Weight Gain and Age: Avoiding that Middle-Age Bulge

Joanne Pallotta Beth Israel Deaconess Medical Center correspondent

JANUARY 01, 2015

Sue from Norwood couldn’t be busier. As the grandmother of two youngsters, the 71-year-old is constantly on the go, taking care of them. But, Sue struggles with her weight, and physical activity is very limited because of problems with her knees.

“I feel like my body betrayed me,” Sue says.

Eating gave her a way to cope. She acknowledges the combination of overeating and lack of exercise created a concerning situation. Sue is not alone.

As we age, weight gain becomes an issue that is not only discouraging but, for some, very dangerous. The older we get, the harder it is to maintain a healthy weight or shed those extra pounds. Our metabolism slows down, we burn fewer calories, and we lose that lean muscle mass.

While the culprits of weight gain may be inactivity, food, or something else, both Hope Ricciotti, MD, of the Department of Obstetrics and Gynecology, and J. Jacques Carter, MD, of the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, agree: a healthy lifestyle early is the most important way to prevent dangerous weight gain later on.

“The big issue as we age has to do with lean body mass and resting metabolism,” says Dr. Ricciotti. “If you can maintain or build muscle mass, rather than losing it with age, even your resting metabolism will be higher.”

Metabolism Slowdown

As women and men age, metabolisms slow down and fewer calories are burned.

“For most of us — both men and women — as we get older, there are changes in our metabolism,” says Dr. Carter. He points to a drop in hormones, like testosterone in men and estrogen in women, as the reason for a slowdown in metabolism and a build-up of fat.

Is weight gain different for men and women? Dr. Carter says yes. When men are young, they have more muscle mass than women. As men age and their hormones drop, he says, men tend to add body fat to their abdominal area. This is known as visceral fat.

On the other hand, Dr. Carter says young women start with a build-up of fat around their hips and buttocks. He says as women age and hormone levels drop, that fat build-up may migrate to the abdominal area.

For women, could menopause be to blame?

“Weight gain is not attributed to menopause alone,” explains Dr. Ricciotti.

It is true that the loss of estrogen at menopause changes how fat is laid down, she says, and that there could be a re-distribution around the mid-section. But, Dr. Ricciotti points out, the actual weight gain has to do with the decrease in muscle mass that can happen as we age and are often less active. This can be prevented or reversed if we maintain or build muscle.

There is no question, however, that weight in the mid-section is dangerous for both men and women. Abdominal, or visceral, fat is associated with a number of diseases, which is why it’s important to avoid gaining weight in this area.

“It’s really fat around those internal organs that is associated with issues like diabetes and cardiovascular disease,” says Dr. Ricciotti.

To determine if a person is in a range that is considered normal, overweight or obese, physicians use the Body Mass Index (BMI). This calculation takes into account weight and height. A score of anywhere from 18 to 25 is considered normal. A number higher than 25 might trigger a red flag, but the system isn’t perfect, says Dr. Ricciotti.

“The problem with BMI is that it doesn’t take into account ‘lean’ body versus ‘fat’ body mass,” she says. She points to some larger athletes whose scores might be higher because of lean body mass.

It’s a Lifestyle

Weight gain and loss can turn into a vicious cycle. As men and women age, many tend to become less physically active for a number of reasons.

“You have to have a sustained program of physical activity, several times a week on a regular basis,” emphasizes Dr. Carter. He says being a so-called “weekend warrior” doesn’t cut it. “I think it would serve both genders well to work on an exercise program because, so far, we are not able to stop some of those normal changes of aging associated with hormonal changes.”

Dr. Carter says the time to be thinking about making good choices is when you’re younger. It’s the combination of diet and regular exercise — building muscle mass and avoiding visceral fat. There are other, simple steps people can take to try and cut down on weight gain as well.

  • Ditch the processed foods: Instead, buy fruits and vegetables, whole grains and lean protein. Learn to make meals instead of buying them and watch your portion sizes.
  • Avoid empty calories: While much of the talk around weight gain and loss centers around food, Dr. Ricciotti and Dr. Carter point to drinks, including soda and alcohol, as a way of gaining empty calories. “I always tell patients not to drink juice,” says Dr. Ricciotti. “You can guzzle down a thousand calories without even batting an eyelash yet, you’ll still be hungry.” She recommends whole fruit instead.
  • Get those zzzs: Your sleeping habits might have a lot to do with how much you weigh. It’s an interesting area that’s getting some attention in the medical profession. “Sleep may disrupt some of the balance of hormones that control appetite,” says Dr. Ricciotti. “So, sleep-deprived people may be hungrier.” She points out those who are sleep-deprived may be too tired to exercise. Or, those who are awake longer may have more opportunities to eat.

Both physicians say the key to maintaining or losing weight is, again, to watch your diet and remain physically active. Dr. Ricciotti’s advice: “Maintain — don’t gain. Move more. Eat less!”

Success For Sue

After numerous, unsuccessful attempts to lose weight, Sue found the Weight Management and Wellness Program at Beth Israel Deaconess Medical Center. This program offers individuals a unique approach to achieving weight loss by providing the education, support, and tools to make it happen. The12-week curriculum emphasizes group and individual support and monitoring. Participants learn how to make mindful choices, how to plan and prepare food, how to set realistic goals, and most importantly how to be comfortable — not ashamed — to eat.

There, Sue learned how to live a healthier, mindful lifestyle — creating better, more self-motivating habits.

“It wasn’t just about food,” Sue says. “It gave information in a lot areas and approaching them in a lot of different ways.”

Sue is also dealing with her physical setbacks and putting as much activity into her routine as possible. “I think it’s a very, very good program,” she adds. “I’m very positive about it.”

To learn more about BIDMC’s Weight Management and Wellness program, contact Liz Preczewski at 617-667-1793 or epreczew@bidmc.harvard.edu.

January 2015


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Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.