Losing weight after the age of 50 is certainly challenging. The difficulties primarily stem from the changes in metabolism, hormonal shifts, medical disorders, nutritional deficiencies and lifestyle factors that often accompany ageing.
The term “weight-loss resistance” is often applicable in these situations. It is used to describe the difficulty some individuals experience in losing weight despite efforts to diet and exercise.
It’s not a medical diagnosis in itself, but rather, a way of describing a situation where typical weight-loss strategies don’t produce the expected results. However, losing weight is still absolutely achievable for older adults. All it requires is some strategic lifestyle and dietary adjustments. Here are key points to consider for weight loss after you hit 50:
Diet
Without doubt, this is the main key factor in any weight-loss journey.
> Caloric intake versus expenditure
A foundational principle in weight management is the energy-balance equation: calories in versus calories out. If you consume more calories than your body uses, you’ll gain weight, and vice versa.
Tailored diets that create a caloric deficit while ensuring nutritional adequacy are essential. A registered dietitian can help design such plans.
> Mindful eating
Techniques that promote awareness of hunger and fullness cues can help prevent overeating.
> Low-carbohydrate diets
For some, reducing carbohydrate intake can help with satiety and reduce insulin spikes. It’s important to choose healthful fats and proteins as part of this diet.
However, it’s not just about quantity; the quality of the calories matters as well. Research has shown that diets high in processed foods, sugars and unhealthy fats can lead to metabolic disturbances and weight gain.
> Macronutrient composition
The balance of carbohydrates, fats and proteins in one’s diet can influence weight loss. Diets with an appropriate balance of macronutrients tailored to an individual’s lifestyle and health status can enhance weight loss and management.
Low-carbohydrate and ketogenic diets have been popular and successful for some individuals, as they can lead to a decrease in appetite and increased fat burning.
Physical activity
Regular physical activity is a critical component of weight loss and maintenance. However, over-relying on exercise without addressing dietary habits can be ineffective.
Moreover, some individuals may not engage in enough physical activity to create a significant calorie deficit, or they may overestimate the amount of energy expended during exercise. The below factors are essential when it comes to effectively utilising exercise to lose weight.
> Aerobic exercise
Regular aerobic activity increases calorie expenditure and is essential for heart health.
> Strength training
Building muscle through resistance training can increase your basal metabolic rate (BMR), aiding in weight loss and maintenance.
> Consistency
The key is regular, sustained physical activity, and not intermittent bursts of exercise.
Metabolism
Each person has a unique BMR, which is the number of calories your body needs to maintain its basic functions at rest. BMR can be influenced by age, sex, body composition and genetic factors. These two other factors are modifiable:
> Meal timing
Some studies suggest that eating larger meals earlier in the day may be beneficial for metabolism.
> Adaptive thermogenesis
This phenomenon occurs when metabolic rates drop in response to calorie restriction, making it increasingly difficult to lose weight despite low-calorie intake. Aim for a slow and steady weight loss to help minimise the effects of adaptive thermogenesis.
Hormones
Resistance to the effects of two hormones can have an important effect on weight.
> Insulin resistance
Insulin is a hormone that regulates glucose uptake from the bloodstream. Insulin resistance can make weight loss more challenging because it can lead to high blood sugar levels and increased fat storage.
> Leptin resistance
Leptin is a hormone that signals satiety (the feeling of being full) and helps regulate energy balance. Leptin resistance can disrupt these signals, leading to increased appetite and reduced energy expenditure.
Sleep and stress
Poor sleep can disrupt hormonal balance, including hormones like ghrelin and leptin that control appetite. Studies show that sleep deprivation can lead to increased calorie consumption, reduced energy expenditure and increase insulin resistance.
Meanwhile, chronic stress can lead to increased secretion of cortisol, a hormone that can promote fat storage, particularly in the abdominal region. Stress can also lead to emotional eating and a preference for high-calorie, high-fat foods.
Medical conditions
Two common medical conditions that can affect a person’s weight are:
> Hypothyroidism
The thyroid gland regulates metabolism. Hypothyroidism, or an underactive or low thyroid function, can slow metabolism and make weight loss difficult.
> Polycystic ovary syndrome (PCOS)
PCOS is associated with insulin resistance and obesity. Women with PCOS may find it harder to lose weight due to hormonal imbalances. A healthcare provider can assess for hypothyroidism or PCOS, and provide the appropriate treatments.
For example, medications like metformin and supplements like alpha lipoic acid, chromium picolinate and vanadium can improve insulin sensitivity in cases of insulin resistance or PCOS.
Medications
Certain medications, including some antidepressants, antipsychotics and antiepileptics, can lead to weight gain or hinder weight-loss efforts. If current medications are contributing to weight gain, a healthcare provider may be able to suggest alternatives. Other methods to help with weight loss include:
> Complementary therapies
Acupuncture, massage and other complementary therapies may have adjunctive benefits in managing stress and promoting overall wellbeing.
> Technology aids
Using apps and devices to track physical activity, sleep and dietary intake can provide valuable feedback and enhance self- monitoring.
> Weight-loss medications
Drugs such as orlistat, liraglutide and phentermine-topiramate can be prescribed for weight loss, in conjunction with diet and exercise efforts.
> Bariatric surgery
For individuals with severe obesity and related health issues, this surgical option may be the most effective treatment.
Psychology
The mind also plays an important part in any weight-loss effort. Habits and behaviours, such as eating in response to emotional cues rather than hunger, can sabotage weight-loss efforts.
There are also eating disorders that can significantly affect weight, e.g. binge-eating disorder where the patient consumes large amounts of calories during binge episodes.
The bottom line
Weight loss is a complex, multi- faceted process influenced by a confluence of biological, psychological, environmental and lifestyle factors. This complexity is why one-size-fits-all approaches to weight loss are often ineffective.
Tailoring weight-loss strategies to the individual’s unique circumstances is critical for success. A multidisciplinary approach, often combining several of the above strategies, tends to be the most successful for long-term weight loss and maintenance.
The interventions must be sustainable and consider the individual’s preferences, lifestyle, metabolic health, hormonal and nutritional optimisation. Continuous evaluation and adaptation of the weight-loss strategy are essential, as is patience and persistence.
It’s also vital for individuals to address weight loss with a positive and health-focused mindset, rather than just an emphasis on appearance. This will lead to more sustainable behaviour change and better overall health outcomes.
In conclusion, maintaining a healthy body weight after 50 can indeed be done. Just remember, gradual and sustainable changes are usually more successful in the long term than quick fixes.
By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, 25 Dec 2023