Why you’re not losing weight after 45 (and what actually works now)

Are you eating healthy and exercising, but the scale refuses to budge?

In this episode, Dr. Orlena reveals why everything that worked in your 20s and 30s suddenly stopped working—and it's not your fault. Your body fundamentally changed, and nobody told you the new rules.

Through the story of "Kate," a frustrated 50-year-old who suddenly gained abdominal weight despite living healthily, Dr. Orlebna unpacks the biological reality of perimenopause and menopause that's sabotaging your efforts.

In this episode, you'll discover:

• Why your body turned against you: How declining estrogen triggers four interconnected "fat begets fat" cycles—from muscle loss and insulin resistance to heightened cortisol sensitivity and gut biome changes—that make abdominal fat almost inevitable without intervention
• The hidden key nobody talks about: Why mindset isn't just motivation fluff but the determining factor between giving up in frustration and confidently navigating the journey, especially when progress is happening but invisible
• The four-pillar system that actually works: How to reverse these hormonal mechanisms without deprivation through strategic nutrition, intensity-focused exercise, sleep optimization, and stress management that matches your body's new reality

If you're tired of feeling frustrated, overwhelmed, and betrayed by your body, this episode will help you move from confusion to clarity and from self-sabotage to confidence.

It's time to stop fighting your body and start working with it.

Sign up for the Stop Dieting and Start Thriving Video:

https://www.drorlena.com/stop-dieting

Looking for support? Book a free call with Dr Orlena: http://drorlena.com/book-a-call-dr-o

Transcript

Introduction: The Struggle with Weight Loss
---

Speaker: You are eating healthily, you are exercising, but the scale just won't move. It's so frustrating, isn't it? And the truth is, it's not your fault. Your body has changed and no one told you how to work with it. Welcome, welcome to Fit and Fabulous with me, Dr. Orlena. Today I want to talk about if you are 40, 45, reaching that perimenopausal and beyond stage.

The scale won't go down. What is going on and how you can change this. And I know that I did a large series in September with quite a lot of long videos, which really dived into everything that you need to know. But I thought I would recap and do a similar thing on the podcast and the YouTube channel, but in a shorter, more succinct way.

So this is what we're talking about today, an overview of what is going on. 


Meet Kate: A Case Study
---

Speaker: Let me introduce you to a client of mine who I am going to call Kate. That's not her real name, but I just like to [00:01:00] change names. So when I first met Kate and she had her what I call discovery or clarity call, which if you would like one, you are more than welcome to book.

And during that call, what we do is we look at the story of what has happened to you. Where to get to where you are and think about where you would like to get to and why that isn't happening and what some of the keys are. So Kate had been skinny. She's now 50, and she had been skinny in her twenties and thirties basically up until two years ago and two years ago.

Weight just went on. She wasn't doing anything different. She was exercising, eating relatively healthily and thinking, wait, what is going on? I'm just leading this relatively healthy life, and suddenly everything seems to have changed. I can see this abdominal weight coming on, and I don't understand what is going on.

And I will tell you what her keys [00:02:00] were in the moment. So actually one of them was stress eating, but that wasn't the only key. Really where she found herself was in this place that she called frustration and self-sabotage, which leads to overwhelm. There's so many different things that I could do, and the internet tells me so many different things.

Which of these things should I do? How do I move forward from this? So being in this place of frustration, overwhelm, self-sabotage, and just. Feeling oh, how do I solve this thing? So some of the keys that we identified with her were hormones. I'll tell you about hormones and how that has a huge great impact on your body.

In a second, stress eating and sleep. And another one that we talked about more, which we didn't identify right at the beginning, is mindset. And the more I work with people, the more I am convinced that mindset is this hidden key, that if you do not address mindset, you will end up giving [00:03:00] up, particularly when the road is not always smooth.

Now, when I work with people, it's really interesting to see that some people. They have what I call a lucky journey in that you make changes and you get results quickly, and that helps motivate you. But there are some people who don't get those changes quickly because they're invisible changes, which I'll explain in a little minute.

