Menopause Weight Gain, HRT and Your Emotions with Dr. Meryl Kahan [Ep. 151]

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This is the Eat Well Think Well Live Well podcast.

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I am Lisa Salisbury and this is episode 151, menopause Weight Gain, HRT And Your Emotions with Dr.

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Meryl Khan.

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Welcome to eat well.

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Well, the podcast for busy women who want to lose weight without constantly counting, tracking, or stressing over every bite.

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I'm Lisa Salsbury, a certified health weight loss and life coach, and most importantly, a recovered chronic dieter here.

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You'll learn to listen to your body and uncover the reasons you're reaching for food.

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When you're not truly hungry, freeing you to focus on a healthier, more fulfilling approach to eating.

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Welcome back to The Eat Well Think Well Live Well podcast.

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I'm so excited to have Dr.

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Merrill Kahn here today.

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She is a board certified gynecologist Menopause Society practitioner And the founder of SHE md.

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So welcome Dr.

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Kahn.

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Why don't you introduce yourself a little bit more beyond that and tell us a little bit about what you do.

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Hi.

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Thank you for having me today.

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So I am, as you mentioned, board certified gynecologist.

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I was practicing OB GYN for about a decade before I opened SheMD in New York City, and SheMD is a direct care gynecology practice where I help.

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Women with all of their gynecology needs, and I have a particular interest in hormonal management, so whether that's perimenopause or menopause or even weight management, because it's something that I had noted in my, you know, decade of prior experience that a lot of women just weren't getting the help that they needed.

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And so prior to opening SheMDI became a Menopause Society certified practitioner.

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I did training in bioidentical hormone replacement therapy as well as weight management.

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And because it all kind of falls into the whole anti-aging and wellness theme, I also, um.

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Did a of training and got a board certification in medical aesthetics So I'm much a one stop shop for women, um, in the New York City area.

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Um, and I love what I do and I also do telehealth where appropriate, um, in New York and Florida.

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Awesome.

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Well, I know I have listeners in New York, um, so well, and Florida that, so that.

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That's available for, uh, telehealth, but also just thanks for sharing your wealth of information and, um, I hope the sound is okay because my neighbors are doing yard work and you just can't control that.

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So, oh, there, there, they're going away.

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Okay, so

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I'm in the heart of New York, so believe me,

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yeah.

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lots of sounds at all times.

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Well, let's talk about, I, I get lots of requests to talk about menopause perimenopause, uh, just the struggles that we have.

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Some to do with weight, but you know, there's a lot of other symptoms.

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Um, but let's start there.

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Why does weight loss feel so much harder in this midlife time?

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And I hear a lot, like the things I used to do don't work.

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I mean, we've all heard this and.

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It's like this weight came out of nowhere.

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Um, what else do I commonly hear?

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Just like I started having symptoms or like sometimes the weight, weight gain is the first symptom that they notice that they're kind of in that perimenopause time.

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And a lot of them too.

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A lot of my clients and listeners have been chronic dieters and so.

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As much as they wanna get away from that fad dieting, which I totally encourage, they also kind of have a knowledge of like what to do and what does work.

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and so they're like, why is this not working?

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It's so frustrating.

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Yeah.

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definitely the things that, worked for them in the past seem to overnight, no longer work anymore.

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Um, this is so common.

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Women will complain that, Um, you know, they haven't changed anything with their diet or if anything, they're eating even healthier now and they're working out.

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Just as much, but they cannot get rid of this stubborn five to 10 pounds usually in the abdominal area.

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Um, no matter what they do, and nothing's changed and they've never had to deal with this before.

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And it's, it's very frustrating.

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And with all the other symptoms going on with menopause, whether it.

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Lack of sleep or hot flashes or more irritability or brain fog, you know, you name it.

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But then having to deal with this too, which affects how they feel, but also now how they're physically seeing themselves.

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Um, so it's, it's a lot to handle.

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It's a big change.

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And so, you know, one of my jobs is to really talk with them about it.

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Also dig deep to try to figure out is this something that is due to an underlying hormonal issue?

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We can talk about the hormonal changes that happen, that contribute to this in particular.

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Um, and then work to try to balance everything so that they're able to get back to how they were.

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So What I have noticed is that getting on, um, menopause horal re hormonal replacement therapy or there's a lot of words.

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Most people just call it HRT hormone replacement therapy, um, bioidentical hormones.

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All of these are kind of really, we're talking about the same bucket of, of.

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Medication, pharmaceuticals, if you will.

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Um, it's my understanding that getting on those is not really a weight loss plan.

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That even when you get on hormone replacement therapy, it doesn't tend to shift weight.

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Would you agree with that?

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So I definitely wouldn't put somebody on hormone replacement therapy if their one goal is weight loss.

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It's not a treatment.

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For that, it's not approved for that.

