270: Cortisol, Insulin, and Why the Scale Won't Move in Midlife

You've been eating reasonably well. You're moving your body. You're trying to get enough sleep. And the scale still won't move. If that sounds familiar, this episode is going to give you something most health advice never does: an actual biological explanation for why your body is responding the way it is right now, in this phase of your life.

Elizabeth came across an article recently about cortisol and menopausal weight gain, and it stopped her mid-scroll. Not because it was telling her anything she didn't already know, but because it put into plain language something she sees in her clients constantly and realized she hasn't explained clearly enough on this podcast. This episode is her response to that article, and it's one of the most direct conversations she's had about the science behind her work.

This is not another episode about eating less and moving more. It's an honest explanation of what is happening inside your body during perimenopause and menopause, why chronic stress and poor sleep have a direct biological impact on your weight, and why the advice you've been following was never designed for the body you have now.

If you've ever felt like you're doing everything right and still going nowhere, this episode is going to make a lot of things make sense.

The Listener Takeaway: Why This Episode Matters

What this episode offers is something the diet and wellness industry rarely provides: a straightforward, non-shame-based explanation for why your body is doing what it's doing. The weight that won't move, the exhaustion, the feeling that you're trying and nothing is working, these are not signs that something is wrong with you. They are signs that your body has changed significantly, and the tools and advice you've been given were never updated to match it. Understanding that distinction is genuinely useful, and it changes everything about how you approach your health from here.

WHAT YOU'LL LEARN

• Why cortisol behaves differently in menopause and perimenopause, and what that means for your weight, your energy, and your ability to manage stress the way you used to
• The real reason sleep deprivation and chronic stress aren't just lifestyle inconveniences: they are direct biological inputs that change how your body stores and burns fat

RESOURCES

• Take the free quiz
• 8 Habits That Healthy People Do and Why They Don't Stick

Free Quiz: Still saying "I know what to do, I just don't do it"?  You don't need more information. You need to know why you're not applying the information you already have. This free quiz identifies the exact reason your healthy habits keep breaking down, and it's not willpower. 15 questions. 3 minutes or less. 4 possible patterns. 1 honest answer. 

Go to https://elizabethsherman.com/quiz

If you’re a woman in midlife who wants better health without obsessing over weight, you’re in the right place. I’m Elizabeth Sherman, a life and health coach and host of the Total Health in Midlife Podcast.

After coaching hundreds of women, I know the real problem usually isn’t “not enough information” – it’s too much of it, and not knowing where to start. With close to 300 episodes, this show can feel that way too.

To make it easy, I created a free Listener’s Roadmap that helps you figure out which episodes are right for you right now. Tell me what you’re struggling with – low energy, emotional eating, stress, sleep, exercise, or all of the above – and I’ll point you to a curated path of episodes and resources to get you moving.

Download your free roadmap at https://elizabethsherman.com/roadmap.

