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Conquering Midlife Weight Gain: Women's Wisdom from Christiane Northrup, M.D.

Midlife is the perfect time to reinvent yourself on all levels, and that includes your body; Dr. Northrup offers smart tips on getting started
by Christiane Northrup, M.D.

Many women struggle to maintain a healthy weight and develop a “spare tire” around their waist at midlife. This often starts around the time they turn 40 and also after significant hormonal events such as childbirth.

We tend to blame midlife weight gain on hormonal changes. And to some extent, perimenopause does favor weight gain. But that's only part of it. This type of weight gain doesn't happen overnight. In most women, it's a slow gradual process that catches up with us in our forties and fifties.

In a nutshell, here is why it happens: During a woman's twenties, she tends to become far more sedentary than she was during her school years (If you participated in a team sport, this is doubly true for you). When you become more sedentary, your body's lean muscle mass gets replaced by fat. Fat takes up more room in the body but actually weighs less than lean muscle mass. That's why it's possible to maintain your weight but actually gain inches over time.

As the body runs out of places to store excess fat in your muscles, it starts storing the excess in the abdomen. Eventually a “spare tire” is the result. But understand that by the time you have that spare tire around your waist, you also have an excess of fat deep in the abdominal cavity as well.

But you are not doomed to carrying 20 extra pounds for the rest of your life, even if you've hit perimenopause. In fact, midlife is the perfect time to reinvent yourself on all levels. And that includes your physical body! Here's how to get started.

Christiane Northrup, M.D., women's health and wellness pioneer, is the New York Times best-selling author of Women's Bodies, Women's Wisdom and The Wisdom of Menopause.

Her fourth book, The Secret Pleasures of Menopause (Hay House, 2008), is now available at

For the latest information from Dr. Northrup, including articles like this, visit her Web site ( and join Dr. Northrup's exclusive Women's Wisdom Circle.

1. Lose the stagnation. If you want to turn yourself into a lean midlife goddess, you have to start moving like one. Exercise, exercise, exercise is the key. Anyone who wants to live a long and healthy life-let alone lose that spare tire around the waist-needs to exercise almost every day. Period. End of story. If you look around, you'll see that the people who are role models for health, beauty, and fitness are all regular exercisers (My own mother is a perfect example of this).

Weight training is essential for building up muscle mass. Don't cheat yourself with those little five pound weights. Most women can get to the point where they're using 10-, 12-, 15-, and even 20-pound dumbbells regularly. It's essential to learn proper form when working with weights. Go to a gym and have a couple sessions with a personal trainer.

Or get the videos known as “The Firm.” They are excellent, show proper form, and can be done in the privacy of your own home. I did “The Firm” videos for years!

Or get Dr. Pamela Peeke's book Body for Life for Women (Rodale, 2005). It shows you everything you need to know about weight training. Pilates is also excellent for both strength and flexibility. It concentrates on lengthening the body and the muscles while also keeping them strong and flexible. Both Pilates and weight training can totally reshape your body.

Exercise does far more than build lean muscle mass, however. It also lowers the stress hormone cortisol, which is associated with increased insulin, fluid retention, sugar cravings, and weight gain. In addition, one session of aerobic exercise exerts a healthy, dilating effect on blood vessels, which maximizes circulation for up to 24 hours by stimulating the release of nitric oxide from the smooth muscle in the blood vessel walls. Talk about cardiovascular protection!

2. Follow the 80/20 Rule. Eat healthfully 80 percent of the time (or more). That means eating any combination of lean protein (chicken, fish, soy, egg whites, pork, or beef) and fruits and vegetables, and cutting way back on “white” foods such as bread, pasta, cookies, potatoes, cakes, and so forth. It's okay to have dessert now and again. In fact, it's important. But when you do, make sure that you have a truly delicious dessert that you savor slowly in full view of everyone. In other words, no gulping a bag of Oreos in secret.

I like to save my desserts for when I go out to eat. I'll often share something decadent with one or two people. But if I really want more for myself, I'll order another one. Really.

3. Go against the grain. Believe it or not, many midlife women (and that includes me) have to cut way back on—or even eliminate—grain products, even whole grains. It's well known that if you want to fatten up a cow or pig for market, you feed them grain, right? Well, it's the same with humans. In addition, many people are allergic to wheat. But it doesn't show up as the usual allergy symptoms of runny nose, itchy eyes, etc. Instead, the wheat allergy manifests as wheat craving and bloating. Many women will easily lose five pounds in a month simply by eliminating wheat products!

4. Eat protein at breakfast to set up healthy fat burning throughout the day. Eating protein early in the day—along with healthy omega-3 fats, plus or minus some healthy carbs —sets the stage for your metabolism for the rest of the day. I almost always have a shake that's made with soy protein and a tablespoon of oil that is rich in omega 3 fats. Another good choice would be oatmeal with some protein powder (add during or after it is cooked) and some healthy oil added to the oatmeal or taken as a supplement in capsule form. An egg white omelette with a little salmon would be another excellent choice along with a slice of whole grain toast, if you're not grain sensitive.

Protein increases the hormone glucagon, which helps the body release stored fat. Eating protein also reduces or completely eliminates that late afternoon blood sugar drop that makes us feel as though we could eat the paper off the wall.

