• Posted December 26, 2025

How to Fight 'Middle-Age Spread'

A steady uptick on your scale is a nasty side effect of middle age.

Most adults in the U.S. put on 10 to 25 pounds between their 20s and their 40s — and there’s more bad news about this "middle-age spread."

As you age, it gets harder and harder to do much about it.

"Your metabolism tends to slow down as you get older, but your appetite and your food intake do not," said Rafael de Cabo, an expert on aging at the National Institutes of Health (NIH). 

The result: "You have a steady increase of body weight with age."

The consequences go beyond needing bigger, baggier clothes. As you age, your risk for heart disease, diabetes and neurodegenerative disease rises — and excess weight intensifies the risk.

So what causes this insidious gain and what can you do about it?

Understanding some basic biology may help. Much of this added weight is, not surprisingly, fat tissue, and that fat tissue begins to shift.

By middle age, there’s less under your skin and more around internal organs, replacing lean muscle. If you have a desk job or tend to be inactive, more muscle will be lost and more fat gained.

"The key is to maintain an active lifestyle," de Cabo told NIH News in Health.

Make it point to take a walk every day or go to the gym. Get a standup desk if you have an office job and spend a few hours every day standing instead of sitting.

"Small doses of exercise throughout the day will help tremendously," said de Cabo, who studies the effects of diet changes on health and longevity.

One strategy he suggests is intermittent fasting, in which meals are interspersed with long periods without eating.

One way: Limit food intake to eight hours a day.

It works for mice in de Cabo’s lab. He’s shown that the critters live longer and stay healthier with long periods between meals. 

And that’s proved true even when the mice eat the same amount and types of food as usual.

To help fight middle-age spread, the NIH recommends:

Eat healthy: Go for fresh veggies, fruits, whole grains, eggs, seafood, lean meats, legumes, nuts and seeds.

Hydrate: Drink plenty of water. 

Don’t smoke or drink: Avoid tobacco and alcohol.

Get moving: Try to log at least 150 minutes of moderate activity every week. Add walking breaks to your day and take the stairs.

Sack out: Get plenty of sleep.

See your doctor: A regular physical will help identify health problems early on when they are easier to treat.

More information

For tips to manage midlife weight struggles, visit UCLA Health.

SOURCE: National Institutes of Health, News in Health, October 2025