What really changes for women after 40 (and what you can do about it)

Claire Turnbull outlines how women can approach body changes in midlife.

I recently returned from a trip to the UK, doing mammoth, crammed-in catchups with family and friends that are often the norm when you live on the other side of the world.

While travelling here, there, and everywhere for a month, trying to fight jet lag and getting very sick of eating on the run, I found myself having the same conversation over and over again with my 40-plus-year-old friends.

The juggle of work, kids, caring for ageing parents and the fog of a perimenopausal brain is intense in this phase of life. Plus, on top of all that, despite eating and exercising the same, the frustration of clothes getting tighter and weight gain around the middle was a strong theme of conversation.

We hear the same story all the time from our midlife clients at Mission Nutrition and the people we work with on our findWellness programmes, and being in my mid-40s myself, I know this firsthand too.

Research also confirms that this is not just in our heads. A recent, rigorous systematic review completed by the International Menopause Society clearly highlighted that weight gain and body composition changes are common among women in midlife. So, if you’re experiencing this, you are not alone.

But why does this happen? And, more importantly, what the heck can we do about it?

As we age, our muscle mass naturally starts to decline if nothing is done to counteract it. Muscle is a very metabolically active tissue, which means it’s ‘hungry for energy’ and burns fuel (calories from the food and drinks you have) not only when you’re moving, but also when you’re sitting at your desk working or chilling on the couch after a big day.

The more muscle you have, the more efficient your body is at using energy. The less muscle you have, the less effective you are at burning fuel and, you guessed it, the easier it can be to gain weight in the form of body fat.

But fear not, this muscle decline is not inevitable. Phew!

Including regular strength (or resistance) training, along with adequate protein based on your needs at this stage of life, can significantly slow and even reverse muscle loss and the metabolic slowdown that comes with it.

On the training front, there’s plenty of debate about how often, how heavy and how hard you need to go, but the bottom line is this: some strength training is better than none.

If you are new to strength training, aim to include bodyweight exercises at home, resistance bands, Pilates, gym-based weights, or online programmes at least two times per week as a good place to start, building up from there.

This also needs to be combined with the recommended minimum of 150 minutes of moderate-intensity exercise per week.

One challenge I personally appreciate is fitting in exercise during this chaotic life phase, but if you’ve been stuck in the mindset that anything less than an hour “doesn’t count”, it’s time to challenge that thinking.

Can’t see how you could fit in two longer resistance workouts a week? Break it down. Do 5-10 minutes a day instead, or 15-20 minutes if you can. Whatever fits into your life is better than not doing it at all. If you’re able to exercise at the same time each day, that can really help anchor it as a habit too.

When it comes to protein, if your social media algorithm looks anything like mine, you’ll be seeing cottage cheese recipes everywhere and protein powder added to just about everything as a woman in your 40s.

But don’t let this overwhelm you or feel like you have to jump on those trends. You can get enough protein from whole foods you probably already have at home, without making it a full-time job.

Aiming for somewhere around 20-30g of protein per meal, with some protein in your snacks (if you have them), is a good place to start to help preserve muscle mass and keep you feeling fuller for longer.

Individual needs vary depending on your weight and activity level, so for personalised guidance, a Dietitian or Nutritionist can help.

If you want help working out what 20-30g of protein looks like in real food, you can grab our free protein guide.

Both strength training and adequate protein intake are also crucial for bone health, which can come under pressure during this stage of life. An added benefit of focusing on these.

Another big change is the shift in our hormones, which can impact almost every aspect of our bodies, from our brains and bladders to our hair and shoulders (frozen shoulder anyone?!), as well as where we store fat.

During perimenopause (which can start, on average, 7-10 years before your final period), oestrogen levels can swing around wildly while trending towards an overall decline. Progesterone and testosterone levels are affected too. These changes can alter fat distribution, often shifting it towards the middle.

Enter tighter undies, jeans that don’t fit like they used to, and the feeling of becoming more apple-shaped than pear-shaped.

At the same time, many women become more resistant to another hormone called insulin, which plays a key role in managing blood sugar levels. When insulin resistance increases, blood glucose can creep up, and the body becomes more likely to store fat. Something people with PCOS, prediabetes and type 2 diabetes may already be familiar with.

While there are things you can do (and I promise I’m getting to them), it’s also important, albeit hard to recognise that this is a normal phase of life.

Despite our desire to fit into the same jeans we wore in our 30s, some degree of physical change is likely. It’s worth asking yourself how far you’re willing to go to chase a particular dress size, because for many women this stage of life requires more effort, more restriction, and more stress than it did before and that can become unhealthy.

Some acceptance and compassion towards your changing body is often necessary, alongside taking care of your physical and mental health.

In terms of what you can do to help with these hormonal shifts, once again, physical activity is a priority. As well as improving how you feel, it can also improve your sensitivity to insulin, meaning your body is better able to manage blood sugar levels.

What and how you eat will also make a big difference. While it’s tempting to think that simply eating a lot less or following the latest diet trend will be the answer, what worked before often doesn’t work anymore, so it’s time for a different approach.

Focus on loading up your plate with two or more handfuls of lower-starch vegetables at lunch and dinner, adding extra veg for snacks where you can, ticking off your protein as mentioned above, and choosing quality carbohydrate sources.

You may also find that slightly reducing refined carbs and replacing them with vegetables works better for you. Think oats, starchy vegetables, pulses, and brown rice over more processed options.

The timing of your eating can also be helpful to consider. Keeping your food intake within an 8–12 hour window may be beneficial for some people.

Sleep disruption is incredibly common during perimenopause and menopause. Middle-of-the-night waking, feeling hot, or multiple trips to the bathroom, sound familiar?

Poor sleep can increase insulin resistance and disrupt appetite hormones, leaving you feeling hungrier, less satisfied after meals, and craving quick-fix carbs or salty snacks.

- Use a good eye mask to minimise disruptions when you wake

- If you get up to the toilet, avoid turning on bright lights, motion-sensor night lights can help

- Don’t check the time during the night; it fires your brain into action and can trigger anxiety

- Remind yourself that rest is still restorative, even if you’re not asleep

- If you’ve been awake for a long time, get up briefly, cool down, then return to bed

- Be mindful of caffeine and alcohol, both of which can wreak havoc on sleep during this phase of life

For some women, Menopause Hormone Therapy (MHT/HRT) may also be part of the conversation, particularly when symptoms like sleep disruption, brain fog, hot flushes or mood changes are affecting quality of life as well as impact how you eat and your motivation to exercise.

So, if you aren't feeling like yourself, reach out and have a conversation with a knowledgeable GP who is upskilled in this area of midlife and menopause. If you need help with your lifestyle, we too can support you at Mission Nutrition and findWellness. Please don’t feel like you have to suffer through challenges alone.

Claire Turnbull has a BSc (Hons) in Dietetics, is a New Zealand Registered Nutritionist, author, and speaker. If you have a question or topic you'd like Claire to address, you can contact her here.