Middle age spread: Why it happens and how to shift it for good

Middle age comes with a bunch of changes, some a little more welcome than others. For those of us entering our 40s, 50s and beyond, weight gain is often one of the more frustrating realities, particularly around the abdominal area.

It’s a phenomenon known as the ‘middle age spread’, and it’s incredibly common among those aged 45+: it’s estimated that women gain an average of 0.5kg per year between ages 45 and 55, with 70% of Aussie women aged 55-74 living with overweight or obesity [1][2].

So, what’s behind it? And can you avoid it or shift the weight once it sets in? Here’s what you should know.

What is middle age spread?

Middle age spread refers to weight gain that happens when you enter middle age. It usually affects your abdominal area the most, resulting in a larger waistline and more fat being stored around your midsection. 

As weight starts to shift here, many people also notice that their body shape changes, too. While not true of all women, body fat is typically stored in the lower half of the body across the thighs, hips and buttocks. When the middle age spread sets in, fat distribution often moves to the abdomen. Lifestyle can change how fast or slow this change happens, but more on that further down.

At what age does middle age spread start?

The middle age spread can start as early as your 30s, but for most people it begins in their early to mid 40s – often when perimenopause kicks in.

When you reach age 30, your body fat levels start naturally increasing. In fact, it’s estimated that you’ll have one-third more body fat (along with less muscle mass) when you’re older compared to when you’re younger [3].

Weight gain often accelerates when you enter your 40s, as your hormones start to shift. For women, this pattern typically continues until the age of 65, after which most women start losing weight [3]. This is because fat is replacing lost muscle mass, with fat weighing less than muscle.

What causes middle age spread in women?

There are several factors behind the middle age spread – many of which are (unfortunately) out of our control.

Hormonal changes

Middle age comes with a number of hormonal changes, largely due to the onset of perimenopause and menopause.

During this phase of life, your estrogen levels fluctuate massively before declining, while progesterone also starts to drop naturally. Changes in these hormones make your body store more fat around your abdomen rather than your hips and thighs.

Loss of muscle mass

As you gain weight during middle age, you also lose muscle mass. This process is called sarcopenia. There are many reasons why we lose muscle function as we get older, but one of the key reasons is that older muscles simply become more resistant to growth signals [4].

Muscle uses significantly more calories than fat, but with less muscle mass across your body, you’re not as efficient at using up the energy you consume. This can result in those extra calories being stored as fat.

Slower metabolism

Many of us assume that our metabolism slows dramatically in middle age, but the good news is that it may actually be fairly stable until the age of 60. 

Some research shows that once we hit this age, both basal metabolic rate (your body’s ability to burn calories while resting) and total energy expenditure (the total number of calories your body burns each day) decrease by around 0.7% per year [5].

As we get older, changes in muscle mass, activity levels and eventually metabolism can mean our bodies require fewer calories. Any excess energy is then more likely to be stored as fat.

Lifestyle and stress factors

Some factors behind the middle age spread aren’t necessarily impossible to control. The reasons we gain weight in middle age can be driven by lifestyle, such as:

• Eating habits: With less muscle and changing energy requirements, your body simply doesn’t need as many calories each day. But if you keep eating the same amount, your body may store additional calories as fat
• Physical activity: Exercise has a direct impact on weight management, as moving your body burns energy. However, between kids, work and other obligations, many of us struggle to maintain a regular exercise routine as we enter midlife
• Cortisol – the stress hormone: Stress causes your body to produce more cortisol, the hormone responsible for the fight or flight response. Excess cortisol production can cause your body to store extra fat around the abdominal region
• Sleep: Sleep quality is often one of the biggest things to decline during middle age. When you’re sleep deprived, your body produces more of the hunger hormone (ghrelin) and less of the satiety hormone (leptin), potentially making you eat more

Genetics

Your genes play perhaps the most significant role in determining weight gain, with research showing that they account for 40-70% of someone’s predisposition for obesity [6].

Genes are behind factors including your likelihood of gaining weight, your appetite and satiety, your metabolism, and where your body stores fat. 

Why is belly fat in midlife a health concern?

Your body stores two types of fat:

• Subcutaneous fat: Fat sitting just below the skin, which is visible, soft and able to be pinched between your fingers. This fat provides benefits like protecting your muscles and bones
• Visceral fat: Fat that lies deep inside your abdominal area and around vital organs like your liver, kidneys, intestines and even your heart. Visceral fat can’t be seen or felt, but because it’s around your abdomen, it’s responsible for making the belly protrude

The main issue with the belly fat that accumulates during midlife is that it’s usually visceral fat. While subcutaneous fat generally doesn’t pose a risk to your health, visceral fat releases harmful inflammatory proteins (cytokines) and fatty acids, and increases the likelihood of several diseases.

