Midlife Body Changes

by | May 17, 2026 | hormones, Menopause, Nutrition, perimenopause, strength training, Weight Loss

I am a member of the International Menopause Society and they have provided some great webinars recently and I found this one particularly interesting. Professor Ekta Kapoor spoke in detail about midlife weight gain and management principles.

Body Composition Changes in Midlife Women.

Weight gain and body composition changes are very common among midlife women. However, body composition worsens, sometimes even in the absence of weight gain. Visceral/central fat increases, and lean and bone mass decreases. This increased central fat is associated with an increased risk of cardiovascular disease and mortality, even among those with a normal BMI.

But what is the cause? Aging? Hormone changes of menopause? 

Midlife females gain an average of 0.4 to 0.7kg per year. Chronological aging leads to:

  1. loss of muscle mass; this reduces resting metabolic rate by 2-3% per decade after age 50
  2. Reduction in physical activity (only 7.2% of midlife women are meeting government exercise recommendations)

These cause a fall in energy expenditure.

Then we bring menopause into the mix, which brings its own unique challenges to the adoption of a healthy lifestyle in midlife women.

  1. Sleep disturbances
  2. Mood and anxiety disorders
  3. Vasomotor symptoms, (hot flashes, night sweats impact sleep and quality of life)

Sleep disturbances have a HUGE impact on disruption of circadian rhythms. This can cause increased hunger, poor satiety signalling and dietary choices.

Key Messages

  • Midlife weight gain in women is mostly as a result of chronological aging.
  • The aging-related decrease in lean mass and total energy expenditure is an important cause of midlife weight gain.
  • Menopause related decline in oestrogen is the major cause of increase in abdominal adiposity among midlife women.
  • Menopause symptoms, particularly sleep disturbances, significantly increase the odds of poor dietary choices.

So what can we do about it??

  1. Calorie restriction is essential, but it needs to be habit change that works long term.
  2. Physical activity, especially strength training, improves body composition, mood, sleep. More muscle means more lean mass which means improvement to resting metabolic rate.
  3. Manage sleep disturbances. In the absence of night sweats, Cognitive behavioural therapy for insomnia (CBTi) is the first line treatment for long term insomnia in the UK. You can access CBTi through the NHS either by asking your GP for a referral or by self-referring to your local NHS psychological therapies service. Depending on your local Integrated Care Board (ICB) and availability, the NHS sometimes funds digital platforms like Sleepstation to deliver online CBTi. You can also use Every Mind Matters on the NHS Website for general self-help tips and meditation guides.

If you want to watch the webinar, here is the link . It’s over an hour long but it has some very valuable information.