Middle-aged spread: How to avoid it

Most women experience a gradual weight gain as they get older but this is not inevitable. By Kirsten Braun

woman pinching her waistline

Many women find that when they reach middle age they start to gain small amounts of weight over time. As this weight gain is often gradual it is not always noticeable at first. Women may become aware of it when clothes that previously fitted are too tight or when they have to go up a dress size when purchasing new clothing.

How much do women ‘spread’?

The Australian Longitudinal Study on Women’s Health has tracked three generations of women, including data on their weight. It found that middle-aged women (those aged 45-50 years when they were first recruited) gained on average 3.43 kilograms (kg) in 8 years. More alarmingly, the number of women classified as overweight or obese increased from 4 in 10 women to 6 in 10 women during that time.

In addition to the amount of weight gained is a change to the distribution of the weight. When women reach middle age, weight shifts from their hips and thighs (pear shape) to their stomach area (apple shape). This change in shape is very significant as an apple shape, or weight around the stomach area, is linked to a higher risk of heart disease, type 2 diabetes and some cancers.

Why does middle age spread occur?

There are many changes that occur during this time in women’s lives that contribute to this weight gain. While some are part of the body’s natural ageing process others are social reasons.


As women reach menopause, the cessation of ovulation and menstruation which occurs between the late 40s and early 50s, they experience a drop in the level of hormone oestrogen. This drop is thought to contribute to a redistribution of weight to the stomach area.

Loss of lean muscle mass

When we age we naturally lose lean muscle mass. Lean muscle mass burns more energy than fat does, even when we are at rest. Therefore, when we experience a decline in lean muscle mass, our body needs less kilojoules. If women are eating and exercising the same as before, they will inevitably put on weight.

Reduced metabolism

In addition to the loss of lean muscle mass, women also experience a drop in their metabolic rate as they age. Our metabolic rate is the rate at which our body burns energy to run all the functions necessary to keeping the body alive. If our metabolic rate decreases it means we do not need as many kilojoules (kJ) as before. Women who are aged 51-70 years of age require approximately 500 kJ less a day than those aged 19-50 years (8800 kJ compared to 9300 kJ). In addition, this reduction in kJ will only maintain a woman’s current weight. If weight loss is required, a further reduction in kJ will be needed.

Sandwich generation

Women in their late 40s and early 50s can often be carers of both children and elderly parents or parents-in-law, referred to as the sandwich generation. Combined with household duties and/or work, these women may find little time for themselves to participate in regular exercise. They may also rely more heavily on caffeine and sugary ‘pick-me-ups’ to get them through their busy day.


When we are stressed we produce the hormones adrenaline and cortisol to help us combat the stressful situation, the ‘fight or flight’ response. While adrenaline gives us the extra physical strength and energy needed, cortisol helps us replenish our energy stores after the stress has passed, by increasing our appetite. This function works fine if we only face a stressful event infrequently. However, our bodies respond in the same way whether we are facing a physical attack or have a lot of bills to pay. Therefore, if women have a lot of stress in their lives they can have high cortisol levels which cause them to be hungry and over-eat. In addition, many women choose foods that are unhealthy (chocolate, biscuits, ice-cream etc.) as a source of comfort in times of stress.

What can women do about it?

As many of the contributing factors are part of the natural ageing process, women do need to make lifestyle changes if they are to avoid the middle-aged spread. The best changes to make are:

Exercises to build muscle

Maintaining lean muscle mass is an important strategy in combating middle-aged spread. Resistance training or strength training makes the muscles work against a weight or force. Examples include: using your body’s own weight as in push-ups, squats, lunges; weight machines such as those found at the local gym; and free weights. The lack of any resistance training is one reason women who do participate in some physical exercise might still find it hard to shift the weight around their middle. While exercises such as walking will contribute somewhat to maintaining muscle mass in the legs, walking up hills or up steps is a more effective way of building lean muscle mass. The Australian government physical activity guidelines recommend that we incorporate muscle strengthening activities on at least two days each week.  

Rethink your diet

If women require less kilojoules as they age, the food they eat needs to be ‘nutrient dense’. There is, therefore, far less room in one’s diet for nutrient poor foods or empty calorie foods such as biscuits, pastries, cakes, potato chips, deep fried foods, white bread and many take-away foods. To reduce the consumption of these types of foods, women can try swapping them for healthier items such as wholegrain breads and cereals, lean sources of protein, fruits and vegetables and healthy fats/oils (nuts, seeds, avocadoes etc.).

Look at portion sizes

One of the easiest ways of cutting back on kJ is to re-evaluate portion sizes. If women are cooking for hungry teenagers they may be used to piling more on their plate. An 18 year old boy, for example, needs 12900 kJ compared to 8800 kJ for a woman aged 51-70. A serve of pasta, for example, is only one cup of cooked pasta and a serve of meat should be roughly the size of your palm.

Watch what you drink

What we drink can easily add to our kJ intake. Women might be avoiding soft drinks but freshly squeezed juices or flavoured coffees might still be contributing extra kJ. In addition, women’s alcohol intake can also be a factor. One study found that middle-aged women drank more than any other age group. It seems that many women are having a few glasses of wine with dinner as a way of dealing with the stress of their busy lives. Women can try and drink more water and have at least two alcohol-free days per week. 

Regular aerobic exercise

In addition to doing exercises that boosts lean muscle mass, women also need to get regular aerobic exercise. The national physical activity guidelines recommend that women accumulate 150 to 300 minutes of moderate intensity or 150 minutes of vigorous physical activity each week. If women wish to prevent weight gain, the amount of exercise needs to be at the upper limits of 300 minutes of moderate intensity or 150 minutes of vigorous intensity each week.

Manage stress

Participating in regular exercise is one way of achieving stress relief. Taking a yoga class, meditation and mindfulness are all good options.

Last updated: March 2016.

©Women's Health Queensland Wide Inc. This article was written by Kirsten Braun and reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey 2016 Issue 1.



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