Transcript

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So, something that I hear constantly from the women I work with is I am doing everything right and nothing is working. And honestly, they're not wrong. They are doing the things. They are trying and they are still stuck. What I haven't explained well enough on this podcast is sometimes why that happens at this stage of life. And I'm not talking about the mindset reasons. I talk about those a lot. I'm talking about the biological reasons, what is actually going on inside the body during this phase of life that makes the standard advice so ineffective. That's what I'm going to be talking about today. And if you have ever felt like your body is working against you, no matter what it is that you do, I think this episode is going to give you the explanation that you've been looking for. So let's get into it. Welcome to the Total Health and Midlife Podcast, the podcast for women over 40 who want peace with food, ease in their habits, and a body that they don't have to fight with. Hey everyone, welcome back to the Total Health and Midlife Podcast. I am your host, Elizabeth Sherman, and I am super glad that you are here with me today. I know I say that every time, but I am. So I want to start by telling you what got me thinking about today's topic. I was reading an article that I stumbled across online. One of the things that I think makes me a great coach is that I am constantly thinking about the things that keep you up at night. And so I am continually reading and researching all of the topics that my clients come to me with and that my followers struggle with. And the article was one of those things that pops up in your newsfeed that you almost scroll past, but something about it made me stop. The article was about cortisol, specifically how cortisol affects weight gain in midlife women. And I read the whole thing, which honestly I don't always do. Sometimes I skim it. And when I finished it, I sat there for a sec and I thought, you know, this is exactly what I talk about. I talk about stress and sleep and why pushing harder isn't always the answer. I talk about it all the time on this podcast and with my clients, but I realized I've been talking about it from the behavior side, from the mindset side. And I really haven't done a great job of explaining the actual biology, the science underneath it. And that feels like a gap that I needed to close. Because here's what I know about the women that I work with. You are so super smart. You have done your research and you have tried all the things. And when something still isn't working, the last thing that you need is another person telling you to try harder or to be more consistent. What you actually need is someone to explain what is happening in your body in plain language so that the struggle finally makes sense. And so that's what I'm going to be talking about today the biology behind what you're experiencing. And not to overwhelm or scare you, but to give you the, oh, that's why moment that I think so many of us have been missing. So the article was specifically about cortisol and weight gain during menopause. And the reason it resonated with me is that it described something that I see in my clients over and over and over again in a way that I really have not been describing it to you. Here's what the article laid out. During menopause, cortisol levels rise naturally in our bodies. Now, cortisol is your stress hormone. It's the hormone that your body releases when it thinks you're under threat. And when cortisol spikes, your blood sugar spikes with it. Now, that's all by design. Your body is trying to give you energy to deal with whatever the threat is. The problem is that when that keeps happening day after day, your body starts storing that extra blood sugar as fat, specifically as body fat. And over time, if cortisol stays elevated, your body becomes resistant to insulin, which is the hormone that manages your blood sugar. And when that happens, losing weight becomes genuinely harder. And not harder because you're not trying hard enough, but harder because your body is stuck in a biological loop that has nothing to do with how much you want it. Your body doesn't care about aesthetics. And what the article also said, and this is the part that really got me, is that this is not just about stress in the way that we usually think about stress. It's not just about having a bad week at work or a fight with your kid. It's about chronic, low-grade, ongoing stress that has been building in your body for years. The kind that doesn't feel like stress anymore because you've been carrying it for so long that it just feels like a regular day. And that really hit me because it's what I see all the time. I work with women who are managing full-time careers, aging parents, kids who may or may not have launched out into the world, relationships, households, and their own health all at the same time. And they are really good at it. They've been doing it for years. They feel capable, but their bodies are now in a phase of life where they are significantly more reactive to stress than they used to be. And no one told us to slow down. Nobody set them down and said, the way that you have been living is going to hit differently now. So they keep doing what they've always done. And they solve the problem by eating less and exercising more. And they wonder why the scale isn't moving and they blame themselves. And that's the part that I want to address today because the standard advice eat less, move more, just be consistent, was never built for a body in this phase of life going through this transition. And understanding why that advice keeps falling short is the first step to actually doing something about it. So let me explain what's actually going on because I think that once you understand this, a lot of things are going to start to make sense. So, first, cortisol is not a bad hormone. You want to start there. Your body makes cortisol for a reason. When you're under stress, whether that's physical stress or emotional stress, your body releases cortisol to help you deal with it. It raises your blood sugar so that you have energy. Out in the wild, it would be if you were under stress for running away from something. Something traumatic is about to happen. And so your body floods you with this energy, your muscles, so that you can go