In a video published on his Instagram account (@mehdi.medecine), Dr Mehdi Terki, a surgeon specializing in the management of overweight, discusses a common but still poorly understood phenomenon: the redistribution of fat as perimenopause approaches. Hormones, muscle mass, sleep and even stress help to gradually reshape the silhouette, even when eating habits remain unchanged.
“I haven’t changed anything“: when the body begins to store differently
This is a phrase that many women say during a medical consultation: “However, I eat like before”. Faced with this destabilizing observation, the temptation is great to question one’s dietary discipline or one’s level of physical activity. However, the explanations often lie elsewhere.
As perimenopause approaches, the transition period preceding menopause, the female body goes through a profound hormonal upheaval. Estrogen levels fluctuate and then gradually decline, leading to a series of metabolic adaptations that are sometimes invisible at first, but eventually show up in the mirror.
Dr. Mehdi Terki summarizes this phenomenon in a simple sentence: “Your body has changed where it stores”.
In other words, the problem is not necessarily a dramatic increase in weight. Sometimes it is the way in which the body distributes its energy reserves that changes.
The fat, previously more localized at the hips, thighs or buttocks, gradually tends to migrate towards the abdomen. Some of this fat is called “visceral” because it accumulates around internal organs.
“Objective measurements have shown it dozens of times, for the same weight, fat migrates towards the center around the age of 40.explains Dr. Terki.
This phenomenon is now well documented by research. The drop in estrogen directly influences fat storage and promotes a more abdominal silhouette. A change often experienced as brutal when in reality it results from progressive biological evolution.
Hormones, muscles and metabolism: the silent transformations of midlife
Fat redistribution is only part of the story, however. With age, other mechanisms gradually take hold. Insulin sensitivity tends to decrease, making the body less efficient at managing energy intake. At the same time, muscle mass naturally begins to decrease.
However, muscles play an essential role in daily energy expenditure. Even at rest, they consume more energy than fatty tissue. When they decrease, the basal metabolism gradually slows down. The body then requires fewer calories to function, which can promote fat storage even in the absence of major dietary changes.
This biological reality is often difficult to accept for women who have sometimes maintained the same habits for years. However, it reminds us of something often forgotten: the body of 45 or 50 years old no longer functions exactly like that of 25 years old.
This observation reflects neither a lack of will nor an error of behavior. It simply reflects a physiological adaptation to a new stage of life.
Understanding these mechanisms already allows us to escape from a form of guilt. Because faced with these changes, the response is generally not to eat less and less. On the contrary. Very restrictive diets risk accelerating muscle loss, thus aggravating the metabolic slowdown that they seek to combat.
Take back control without exhausting yourself: the three essential levers
So how should we act in the face of these transformations? For Dr. Terki, the priority is to first avoid the trap of excessive restrictions. The goal is not to further deprive an organism already experiencing hormonal changes, but to preserve its ability to function effectively.
The second lever concerns the maintenance of muscle mass. Resistance exercises – strength training, work with weights, body weight exercises – combined with sufficient protein intake are particularly important tools at this time of life.
But the specialist also emphasizes two factors often relegated to the background: sleep and stress.
“Sleep and stress matter as much as the plate”he emphasizes.
This statement is far from trivial. Chronic lack of sleep disrupts hormones involved in regulating appetite and metabolism. As for prolonged stress, it promotes the secretion of cortisol, often nicknamed “stress hormone”. However, high cortisol levels are associated with increased abdominal fat storage.
In other words, the silhouette is not only built on the plate. It also reflects the quality of sleep, the level of psychological tension and overall hormonal balance.
This is why Dr. Terki encourages concerned women to raise these subjects with their doctor rather than remaining alone with their questions. Because behind a belly that is rounding for no apparent reason sometimes hides a simple but essential reality: the body is not “giving up”. He adapts.
Understanding this new hormonal and metabolic reality allows you to change your outlook on yourself. Not by trying to fight against your body, but by learning to support it differently. An approach that is often more effective, but also more caring, in a period of life where transformations are numerous and sometimes confusing.