Maggie McKay (Host): When you're younger, you hardly ever give weight loss a thought. But as we age, it gets harder and harder to shed those unwanted pounds. Today, Dr. Matthew Fourman, Director of Bariatric Surgery at ProMedica, will talk with us about what we need to know when it comes to losing weight after 40.

Welcome to Happily Ever After 40, a podcast brought to you by ProMedica, where we discuss midlife health and wellbeing. In this episode, we'll talk about losing weight after 40. Dr. Fourman, it's great to have you here today. Thanks for making the time.

Dr Matthew Fourman: It's great to be here. Thanks for having me.

Host: Well, it's a topic anyone over 40 can probably relate to. Why is it harder, so much harder to lose weight as we age? And we're not just talking about men or women, right? It's across the board.

Dr Matthew Fourman: A hundred percent. it's not a gender-specific problem. We all, as we get older, it just gets harder to shed those unwanted pounds. And even when we're younger, it's hard. But certainly, mother nature makes it harder the older we get.

Host: And how important is strength training as we age and what is it for people who don't know?

Dr Matthew Fourman: Absolutely. So, strength training, it's one of my passions because we are told all of our lives, and there is this myth that keeps getting perpetuated year after year, that if you want to lose weight and you want to drop fat and change your body composition, you need to do more cardio. And so, I battle this a lot in my practice with patients that get very frustrated because they're putting the time in at the gym and they're just not seeing that number go down on the scale. And so what I will ask them is, "Well, what are you doing when you go to the gym?" And, "Well, I get on the elliptical and I do that for 30 minutes. And then, I get off and I go home." And so, we have been told our entire lives that more cardio equals weight loss. And there's been a lot of interesting research done in exercise physiology over the last 10 or so years and we have learned that actually strength training. So at its core, it's lifting weights, but you don't have to go in lift really heavy weights. These can be done with exercise bands, your own body weight works. But doing some form of resistance training is absolutely vital for weight loss as we age.

One of the problems that happens with hormonal changes with age is we just naturally lose muscle. And that is a condition known as sarcopenia. All that means is decreased muscle mass. The problem with that is muscle tissue is very highly metabolically active. So, it actually raises our metabolic rate. And so as we lose muscle, our metabolic rate drops, which then is a compounding problem and makes it harder and harder to lose weight.

Host: That's interesting. I did not know that. I remember when I was little, my mom doing Jack LaLanne. I remember. Are you old enough to remember?

Dr Matthew Fourman: Oh, absolutely. one of the godfathers of resistance training. Absolutely.

Host: And he looked great until like 90, 100, whatever. So Dr. Fourman, what are a few daily habits that will help with weight management?

Dr Matthew Fourman: So, we hear this all the time and yet I think it, for some people, kind of goes in one ear and right out the other, but the importance of adequate hydration. One really easy thing to do is get a minimum of 64 ounces of water every single day. Water is a natural appetite suppressant. Our bodies are made up predominantly of water. And so in order to function in an optimal state, we have to be adequately hydrated. And so, that is a really easy, but very beneficial habit that should be a part of our lives.

The other thing is, and there's a lot of reasons for this, but we generally don't get enough sleep either. And we think of sleep as just something we have to do. But actually when it comes to weight loss, adequate sleep is really important. Your body uses the time that you're sleeping to rebuild muscle. So all that resistance training that we're doing now, we're going to see fewer gains if we're not getting adequate sleep. So traditionally, it's been six to eight hours of sleep every night. And I would say the research now is definitely leaning more towards that eight hours, which is necessary for both muscle function, but also for our overall health. If we are not well rested, we have higher circulating levels of a stress hormone called cortisol. And one of the effects of cortisol is to cause us to store fat. And so, we often undervalue sleep as a part of a weight loss regimen.

The other thing is to avoid liquid calories. So, one really, again, kind of low-hanging fruit here, how can we eliminate some things to help us lose weight. And liquid calories really are unnecessary. Most of your fluid intake should be calorie-free. So again, I like to try to give people very simple and attainable things that they can incorporate into their lives.

And then movement, okay? So, this is a tough one because some people, a lot of us nowadays have jobs that require us to sit a lot. But even if we can find a way to squeeze in three, 10 minute walks a day, ideally after a meal, if you can find a way to move your body, and just go for three 10-minute walks every day, I realize that's easier said than done sometimes, but that can be something that's really powerful at managing blood sugar and helping us maintain a healthy weight.