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That's a really, uh, more in-depth conversation, what it is approved for.

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Um, but what we do know is that when you are on hormone replacement therapy, It can change your body composition that was altered when you entered perimenopause or menopause.

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and it can also improve your, muscle mass.

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We all lose muscle mass as we get older, and the muscle mass is so important for us to remain functional.

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It helps with our, you know, basal metabolic rate.

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Um, and so when we replace our depleted hormones.

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It can certainly help with the body composition.

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Um, I would say that more so than weight loss per se.

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Um, that being said, there is a study that shows that for women on semaglutide, um, also known as Ozempic, that the women who are also on hormone replacement therapy do lose about 30, 35% more weight.

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Than if they're on Semaglutide alone.

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Um, and so, you know, they do work together.

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But it is not in itself really a treatment.

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I mean, you might lose a few pounds on it alone.

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Sure.

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Um, but it's not a, quote unquote treatment for weight loss.

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Yeah.

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I think that's just so important to realize that just because we're going to like replace those hormones doesn't, yeah.

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That is not, it's not really in the class of weight loss drugs by any stretch of the imagination, but that's, that's fascinating that, um, in conjunction with the semaglutide, that, that, Um, I mean, 30 to 35% is a significant number.

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It is, I mean obviously it depends, like if you're going on semaglutide to lose 10 pounds, I don't know that you really need to be on Semaglutide, but you know, that would be an extra three pounds.

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Um, but if you do have a significant amount to lose 30%, that is a lot.

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Yes, for

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Yeah.

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That's, that's really good news.

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okay.

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So what do you think the, some of the things, symptom wise that legitimately make it harder to lose weight in midlife?

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Um, because there are some changes that happen, I mean, right off the top of my head, so I'm gonna kind of stare you a little bit here because.

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I know for one thing it's sleep, right?

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We're not sleeping well.

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And um, progesterone has really helped me with that.

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But, you know, it's not perfect.

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It's helped, but I'm still like, you know, still have a lot of awakenings in the night and things like that.

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Um, but when we're not sleeping well.

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It really can affect our weight loss because number one, we maybe don't have the energy.

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We're gonna move less during the day.

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Number two, you're gonna mess up your hunger hormones, leptin, ghrelin.

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So, you know, there's a lot reasons why sleep contributes to our inability, like poor sleep contributes to our inability to lose weight.

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So, along those lines, what else changes?

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And feel free to add more on the sleep aspect as well, but what else is happening in this midlife time that makes it harder?

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You took that one.

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Literally right outta my mouth.

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I mean, I think number one, well, number one is sleep.

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It is so important.

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Exactly as you're saying.

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If you're not getting enough sleep, you just cannot function.

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You can't be functional.

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And so if I wanna tell someone to out Even half an hour a day when women are already busy.

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Whatever they're doing, taking care of their home, taking care of their kids, going to work, you know, whatever it is so busy.

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So define the time to work out, either let's say at the end of a busy day or wake up even earlier to work out, you know, it's nearly impossible if you're not feeling rested or you're up throughout the night.

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So that one is so very important.

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Absolutely.

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Um, and then another thing that can affect the sleep too is the cortisol.

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Um, that's a stress hormone and a lot of times we don't really think about how the cortisol can impact our sex hormones and menopause, but It's really important to remember that these hormones are all connected and related, and cortisol is so important to help us manage acute stress so that you know back in the day if we came across a saber tooth tire, our cortisol is going to.

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Spike and that will help us run away.

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I'm sure we've all heard that before, but the problem then becomes when we're chronically exposed to high levels of cortisol, then it's no longer suiting us.

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But because we need that cortisol to survive, what happens is that, the sex hormones and progesterone and cortisol have the same precursor.

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So if we need the cortisol to survive.

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That precursor is going to get shunted towards making more and more cortisol to keep us alive as opposed to going down the pathway of making the sex hormones.

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and so it's really important to.

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That we manage our stress levels to keep the cortisol in check so that we don't have to keep producing more and more of it.

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And cortisol can also be responsible for us waking up in the middle of the night or not sleeping very well.

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Um, absolutely it can be responsible for like the sugar cravings.

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And mood swings and all that.

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It relates to insulin as well and the thyroid.

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'cause again, all of the hormones are connected and so it's very important that everything is balanced.

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And unfortunately with cortisol, there's no quick, I mean, I can't really give someone a prescription like I can for progesterone to fix it.

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So it is something that.

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Really takes a lot of, I would say, buy-in, you know, from the woman to work on things, whatever that may be for her that she finds will help, with stress reduction.

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So that could be going on a walk, that could be listening to relaxing music, that can be journaling, meditating, yoga, you know, you name it.

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But that's another thing.

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I mean, there's also some supplements.

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There's differing opinions on supplements.

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But they exist and they're helpful for some people, but by no means are they going to be sufficient on their own.

