Dr Rangan Chatterjee

This Is Why You’re Gaining Belly Fat After 40 (And How to Reverse It) | Dr. Stacy Sims

This episode is brought to you by: BON CHARGE: Save 20% off with code LIVEMORE https://boncharge.com/livemore AG1: Get 10 FREE Travel Packs and Welcome Kit worth $80 visit: https://bit.ly/43FwxQl Download my FREE Breathing Guide HERE: https://links.drchatterjee.com/468qpEd As we get older, have you ever wondered why the exercise advice we’ve been given doesn’t seem to work as well as it once did? As we move into our 40s and beyond, our physiology changes in ways that can often feel confusing and frustrating. But what if we could harness those changes to feel stronger, healthier and more resilient than ever before? My guest this week is exercise physiologist and nutritional scientist, Dr Stacy Sims. Stacy is dedicated to helping active women – and the people who support them – take back control of their bodies, health and lives through science-based knowledge and practical tools. She is the author of two book, including ‘ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life’ and the creator of her signature course, Women Are Not Small Men, after recognising the lack of research specifically done on women in exercise, nutrition and medicine. In this conversation, we discuss: • Why conventional fitness advice often fails women in midlife, and how we can move beyond outdated recommendations • How hormonal changes during perimenopause affect everything from metabolism and muscle strength to mood and sleep • The crucial role of resistance training in maintaining bone density, muscle mass and cognitive function as we get older • Why high-intensity interval training can boost our metabolism, balance blood sugar and reduce harmful belly fat • How the language around “muscle toning” can be unhelpful, and why lifting heavier weights is so important for building real strength and protecting our long-term health • Practical ways to start strength training safely, even if you don’t enjoy the gym, and simple strategies for fitting effective movement into a busy week with minimal time • How building strength now supports our independence, resilience and vitality, helping us stay active, prevent injuries and feel confident as we age This conversation is an invitation for all of us to rethink what’s possible as we grow older. Stacy’s insights remind us that with the right information and support, we can build strength, confidence and better health at any stage of life. And if you find this episode helpful, why not share it with the women in your life – friends, family or colleagues – so they can feel empowered and informed about their bodies, too. #feelbetterlivemore ---- Connect with Stacy Sims: https://www.drstacysims.com/ https://www.facebook.com/drstacysims https://www.instagram.com/drstacysims https://www.youtube.com/channel/UCPD55VPa1ZWx1a_nzWC2VJA Courses https://www.drstacysims.com/courses Newsletter https://www.drstacysims.com/generic_optin Books: ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life US https://amzn.to/46BOSSp UK https://amzn.to/46EeFJC Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond US https://amzn.to/4gvfx72 UK https://amzn.to/3K7oB5D #feelbetterlivemore #feelbetterlivemorepodcast ------- Order MAKE CHANGE THAT LASTS. US & Canada version https://amzn.to/3RyO3SL, UK version https://amzn.to/3Kt5rUK ----- Follow Dr Chatterjee at: Website: https://drchatterjee.com/ Facebook: https://www.facebook.com/drchatterjee Twitter: https://twitter.com/drchatterjeeuk Instagram: https://www.instagram.com/drchatterjee/ Newsletter: https://drchatterjee.com/subscription DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Dr. Rangan Chatterjeehost

Sep 16, 20252h 10mWatch on YouTube ↗

WHAT IT’S REALLY ABOUT

Why women gain belly fat after 40—and exercise fixes it

Traditional “eat less, move more” and excessive walking often fail women in perimenopause because hormonal shifts change muscle function, metabolic control, and stress physiology.
Perimenopause can begin in the late 30s with more anovulatory cycles, shifting estrogen–progesterone ratios and contributing to insulin resistance, higher LDL, higher baseline cortisol, poorer vascular function, and rising visceral fat.
Heavy resistance training (true strength/power work) helps preserve strength, lean mass, bone density, neuromuscular function, and brain health—adaptations that lighter “toning” workouts typically don’t provide.
True HIIT—especially sprint-interval training with full recovery—improves glucose uptake without insulin (GLUT4), supports healthier lipid handling via myokines, and improves vascular compliance, which together helps reduce belly/visceral fat and cardiometabolic risk.
Menopause hormone therapy is framed as a tool (mainly for hot flashes and bone health) rather than a full “replacement,” and lifestyle (sleep, training, nutrition, stress) remains essential and individualized.

IDEAS WORTH REMEMBERING

5 ideas

Walking alone is not enough for aging well after 40.

Walking supports general cardiovascular health, but it doesn’t sufficiently protect bone density, strength/power, vascular compliance, or the metabolic shifts that drive visceral fat gain during perimenopause.

Perimenopause can start earlier than most women expect.

Sims notes it may begin around 37–38 with anovulatory cycles (no ovulation but still bleeding), altering estrogen–progesterone ratios and affecting multiple systems long before “official” menopause.

Heavy resistance training targets the specific neuromuscular losses from declining estrogen.

Loss of estrogen reduces strong actin–myosin binding and acetylcholine-related neuromuscular signaling, so true heavy lifting (low reps, high load) provides the stimulus to preserve strength, power, and function.

“Toning” workouts often create metabolic stress without building the strength women need later.

Higher-rep, lower-load classes (often marketed to women) can feel hard but may not provide the nervous-system and bone-loading stimulus needed for long-term independence and fall resilience.

Sprint-interval training is a direct lever for belly/visceral fat and metabolic markers.

Short all-out efforts (≤30 seconds) with long recovery increase GLUT4 expression (glucose uptake without insulin) and myokines that discourage visceral-fat storage while improving lipid handling and blood pressure regulation.

WORDS WORTH SAVING

5 quotes

The biggest thing is following traditional trends, where if we're looking at women who are in this kind of 40-plus or maybe 45-plus age group at the moment, grown up in the whole diet culture of move more, eat less, and that's what people tend to do when, especially when they're trying to lose weight.

— Dr. Stacy Sims

When women are talking about this, they're like, "I can't open the jar of pickles anymore. I have a really difficult time opening a jar of pickles 'cause my grip strength isn't there."

— Dr. Stacy Sims

It doesn't mean spending 90 minutes doing a workout, because that puts womens fully in a metabolic stress that is too easy to be hard to be zone two or recovery or relaxation or improve our parasympathetic and is way too easy to be hard enough to instigate any kind of adaptive change that we want for body composition and longevity.

— Dr. Stacy Sims

Be the oldest person in the gym, not the youngest person in the nursing home.

— Dr. Stacy Sims

Perimenopause is not a female hormone deficiency syndrome. It's not a deficiency in hormones that need to be replaced.

— Dr. Stacy Sims

Women are not “small men” physiologyPerimenopause timelines and anovulatory cyclesVascular compliance, LDL rise, insulin resistanceHeavy lifting vs “toning” (gendered fitness marketing)HIIT vs sprint-interval training and the “gray zone”Zone 2: why it benefits men more than women (time efficiency)Oral contraceptives, symptom masking, and hormone therapy nuance

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