They aren't making improvements, but they can't see them in the way that they expect to see them. And that leads to frustration as well. So one of the really big pieces is. Is mindset and understanding how your body works. It's partly understanding how your body works, but it's also understanding how your brain works.

Now, where Kate wanted to get to was confidence, and it's partly confidence in yourself, but it's also confidence in knowing that I am doing the right stuff for me. I can forget about what everybody else is doing, and I know that this is what my body wants and this. Is what I just need to keep doing. And it's easy.

I [00:04:00] don't have to think about it. Hooray. 


Understanding Hormones and Menopause
---

Speaker: So today I want to have a little think about hormones because hormones are a really big player in this picture, and I think a lot of people don't understand the huge impact that hormones has. And it's not all doom and gloom. It's not okay, your hormones change and that's it.

You just have to put up with this new state of affairs. But if you can understand and understand the new rules that are there, then you can work with your body and with your mind. And that may mean rewriting your expectations. That does depend, and it's difficult to predict exactly what that looks like.

Okay, so what happens to your hormones? Menopause basically. So when we think about menopause is the time that. Our body changes. So when we're in our teenage years, we have these introduction of what we call sex hormones. So estrogen, progesterone, because we are [00:05:00] fertile, we want to reproduce.

And so we have this monthly swing of estrogen and progesterone, and as estrogen goes up, progesterone comes down. It's almost like a little sea salt. Now when we reach sometime normally around 45 to 50, there's five years of what we call perimenopause, and that is when instead of having this nice regular seesaw, things start to become a little bit more erratic.

So that perimenopause stage can be. Too much estrogen or too little estrogen, or when I say too much or too little, more or less until we get to this stage where our estrogen and progesterone basically go down. And we stop having periods. And the year after our last periods, we say that is menopause.

And after that time, we have very much less estrogen and progesterone. There are little bits, but they're not having the same role as they used to have in our body. And that is now we are menopausal. This is the state. Of our life moving forward, this is it. We are not gonna change again. And now [00:06:00] we have to get used to not having those sex hormones.

And those sex hormones have a huge, great impact on not just reproduction, but all of our body. So actually estrogen is very protective. So as our estrogen goes down, it actually protects our heart and it protects our brain and it helps improve muscle mass and bone density, and it helps boost our mood and we are losing all of this estrogen.

So n now suddenly we have to start thinking about doing things in different ways. Now there are what I call the fat begets fat cycles. Now, first thing we need to consider is from the age of 30, we start losing our muscle mass from the age of 30. Yes, I know it's a shock, isn't it? And why is this important?

Muscle is. Really important for longevity. It is what has been coined. The lge, excuse me, longevity organ. It is really important. It's [00:07:00] almost like the difference between when we get into our eighties, nineties, the difference between independent living or assisted living. It is the thing that allows us to.

Do all the things that we want to do every single day. When our muscle mass gets too little, we get frail. That's when we get old. So I always think, when do we get old? We get old when we get frail. We get frail when we don't have enough muscle to be able to do the things that we want to do. And that really marks a.

Okay, now I'm no longer independent. It's all related to Muscle. Now, on top of that muscle not just allows us to do things and be mobile and walk and all of these things, but it actually has positive effects as well. So it has positive effects on our body composition. It helps us burn fat more. So all kinds of things that are gonna impact your body composition.

So we want muscle. We don't want abdominal [00:08:00] fat. We do want muscle. And I understand that a lot of people like want to feel aesthetically good in their body, and I know that society has told us this. Sold us this image of we need to be lean and thin. And that's, what a lot of us aspire to. But actually when we're looking at it from a health perspective, we want muscles.

So it's not about losing weight, it's about losing abdominal fat. We want to be healthy and we want to be strong, and that means having strong muscles that we can use. Obviously we don't want too much abdominal fat because that is what we consider the dangerous fat. It increases our risk of things like heart disease.