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So cortisol as well.

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I think it's so, um, tricky for a lot of us in midlife because we have teenagers.

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I don't know if you do, but, um, I do.

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And so our brains don't have the ability to distinguish the stress of the saber, the stress and this, and the danger of a saber tooth tiger and a mean girl.

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And, um, some of us have mean girls living in our houses.

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Yeah.

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You know what I mean?

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So, you know, it's like this strange case of, you know, you've got, um.

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Uh, perimenopause symptoms.

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And then you also have a child or children in, um, my case with two teenage daughters.

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One's out of the house now, but, you know, going through puberty and it's kind of a mean turn of events where we're at this age where we have, children, you know, that are also struggling with their hormones.

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And so and I'm not throwing my, my girls under the bus if you know me personally, you know, my girls are delightful, but we all have our moments.

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but I have talked to other clients who, you know.

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We have teenagers.

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And so it is, it's hard to be like, reduce your stress and you're like, what am I gonna do?

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Kick'em out.

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So, I find that to be, um, just of a, a challenge with this age range know, a, a challenging and often you're at the height of your career.

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Like there's just a lot of reasons that stress can be high.

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And so it's um, kind of one of those easier said than done things as far as reducing stress, but there some great tactics.

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yeah, like you said, I mean, for most women, when body goes through all these changes for women is the same time, you know, if you have kids that you happen to be, they happen to be in that stable tooth tiger or mean girl.

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So it's, everything's like piling on all at once for sure.

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And I know it's definitely easier said than done and that's why so many women do struggle with getting the stress portion, um, under control.

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I will say though, that when women are on hormone replacement, especially progesterone, they tend to report back that they find they're able to manage the stress better though, so they still have it.

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You know, the goal is not to remove all stress from your life because that will never happen.

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Um, but it's able to calm them down a bit more so that they're better able to manage it.

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Maybe not be as short, not be as irritable.

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Um, and so, you know, that helps too.

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But another thing in terms of, what changes can happen is the estrogen also, we all know estrogen drops tends to drop vader, then the progesterone.

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And one thing estrogen does is it really helps with the insulin sensitivity.

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And so insulin sensitivity helps with your blood sugar.

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And so when you have less estrogen, then your body's not as sensitive to insulin.

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It doesn't react as well at keeping your blood sugar steady.

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And so then you have these sugar cravings.

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Also, you can have crashes, and it's just everything you can see as we've been talking about.

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Really has to kind of be working in perfect harmony and if not, even if one thing's off, it just affects everything else.

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And that can really affect your energy, your diet, your glucose, your body capita.

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And so yeah, it's, it's a lot.

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It is.

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So I get a question a lot, which is like, what can I do?

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I don't wanna be on hormone replacement therapy.

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What can I do from a lifestyle standpoint?

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And I'm always like, why?

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Like, first of all, why like, ask your doctor you're a candidate.

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I'm not telling you everybody is, but.

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there's really nothing scary about hormone replacement.

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We're not going for, extra high doses.

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We're trying to just replace what was lost.

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I think it's interesting because there aren't other hormones in the body that were afraid to replace.

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If you had your thyroid cut out, you would take thyroid hormone.

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If your insulin doesn't work, you know you're diabetic, you take insulin.

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Like that's why if you have a type one diabetic child, like you would never be like, well, I don't know why that hormone's not working, but it's too scary to replace it, so it's.

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It's interesting to me that there is some fear based around it.

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So I'm always like, why?

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Like, let's have a conversation with your doctor and see maybe if, if you could be a candidate, but if for some reason you're not a candidate, or even if you are, even if you're on it, they don't work in isolation.

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Like we still need to have some lifestyle components.

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And, um, I talk, I talk to my mom about this a lot.

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Um, my listeners know I take care of all of her healthcare.

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I'm always at the doctor with her.

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Because she has dementia, she has a hard time following through with the lifestyle aspect of the things they ask her to do.

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And I'm like, these medications do not work in isolation.

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You can, like, if you're on a high blood pressure medication and you still eat fast food three times a day, like that medication cannot just like.

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Work magically, they don't work in isolation.

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And so we do have lifestyle factors that are gonna affect even if you're on medication.

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So even if we're on hormone replacement therapy, what are the like main lifestyle changes and things that we need to do outside of just, you know, popping that patch on, rubbing on our cream or gel or however you are taking it.

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I mean, I think I've touched on some of them already.

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Really as it relates to stress management.

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But as far as certain dietary changes, we need to really be mindful of what we're eating.

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Of course.

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I mean, we've heard so much lately about how terrible processed foods are.

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But protein is so, so, so very important.

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And I would recommend aiming for around a hundred, grams a day of protein, and that could be divided up among your meals, and that's really important to help us maintain our muscle mass.

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And also fiber is super important too.