Fortify yourself with healthy meals and snacks throughout the day so that your blood sugar stays under control. That means a mid-morning snack at about 10:00 a.m. (an apple and some low fat string cheese is one of my favorites), a healthy lunch (tuna over salad greens with vinaigrette dressing), a mid-afternoon snack (celery with peanut butter or a nutrition bar), and then a light dinner (broiled fish, a salad, grilled vegetables).

Don't eat after 8:00 p.m. Studies have clearly shown that the calories you eat earlier in the day are far more apt to be burned up while those you eat just before bedtime tend to stick around as fat.

5. Avoid empty calories. There are a lot of foods that just aren't worth it—ever. Even for a snack. These include almost all snack foods such as potato chips and soda pop, which are nothing but empty calories. If you're craving something sweet, skip the Coke and enjoy a brownie for the same caloric load.

6. Monitor portion size. We tend to eat what's on our plates. One of the easiest ways to lose excess pounds gradually and painlessly is to cut down on portion size. A serving of meat should be about the size of a deck of cards. Then don't go back for seconds. (This rule doesn't apply to green vegetables, which have almost no calories. These include sprouts, broccoli, kale, collards, salad greens, green beans, and so on.) When you're going out to eat, it's a good idea to split an entrée with someone else and order a large salad for yourself.

7. Sleep off the pounds. Most people need a minimum of eight hours of sleep per night. Some (like me) need even more! Sleep deprivation results in high cortisol levels. Cortisol is a stress hormone that results in increased insulin levels, fluid retention, and sugar cravings. Whenever I've been on the road and don't get enough sleep, I gain weight-no matter what I eat.

When I get home, I make sure that I don't schedule anything for a couple of days so I can catch up on my sleep—and sleep those excess pounds away! It works like a charm. When I give myself the opportunity to sleep until I wake up (sometimes 12 hours or more) I often lose three pounds overnight.

8. Control Your Blood Sugar. The key to midlife weight control is controlling your blood sugar and insulin levels. This isn't just about weight. Syndrome X is the name that doctors give to the large number of conditions that result from unchecked blood sugar and insulin levels. These may include some or all of the following: abdominal and upper body weight (apple-shaped figure), high blood pressure, excess facial hair, male pattern baldness, weight gain, heart disease, and diabetes.

And guess what? Just about all of it can be eliminated by getting insulin and blood sugar back in control (The pounds can also just melt away when you do this!). Exercise helps the process enormously because it raises the metabolic rate and helps insulin move blood sugar into the muscles where it is burned as fuel, instead of stored as fat!

In order to balance insulin and cortisol levels you have to learn to deal effectively with stress. And the first step in dealing with stress is knowing what it is. I define stress as the degree to which we require people and circumstances outside ourselves to change so that we can be happy.

Stress will decrease dramatically once you discover that you have the ability to choose thoughts and behaviors that are uplifting and fun instead of depressing and aggravating. And in the process you'll restore balance to your insulin and cortisol, and lose (or at least lessen) sugar or starch cravings, which will result in weight loss.

9. Lighten up on all levels. Our bodies are a reflection of our thoughts and beliefs about ourselves and our lives. The “lighter” our thoughts and beliefs become, the easier it is to lose weight and keep it off.

Do you remember being in love for the first time and not being able to eat? Or not caring if you eat at all? I've seen women lose five pounds in a week when they're in love. They're so filled with the joy of the experience that food isn't necessary. You'll also find that when you're enthralled with a project, it's easy to lose track of time and forget to eat. Time stands still.

Remember that we build our bodies, our health, and our weight one thought at a time. And we lose weight one thought, one choice, and one bite at a time. Your power to have a goddess' body at midlife is accessible right now!

Healthy Meals and Snacks
To get you on your way, I've provided some examples of healthy meals and snacks:


Most mornings I have a high-protein, high-fiber shake or a nutrition bar made with soy protein (or blended protein source). For variety, I often add fresh or frozen organic fruit. Here are some other good options:
  • Oatmeal. It's okay to prepare it in a microwave, but I have to tell you, it tastes a lot better when you make it the old-fashioned way-in a pan with boiling water. When it's cooked, add a couple tablespoons of soy or whey powder, a tablespoon of flax or other omega-3 rich oil, a teaspoon of honey, and enjoy.
  • Omelette. Use 2 eggs that are high in omega-3 fats (available at almost any whole foods market). Add left over vegetables from the night before such as broccoli, bell peppers, etc. Sprouts are also good.
  • Open faced cheese sandwich using millet, oat, or spelt bread. Spread bread with an omega-3 rich spread (available at natural food stores). Put in toaster oven or under broiler with a piece of low fat cheese on the top and a couple tomato slices. Add salt and pepper to taste.
Mid-Morning and Mid-Afternoon Snacks:
  • Baby carrots with yogurt dip
  • Apple with low-fat string cheese (2 sticks)
  • Celery with organic peanut butter
  • Nutrition bar made with soy protein
  • Meal replacement bar with at least 12 grams of protein (and no partially hydrogenated fat)
Lunches and Dinners:
  • Any combination of salad greens, 4 ounces of tuna, 1-2 tablespoons of dressing made with olive oil and vinegar or lemon juice
  • 4 oz of grilled fish, unlimited green vegetables, grilled carrots, parsnips, summer squash
  • 1 baked chicken breast, 1/2 cup brown rice (unless grains are a problem), 1/2 baked sweet potato with a pat of butter, green salad
  • 1/2 cup low-fat cottage cheese, 1 cup mixed fresh fruit
© Christiane Northrup, M.D. Excerpted with permission from her website located at