Significant weight loss can be challenging at any age.
But for women in their midlife, it’s even harder to drop the pounds. Between the ages of 40 and 65, female metabolism and muscle mass typically decline. With Mayo Clinic obesity medicine physician Daniela Hurtado reporting that women gain an average of 0.8 to 1.5 pounds a year as soon as they hit middle age.
It’s also around this time that physical activity levels decline. With only 17.6% of women aged 50-64 meeting the CDC’s recommended guidelines for aerobic and muscle-strengthening activities in a 2022 report. These bodily changes take effect from the inside out, starting with hormonal imbalances associated with menopause.
“This makes losing weight even more difficult because insulin tells our body to store consumed carbohydrates as fat.”
Hormone-Fueled Weight Changes:
When estrogen and progesterone levels, instrumental in fertility – decrease. Metabolic changes occur in the body. And lost muscle mass is replaced by fat, most noticeably in the abdomen. Belly fat then results in insulin resistance. This makes losing weight even more difficult because insulin tells our body to store consumed carbohydrates as fat.
Another aspect of weight gain that isn’t often discussed is sleep quality. During middle age, women often wake at night to tend to their children. Or are stirred uncomfortably from sleep due to hot flashes. A study published in the Journal of Endocrinology has found that sleep, diabetes, and obesity are inextricably linked. Because sleep disruption can create imbalances in two appetite-regulating hormones: ghrelin, which signals hunger. And leptin, which lets you know you’re full. Because leptin levels are elevated during sleep, a lack of sleep results in feeling hungrier.
Weight gain, in turn, results in negative body image. In a study of over 75,000 postmenopausal women, a staggering 83% showed a prevalence of body image dissatisfaction, which can discourage many from going to the gym, for instance. So, what other options do women have when biology makes it more challenging to maintain or lower their weight with diet and exercise?
Considering Medical Weight Loss:
Gone are the days when medical weight loss meant unregulated diet pills with potentially harmful side effects. With today’s advancements in medicine and the guidance and approval of the Food and Drug Administration (FDA), qualified patients could gain access to weight loss medications that can treat serious weight gain and obesity.
Before moving forward with any medication, your doctor will likely assess your lifestyle and medical conditions first. If your physician does recommend medical weight loss, you may need to evaluate the prescription weight loss drugs Saxenda vs Wegovy, as well as the type 2 diabetes drug Mounjaro. All three belong to a class of drugs called incretin mimetics but have a few key differences and similarities. For starters, both Saxenda (liraglutide) and Wegovy (semaglutide) are FDA-approved for chronic weight management, and they are both GLP-1 agonists.
“But there are still ways to achieve your health goals sans medication.”
They mimic a hormone called glucagon-like peptide 1, which balances out blood glucose. When glucose is balanced, blood sugar spikes are minimized, and you feel full for longer, which means less cravings and subsequent overeating.
Bust The Weight Loss Excuses:
On the other hand, there’s Mounjaro, which some physicians are prescribing off-label for weight loss. It mimics GLP-1 and the gastric inhibitory polypeptide (GIP) hormone, which induces insulin secretion to help the body convert glucose into energy.
Another thing all three drugs have in common is how difficult they might be to access – even with a doctor’s recommendation, shortages are rife across the US, so you may need to wait before these medications are more widely available. But there are still ways to achieve your health goals sans medication. It could begin with counseling, which helps you understand your self-image and relationship with food. A personal trainer may help you ‘Bust The Weight Loss Excuses’ and make physical activity a permanent part of your life.
Finally, small but sustainable diet changes – such as a few plant-based meals a week or eating from smaller plates – could help you get a headstart before integrating weight loss medication into your journey.
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I take Mounjaro, and while I love this medication, I’m on it for diabetes 2. I think it’s great, and have lost a bunch of weight in the past couple of months on it, but if you’re doing it for weight loss, you need to understand that you’ll be on this expensive drug for the rest of your life, or the weight will come back. It’s a bit of an issue because of those factors.
Is it helping with weight loss, or not so much?