The risk of these diseases goes up substantially if you have excess visceral fat. Generally speaking, a waist measurement of 88cm or more (or 102cm or more if you’re a man) indicates that there’s too much visceral fat in your abdominal area.

How to get rid of middle age spread

By now you’re likely wondering if the middle age spread can be shifted. The good news is that despite some factors making it more difficult to shed body fat (like hormonal fluctuations and a slowing metabolism), it’s entirely possible to lose weight in middle age. Here’s how.

Review portion sizes

With your body less efficient at burning calories, you simply don’t need to consume as many each day. It’s estimated that women aged 26-50 need around 1800 calories daily, while women aged 51+ need 1600 [7].

Habits like adjusting your portion sizes, eating only until you’re full, avoiding snacks between meals, opting for lower-calorie foods, and choosing water over other drinks can all contribute to lower overall calorie intake.

Prioritise protein and fibre, and eat less processed foods

Protein and fibre are excellent nutrients to focus on in your diet, as they both promote a feeling of fullness and help you avoid overeating. They also stabilise your blood sugar, making you less prone to energy crashes and the consequent food cravings. Protein is especially beneficial because it helps build muscle mass.

High-fibre foods to enjoy more of in your diet include whole grains, wholemeal bread and pasta, brown rice, legumes, vegetables and fruit. Lean proteins include chicken breast, seafood, tofu, eggs, Greek yoghurt and cottage cheese.

While you’re at it, avoiding ultra-processed foods can also help with weight loss. These foods are stripped of much of their nutritional benefit (especially fibre) and are often high in sugar, salt and trans fats, making it harder to feel full and more likely that you’ll want to overeat them. Examples include supermarket white bread and wraps, mass-produced baked goods, chips, instant noodles and soft drink.

Cut back on alcohol

Alcohol is full of empty calories – calories that provide no nutritional benefit. Consuming too much alcohol can lead to excess calorie intake and consequent weight gain, plus alcohol can disrupt the way your body processes and stores fat. Reducing your alcohol intake to just a few drinks each week may help support weight loss.

Prioritise strength training

Strength training – also known as weight training or resistance training – involves working your muscles to help build and strengthen them. It’s particularly important in middle age, as it can help protect against age-related muscle loss and manage your weight by boosting your metabolism [8].

It’s generally recommended to do 2-3 strength training sessions per week, alongside cardio. A session can incorporate everything from using free weights and weight machines to exercises like squats and lunges, which rely on your body weight to build muscle strength.

Manage stress and cortisol

Keeping your stress levels in check may have a huge benefit for keeping your weight down. Try calming activities like meditation, deep breathing, yoga, journaling, spending time with family and friends, or even just an easy walk around the block.

Improve sleep quality

If sleep is an issue for you, there are a few things you can do to try and improve the quality of it.

Avoid screens for about an hour before bedtime, make your bedroom a dark, cool and quiet environment, steer clear of caffeine for 6-8 hours before you hit the sack, and try to go to bed and wake up at the same time each day – even on weekends.

Try a weight loss program

If you’re finding it hard to lose weight on your own, know that help is at hand.

The Juniper Program combines expert guidance with breakthrough weight loss medication to give you all the tools you need to lose excess weight and keep it off.

You’ll have on-demand access to a team of doctors, dieticians and health coaches, a handy app to track and monitor your progress, and weight loss medication delivered to your door.

All up, Juniper patients are 4.5x more likely to lose weight than those using treatment alone.

Can you prevent middle age spread?

It’s absolutely possible to slow the onset of middle age spread or, in some cases, prevent it altogether. 

Using the same approaches mentioned above – diet changes, exercise, stress management and improvements to sleep hygiene – you may be able to avoid gaining weight as you get older.

When to speak to a healthcare professional

While weight gain is often a normal part of ageing, there are some scenarios where a visit to your doctor may be warranted:

• If the weight gain is very rapid
• If it’s accompanied by other symptoms, like hair loss, digestive changes, heart palpitations or fatigue
• If you’re experiencing menopause symptoms before age 45
• If your waist circumference measures more than 88cm (102cm for men)

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