However, having said that, there is a little bit of fat that we can have that is not dangerous from a health point of view, but some people don't like it. So it depends on what your goals are. We start losing muscle. Now, estrogen is the hormone that signals to our body, yet we want to have muscle.

[00:09:00] So men have testosterone. I have a 16, 17-year-old son. He's shooting up, he's getting strong. He's, his body is changing from little boy to big proper man. Why? Because he has testosterone. Now, women do have testosterone, a little bit of testosterone, not as much as men, but it doesn't have the same function for us.

For us, it's estrogen. Now, when we go through menopause. We lose fat estrogen. So we are losing that stimulus to create muscle. So if our muscle is declining and we now no longer have a stimulus to build it, what are we gonna do? Okay, I'll explain what we can do in a little bit. So we've got muscle going down.

On top of that, here are what I call the fat begets fat cycles. Number one, we become less sensitive to insulin. And what this means is. Fat. We have more insulin, which means we have more abdominal fat. So one mechanism that is basically promoting abdominal fat. [00:10:00] Number two, we become more sensitive to cortisol, which is our stress hormone, which means we have more abdominal fat, we're more likely to put on abdominal fat.

Now, abdominal fat also has four times as many cortisol receptors on it, so it's more sensitive. To stress than our abdominal, than our subcutaneous fat. So we get more sensitive to stress. We put on fat, which makes us even more sensitive to stress. We have a little bit of stress. We put on more fat. So it's almost like this vicious cycle of we get stressed, we put on abdominal fat.

And in my opinion, the stress piece is your mindset piece that I talked about earlier, and it is a. It's a difficult one to change in terms of it's much slower to change than, for example, if your problem is I eat in a way that is not healthy, I change my eating, you are generally going to see results more quickly.

[00:11:00] When it comes to stress. It's much slower. Partly because it's almost like you have to lose the fat. To lose the fat. I know, right? Like how does that work? So number two is cortisol. We become more sensitive to cortisol. Now, the third fat begets fat cycle is our bio, and what happens in our bio is essentially pre menopause.

Our Es, our ovaries release estrogen. Now that estrogen goes to your liver, and in your liver it gets coupled to something called sex hormone binding globulin. And when it's coupled to this thing called sex hormone binding globulin it isn't active. It then goes into your gut and there are some bugs there which decouple it.

Which basically make it active. So after it's been in your gut and been through this bug processing unit, it goes out and now it is [00:12:00] active in your body. But as we get declining estrogen, those bugs change because we no longer need those bugs. And even if you go onto hormone replacement therapy, it doesn't have, it doesn't use that same.

System. So now those bugs are not being needed and it changes the whole composition of our biome. And on top of that, quite often we have increased permeability in the gut barrier, which means that things, inflammation, inflammatory things are more likely to leak out. So this means, guess what? We are more likely to put on abdominal fat.

So we've got four things going on. We've got reduced muscular. Reduce it muscular mass, which means we are not burning fat in the same way that we are when we have got more muscle mass. On top of that, we have got in, sorry, decreased sensitive to insulin, increased [00:13:00] sensitivity to cortisol, and our biome is changing, and all of these mechanisms are basically working to.

Help you put on abdominal fat. So if we go back to Kate and go, okay, so well, I'm doing all of these things. I'm eating relatively healthily and I am exercising. What is going on? Those mechanisms are going on. So you might be doing all of these things. Yes, eating healthily, but with a little bit of stress eating, coming in there, and that's having a double effect because it, you are stressed and also you are stressed eating sugar.

People don't stress eat carrot sticks or apples. They stress eat sugar. So now you're stressed and you are increasing your refined sugar intake, which is now driving into that mechanism for your glucose, your insulin, and your glucose. So although the vast majority of things stay the stay, there are some bits that are changing.[00:14:00] 

So what are you going to do about that? The good news is there are things that you can do. You can reverse these mechanisms. And when you reverse them, you can lose the abdominal fat. What do you need to do to reverse them? So the way I teach people, and when we look at what does science say?

What I'm taking is the science that we know and putting it into a system. So I will just give you a brief outline now. 


