Why She Struggled Despite Doing Everything Right and Understanding Body Changes
- Mar 24
- 6 min read
Written by Nelum Dharmapriya, Doctor & Health Coach
Dr. Nelum Dharmapriya is a Brisbane-based GP with a special interest in metabolic health, menopause, and lifestyle medicine. She combines 30 years of clinical experience with a personal passion for helping women thrive in midlife and beyond.
As women age, they often face the challenge of aligning their health strategies with a changing body. Understanding the physiological shifts that occur after 50, especially in terms of food, fasting, and brain health, is crucial for maintaining vitality and mental clarity.
Rethinking food, fasting, and brain health after 50
For most of my adult life, I thought I was doing everything right. I exercised regularly, often trained on an empty stomach, and tried to eat well, stay disciplined, and follow what I believed was “healthy.” And for years, it worked. Until it didn’t. Somewhere in my late 40s and early 50s, things began to shift in ways I couldn’t quite explain at first. Sleep became lighter, recovery took longer, and energy felt less predictable. The things that had always kept me well suddenly weren’t enough. It wasn’t a lack of effort. It was physiology. And once I began to understand that, everything changed.
The conversation no one is having properly
Women over 50 are surrounded by conflicting advice. We’re told to fast, but also not to fast. To eat early, but also to fit into family life. To train hard while also reducing stress. It’s no wonder so many women feel confused. What I’ve come to realize, both personally and through my work, is that the question is not, “What is the right diet or routine?” It’s, “What does this body need right now?” Because the answer is not the same for everyone.
The woman who feels out of control around food
I see her often. She’s busy, capable, and used to looking after everyone else. Somewhere along the way, her own health slipped quietly into the background. She finds herself grazing in the evening, feeling tired in the afternoon, and wondering why her weight, particularly around her middle, has crept up despite her efforts to lose it.
When we look a little deeper, we often see the same pattern. Her body is constantly exposed to food, and her insulin levels rarely get a chance to fall. Over time, this can lead to insulin resistance, where the body becomes less responsive to insulin, making fat loss harder, energy more unstable, and cravings more persistent.
For her, the issue is not a lack of discipline. It’s a lack of metabolic space. When we gently introduce structure, often something as simple as finishing dinner and allowing a longer overnight break before the next meal, things begin to shift. Hunger settles. Energy stabilizes. The constant pull toward food softens.
In this context, fasting becomes less about restriction and more about restoring metabolic rhythm. I explore this further in Fasting for Women Over 40: Fuel or Fast, where the focus is on using fasting appropriately for women who are metabolically overloaded rather than under-fueled.
The woman who is doing everything “right”
And then there’s another woman. She’s lean. She exercises regularly. She strength trains. She’s disciplined, motivated, and doing everything she’s been told is “optimal.” She often trains fasted. She fasts for long periods. And yet she doesn’t feel well. She feels tired, sometimes wired at night, and not recovering the way she used to.
This is where the conversation shifts. Because her issue is not excess. It’s under-fueling. And when under-fueling is combined with fasted training and high-intensity exercise, it creates a very different physiological response.
One of the most important concepts I’ve come across, through the work of Stacy Sims, is the idea of “fueling for the activity at hand.” When a woman lifts weights, sprints, or pushes her body hard, she is creating a stress that should lead to adaptation, stronger muscles, better metabolism, and improved resilience. But if that stress is layered on top of insufficient fuel, the body doesn’t adapt. It compensates. Cortisol rises. Recovery slows. Sleep becomes disrupted. Progress stalls.
For this woman, the answer is not more effort. It’s better support. Often, simply eating around training, particularly before or after higher-intensity sessions, can dramatically improve energy, recovery, and results.
The pressure to be perfect
Then there is a quieter struggle I see in many women. The desire to get it exactly right. To eat at the “perfect” time. To stop eating early in the evening. To align perfectly with the circadian rhythm. And yet, life doesn’t always allow that.
Dinner, for many of us, is the only time the family comes together. It’s when conversations happen, when we pause, when we connect. When women try to override that in the name of health, something else begins to suffer. Not physically, but emotionally. And that matters more than we often acknowledge.
There is good science behind eating earlier in the day. Our bodies tend to be more insulin sensitive earlier, and hormonal rhythms support metabolism during daylight hours. But in real life, the difference between eating at 6 p.m. and 7:30 p.m. is often far less important than what happens afterward. It’s not dinner that causes the problem. It’s the quiet, unstructured eating that follows.
I’ve explored this balance between physiology and real life in Circadian Rhythm Eating for Women Over 40, because health has to work within the context of family, culture, and connection.
The piece that changed my thinking
Perhaps the most surprising shift in my own understanding has been around something I had completely misunderstood for years, lactate.
For most of us, lactate was something we were taught to avoid, a sign of fatigue or failure. But we now understand that lactate is something quite extraordinary.
When we move our bodies with intensity, when we lift something heavy, climb a hill, or push ourselves for short bursts, our muscles produce lactate. And that lactate doesn’t just stay in the muscles. It travels. It becomes a fuel. And, importantly, it becomes a signal to the brain.
Research suggests that lactate stimulates the production of brain-derived neurotrophic factor, or BDNF, a compound that supports memory, learning, and the growth of new neural connections. This matters deeply when we consider that, in Australia, dementia is now the leading cause of death in women, and that women are about twice as likely as men to develop Alzheimer’s disease.
It reframes exercise completely. It is no longer just about weight or fitness. It is about protecting the brain.
I explore this further in Brain Health for Women Over 40: Why Lactate Matters, because this is one of the most powerful and often overlooked reasons women need strength and intensity in midlife.
What about ketones?
At the same time, there has been increasing interest in ketones, another alternative fuel for the brain. Ketones are produced when the body shifts into fat metabolism, often during fasting or carbohydrate restriction.
What is fascinating is that in Alzheimer’s disease, the brain’s ability to use glucose becomes impaired, yet its ability to use ketones remains relatively preserved. This has led to growing interest in whether ketones may support cognitive function.
But this doesn’t mean every woman needs to be in constant ketosis. It simply reinforces something more important. The body benefits from having options, from being able to switch between fuels.
A different way forward
What I have come to believe, both personally and professionally, is that the goal is not perfection. It is flexibility. A way of living that allows the body to move between different states, fed and fasted, rest and effort, fueling and repair.
For many women, this might look like eating well, allowing a natural overnight break from food, moving regularly, and occasionally pushing the body hard enough to create adaptation. It’s not extreme. But it is powerful.
The conversation we need to be having
If there is one message I would want women over 50 to hear, it is this. You have not failed. Your body has changed. And it is asking for something different. No more restrictions. Not more effort. But more understanding.
Because the goal is not just to live longer. It is to remain strong, clear-minded, independent, and connected for as long as possible. And that requires a shift, from following rules to listening to physiology.
A gentle invitation
If this resonates with you, you’re not alone. So many women are trying to do the right thing, yet feel confused about what their body actually needs at this stage of life.
If you’re navigating these changes, whether it’s around fasting, fueling, strength, or simply understanding your body better, I invite you to explore more through our work at Whole Food Revolution. Or reach out. Sometimes, a simple conversation can bring clarity, direction, and reassurance that you’re on the right path.
Read more from Nelum Dharmapriya
Nelum Dharmapriya, Doctor & Health Coach
Dr. Nelum Dharmapriya is a Brisbane-based GP with 30 years’ experience in women’s health and metabolic wellbeing. Founder of Whole Food Revolution, she empowers women 40+ to reclaim energy and confidence through the three pillars of science, lifestyle, and mindset.
