Unlike in our younger years when our metabolisms were working overtime, we can’t wake up on a Monday, hoping for a quick five-pound weight loss by Friday. “As we age, the biggest change we see is a decrease in metabolism, especially approaching our mid-40s,” says Pittsburgh plastic surgeon Jeffrey Antimarino, MD. As our metabolism stalls, it becomes more difficult to lose excess fat. “Hormonal changes are also at play,” he explains. “Women, especially in their late 40s, start becoming perimenopausal and menopausal. This is when estrogen dips and they start to store fat in areas they’ve never had before, mostly in the midsection and upper part of the abdominal wall.”
While we love good transformation stories, ones like Kim Kardashian’s rapid weight loss for the Met Gala draw ire for what some believe is an unhealthy approach. The star boasted dropping more than 16 pounds in less than a month. “The goal is to sustain the weight loss over time, so crash dieting is not a good idea,” says nutritionist Jennifer Hanway. “No one wants to hear it, but if you’ve been gaining weight for the last two years, you are not going to miraculously lose it in two weeks.” Hanway notes that “quick fixes” typically have an opposite effect: “Dropping your caloric intake too much reduces lean muscle mass and lowers your metabolism. It can also lower thyroid function, both of which can slow your weight-loss results.” Here, pro tips for slow and steady weight loss that wins the race.
The Food Factor
Feeling too overwhelmed to start Keto, Paleo or intermittent fasting? Follow these simple steps to make healthy changes.
01: Cut It Out
Reducing or eliminating highly processed foods is the best starting point. “Highly processed foods—candy, chips, cereal, baked goods and even some ‘healthy’ energy or protein bars—are full of sugar, refined carbs and unhealthy fats that can lead to blood sugar imbalances, weight gain and increased inflammation,” says Hanway. “Replace them with whole food options like proteins, vegetables, nuts, seeds, and cellular carbohydrates.”
02: High + Low
A low-carb, high-protein diet with healthy fats and vegetables helps to jump-start weight loss. “It balances blood sugar, boosts metabolism and switches the body into fat-burning mode, even when nothing else has worked before,” Hanway says.
03: Sleep, Walk, Relax
Catching more Z’s can help increase insulin sensitivity and balance blood sugar, leading to reduced cravings for high sugar and high carb foods the next day” says Hanway. “Walking and stress management also help balance blood sugar levels, leading to lower insulin secretion and less fat storage.”
Fitness Focused
You don’t need ClassPass or a high-tech spin bike to trim down. Celebrity fitness trainer Erin Oprea shares her best tips to get moving and feel the burn.
01: Where to Start
“Walking! It sounds silly but you need to get into a movement mindset. Go outside and get some vitamin D. It will make you feel good, too!”
02: How Often and How Long
“Start with three to four days of walking for 30 minutes. As you get comfortable with this routine, up the intensity—jog, run or add more cardio. Easy isn’t effective. Nothing grows in comfort.”
03: To Lift or Not to Lift
“Don’t be scared of weights or strength training. The more muscles you have, the more calories you burn at rest!”
04: Home Gym
“Ditch the workout devices and pick up dumbbells. Apps like mine, Pretty Muscles, include cardio and strengthtraining workouts you can do at home with minimal equipment. Just start. That’s the most important part.”
New Weight- Loss Drugs
For those struggling to maintain a healthy weight, New York endocrinologist Judith Korner, MD says these new medications have proven to be more effective than anything we’ve had before.
Ozempic / Wegovy (Semaglutide)
Although both drugs are made from the same manufacturer and contain semaglutide, they’re licensed to treat two different conditions: Ozempic was created to treat Type 2 diabetes, and Wegovy was created for weight management once weight-loss results were noted. Both are administered as a once-a-week injection in the abdomen, thigh or upper arm, and possible side effects include nausea, diarrhea, indigestion, inflammation of the pancreas, and thyroid tumors. “Semaglutide has been around for several years,” says Dr. Korner. “It was developed as a diabetes drug and mimics a hormone our body makes when it senses there is food in the intestine, helping the pancreas make insulin when glucose levels are high. It was later found to slow down gastrointestinal motility, helping us feel full and acting on appetite centers in the brain.”
Qualifying BMI: 30 or higher; or a BMI over 27 with at least one weight-related condition
Possible Results: “In a trial, about 50 percent of people treated with semaglutide lost at least 15 percent of their body weight,” said Dr. Korner.
Mounjaro (Tirzepatide)
FDA-approved this spring for type 2 diabetes (not obesity or weight loss) Mounjaro is made of tirzepatide, and like semaglutide, it mimics hormones that stimulate insulin release and regulate blood sugar; it also signals the brain that you’re full. It has the same list of possible side effects as semaglutide, too. The drug is showing promise in clinical trials and Chicago, IL bariatric and lifestyle specialist Neha Shah, MD says this weekly injection is turning out to be a game-changer.
Qualifying BMI: 30 or higher
Possible Results: “The average weight loss achieved in the clinical studies was more than 20 percent of total body weight, which is comparable to what we see in bariatric surgeries,” says Dr. Shah.
Plenity (Cellulose and Citric Acid)
FDA-cleared as a medical device, this twice-a-day pill is made from naturally derived modified cellulose and citric acid. “It’s a really cool concept,” says Dr. Shah. “It works as a fiber matrix, and when you take it before a meal, it expands to about 100 times its size, mimicking the effect of eating two extra cups of food.” However, side effects may include diarrhea, distended abdomen, infrequent bowel movements and flatulence.
Qualifying BMI: 25 and above
Possible Results: In a clinical study, 6 out of 10 participants lost at least 5 percent of their total bodyweight. Dr. Korner notes the average weight loss is around 6.5 percent.
Fine-Tuning Results
Once a healthy weight has been achieved, these noninvasive and surgical options help reshape the body even further.
Radio-frequency treatments like BodyTite, EON and SculpSure deliver focused heat that can help reduce fat. “They are good for targeted volume reduction and mild skin tightening. Most patients will need more than one session,” says Richmond, VA plastic surgeon John Zinsser, MD. Other treatments, like Emsculpt NEO and truBody, add muscle building to boost strength while targeting fat.
While nonsurgical solutions can be beneficial for the appropriate patient, results can be temporary. The gold standard for long-lasting fat reduction is liposuction. “To eliminate larger pockets of fat along the waistline, back, arms or legs, I combine ultrasonic VASER lipo with power-assisted liposuction, which has a rapidly vibrating cannula,” says Dr. Antimarino.
New York plastic surgeon Roman Rayham, MD says patients can address skin laxity after weight loss with breast lifts, tummy tucks, bodylifts, and arm and thigh lifts. “Surgery works best to create a more sculpted look by eliminating fat and excising sagging skin.” New York plastic surgeon Daniel Y. Maman, MD says wait a year after maintaining a stable weight and cautions not to treat the arms and thighs at the same time: “Typically I’ll combine surgeries, but treating the arms and legs together reduces mobility during recovery.”
