga that really engage your muscles and core (like power yoga or vinyasa) can also help with your strength and metabolism. Yoga has also been shown to reduce other menopausal symptoms like brain fog, hot flashes, and insomnia. Other options would be body-weight exercises than can be found in a plethora of YouTube videos, Pilates, or barre workouts. The key is finding a workout that you like (or at least don’t hate) and staying consistent. Check Your Refrigerator While exercise can help improve your metabolism and maintain your weight, you cannot exercise your way out of a bad diet. I often will gain 3-5 pounds when I am marathon training (running 40-50 miles a week) because I am so hungry, I eat all the time. When I was in my 20s, I could mostly eat what I wanted as long as I exercised daily, but when I hit my mid-30s, I had to start watching my diet too. And by 40 I had to be purposeful about both to maintain a healthy weight. Many of us have let some healthy habits lax over the last year of 2020, and it’s time to get our health back on track. The first step is to cut out or significantly cut back on added sugar and alcohol. Your body doesn’t need these empty calories, and they provide no nutritional value. I love cookies and wine as much as anyone, but my metabolism does not. You will also enjoy them more if they are a special-occasion treat and not an everyday habit. Next is trying to make sure you are eating five to seven servings of fruits and vegetables a day. Limiting fried foods, processed foods, and red meat is also important. I do not recommend any specific “diet,” but rather finding a healthy way to eat that you can incorporate into your life for the long term. Some resources I recommend to my patients are the book The Obesity Code. I find this type of eating plan is especially helpful for patients who tend to carry their weight in their abdomen, have PCOS, or have prediabetes or metabolic syndrome. For patients who struggle with forging new healthy habits, I like the book Better Than Before or One Small Step Can Change Your Life. Practice Acceptance “It's not fair. I used to be able to cut back for a week or two and drop 10 pounds and now that doesn’t really work.” I ...

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Brandy Hunter

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September 20, 2025 10:28 am

@ieshabakeriectskin-com My mom struggled with this as well. I felt really bad for her and I am not looking forward to it haha.

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Brandy Hunter

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September 20, 2025 10:29 am

@jaydensugickiectskin-com I couldnt agree more! I am actually looking to get my levels checked here soon. I know for sure that my levels are not the same in my 30s as they were in my 20s.

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