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One of the things it does is it helps keep us full longer.

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So we don't feel like we have to be eating at all times.

00:19:20.106 --> 00:19:25.926
You wanna maintain hydration, so be drinking water throughout the day.

00:19:26.317 --> 00:19:35.977
And I just tell patients like, an easy way to know if you're, if you're drinking enough water, is if your urine is light in color.

00:19:36.457 --> 00:19:44.457
So if it's yellow or bright yellow, then that's a very easy way to tell that you are likely not taking in enough.

00:19:45.017 --> 00:19:46.606
And so that's super important.

00:19:46.906 --> 00:19:56.586
Going on walks even after a meal, doesn't have to be anything long, but take a 10 minute walk, can help with your blood sugar also.

00:19:57.217 --> 00:19:57.906
And.

00:19:58.672 --> 00:20:01.882
Working out, especially resistance training.

00:20:02.451 --> 00:20:05.422
A lot of people are afraid of resistance training.

00:20:05.422 --> 00:20:12.806
I mean, when we hear that or weight training, we just kind of picture, a bodybuilder or something like that.

00:20:13.145 --> 00:20:15.905
But that's not what it is necessarily.

00:20:16.439 --> 00:20:16.949
Don't worry.

00:20:16.949 --> 00:20:21.179
Even if you're on testosterone replacement, you're not going to look like that.

00:20:21.278 --> 00:20:29.568
but resistance training can be anything as simple as even body weight exercises, or resistance bands.

00:20:29.848 --> 00:20:34.558
so things that don't necessarily involve heavy weights.

00:20:34.588 --> 00:20:36.388
I mean, you can certainly progress.

00:20:36.699 --> 00:20:42.278
but that is so important to maintain our functionality too as we get older.

00:20:42.669 --> 00:20:45.038
I mean, you mentioned helping your mom.

00:20:45.038 --> 00:20:45.939
I also am.

00:20:47.618 --> 00:20:59.348
you know, dealing with my mom right now who has having issues with balance and falling and so it's so important to do what we can at this stage to prevent that.

00:20:59.798 --> 00:21:05.409
Um, and so you don't have to worry later on about how you're gonna manage, right?

00:21:05.409 --> 00:21:07.388
Just something as simple as walking.

00:21:07.479 --> 00:21:07.868
Right.

00:21:08.269 --> 00:21:15.019
and so it's so important to be looking ahead and prevention is so much more helpful than.

00:21:15.588 --> 00:21:17.209
Treatment after the fact.

00:21:17.209 --> 00:21:33.259
I mean, I can prevent so many things, not everything, obviously, but you're way better off now than down the road when you're, you know, you miss years or decades of being able to set yourself up for success.

00:21:33.263 --> 00:21:43.669
And so just incorporating like those little things in, whether you do go on hormones or not, it's only gonna benefit you.

00:21:44.682 --> 00:21:46.541
That is like, perfect.

00:21:46.541 --> 00:21:53.862
I couldn't have scripted your answer any better because this I just wanna recap for, for the listeners, like Dr.

00:21:53.862 --> 00:21:59.201
Kahn said, manage your stress, eat protein and fiber, drink water, strength, train, and walk.

00:21:59.412 --> 00:22:01.541
That's essentially the list that you gave us.

00:22:02.666 --> 00:22:04.467
And it is like the boring stuff.

00:22:04.616 --> 00:22:05.666
And this is what I,

00:22:05.672 --> 00:22:05.961
Yeah.

00:22:07.646 --> 00:22:15.336
this is what is so like maddeningly frustrating is I get, I get questions like, you know, what, what can I do?

00:22:15.336 --> 00:22:24.707
And people want like the super foods of menopause and you know, they're on Instagram or social media and they see videos of like, do this one thing.

00:22:25.247 --> 00:22:26.596
And I'm like, I'm sorry.

00:22:27.201 --> 00:22:28.612
It's not that sexy.

00:22:28.761 --> 00:22:31.551
It's just this same boring list.

00:22:31.551 --> 00:22:37.251
And if you've heard this list from me before, it's because it's evidence-based it, these are the

00:22:37.547 --> 00:22:38.537
Right and true.

00:22:38.656 --> 00:22:39.047
Yeah.

00:22:39.557 --> 00:22:40.247
and true.

00:22:40.277 --> 00:22:40.936
Yes.

00:22:41.356 --> 00:22:42.707
It's the boring stuff.

00:22:42.977 --> 00:22:45.406
I just, I had a message from a friend the other day.

00:22:45.507 --> 00:22:53.757
I have started to be friends with a group that is significantly younger than me, so she's asking me for advice, um, for her mother-in-law who's like my age.

00:22:54.386 --> 00:22:59.544
And she's like, she's having a hard time menopause and, And I was like, she's not missing the super food.

