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My friend Karen stepped on the scale last Tuesday and called me before breakfast.
Lunch, walks, the Friday glass of wine… all the same as last year. But the number was up seven pounds from spring.
“I feel like my body is lying to me,” she said.
I told her the body wasn't lying. New rules kicked in… and nobody handed her the sheet.
Maybe you know that feeling. You eat what you always ate. And move the way you always moved. But the scale keeps creeping… like someone is adding sand to your pockets while you sleep.
So let me show you what changed.
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Your body burns most of its calories just keeping you alive… breathing, pumping blood, holding your temperature steady. And the tissue that burns more calories than fat, pound for pound, is muscle.
Think of it like the cast iron in a woodstove. The heavier the iron, the more heat it holds and throws into the room… even after the fire dies down. That is your resting metabolism. Muscle is the iron.
After 30, women lose roughly 3 to 8 percent of their muscle mass every decade. And when estrogen falls off a cliff in perimenopause, that loss speeds up. Less iron in the stove, but the same logs on the fire. So the extra fuel has nowhere to go.
It gets stored on you.
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Surgery Won’t Fix Your Leaky Bladder (But This 7-Second Ritual Will)
My name is Dr. Sarah Pachtman Shetty and I want you to know that you’ve been lied to when it comes to pee leaks.
❌ “It's normal after kids/getting older.”
It's COMMON, not normal. And common means it can be fixed.
❌ “You need surgery to fix it.”
❌ “You just have a small bladder, it must run in the family.”
No it doesn’t. That’s just an excuse doctors make up to avoid treating you.
Your bladder CAN be reset in just 7 seconds a day. You don’t need invasive surgery, annoying kegels or toxic pills.
I made a free video showing you exactly how:
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Read this part twice
Your metabolism didn't break. It lost the tissue that kept it running. Every pound of muscle gone took about 6 calories a day with it… add that up over years.
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No one tells you this part. They just say “eat less, move more,” as if willpower is the problem. It was never willpower.
In 2021, a study in Science looked at more than 6,400 people across 29 countries. Resting metabolic rate held steady from age 20 to 60… once they accounted for body composition. So the metabolism didn't slow. The muscle left.
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A few things that may help, starting tonight
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Lift something heavy twice a week. The American College of Sports Medicine recommends at least two resistance sessions a week for all major muscle groups. Bodyweight squats and wall push-ups count.
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Eat more protein at every meal. Experts now recommend 1.0 to 1.2 grams per kilogram of body weight daily for women over 40. That works out to roughly 25 to 30 grams per meal.
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Stop cutting calories too low. When you diet hard, up to a quarter of the weight you lose can be lean tissue. And that leaves your metabolism even slower than before.
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Ask your doctor about hormone therapy. Studies suggest estrogen may help preserve muscle mass during the transition. It won't replace lifting, but it may slow the loss.
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The latest trick making the rounds is “metabolic confusion.” Alternate high and low calorie days… and supposedly “trick” your body into burning more fat. At least, that's the pitch.
Here's the grain of truth… cycling calories can make a diet feel easier to stick with. But research shows it works no better for fat loss than a steady, boring deficit. And it does nothing about the real problem, the muscle that left.
You can't confuse your way out of lost muscle. Build it back.
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The words to bring to your appointment
“I've gained weight without changing how I eat. Can we [NEED: a test that measures hormones, as body composition cannot] and talk about whether muscle loss and hormones are part of this?”
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Of course, thyroid and blood sugar and sleep all play a part too. Get those checked. But if nobody has talked to you about muscle, now you know where to start.
Start with the weights…
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Are you eating the same but gaining anyway?
Just a quick poll. Your answer helps me choose what to cover next.
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We'll figure out the rest together.
— Diane
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P.S. You don't need a gym. Two cans of soup, held at your sides, ten slow squats in the kitchen. That's resistance training. Your muscles don't care where the weight comes from.
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