Middle-age spread: Why does it happen in your 40s and how can you lose the extra kilos?
Welcome to your middle age, where everything either hurts, bloats, tires or causes you to put on weight. The question is, how do you lose the extra weight when jogging doesn't seem to work and just a potato chip is enough to add kilos on you?

(Photo: iStock/FredFroese)
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Once upon a time, you could easily slip into small or even extra small-sized clothes (yes, including Uniqlo’s ridiculously tiny sizes) like Cinderella does with her glass slippers. You didn’t have to Google the location of the nearest gym because, pffft, who needs to work out when your food baby magically flattened itself out right after a night’s sleep?
But somewhere between that and “happily ever after”, you’ve become the pumpkin carriage. Your pants can’t get past your knees without you Hulking out. By the time you hit your 30s, terms that are usually reserved for delicious bakes such as muffin tops now apply to your midsection. You’ve adopted a beer belly that resembles a four-month pregnancy.
And by the time the 40s come knocking on your door, your willpower to start exercising and snack less has fizzled out like ephemeral New Year resolutions in February.
Even the determined ones among us struggle to prevent the number on the weighing machine from climbing. Your weekly jogging sessions don’t seem to cut it anymore. Yoga feels like a stretch at keeping the kilos off when before, being able to hold a plank pose was enough to maintain your six-pack abs. And it doesn’t help when a nibble of chocolate or a single potato chip is all it takes for yet another kilo to find its way onto you.

Sure, you have been too busy (and tired) to break out your running shoes after work. Eating out frequently has ensured a steady intake of calorie-dense foods in your diet. And besides, your metabolic rate naturally tanks after a certain age; not much you can do about that, can you? Maybe you can.
YOU ARE LAYERING ON NEW FAT
Welcome to your middle age, where everything either hurts, bloats, tires or causes you to put on weight. It is the phase in life where you build a new wardrobe of black, body-skimming clothes to style the extra you. Internally, you’re also building new layers of fat that contribute to the phenomenon known as the middle-age spread.
Fat represents energy stores and your body squirrels these reserves away in two ways, said Dr Benjamin Lam, a senior consultant and head of Khoo Teck Puat Hospital’s Integrated Care for Obesity & Diabetes clinic: Subcutaneous, which is underneath the skin (subcutaneous adipose tissue or SAT); and in the abdomen (visceral adipose tissue or VAT).
But VAT is the new fat that enters the chat in your mid-40s – and it is particularly fond of setting up shop in your mid-section, which explains the classic love handles and potbelly among aunties and uncles.
That’s not the only downside. “When the storage thresholds of SAT and VAT are exceeded, the excess fat can be stored in organs such as the liver, pancreas and around the heart and muscles, where fat does not usually accumulate under normal circumstances”, said Dr Lam.
This is known as ectopic fat deposition and has been linked to diabetes and cardiovascular disease, he said. In fact, VAT accumulation is not a good sign as it’s a marker of increased ectopic fat, he added.
YOU LOSE MUSCLE MASS
First, let’s talk muscles. Muscles are the powerhouses in your body that consume energy. They contribute to your basal metabolic rate (BMR), which determines the minimum number of calories your body needs to perform basic life-sustaining functions such as breathing.
“One unit of muscle will consume the same amount of energy whether you’re 20 years old or 60 years old,” said Dr Lam. By that logic, “somebody with 10 units of muscle will expend more energy than someone with five units of muscle”, he said. Which is why if you perform strengthening exercises to build more muscle mass, you raise your BMR.

