PROFESSIONAL ARTICLE

By: Dr. Vanessa Sousa Mendes | OM: 54464

Specialist in Preventive Medicine and Longevity | Physician at Timeless by Marta Padilha

Does fat accumulate more in the belly after 40?

“I haven’t gained that much weight, but my belly has changed.” This is a common phrase after the age of 40. The waistline expands, abdominal fat seems harder to lose, and for some women, a feeling of "bloating" also appears. It is not just an impression. After 40, the female body begins to change, but this does not mean that all women are already in perimenopause. Menopause occurs, on average, around age 51, and perimenopause, the transition period that precedes it, lasts on average about four years, although there is great variability.

Why does abdominal fat increase?

During perimenopause, hormones, namely estrogen, become more irregular and eventually decline. This change favors a shift in body fat distribution, with a greater tendency for accumulation in the abdominal region, including visceral fat, which is located around the organs. At the same time, with age, we tend to lose muscle mass. And less muscle also means lower energy expenditure. If we add less physical activity, sleep disturbances, and stress, we can see why it is possible to maintain similar habits and yet start to notice differences in the body.

But not all abdominal volume increase is fat!

Abdominal fat and abdominal bloating are different — and they can coexist. Abdominal bloating, what we usually call a "swollen belly," can be related to constipation, excessive gas production, changes in intestinal motility and microbiota, functional bowel disorders, food intolerances, or even certain dietary habits. Therefore, before trying to "lose the belly," it is important to understand what is actually happening: abdominal fat, bloating, or a combination of both?

What can we do to counteract these changes?

The solution is not simply to eat less. A balanced diet, with adequate protein, fiber-rich foods, and good hydration, helps to preserve muscle mass, control appetite, and keep the bowel functioning regularly. Strength training and regular physical activity are equally important for preserving muscle, controlling abdominal fat, and improving metabolic health. Sleep and stress management are also part of this balance. Sleeping poorly and living under constant stress can interfere with appetite regulation and make weight control more difficult. And when constipation, abdominal bloating, or other intestinal symptoms persist, it is important to understand the cause rather than simply cutting out foods or increasing fiber.

After 40, taking care of the body is also investing in longevity.

These changes should not be viewed as an inevitable consequence of age. An individualized assessment allows you to understand what is changing and act on factors such as diet, exercise, sleep, gut health, and, when necessary, the hormonal context. And the goal goes far beyond aesthetics. Preserving muscle mass, reducing visceral fat, and maintaining good metabolic health are fundamental to aging more healthily. Because talking about longevity is not just about living more years. It is, above all, living more years with health, autonomy, and quality of life.