Middle-aged spread and the erosion of self-esteem

We add between one and two pounds around our middles every year from the age 35 to 55

While most of us enjoy the summer months, the prospect of minimal clothing and increased bared flesh can feel like a dark cloud overhead. From baby bellies to mid-life spreads, the problematic pockets of fat that seem resistant to good diet and exercise can not only cause damage to health, but self-esteem.

Ask women going through menopause, or men of a certain age what the most difficult aspect of reaching mid-years is and they will possibly say onset of middle-aged spread.

Caused by a shift in hormone balance, mainly a dominance of oestrogen (in men as well as women), it predisposes the body to store fat around the abdomen, and research shows that, on average, we add between one and two pounds around our middles every year from 35-55.

"I was always a size 12," says 48-year-old Rebecca Byrne from Newbridge. "But following a hysterectomy three years ago I went straight into menopause. The doctor had warned me I would put on weight, but my whole body shape changed and I ended up a size 16. For a year I was so upset I wouldn't set foot inside a shop."


Middle-age spread is a reality for many menopausal women as hormone changes shift the location of fat deposits that are stubborn as hell. “I was exercising an hour every day for two years, and although I lost a bit of weight, the fat in my belly and back wouldn’t budge.”

Health risks of being overweight are well known. And while body positive is an important campaign to counter the modern day obsession with perfection, being unable to attain the body shape you feel happiest with can affect your self-esteem.

“It really affected me,” explains Byrne. “It was awful. I actually have nice enough legs and shoulders, but I had to buy clothes much bigger to accommodate my belly. I had always kept myself in good shape so developing this middle-age spread made me feel a lot older and I was depressed. I blamed myself for letting myself go, despite the fact I was eating well and exercising.”

Tracy O’Neill, a Dublin based counselling psychologist often sees people, in middle age, who are feeling at a loss with the changes happening to them. “The shift in body shape can affect self-esteem in both men and women, as they no longer feel they look the person they thought they were. Self-image is so low they can’t enjoy sex or relationships.”

For Byrne, cosmetic surgery wasn't an option but a new technique which arrived in Ireland in 2012 was.

With "fat-busting", non-surgical options becoming increasingly popular every year, Sabrina Crowe, a medical aesthetic practitioner, brought 3D-Lipo machines to Ireland. "The technique is really helpful for sculpting the body better," she claims. "Now it's much easier to get rid of those love handles, post-pregnancy pooch, or 'muffin top' comfortably, conveniently and safely. Losing abdominal and back fat through diet and exercise is practically impossible for many of us and this is particularly successfully in treating stubborn fat areas and cellulite."

Ask women going through menopause what the most difficult aspect of reaching mid-years is and they will possibly say onset of middle-aged spread. File photograph: Getty Images

The process, called cavitation, is usually carried out over a series of one-hour treatments. It involves using low-frequency ultrasound which produces a strong wave of pressure to fat cell membranes which apparently makes them disintegrate into a liquid state. The excess fat is then released into the space between the cells, where it is metabolised to glycerol and free fatty acids. The glycerol is then absorbed by the circulatory system and used as the energy source while the insoluble free fatty acids are then processed in the liver and kidneys and eliminated from the body.

However, is this really the solution to our growing obesity-related health problems?

Helen Heneghan, consultant bariartric surgeon at St Vincent's hospital, Dublin, who carries out two fat-reduction surgeries a week does not think so.

“While these procedures might make the person feel good because they look better, they don’t deal with the health issues related to obesity. Although they remove fat, it isn’t the deeper subcutaneous tissue which fits around organs such as the liver that are responsible for the dangerous health aspects related to fat.”

So not a health benefit, but a psychological one? “What I have seen over and over again,” says Crowe, “is that with initial fat removal, my clients are so delighted wth the changes to their body, that it is the impetus they need to get a healthy fitness and diet regime back on track”.

Byrne agrees that the initial fat loss gave her the drive she needed. “It’s been a real boost to my confidence and given me the motivation to keep it off. I’m not going to sit around and let it build back up so I jog every day now and the difference in myself is amazing. I’m a lot happier as the whole shape of my body is more like it used to be.”

For Byrne, it has changed the way she feels. “It gave me a head start and now I exercise every day, eat well and drink lots of water. I’m back to about a size 12 and back in the shops! At the time I didn’t realise how bad I felt, but I had no interest in buying any clothes because I would just come out in bad form and depressed. So I avoided it.”

Non-surgical fat removal is only effective if the fat does not go back on, and only healthy eating and exercise can achieve that. It also won’t affect any underlying health issues related to obesity. “It must be made clear that treatments like this are a temporary fix and do not deal with the root of the problem because it doesn’t target the deeper fat,” warns Heneghen.

“If that makes them feel better then good for them, but this is not a health solution, and the fat will re-accumulate really quickly if someone doesn’t change their behaviours.”

O’Neill agrees, but believes that “while it may not serve as a health benefit, it can be a motivational driver to stay active. In that sense, it might not be seen as vain, but as self-care. Making yourself feel as good as you can is an essential part of mental and physical health. It’s the same of dying your hair, which we don’t necessarily see as vain, but a feeling that we don’t have to go as nature intended.”