But age-related muscle loss or sarcopenia is a very real thing and it begins in your 40s. Scientists think that sarcopenia is caused by ageing when your body doesn’t produce the amount of proteins and hormones your muscles need to grow, according to Cleveland Clinic.
Add bad lifestyle choices such as a tendency to exercise less and eat more to this biological downturn and you have a recipe for middle-age spread. Processed foods, sugars, poor or inadequate sleep, stress and certain medications can also contribute to an obesity-causing environment, said Dr Lam. Furthermore, “some people are more vulnerable than others when exposed to this environment”, he said.
MEN VS WOMEN
Men and women tend to gain weight in their mid-20s at a rate of approximately 0.5kg to 1kg per year, according to endocrinologist Dr Ben Ng from Mount Elizabeth Novena Hospital. If you do the math, that’s at least an extra 12.5kg by the time you hit age 50. However, “this rate slows in the mid-30s to 40s and tends to plateau in the 50s”.
“Weight gain differs between men and women after the age of 45,” continued Dr Ng. “In women, the decline in oestrogen levels during menopause leads to a change in fat distribution. While younger women tend to gain weight in their face, chest and thighs due to the oestrogen effect, ageing and menopause shift fat storage towards the midsection.” In men, the weight tends to concentrate in the waist, no matter their age, he said.
“However, as women age and oestrogen levels fall, the fat distribution after their mid-40s becomes similar to that of men. Hence, women are more susceptible to middle-age spread due to this shift in fat distribution, whereas men tend to maintain a consistent pattern throughout their lives.”
Men's testosterone levels also decline with age. "An accelerated decline is called andropause," said Dr Ng, where testosterone levels drop so rapidly, it leads to a loss of muscle mass.
"This can potentially affect metabolic rate and impede muscle development despite regular exercise. While the metabolic rate may stay relatively stable during this period, there is a notable increase in fat accumulation compared to muscle in individuals experiencing andropause."

EXERCISE OR DIET: WHICH HAS A BIGGER IMPACT?
Weight loss comes about when your body expends more calories than it stores away – and it can occur over a few phases, according to Alefia Arshad Vasanwala, the principal dietitian at Mount Elizabeth Hospital.
“In the initial phase of weight loss, diet appears to play a bigger role,” she said. However, consistent exercise is vital throughout the journey to complement your dietary regimen. “Regular exercise not only aids in increasing metabolic rate but also enhances calorie-burning efficiency. In short, the safest and most sustainable approach to reducing weight is a combination of mindful eating habits and a consistent exercise routine,” she said.
Whether middle-aged or not, Dr Lam agreed that both exercise and diet are important. “Additionally, in this context of middle-age spread, exercise is needed to address the loss of muscles, a primary reason in age-associated weight gain.”

HOW DO YOU LOSE WEIGHT IN YOUR 40S?
It really isn’t any different from when you were in your 20s or 30s. It’s just that you have more obstacles to overcome in your 40s such as greater work and family responsibilities, lower energy levels and your body’s biology working against you.
The key is to create an energy deficit of 500kcal to 1,000kcal from your daily diet and expending about 300kcal to 500kcal through moderate to intense exercises, said Alefia. Aim for a total of 150 to 300 minutes per week – and include both cardio and resistance training. “Following this regimen will help one to achieve a modest weight loss of 0.5kg to 1kg per week,” she said.
If you don’t have the time to exercise, try tracking your steps and aim for at least 10,000 steps daily. “Stay active throughout the day and reduce prolonged sitting,” suggested Alefia.

And don’t set your target too high; losing 5 per cent to 10 per cent of your body weight is realistic for middle-agers with no existing health conditions, said Dr Lam. This means if you weigh 82kg, aiming to shed 4kg to 8kg is a good start.
“However, there might be some who need more than 10 per cent weight loss to address obesity-related conditions,” said Dr Lam. “To achieve that, diet and exercise alone may not be sufficient and other treatment modalities like medications or even weight-loss surgery may need to be considered.”
Diet-wise, avoid snacking on high fat foods but include more wholegrains, fruits and vegetables. As for your protein intake, eat a mix of lean and plant-based protein (but not plant-based meat alternatives). Choose foods and beverages with little or no added sugar. When in doubt, plan your meals using the My Healthy Plate concept, said Alefia.
“I think we have to accept the fact that muscle mass loss and fat buildup tend to happen as we age,” said Dr Ng. But if efforts through exercise and diet prove ineffective, it may be time see your doctor, physical therapist or dietician for further advice, he said. “Various factors, including insufficient protein intake, improper exercise techniques and the presence of other illnesses, can sometimes hinder weight loss and muscle development.”