00:22:59.723 --> 00:23:02.844
Like that's what kind of what the, what the question centered around.

00:23:02.844 --> 00:23:11.394
And I'm like, I just wanna remind you guys, you're, you're not missing some secret somebody on Instagram that tells you that you're missing that one secret.

00:23:12.034 --> 00:23:16.743
They're wrong unless this is their secret strength.

00:23:16.832 --> 00:23:18.301
Walking protein fiber.

00:23:18.422 --> 00:23:23.311
So, um, real quick, you did give us a recommendation on protein, which is about a hundred grams.

00:23:23.372 --> 00:23:26.372
That's what I generally do shoot for as well.

00:23:26.672 --> 00:23:28.652
Um, what is your fiber recommendation?

00:23:30.061 --> 00:23:32.807
Fiber, I would say about 25 to 30 for the day.

00:23:32.876 --> 00:23:33.166
Yeah.

00:23:33.477 --> 00:23:33.767
Okay.

00:23:33.886 --> 00:23:43.307
Um, and if you find that you're unable to get that in your diet, um, you know, you could do supplements as well.

00:23:43.307 --> 00:23:46.846
I think you really need to focus on your diet primarily.

00:23:47.356 --> 00:23:54.406
but one thing I like to tell people to do, I mean, I'm not a dietician, I'm not a nutritionist.

00:23:54.856 --> 00:24:10.727
But I find that using something like chat, DPT honestly, can be helpful in terms of coming up with meal suggestions or recommendations, especially if you're looking, at these goals in terms of how much you wanna get in.

00:24:11.057 --> 00:24:18.406
And you can therefore put in maybe the foods you like or what you have on hand, or what you hate, you know, and it can really come up with some.

00:24:18.652 --> 00:24:21.862
Very quick and easy recommendations for you.

00:24:22.372 --> 00:24:26.362
Um, you know, you can put your budget in, how many people you wanna feed, whatever it is.

00:24:26.362 --> 00:24:35.422
And that just really gets sort of that barrier for saying like, like I say all the time, like, I just don't know what to make.

00:24:35.422 --> 00:24:36.352
I'm not creative.

00:24:36.682 --> 00:24:42.112
Well now you don't have to be, you know, so it's just getting easier to be able to do this.

00:24:42.362 --> 00:24:45.122
but of course you still have to put in the work.

00:24:45.551 --> 00:24:52.392
to actually make sure you're getting in the, the proper food, but it, it really is doable.

00:24:52.392 --> 00:24:59.102
Yes, it may be boring, but let's not forget about the, the OGs of health, I would say.

00:24:59.866 --> 00:25:03.586
Yeah, I, I've been focusing on protein for so many years.

00:25:03.586 --> 00:25:05.626
That protein just feels easy.

00:25:05.626 --> 00:25:09.856
And it's not that I hit a hundred grams, every single day, but I know why.

00:25:09.856 --> 00:25:12.616
When I don't, I'm like, well, yeah, it's obvious.

00:25:12.616 --> 00:25:19.666
I'm not confused about protein, but fiber has been my new thing that I've been focusing on the last couple of years, and.

00:25:21.201 --> 00:25:25.461
It is trickier because protein, you get a serving and you're counting in kind of like tens.

00:25:25.461 --> 00:25:29.182
You know, this is 10 or 20 or 30 grams of protein for this serving.

00:25:29.602 --> 00:25:36.021
Whereas fiber, you're counting in ones and twos and so you're like, oh, I'm going to eat this whole mango, and you're like.

00:25:36.237 --> 00:25:36.926
Five grams.

00:25:36.987 --> 00:25:37.707
Five grams.

00:25:37.737 --> 00:25:38.067
What?

00:25:38.217 --> 00:25:41.727
I just thought this was gonna meet my entire daily recommendation for fiber.

00:25:41.727 --> 00:25:45.926
You think that the food has more fiber than it does, and so don't get discouraged.

00:25:45.957 --> 00:25:52.977
It's okay that you're counting if you're just,'cause I notice that people that are used to counting protein grams, when they start to count fiber grams, they're like.

00:25:53.136 --> 00:25:55.356
It's like nothing, like, keep going.

00:25:55.386 --> 00:25:57.217
It's just a couple, couple here and there.

00:25:57.217 --> 00:25:58.987
It all adds up.

00:25:59.037 --> 00:26:03.057
I found the easiest way for me to meet my fiber goals is to have a serving of beans.

00:26:03.136 --> 00:26:07.217
last week I did like a cabbage and bean and all kinds of different vegetable salad.

00:26:07.267 --> 00:26:11.557
Like sturdy kind of vegetables, put it in the refrigerator and a ate that for lunch every day.

00:26:11.557 --> 00:26:15.307
And I was like, ES on my fiber goal every day that, that week.

00:26:15.307 --> 00:26:15.997
'cause I'm like, okay.

