Marlo Thomas on Weight Loss at Middle-Age I work hard at staying fit - it's a real passion of mine! But I never guessed how much of a struggle it would be to keep the pounds from creeping on after 40. So I asked Dr. Judith Reichman why it is that women have an especially hard time with gaining weight as they get older and what we can do about it. Here's what she told me.

Hi Marlo - it's absolutely true that women tend to gain weight as they get older. There are three basic reasons for it. First are the accumulated years of caloric excess. We're fed more, make larger quantities, cook for more people (and our kids love calorie-dense high­-sugar foods), eat out more, snack more, and expect more food for our money. We simply consume too many calories. Second is pregnancy - women add an average of three permanent pounds with the birth of each child. Finally, there's age: We experience a four to five percent decrease in metabolic rate per decade. As we age, there's a gradual decline in our high-energy-using muscle cells, which make up our lean body weight - so it takes less food to maintain our weight. We also tend to move around less with age.

The average American woman gains "just" 0.8 pound a year. But that's 20 pounds between the ages of 25 and 50! This partially explains many a woman's dilemma: You're eating the same number of calories as you used to, but you're gaining weight. Because of the decrease in metabolic rate and because you are less active than you were 10 years ago, you're probably burning 100 fewer calories per day. So, if you eat the same way now as you did 10 years ago, those 100 calories over 35 days will add up to 3,500 calories, or one extra pound. That's almost a pound a month, or more than 10 pounds a year. And when you casually add one additional 100-calorie snack a day ("How bad can it be? It's one cookie, and it's low fat"), this can easily turn into 20 pounds.

There are two ways to tackle this trend - you need to evaluate the way you're eating now, but you also need to add exercise to get your metabolism going. Exercise builds mus­cle mass, and muscle metabolizes calories more efficiently than fat tissue, ­burning that accumulation of stored calories.

I know - you have no time to exercise. Your family responsibilities, your job, the rest of your life...there's just no time left to work out. Then there's the expense of a gym membership. But if you don't fit in exercise, there are a lot of other things that, ultimately, you'll never get to do, because - aside from antibiotics for a life-threatening infection - there's no medicine or anything a physician can prescribe that positively affects the quality and length of your life like regular exercise does.

Researchers in the Netherlands have found that women who are over­weight at age 40 lose an average of three years from their lifespan; obese women lose more than seven years. (A 5'5" woman who weighs at least 150 is overweight; at 180-plus pounds, she's obese.) For smokers the news is worse; the typical obese smoker can expect to die 13.3 years earlier than a normal-weight nonsmoker. Furthermore, recent studies reveal a not-so-obvious finding: Regular physical activity partially offsets the health risks - heart disease, diabetes, and early death - of extra pounds. Believe it or not, an active 180-pound woman is likely to be healthier and to live longer than a 120-pound couch potato. Inactivity and poor cardiores­piratory fitness are killers of women of all sizes.

So that's why we gain weight as we age and why we need to act on it. I know it's easier said than done. But unless you make exercise one of your top four priorities on a given day, you won't get to it. So print out my checklist of the different types of exercise, and create a plan for yourself, then schedule it!

Judith Reichman, MD is an attending physician at Cedars-Sinai Medical Center in Los Angeles, assistant professor at the UCLA David Geffen School of Medicine, and a fellow of the American College of Obstetricians and Gynecologists.


What do you think? Join the conversation by posting your comments below. To post, you'll need to log in with an Aol or AIM screen name. If you don't have one, sign up for one now – it's fast, free, and protects your privacy. What are you waiting for?