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Since muscle burns the most calories, a reduction in muscle means a lower resting metabolic rate, which translates to weight gain unless you eat less.
“When people age, they tend to get less physical activity, as well,” said Tewksbury, who recommends weight-bearing exercise and eating enough protein daily to build muscle.
But as an athlete who continues to go out for six-hour bike rides with friends on weekends, she realizes that she can’t live on 1,000 calories a day.
“I need to eat 250 to 450 calories an hour to keep my strength up during a bike ride,” says Cohen, who once took four blood pressure medications and now takes none.
She drank more water, gave up alcohol, and took a tiny amount of a prescription appetite suppressant for about a year, to help her adjust to eating less.
And, she slowly lost 12 pounds, which brought her to the “tippy top of the normal range” for her 5-foot-7 frame.
“My experience with weight loss was always trying to lose a couple of pounds, trying to be healthy, eating a low-fat, high-carb diet and thinking of it as calories in, calories out,” said van den Berg-Wolf.
She often found herself cutting back on lunch and then devouring a box of low-fat cookies later in the evening. Her experience, as many women can attest, is common. But it’s not impossible, said Janine Kyrillos, director of the Jefferson Comprehensive Weight Management Program at Bala.
“We don't put an age limit on bariatric surgery,” said Tewksbury. If we have a 70 year old with a BMI of 40 who is metabolically healthy but at risk of disease we will consider surgery.
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Metabolic changes during menopause, which make women more sensitive to carbohydrates, including sugars, can also promote fat storage, said Kyrillos.
“During menopause, you become more sensitive to carbs, so you become more insulin resistant.
“At 50, my metabolism stopped, despite doing all this exercise.