Host: I'm taking notes. I was doing so well. I'm like, "I do that. I do that. I do that." Until you said the liquid calories. So like, if you have a Coke a day, just get rid of it, right?

Dr Matthew Fourman: It's so hard because that stuff is so good. But, you know, calories should be something that our body can actually utilize for a purpose. And there's a whole other podcast that we could have on the dangers of soda and the soda that ultra-processed liquids. But certainly liquid calories, if you flip that can around and look at the nutrition facts on the back and the amount of sugar that those things contain, if we put the amount of sugar in food form versus liquid form and I showed you, "You think this is healthy if you looked at the food formula?", Oh no, you know, I would never eat four donuts, but we don't even think twice about drinking a can of soda. And you know, I'm guilty of that too. But it is a really simple way to decrease your overall caloric intake in a day.

Host: That's what my trainer said, and he's all into strength training, like you're talking about. And he's like, "Get rid of the coke. He said he had a client that dropped soda and he dropped weight," like amazingly fast.

Dr Matthew Fourman: I see patients like that all the time. The amount of soda consumption, it's remarkable. I have patients who, "Yeah, you know, I was drinking two two-liters of Mountain Dew a day." And then, they eliminate it. And I mean, it's almost instant. I mean, it's not, but it's almost instant weight loss because there's also a downstream effect of that. When you drink sugar, it makes you want to eat more too. So, it's not even just the calories from the liquid, it's also the subsequent food caloric intake that that stimulates. So, it's a double whammy.

Host: All right. Well, let's talk about the scale. Is it our enemy or our friend? Should we shift our focus away from the scale as a measure of health?

Dr Matthew Fourman: So, this is an interesting topic. And I think there's a balance, just like with anything. I'm going to try to be very political here. So, accountability is key. And that's true for many, many things, but especially with weight loss. Some of the most successful weight loss programs are much less about content and more about accountability. And so, I'm a big fan of using the scale as sort of an easy way to keep yourself accountable. But just like with anything, there can be a borderline obsession. So, it is certainly not the end-all be-all. And I can explain why.

So if you're doing all these things that we talked about, especially the resistance training, one of the things that I try to divert people's attention to away from just the number is your body composition. So, one of our goals shouldn't be to drop absolute numbers on the scale, but to change our body composition. So, we want to decrease fat and increase muscle tissue.

Well, as you can imagine, as we start to do that, the number on the scale might not really reflect what's going on. And so, I think some element of accountability is important, but also understanding the big picture. Another really good way to keep yourself accountable is take some measurements, measure your waist circumference, measure your arms, measure your thighs, because I will often see people who say, "The number on the scale isn't moving, but I'm still dropping pant sizes or shirt sizes." And that's just a testament to them doing some element of body recomposition, which is a very healthy thing. And so, I guess the answer to your question is the scale is important, but it isn't the only thing that matters.

Host: Do you think every day or once a week?

Dr Matthew Fourman: I'm very anti-every day. I don't want people weighing themselves every day. Once a week, and the other key to that is make sure it is the same day of the week, the same time of day, because we know this, right? Like if you weigh yourself at seven in the morning versus seven at night, there's going to be some differences. Even little things like making sure the scale is on the same place on the same floor in the same room of the house, I mean, little subtle things like that make a big difference. So once a week, I think, is adequate.

Host: Okay, great. In closing, is there anything else you'd like to share about how to lose weight after 40 or at least maintain it?

Dr Matthew Fourman: So, I think the biggest thing is consistency and we all want, myself included, we want a quick fix. I want a quick, easy five-step program. That's going to help me accomplish all of my fitness goals with little effort. And the reality is that's just not going to happen. So, we want to do things that are attainable and sustainable. So, I want to help people understand that consistency in little things every day, and that includes nutrition and exercise and all those things that aren't easy to do, but consistency is really key. And it becomes even more important as our physiology starts to change over the age of 40.

Host: Thank you so much again for this invaluable information. It's been eyeopening and very useful.

Dr Matthew Fourman: Thanks for having me. It was fun.

Host: Again, that's Dr. Matthew Fourman. And if you'd like to find out more, please visit promedica.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.

I'm Maggie McKay. This is Happily Ever After 40, a podcast from ProMedica. Until next time, stay happily ever after 40.