00:26:15.997 --> 00:26:22.547
Yeah, that's, so find something like that that you like, that you can incorporate, as often as you can.

00:26:22.547 --> 00:26:24.646
What's your favorite way to get fiber?

00:26:25.788 --> 00:26:26.574
I do like beans.

00:26:26.574 --> 00:26:27.683
I don't have them enough.

00:26:27.773 --> 00:26:30.203
I'm someone who I could do better on it.

00:26:30.203 --> 00:26:34.584
I've been taking fiber supplements myself for several years.

00:26:34.644 --> 00:26:34.973
Um.

00:26:34.973 --> 00:26:38.273
Because I have Celiac and that was ConEd to me.

00:26:38.574 --> 00:26:51.773
So, and but to your point, actually recently, don't ask why I hadn't done this sooner, but I looked at the bottle to see like, how much fiber am I taking and just with this, and I was like, why is it so low?

00:26:52.163 --> 00:26:53.993
It's like five grams, right?

00:26:54.443 --> 00:27:04.374
So, um, yes, you do need to take in more absolutely through the diet, which again, I'm not always so good at, but.

00:27:05.108 --> 00:27:05.588
Beans.

00:27:05.588 --> 00:27:12.788
I do enjoy, air filling and protein also, but meal prepping too, right?

00:27:12.788 --> 00:27:20.439
Like if you prepare things for the week, then you don't have to, you know, take it off your plate for the rest of the week.

00:27:20.469 --> 00:27:24.368
You don't have to wander like every night, like, oh my goodness, it's another night.

00:27:24.368 --> 00:27:26.108
I have to go through this cooking again.

00:27:26.108 --> 00:27:27.759
Or what am I gonna take for.

00:27:28.028 --> 00:27:31.419
For lunch every day, which is a struggle for sure.

00:27:31.749 --> 00:27:34.118
Um, especially for me living in New York.

00:27:34.118 --> 00:27:36.159
I'm surrounded by like food everywhere I go.

00:27:36.669 --> 00:27:46.538
Um, so if you take like a little bit of time on the weekend, that's another way just to like plan in advance to ensure that you're getting and what you need to.

00:27:47.821 --> 00:27:48.112
Yeah.

00:27:48.116 --> 00:27:51.977
Um, so I talk a lot about mindset for eating.

00:27:52.007 --> 00:28:00.906
We talk a lot about, Really thinking about why you're eating when you're not hungry and sometimes is really important rather than like specifically what you're eating.

00:28:00.906 --> 00:28:12.501
Obviously today we're talking a little bit more about what you're eating, but, when we're thinking about why we're eating when we're not hungry, and I work on that mindset shift, you were telling me that, sometimes there are signs your body needs.

00:28:12.821 --> 00:28:16.071
More than just the mindset shift that I teach.

00:28:16.122 --> 00:28:20.412
What are those signs that you notice that we need to get beyond the thought work?

00:28:21.506 --> 00:28:32.996
I think that, If you are struggling with weight changes and the things that have been working for you are no longer working again, it can be really frustrating.

00:28:33.276 --> 00:28:38.976
You might end up being hard on yourself, like, obviously I'm doing something wrong and this used to work for me.

00:28:38.976 --> 00:28:40.625
Why isn't it working anymore?

00:28:41.076 --> 00:28:45.365
But I think if you look at the whole picture.

00:28:46.175 --> 00:28:48.486
See what else is going on.

00:28:48.726 --> 00:28:54.556
Whether that is changes in your mood, maybe you're more irritable or more anxious.

00:28:54.766 --> 00:29:07.395
If you're just exhausted all the time, you're having the sugar cravings, you're not sleeping well, maybe your libido is off or your memory isn't as good, you know, any of those other symptoms.

00:29:07.740 --> 00:29:11.730
That could be very suggestive of hormonal changes.

00:29:12.151 --> 00:29:22.300
I would really take those as like messages from your body that, there's something else going on that goes beyond a mindset problem, you know?

00:29:22.300 --> 00:29:30.040
And so that's why, especially if you're doing everything right, I think it's really worth.

00:29:30.261 --> 00:29:38.122
Looking into your hormones and finding a provider that is open to helping you with that.

00:29:38.461 --> 00:29:40.576
because again, they're all related.

00:29:40.576 --> 00:29:46.605
All the hormones are related and hormones are responsible for how our entire body functions.

00:29:46.951 --> 00:29:56.070
And so if those are out of balance, like no amount of mindset shift or motivation or anything is, is going to help that, unfortunately.

00:29:56.401 --> 00:30:03.330
and so again, I think that's when it would benefit you even if you decide not to.

00:30:04.171 --> 00:30:07.320
Move forward in terms of any sort of hormone replacement.

00:30:07.530 --> 00:30:09.721
You know, some people need it, some people don't.

