🎧 Episode Overview:

Dr. Ali Novitsky returns with renewed energy and exciting updates—including an upcoming trip to Japan and life with new chicks!

In this episode, she tackles a timely and often misunderstood issue: weight gain in lean women during perimenopause and menopause. Through personal insights and a detailed case study, she explores how hormonal shifts impact metabolism, body composition, and mental health—and how to approach this population with compassion and strategy.

1. Understanding Hormonal Shifts

·       Estrogen & testosterone decline, cortisol increases

·       Impact on muscle mass, fat distribution, energy, and anxiety

·       Dr. Novitsky’s personal hormone journey

2. Case Study: Laura (Age 45)

·       Lean, active woman experiencing weight gain

·       Symptoms, lab results, and emotional impact

·       Guided steps for clinical management

3. Tools for Tailored Assessment

·       Importance of motivational interviewing

·       Taking weight history and analyzing body composition

·       Using InBody scans to assess fat/muscle distribution

4. Nutritional and Lifestyle Strategy

·       Conducting a nutrition audit

·       Realistic food tracking goals

·       Importance of strength training in midlife

5. Addressing Resistance & Setting Expectations

·       Normalizing frustration and resistance

·       Setting achievable fat loss goals

·       Supporting “naturally thin” women who are metabolically vulnerable

6. When Lifestyle Isn’t Enough

·       Recognizing when medication may help

·       Debunking stigma around pharmacologic support

·       Advocating for early, proactive intervention

·       Hormonal changes in perimenopause affect more than weight — they impact muscle, mood, and metabolism

·       “Normal weight obesity” is real — body composition matters more than BMI

·       Strength training is key for sustainable metabolic health

·       Compassion + data = successful clinical care

🕒 Timestamps:

00:00 – Summer update + trip to Japan

00:43 – Weight gain in lean perimenopausal women

05:05 – Case Study: Laura

09:47 – Motivational interviewing and trust-building

13:08 – Hormonal shifts: cortisol, testosterone, thyroid

15:00 – Sleep, hunger hormones, and weight

19:04 – Detailed weight history

22:03 – Body composition metrics that matter

29:08 – Nutrition audit tips

35:02 – Why strength training is essential

42:09 – When to consider medication

43:22 – Wrapping up and next week’s teaser

🎤 Final Thought:

Dr. Novitsky reminds us that weight gain during perimenopause isn’t a personal failure — it’s biology.  With compassionate care and science-backed strategies, women can navigate this life stage with confidence and clarity.

🎯 Ready to Personalize Your Health?

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