The one thing a woman over 40 might need in order to change her body


Are you in lockdown thinking this is the perfect time to get fit while no one is watching, or are you comfort eating your way through the worry knowing you are less likely to be sitting on a beach this Summer?

I am hoping to encourage you that this could be the perfect time for a body and mind makeover for your life ever after, not just a quick fix.

As someone who never sits down but just did for a couple of years to write, I feel the change as a woman now over 45 and am not sure how much of this I should lie down and just accept.

Women are historically known to lament about the effects of middle age on their middles but is this a myth? I don’t think so. We all know ‘lucky’ friends who may be the exception to the rule but are they really simply ‘lucky’? If you looked at their lifestyle and the effects on their metabolism would you see the whole picture? Would you then find they were not necessarily effortlessly maintaining a fabulous figure? Whether conscious of it or not, there might be some aspects of their life that were making them apparently ‘lucky’ in the battle against the bulge.

As a GP, women might consult me about their weight with a heavy heart. No pun intended. As a friend to many women and a medical writer now, many will discuss with me the change that has happened to their bodies and the fact that it’s really real. Interviewing women for my book it was evident that not many just sat around on the sofa, bingeing on boxsets with no activity or awareness of nutrition. If they were staying well and apparently fit they were conscious of how they do it. So what would be the secrets that we could learn from all this knowledge about how to turn the tide on that pesky seven….  maybe ten pounds….maybe a whole stone or more that has crept upon you? What if you are reading this thinking you just have to accept the inevitable change you see and feel?  Boy do we feel it – this is not just aesthetics – we may feel the tide of time turning us onto a slower frequency with aches and pains and just a different pace making any new lifestyle change just too great an effort.

Is there a way out and what do you need?

Well I cut it down to one word.


Anyone who knows me will know I have a dislike for the word diet. The evidence is that if we suddenly severely calorie restrict for a period of time, yes we may lose the weight but then we return to some variant of normal food intake and the weight returns, maybe with an extra bit for kicks. We are left feeling despondent after all of that effort having not achieved the before and forever after we were promised.

Something that is going to work which may include healthier ‘diet’ or food choices, healthier portion control and less empty calories is a lifestyle choice that we can carry on forever. Something that is going to work which includes a fitness boost from a routine that you can build into your life forever will provide lasting results. This will give us what we want but it requires that huge commitment of patience and I want to explain why.

What happens to us over 40?

Along with now gratefully knowing ourselves we might also have some changes going on that we are not so keen on. Many women ask me about the menopause  but that ten years or so leading up to a natural menopause might also be vitally important and it might help to know why our bodies are changing.

Hormonal changes

It is not necessarily a slam dunk when you have gone through the menopause and then suddenly the hormones are different. There is a more gradual process before that as well, not so dramatic but one that does change our body and mind. If we don’t already have a great nutrient rich diet and a fab fitness regime (or a revised one relevant to our current needs) we may really feel that our body no longer quite ‘looks or feels’ like ours. Changes in oestrogen, progesterone and testosterone all have an effect. We tend to start changing where we keep our fat – it might be diverted from some areas (hooray I hear you but no…. sadly not hooray) and tend to favour our tummy/belly/pooch area.

Our reaction to ghrelin (the hunger hormone) and leptin (the ‘I feel full and don’t want pudding’ hormone) are a little diminished. Maybe our receptors don’t work as efficiently as they did – whatever it is, your cravings for bad stuff and your ‘self control’ when opening the fridge (even if you have a bikini model photo taped to it as a deterrent) may be tested.

We might be becoming naturally more insulin resistant with time. This adds to sugar highs and slumps and cravings if we dare give in. With this rise in insulin resistance the fat in our middle is up and then we continue to store even more carbohydrate as fat.


