Midlife Weight Gain: What's Healthy, What's Not?

We’re not talking vanity-those extra pounds are downright dangerous.

By Joan Raymond
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Photograph: iStock

Linda Gourley has two sets of clothes. Her skinny ones, which she wore up until about five years ago, are packed away in boxes to make room for what she calls “the nightmare of fat stuff” that now takes up all available space in her closets. Almost no one would call the five-foot-six-inch, 168-pound Cleveland resident obese. But with a body mass index (a calculation of height and weight) of 27.1, Gourley is planted firmly in the cohort of the overweight. “You used to be able to bounce a dime off my belly,” says the 52-year-old. “Now it’s my belly that bounces. I really hate this.”

Depending on which research you read, the average woman packs on as little as five pounds or as much as 15 during the perimenopausal and menopausal years. Either way, the upshot is that by the ages of 40 to 59, two thirds of American women are overweight (BMI of 25 to 29.9) or obese (BMI of 30 or more), split evenly between the two categories. Studies show that it’s not just the obese who potentially suffer from weight-related health problems. Even the overweight are at increased risk for conditions such as heart disease, diabetes and breast cancer. (Find your number.)


The risks for women of being simply overweight became evident in the mid-1990s during analyses of the long-running Harvard Nurses’ Health Study conducted by JoAnn Manson, MD, chief of the division of preventive medicine at Boston’s Brigham and Women’s Hospital, and others. The 16-year study of 115,000 healthy, non-smoking women found that those who fell into the over-weight category were about 60 per-cent more likely to die prematurely than lean women. Midlife weight gains of slightly more than 20 pounds not only upped the risk for heart problems but also for cancer of the breast, uterine lining and colon.

More recently, an analysis of 57 studies (in North America and Europe) published in the online version of The Lancet last spring reiterated that being overweight is a distinct risk, but is clearly not as dangerous as being obese. The analysis reported that for every five-point increase in BMI above the healthy range (that’s 18.5 to 24.9), the chance of early death increases by about 30 percent. And so people who fall into the overweight column may have their lives shortened by one year; obese folks with a BMI of 30 or more stand to lose three years of life; and the extremely obese, with a BMI over 40, might be shortchanged about a decade—exactly the same as if they had been lifelong smokers.

“A BMI that places you in the overweight category is a less significant health risk than a higher BMI,” says Charles Burant, MD, professor of internal medicine and director of the Michigan Metabolomics and Obesity Center at the University of Michigan, in Ann Arbor. But, adds Wulf Utian, MD, PhD, executive director of the North American Menopause Society, “The data is clear that, for most women, leaner is better. For some women, mid-life weight gain is a real issue, and we need to get out the message that you don’t have to be severely obese to have health problems related to weight.”

The good news “If you lose those 10 to 15 extra pounds, it can have a really positive effect on disease risk and health,” Manson says. Adds Burant, “You can’t do much about your family medical history and your genes, but you can try to control your weight and give yourself better odds.” You can also take several other steps to improve your health. (See “What If I Can’t Lose Weight?”)

Culprit No. 1 


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