Sarah Di Lorenzo: Why eating less & skipping meals doesn’t work for women over 35

So many women come to see me wanting to get to a healthy weight quickly, and one of the most common strategies I still see is skipping meals and eating less and less.

It feels logical, but for many women over 35 it’s usually ineffective and, in many cases, completely counterproductive.

In the real world, I see this pattern drives more fatigue, worse appetite control, loss of lean muscle and, over time, poorer weight and health outcomes — especially in women already juggling early perimenopausal changes, high stress, broken sleep or low muscle mass to begin with.

From the mid-30s onward, our hormones start to shift. Oestrogen and progesterone can begin to fluctuate years before any obvious signs of perimenopause. Those changes don’t just affect periods — they can influence how we handle sugar, how hungry we feel, how we sleep, our mood and where we tend to store fat.

For many women, this shows up as more weight around the middle, even when nothing else seems to have changed.

Layer on to that the natural age-related decline in muscle mass and the fact that many women aren’t doing regular resistance training or eating enough protein, and you can see why the “just eat less” approach doesn’t work the way it did at 25.

Muscle is metabolically active tissue. It helps determine how many calories you burn at rest, how well you handle glucose and how resilient your metabolism is.

As lean mass drops, your baseline energy needs might go down a little, but what really suffers is metabolic flexibility and blood sugar control. In that context, aggressively cutting calories or constantly skipping meals doesn’t fix the problem — it tends to make it worse.

We also have to think about how the body adapts. When you keep your intake too low for too long, your body reacts by turning down the dial on energy or calories burned.

This is called adaptive thermogenesis and it means you’re burning fewer calories than you’d expect for your size. That’s our survival mechanism, not failure on your part. Women often tell me, “my metabolism is broken” but in reality, their body is doing exactly what it’s designed to do in a perceived famine — conserve and store.

Another problem is what happens to your body composition. If you’re under-eating — especially not getting enough protein — your body is far more likely to break down muscle as well as fat.

For women in midlife, that’s the opposite of what we want. Preserving muscle is critical not just for how you look and how clothes fit, but for insulin sensitivity, day-to-day strength, bone health, and healthy ageing.

Weight loss that comes with a big loss of lean mass is definitely not a good trade-off.

Skipping meals tends to magnify all of this. Some people can cope well with longer gaps between meals but many women in their late 30s, 40s and 50s don’t. They report feeling more hunger, more cravings, less willpower, poorer food choices later in the day and real difficulty hitting their protein targets when they’ve cut out a meal.

Long stretches without food can leave you feeling wired, tired and then ravenous. This often leads to overeating in the evening and reaching for quick, energy-dense foods.

Clinically, I see the same story over and over. Very little food during the day, then grazing and picking from late afternoon into night, followed by huge frustration because they feel they’re “hardly eating” yet still not losing weight.

Chronic food restriction, on top of a busy, high-pressure life and poor sleep, can keep cortisol higher for longer.

Cortisol isn’t the bad guy but in the wrong context it’s linked with increased appetite, poorer blood sugar control and more central fat gain in susceptible women and this is often called the cortisol belly.

So the very strategy that was meant to shrink your waistline can end up nudging things in the opposite direction.

A far more effective approach in this life stage is to focus on metabolic stability and muscle first, then create a gentle, sustainable and sensible calorie deficit if weight loss is a goal.

What this looks like is regular meals, a solid protein hit at each one, resistance training, plenty of fibre and an overall pattern that keeps blood sugar steady and you feeling satisfied.

I strongly encourage not skipping breakfast or your first meal, keeping dinner the smallest meal of the day and eating in line with your circadian rhythm, because our hormones are closely tied to that internal clock.

For women over 35, especially in midlife, constant under-eating and meal skipping usually fan the flames of the very issues that make weight harder to manage in the first place. The real work is in fuelling properly, protecting your muscle and supporting your metabolism, rather than punishing it.