00:30:09.721 --> 00:30:12.421
Some people want it, some people can't have it, whatever it may be.

00:30:12.780 --> 00:30:16.875
But definitely worth, um, a deeper dive to see what is going on.

00:30:17.951 --> 00:30:19.330
Yeah, definitely.

00:30:19.330 --> 00:30:24.221
And I think, um, I, I always am recommending my clients like, check with your doctor on that.

00:30:24.221 --> 00:30:26.320
'cause obviously that's not my scope.

00:30:26.590 --> 00:30:37.451
I do think it's so important to make sure everything's working medically and you are in integrative women's health more than just, uh, traditional medicine.

00:30:37.451 --> 00:30:42.340
So if somebody's looking for, you know, somebody to help them with their hormones.

00:30:42.695 --> 00:30:45.816
Can you tell us like how to find or what to look for?

00:30:45.816 --> 00:30:54.516
Like what are we looking for maybe on their website that tells you that it's more of an integrative or personalized care that you do?

00:30:54.558 --> 00:30:56.388
If they're not in New York, obviously.

00:30:56.440 --> 00:30:57.142
Sure, sure.

00:30:57.259 --> 00:30:57.548
Yeah.

00:30:57.548 --> 00:31:06.066
So integrative, really integrates kinda like the best of both worlds with the traditional medicine, um, which we all know as.

00:31:06.605 --> 00:31:12.336
Typically you go in, you're sick, you get treatment, medication, and then hopefully you're better.

00:31:12.605 --> 00:31:21.346
Combining that with more traditional, like lifestyle changes, using nutrition supplements.

00:31:21.375 --> 00:31:23.836
So things that really compliment each other.

00:31:24.165 --> 00:31:34.786
And then looking at the whole body as one, as opposed to looking at your heart versus your reproductive system versus your brain health.

00:31:35.006 --> 00:31:37.195
And really seeing how like everything's connected.

00:31:37.526 --> 00:31:38.365
And so.

00:31:39.175 --> 00:31:47.875
I think what's so important, if you're looking for that kind of care, is of course, it depends where you're looking for it.

00:31:47.875 --> 00:31:49.556
There's so many ways to find care.

00:31:49.915 --> 00:32:10.455
But there are certain keywords I think are helpful and those can be helpful whether you're looking on social media, if you're looking on Google now, even in the ai, models, there is becoming more and more, Of a use for those, even in terms of searching for businesses or doctors or whatever it may be.

00:32:10.875 --> 00:32:18.076
So I think looking up like holistic, whether it's um, gynecology or doctor provider.

00:32:18.435 --> 00:32:21.346
Um, but holistic wellness, integrative.

00:32:21.915 --> 00:32:26.596
You can look up functional medicine though it is not really quite the same thing though.

00:32:26.596 --> 00:32:27.675
There's some overlaps.

00:32:28.125 --> 00:32:28.605
Um.

00:32:28.935 --> 00:32:31.786
Bioidentical hormone replacement therapy.

00:32:32.026 --> 00:32:42.556
I think just having that term bioidentical, um, is important and it will likely find you more of that, um, integrative approach as well.

00:32:43.006 --> 00:32:47.536
Um, full body complimentary.

00:32:47.536 --> 00:32:52.695
So those are some words I think could be helpful in, in your search.

00:32:53.756 --> 00:32:56.355
Good because it's, it's tricky.

00:32:56.355 --> 00:32:59.685
You know, not all of us have insurance where we can go wherever we want.

00:32:59.685 --> 00:33:05.016
For years, I, I think almost a decade I was with, Kaiser, if you're familiar with, California.

00:33:05.441 --> 00:33:06.040
Healthcare.

00:33:06.040 --> 00:33:16.451
It's, it's like a HMO, you know, and so everything's in one building and which, you know, there's some good and some bad, but fairly limited on, doctor Choice where I am at.

00:33:16.451 --> 00:33:21.300
You know, it, it depends, but our insurance just shifted and so now I am.

00:33:21.441 --> 00:33:24.080
It's more of a PPO, I have more access.

00:33:24.080 --> 00:33:30.471
And so it is delightful to just really get to search for a provider that you want look at recommendations.

00:33:30.810 --> 00:33:35.040
also the Menopause Society practitioner, do they have lists that you can look at?

00:33:35.090 --> 00:33:35.310
Yes.

00:33:36.175 --> 00:33:42.945
Yes, they do have a directory, that is for the public, of course, on the Menopause Society website.

00:33:43.246 --> 00:33:44.776
I think it's menopause.org.

00:33:45.675 --> 00:33:53.006
And, yes, so anyone who is a certified member, or provider will be on that directory.

00:33:53.006 --> 00:33:54.986
So you can search by location as well.

00:33:56.361 --> 00:34:03.711
I, I think that's how I found, found my current provider because I really was interested in someone that could really work with my hormones.