I don’t know how you are having time to read this – I would guess you have a very busy life with anyone or all five of work, home, partner, family and pets claiming your time. You might not feel stressed but you might be juggling time as a carer for many or simply trying to make  a living. This ‘busy-ness’ that we can thrive on can also mean our cortisol (stress hormone/fight or flight reaction chemical) is rampant and it just loves you to hold onto some tummy fat and give you rabid sugar cravings.

In the time we are going through now in lockdown you may in fact have more time to self contemplate while the sun is shining outside. You may be worrying about  your health more than ever – if you are in this camp then have patience with me and read on – I truly applaud you wanting to possibly improve it.

Muscle loss

Left unhindered our muscle mass declines a little every year. We lose some of the little components that work the muscle (the motor unit where the nerve meets the muscle) as we age. This means we burn less calories full stop, but also the muscle acts less on our bones to keep them strong so it can be a double whammy for our musculoskeletal frame.  You are not converting muscle to fat as you age – one is a separate entity from the other – but you naturally would lose muscle and gain fat if you left your body to its own devices. We tend to sit more these days – it’s not our age darling it’s the amazing selection of stuff we can do passively – work at a computer then you no longer walk around an office when not in lockdown to chat to a colleague – you just email them! We don’t travel out to see friends when not in lockdown, we whatsapp them – we don’t even walk to the letter box to post a letter. We can sit down and watch five episodes of our favourite cult horror without even a toilet break (unless desperate) but what horror is it doing to your thighs?

This reduction in muscle and our general hormonal change lead to a lower metabolic rate and weight gain. Move less, eat more, it’s catastrophic to our dress size.

Do you need to lose weight?

Calculate your Body Mass Index (BMI).

This is your weight in kg divided by your height in metres squared so

Kg divided by metres squared.

If this is in the range 18.5 to 24.1 it is considered normal as a non-pregnant, non-lactating adult, 25 – 29.9 is considered overweight and over 30 obese. Less than 18.5 is considered underweight.

Being in the underweight category is not a good ambition either. Our fatty tissue is one of our main sources of oestrogen for our bones when we are older so being underweight puts us more at risk of osteoporosis.

This is often an oversimplification though and muscular people might seem to have a less healthy BMI and so on.

Another factor is to try measuring your waist to height ratio in the same units with a simple tape measure. If the waist is less than half the height then this is a good indicator. If it is higher this might indicate you are at higher risk of metabolic disease (like diabetes) and cardiovascular disease. We know this waist height ratio is related to the amount of visceral fat (see below).

What do I suggest?

We women intuitively know when we don’t feel right. When the jeans that always fit perfectly don’t fit. We don’t feel happy with ourselves. If your waist is expanding the last thing I want to advocate is obsession and sadness, many of the changes that occur we can happily accept. The worry is if the jeans really don’t fit at all, the expanded waist might mean the fat beneath (our visceral fat) is expanded. This is the fat wrapped around our organs and that is a reason other than vanity to take action as it just ain’t good for our health.

How do we step away and have more freedom away from the scales?


Those women that ‘have it all’ and are a similar size to in their twenties or even stronger have the key. Much of the above is reversible or at least can be stemmed with a little daily effort.

Get eating well

Bite the bullet and look at your plate. Serve yourself a healthy breakfast with a good fibre and protein content and rev your metabolic rate up. There are studies on intermittent fasting and its benefits, indeed I have written about them in my book, but for women in midlife I think ensuring you have a good start to the day may in fact be more paramount. Don’t let a sugary cereal or a tasty pastry be your definition of a healthy start. That is not breakfast. Avocado on wholegrain or sourdough toast with some salmon, porridge with some unsweetened peanut butter and some fresh fruit will give you more health benefits than I can list here.

Look at your portion sizes. I hate advocating calorie counting for all the worries of eating disorders but some temporary awareness might educate you to know what portions should be. Don’t overload at any meal. Use the Japanese HARA HACHI BU principle of eating until you are 80 per cent full, not literally ‘stuffed’. Make sure you are well hydrated and not confusing thirst with hunger and make water your primary fluid source.