The Four Pillars of Health
---

Speaker: So I teach people four pillars. We have got pillar one nutrition. We don't want to be depriving ourselves. The idea that. We starve ourselves. Go into a calorie deficit. That basically can mean that you end up using your muscle mass as an energy source, and that is not what we want.

That is not a great place to be. So we are thinking about fueling our body with healthy plant-based proteins. That doesn't mean you can't eat meat, it means that you're getting. Plants and meat. If you want to [00:15:00] have meat, you don't have to have the meat, but if you want to, you can. So you're thinking about fiber, you're thinking about protein, and you're thinking about fueling your biome.

So you want to have a healthy biome. You want to be looking at that glucose. Mechanism, you don't want to be having lots of sugar because that is just going to feed that glucose mechanism in a negative way. So nutrition pillar number one is nutrition. Pillar number two is exercise. And we want to think about things that we enjoy doing because that means that we are gonna carry on doing them.

But we also want to think about building our muscle. Which is resistance training, going to the gym and doing some weights. We also want to think about high intensity and sprint because A, this is gonna keep us fit and it's super fun. And secondly, it's gonna help you with breaking that glucose cycle. So intensity is a really important thing when this is really good news, because it means you don't have to spend hours and hours doing exercise.

It's [00:16:00] more about intensity than it is about hours and hours. Pillar number two, exercise, sleep. Pillar number three is sleep. And so many people overlook sleep. So many people say to me, yeah, I know I don't get enough sleep. Oh, I don't get enough sleep. And then it's okay, you realize you don't get enough sleep.

How are you going to prioritize your sleep? And sleep is such an amazingly simple thing to do. It's really important your growth hormone goes up when you're sleeping. Which helps you burn fat and build muscle. So super easy. All you have to do is go to bed. I know, right? Why don't people do it? And then your last pillar is thinking about stress, emotions, and stress really is how we think about things.

Two, people can be in the same situation, two people late for work in a traffic jam. The same job. Thinking about things in a different way. One of them is thinking, oh my goodness, I'm gonna be late. It's gonna be a disaster. They're feeling stress. Somebody [00:17:00] else thinking, oh my goodness, I'm so happy I'm late.

I hate that first meeting that I have Anyhow, and now I've got a perfect excuse not to go, hooray, or I can listen to Dr. Lina's podcast. You can see how the way they think about them is going to impact how they're feeling. One is feeling happy, one is feeling stressed, so understanding how your brain works.

Is the key to reducing stress. I say reducing because I don't think it's possible to eliminate stress from our life, but we can definitely reduce it. And on top of that mindset piece, once you understand how your brain works, it gives you. The ability, the skill to be objective about what you're doing.

So for example, if you're saying, oh my goodness, I'm doing this one thing and it's not working, it's A, is it truly not working? And B, if it isn't working, what are you going to do about it? Instead of, oh no, oh my goodness, this isn't working. It's all hopeless. Frustration, overwhelm. When I take you back to the story of Kate, what she is [00:18:00] feeling is negativity.

Frustrated, overwhelmed, self-sabotaging as opposed to being in positive brain, being in that productive place of going, yeah, I know what to do. I've accepted this situation, and I am going to move forward. So those are the four things that you really need to work on. Nutrition, exercise, sleep, and stress, stroke emotions.

So easy and so fun. Okay. 


Conclusion and Next Steps
---

Speaker: In the next video we or podcast, we will talk a little bit more about nutrition. In the meantime, if you would like a succinct overview of everything that I teach, then I invite you to sign up for my free video, which is called Stop Dieting and Start Thriving. When you have watched that video and you think, okay, I get all of this.

I need some help implementing it. Why do you need help? It's quicker when you've got help. It's easier when you've got help. It's more fun when you've got help. I want some help. Then I invite you to book a call and if you sign up, it will send you out emails. It will send you the video and then it will send you a link to [00:19:00] say, would you like to book a call.

Have a fabulous week and I look forward to chatting with you in a couple of weeks time. Goodbye.