00:34:03.740 --> 00:34:06.651
'cause I ended up working with a naturopath as well as my Kaiser doctor.

00:34:06.651 --> 00:34:09.981
And then they were just saying like two completely opposite things and it was very confusing.

00:34:09.981 --> 00:34:15.681
So it's been nice this year, this calendar year, to consolidate my care into one.

00:34:16.251 --> 00:34:20.210
Office that really does this integrative healthcare for women.

00:34:20.210 --> 00:34:22.190
So I've been appreciative of it.

00:34:22.190 --> 00:34:24.619
I know that's how you run your practice.

00:34:24.619 --> 00:34:29.659
And so, um, yeah, I think it's really super, super helpful.

00:34:30.199 --> 00:34:30.679
Alright.

00:34:30.679 --> 00:34:40.909
Any last words of wisdom on those that are struggling with some of these symptoms with menopause that you would, um, tell, tell your patients?

00:34:41.373 --> 00:34:47.639
Definitely, first and foremost is, you know, you best, so advocate for yourself.

00:34:47.639 --> 00:34:48.869
I've had so many.

00:34:49.318 --> 00:35:06.918
Patients in their thirties, and older who, you know, they come to me after their doctors, just tell them either you're too young to be in perimenopause or your hormones look fine, or just take this birth control, to balance everything, you know, whatever it is.

00:35:07.338 --> 00:35:12.349
If something isn't feeling right with you, then let's have it looked at.

00:35:12.679 --> 00:35:16.639
there's no shame in finding someone else who you feel like.

00:35:16.748 --> 00:35:18.311
fits you better.

00:35:18.621 --> 00:35:24.532
it is a personal relationship and so it is important that you feel comfortable wherever you're going.

00:35:24.831 --> 00:35:26.871
It's not a one size fits all approach.

00:35:27.112 --> 00:35:29.481
So really just advocate for yourself.

00:35:29.771 --> 00:35:38.391
educate yourself, and there are plenty of, very well qualified doctors out there who are available to help you.

00:35:39.148 --> 00:35:39.599
Great.

00:35:39.628 --> 00:35:40.978
Thank you so much.

00:35:41.009 --> 00:35:45.998
And I would love to put your links in the show notes if you are in New York or Florida.

00:35:45.998 --> 00:35:49.023
Is there anything else that you want to direct people to?

00:35:49.583 --> 00:35:49.704
I.

00:35:49.893 --> 00:35:58.204
so my social media, um, and my website, I'm gonna have a new website soon, but for now it is gmd ny com.

00:35:59.349 --> 00:36:02.858
And yeah, I'm always available.

00:36:02.918 --> 00:36:04.869
Um, follow me on social.

00:36:04.869 --> 00:36:10.509
You can DM me or again, if you're in New York or Florida, reach out.

00:36:11.409 --> 00:36:11.949
Okay, great.

00:36:11.949 --> 00:36:12.563
Thank you so much.

00:36:14.775 --> 00:36:15.105
Dr.

00:36:15.105 --> 00:36:19.244
Khan and I went on to chitchat about GLP ones and the trend of microdosing.

00:36:19.275 --> 00:36:24.735
I ended up asking her if I could send that section out just to my email subscribers, she said yes.

00:36:24.795 --> 00:36:28.034
So it's a little less formal, but I think you'll get a lot out of it.

00:36:28.275 --> 00:36:30.344
The link to that download is in the show notes.

00:36:30.655 --> 00:36:37.534
If this episode hit home for you and, you want support working through your perimenopause or menopause symptoms and weight gain, I'd love to talk with you.

00:36:37.835 --> 00:36:42.755
I have two free resources right now that I know will help download the What to Do When You Overeat Course.

00:36:42.905 --> 00:36:50.074
If you find yourself overeating too many times in a week to see lasting weight loss, Or you can grab my brand new GLP one success.

00:36:50.090 --> 00:36:50.809
Starter kit.

00:36:51.079 --> 00:36:58.849
This is for anyone already on GLP ones, but don't have any support or structure around what to do or if you're even remotely considering medication.

00:36:58.880 --> 00:37:01.400
Grab this so you know what to expect.

00:37:02.164 --> 00:37:13.713
You can also schedule a free consult session to see if my Premier 12 week one-on-one coaching program is right for you, or my brand new GLP one confidence method that I've recently developed to see if that is the perfect fit.

00:37:14.074 --> 00:37:19.713
So all the links are in the show notes for both of these free resources as well as the link to schedule an appointment with me.

00:37:19.983 --> 00:37:23.224
Remember, it's not just about the food, it's about empowering yourself.

00:37:23.233 --> 00:37:31.153
With the choices that truly serve you Have a great week and as always, thanks for listening and sharing the Eat Well Think Well Live Well podcast.