Many of my middle-aged women patients ask me similar versions of the same question: why isn’t this weight loss technique that has always worked for me in the past working now?

The answer lies in the complex ways that our hormones change and impact our metabolisms during perimenopause.

I advise them that continuing the same diet plan that worked well in their 20s will not yield the same results in their 40s and beyond. Here are five dieting mistakes related to menopause weight gain to look out for, along with better strategies that meet your new metabolic needs.

Neglecting Strength Training

In a natural process called sarcopenia, your lean muscle mass declines by about one percent per year beginning at age 30 and accelerates in your 40s. One of the many problems this poses to women and men alike is that your basal metabolic speed is in large part determined by how much lean muscle mass you have.

In other words, as you lose muscle, your metabolism slows down accordingly, and is generally replaced by fat. For women, these fat cells aggregate around the waistline.

The most effective way to counteract sarcopenia is through a strength training regimen, or working out with weights. The good news for women in perimenopause is that lean muscle mass can be replaced effectively with as little as two strength training sessions per week.

Not only will strength training reverse muscle loss and help you to lose weight, it also provides the following health benefits: sharpening memory and cognitive abilities; strengthening bones; lowering stress levels; and reducing risks for type 2 diabetes, high blood pressure, heart disease, and some forms of cancer.

It is never too late to start weight lifting. Try exercises that work several muscle groups at a time, and increase in weight and intensity as you progress. My colleague, Dr. Wayne L. Westcott, who directs the Exercise Science Program at Quincy College has written over 28 books on strength training, has recently released a book entitled Building Strength and Stamina that is perfect for beginners.

Not Adjusting Calorie Needs Impacts Menopause Weight Gain

Closely related to my first point, your body requires fewer calories as you age. This happens due to a combination of hormonal and environmental factors. The end result? If you are eating the same amount of food as you did in your 20s, you are probably eating too much.

By age 45, the average person burns about 200 fewer calories per day as compared to age 25. This may not sound like a big difference, but if no dietary adjustments are made, this deficit will add up to 12 pounds of excess weight over the course of a year.

I advise my middle-aged patients to switch to a high protein, whole foods diets to cut back on calories without feeling hungry. Protein is the most satisfying of the macronutrients and keeps blood sugar levels stable longer than fats or carbohydrates. Build meals around lean protein sources, such as fish, poultry, and lean meats, add in a variety of fresh produce, and limited amounts of whole grains for meals that will keep you feeling full longer on less.

Another excellent strategy to cut back on calories without hunger pangs is to swap out a meal with a high protein smoothie. This encourages your body to tap into excess fat for energy, while simultaneously protecting the muscles. I offer many recipes for smoothies on my blog.

Consuming Added Sugars

There are two types of natural sugar found in whole foods: lactose, the sugar naturally occurring in milk and fructose, the sugar naturally occurring in fruit. When these sugars are eaten in their natural, unprocessed forms, they are consumed in a package that includes fiber, nutrients, and in some cases, protein that stabilize blood sugar. They have a lower glycemic index and do not promote fat storage in the body or trigger addiction centers in the brain.

Added sugars, on the other hand, spike the blood sugar while providing no nutritional value. These sugars provide a temporary energy high, followed by a crash, accompanied by cravings for more sugar and hunger pangs. They are a leading contributor to the obesity epidemic, and are found in many packaged foods.

Not only are sugars added to items like candy, soda, and pastries, they can also be found in breakfast cereals, flavored yogurts, and marinara sauce. These sugars lead to weight gain at any age, and interfere with leptin, one of the primary hormones responsible for feelings of satiety.

These dietary issues are exacerbated during menopause, when blood sugar is naturally less stable. In addition, in clinical studies, added sugars have been shown to worsen hormonal imbalances and symptoms in women. Your best bet? Remove or severely limit them in your diet, and turn to fresh fruits for sweetness instead.

Going Fat-Free

While going fat-free may sound like a good idea in theory, fats are a macronutrient that the body relies on for energy. They play a role in vitamin absorption, metabolic health, maintenance of healthy cholesterol levels, and even prevention of heart disease. In terms of weight loss, many women who switch to a fat-free diet end up choosing processed foods that replace fats with added sugars.

While I definitely recommend staying away from trans fats, the type found in fried foods, fast food, and many processed dessert items, you should include balanced amounts of monounsaturated fats, found in almonds, olive oil, and avocadoes, and polyunsaturated fats, found in foods like fish, flaxseed, and cruciferous vegetables. Saturated fats, the type found in dairy and poultry, are also okay in moderation.

Skimping on Produce

Adding plenty of fresh fruits and vegetables to the diet is important at any age. These foods contain high amounts of antioxidants to protect your health and fiber to prevent weight gain. How does this work? Dietary fiber helps to reduce insulin levels following a meal. When high fiber foods, like vegetables, are consumed regularly, insulin sensitivity increases.

The opposite condition, insulin resistance, occurs when the body digests too many foods high in added sugars and refined carbs, and becomes desensitized to insulin. Insulin resistance is linked to raised risks for type 2 diabetes, weight gain, and chronic inflammation. In fact, you might say that the more insulin resistant a person is, the more weight they are likely to gain. Guard against this by getting at least five servings of fresh vegetables per day. The fiber content will also help to keep you feeling full longer than other foods.

For women in menopause, eating plenty of vegetables carries an added bonus. Cruciferous vegetables, such as cauliflower, broccoli, and bok choy, combat the excess estrogen that is associated with higher risks for breast cancer. Other great choices include asparagus and watercress, which help to decrease the bloating associated with menopause, and dark leafy greens like spinach and kale to guard against osteoporosis.

Don’t love the taste? Try some in my Toasted Coconut Coffee Smoothie. This recipe contains a full serving of leafy greens that you won’t even taste.

What do you do to stay healthy and fit? What are you doing to change your eating habits to meet changing metabolic needs in your 60s? Do you have any smoothie recipes that you love? Why do you think menopause weight gain is so difficult to address? Please share in the comments.

Caroline ApovianDr. Caroline Apovian has worked in the nutrition and weight loss field for over 25 years. She is currently the director of the Nutrition and Weight Management Center at the Boston Medical Center, a professor at the Boston University School of Medicine, and the vice-president of The Obesity Society. Please visit her website here or connect via Facebook or Pinterest.

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