Ditch the easy refined sugars – processed carbs, sweets, cakes and pastries (still have treats if you can manage not to overindulge) and choose water or real fruit instead of liquid sugar from pure fruit juice that your body does not have to work for. If you are having a smoothie then preferably make it a green savoury one or add protein sources such as peanut butter to the more sweet ones and limit your intake of those. Again your body does not have to work much for a fruit smoothie and the sugar crash after leads to the inevitable.

All you might need to do is to cut the c**p out of your daily food intake. Many of us are guilty of healthy meals and endless empty comfort food in between. A couple of days may be all it takes for your body to deal with the change and the cravings to go. This lockdown is a test for emotional eating and we don’t want to end up like the crazy funny memes not being able to get through the door when this is over.

Try to limit your eating after say 6pm so your food is well digested and you are not trying to burn it off while you sleep as you just won’t.

Limit your alcohol – it is so easy to replace meals with a cheeky bottle of rose but save this for celebrations and weekends and try and have a minimum of 3 drink free days (ideally 5) in the week. If you want to swap your wine for something less calorific look at healthy mixers or soda and lime instead of coke and juices. Every little helps. Simply savour your non alcoholic drink in your favourite glass – sparkling water with lime and mint to garnish may make you feel kind of spoilt.

Get relaxed

Meditation, massage, bathing, reading, gardening, chatting, music, silence, great films, great food. We all have different ways of relaxing and switching off but we have to make time to do them. It is not selfish but essential.

Get moving and get stronger

Walking is great. Cycling is great. Dancing is superb in many ways. Moving anyhow is great.

If you are really serious though about losing excess tummy fat you may need to dial things up a notch and work for it as in sweat. If your pelvic floor, ailing back or an old injury would impede you then find an instructor who can initially guide you or if following a written regime/video class replace the leaping about you cannot do with something else.  Squats, mountain climbers, the plank, push ups and working with weights that you can manage is not just for the 20 year old sylph in the gym. This will all raise that resting metabolic rate and dial back the years. It might well be what your body needs in order to cooperate and it might accelerate the changes in your body to get back to the normal you. You body likes changes and HIIT might be attainable for you. If you are well in health you need to be doing something that gets your heart pumping. I don’t encourage obsession but a pedometer or a heart rate watch can be an incredible motivator if we are limited to staying at home. Find a workout mate or two, share achievements with your friends and commend them on theirs. Using weights rarely bulks women but it does keep the muscle working, the metabolic rate up and the body toned and it’s just one of the ways to defy the ageing of your body.

If you were consuming empty calories of chocolate and processed junk (I am not talking about 80 % cocoa solids chocolate you are having for the antioxidants) and just stopped this extra rubbish and started a good 20 minute body resistance with cardio regime 4 or 5 times a week in lockdown you still have to remember my magic word when looking at the scales alone…patience. A good aim would be just a pound or two per week, no more as your body likes gentle change and it will be longer lasting.

What might surprise you is the change in the mirror quickly as you tone up and lose some belly fat and that summer dress just starts to fit a bit better.

Weight might not be the only or most accurate barometer of health. Unless you have a lot to lose you may find your weight stays stable or even climbs slightly as you lose fat and work your muscle more. You will look leaner but the scales might not reward you unless you have accurate bioimpedance scales that measure muscle and fat mass separately (often inaccurate as well at home). So cut yourself some slack if you are looking and feeling better and don’t measure your health entirely by the scale number. We may be destined to be stronger and fitter now than when we were in our twenties when we may have simply been ‘skinny fat’ skinny. 

If you are lucky enough to be safe and well in isolation and lockdown I just want you to think what you can use this time for. Chances are you have a bit more of it than normal so why not be selfish and get it to workout well for you? Have patience.

Stay well, stay safe XX

If you enjoyed the article, you’ll find lots more in my new book below …