Exclusive: Navigating Weight Loss Challenges in Middle Age
Weight management often becomes significantly more challenging for individuals once they reach their fifties, even when maintaining consistent exercise routines and healthy eating habits. This phenomenon is not merely anecdotal but rooted in physiological changes that occur as we age. Understanding these shifts is crucial for developing effective and sustainable strategies to manage weight safely during midlife and beyond.
The Physiological Shifts Behind Midlife Weight Gain
Dr. Craig Primack, an obesity medicine specialist and Head of Weight Loss at Hims & Hers, explains that two primary factors contribute to increased weight loss difficulty in middle age. The first is a physical change known as anabolic resistance, which gradually develops from our late twenties onward. "We become less efficient at using protein to build muscle," Dr. Primack states. "Consequently, our basal metabolic rate—the number of calories we burn while at rest—declines."
Hormonal changes further complicate matters. Women experiencing menopause and perimenopause see a reduction in oestrogen levels, which alters fat distribution patterns. Meanwhile, men produce less testosterone as they age, making it harder to maintain muscle mass. The second factor involves lifestyle shifts: priorities often change in middle age, leading to more sedentary behaviour at work or home, increased family time, and generally reduced physical activity.
Dr. Primack notes that many individuals feel discouraged witnessing these bodily changes. However, he emphasises that with the right approach, effective weight management remains achievable. He shares five key pieces of advice tailored for people in middle age and older, focusing on safe weight management while preserving muscle mass, energy levels, and long-term health.
Five Expert Strategies for Midlife Weight Management
1. Prioritise Protein While Monitoring Caloric Intake
Dietary adjustments are fundamental for seeing results, according to Dr. Primack. Rather than simply cutting out sweets, he advocates "boosting protein higher." For years, diet culture has promoted eating less, but this approach is often unsustainable. "Protein first is a good way to think about it," he suggests. "Ensure you get your protein intake, and if calories remain in your daily allowance due to activity, keep other portions modest." This strategy helps maintain muscle while managing overall energy consumption.
2. Establish a Consistent Sleep Routine
Sleep plays a critical role in weight management, particularly for women. Menopause can significantly disrupt sleep patterns, which in turn affects appetite regulation. Dr. Primack explains: "Appetite is controlled by hormones called leptin and ghrelin—we want ghrelin low and leptin high. Sleep deprivation reverses this, leading to increased hunger and cravings for high-sugar, high-fat foods." He recommends aiming for at least seven hours of restorative sleep nightly to support hormonal balance and motivation.
"When you're tired, the last thing you want to do in the morning is get up and be active," Dr. Primack adds. "Reduced activity leads to sluggishness, often prompting us to use food for mood or energy boosts, creating a negative spiral."
3. Emphasise Strength Training and Gentle Daily Movement
When exercising, Dr. Primack advises against focusing solely on cardiovascular workouts. Strength training is essential for building and preserving muscle mass, which supports metabolic health. He suggests a balanced routine of one hour, two to three days per week, noting that fancy equipment is unnecessary—even household items like a sack of flour can suffice.
"Trying to do something gently active every single day, even a 20-minute neighbourhood walk after meals, is always beneficial," Dr. Primack adds. "This movement aids digestion, helps lower blood sugar, and improves sleep quality hours later. The benefits are multifaceted."
4. Consider Weight Loss Medications When Appropriate
Appetite control is challenging for many, and weight loss medications can help quieten persistent "food noise." While lifestyle changes work for some, others struggle with weight loss for years or decades. Hims & Hers offers a comprehensive programme including GLP-1 medications for obesity management, provided alongside dietary and exercise guidance.
"Weight loss has been hard when you do it on your own," Dr. Primack remarks. "Medications are now a distinguishing factor that can enhance outcomes."
5. Set Realistic and Healthy Expectations
Dr. Primack stresses that weight loss is not about perfection or daily gym attendance. Consistency is key, not short-term fixes. "You don't have to be perfect every day," he says. "Aim for 80% good daily. Some days it might be 60%, others 100%." Even on difficult days, complete failure is unlikely.
Ultimately, longevity involves living a long, healthy, productive life doing desired activities. "As we reach our seventies and eighties, that means spending time with grandchildren and pursuing interests deferred during working years," Dr. Primack concludes. "Maintaining health enables these fulfilling experiences."