and be effective. It tells your body something is happening. Pay attention. It sharpens your focus. And that system works really, really well when the stress is temporary. You deal with the thing, you run away, cortisol drops back down, your body goes back to normal. That's how it's supposed to work. But here's what happens in modern situations, and especially during midlife. During perimenopause and menopause, your estrogen drops. And one of the things that estrogen does that most of us never learn is that it actually helps us to regulate our cortisol. It kind of acts as a buffer. So when estrogen is high, your stress response is more controlled. Your body releases cortisol when it needs to, and then it settles back down. And when estrogen drops, that buffer goes with it. And your body becomes much more reactive to stress. Things that you used to be able to shake off, a hard conversation, a bad night of sleep, a week where everything went sideways. Your body now responds to those things with a much bigger cortisol release than it would have 10 years ago. So you're not imagining it when you feel like stress hits harder now. It totally does. And that is not a mindset problem. That is just biology and how our bodies work. Now, here's where the weight piece comes in. When cortisol spikes repeatedly, your blood sugar keeps going up and then coming back down again. And every time that happens, your body releases insulin into your bloodstream to manage the blood sugar. Insulin's job is to clear the sugar out of your blood and either use it for energy or to store it. And when there's more sugar than your body needs for energy, it stores it as fat, preferentially around your midsection, which is why so many women in midlife notice that their weight is shifting even when the number on the scale isn't dramatically different. And so over time, if your cortisol level is chronically elevated, your cells start to become less responsive to insulin. This is what's called insulin resistance. And what that means practically is that your body has to produce more and more insulin to do the same job. And more insulin means more fat storage. And it means that your body has a much harder time accessing the fat that's already stored for energy. And so this is why the calories in versus calories out approach stops working the way that it used to. It's not that the math is wrong, it's still the foundation for weight management. It's that your hormones are overriding the math. Your body is getting signals from cortisol and insulin that have nothing to do with how much you ate for lunch. And here's the part that I really want you to sit with. Sleep deprivation raises your cortisol. Not sleeping well is not just a lifestyle inconvenience that makes you want to reach for pretzels in the afternoon. It's a direct biological stressor that tells your body to produce more cortisol, which raises your blood sugar, which triggers more insulin, which promotes more fat storage. One bad night's sleep starts that whole cascade. Chronic stress does the exact same thing. Not just the acute stress on a difficult day, the low-level ongoing background stress of a life that is too full with not enough recovery built into it, and that keeps your cortisol elevated in a way that your body in this phase of life is not equipped to compensate for the way that it used to be able to do that. So when a woman comes to me and says, I am doing everything right and nothing is working, I 100% believe her because she probably is doing everything that she was taught to. She just wasn't taught the right things for the body that she has now. And that's not her fault. And it absolutely is something that we can work with. Now, here's what I want to get a little bit more personal with you because I don't think that the biology alone tells the whole story. Most of the women that I work with, and honestly, most of the women that I know have spent the last 20 or 30 years operating at an extremely high, overfunctioning level. There's careers, kids, relationships, aging parents, households, all of it often hitting at the same time. And we've gotten really good at it, like really, really good at it. They learned how to manage, how to push through, how to keep going, even when they were running on empty. And for a long time, it worked. Not perfectly, but well enough. And so the message that most of us absorb somewhere along the way is that we can have it all and we can do it all. That if we are organized enough, if we're efficient enough, if we're committed enough, we can manage every single piece of our lives without anything slipping. And a lot of us built our identities around being the person who holds it all together. And I'm not here to tell you that that was wrong. That version of you got a lot done. But I am going to tell you that your body is no longer on board with that story. Because what I just explained about cortisol, that your body is more reactive to stress right now, that it takes longer to recover, that chronic low-grade stress keeps your hormones in a state that actively works against you. That means that running at full capacity without enough recovery is not a neutral choice anymore. It has a direct biological cost that shows up in your body. And the hard part is that most women that I work with know that something is off. They feel it. They are more tired than they used to be. Things that used to roll off of them don't anymore. And they're not sleeping as well. They're gaining weight even when their habits haven't changed dramatically. And instead of reading those signals as information from their body, they read them as it's my fault. I have done something wrong. There's something wrong with me. They think I used to be able to handle this. What is wrong with me? There's nothing wrong with you. Your body is telling you that something needs to give. And the cultural story that we've been living inside doesn't have a chapter for that. We were never taught that slowing down is a biological necessity to life, that it's not a luxury. We were taught that rest is something that you earn, that you slow down when everything is done, which means you never slow down because there's always something to do. We were taught that pushing through is strength and that needing recovery is weakness. And I want to be really clear here. I'm not talking about giving up or doing less forever. I'm talking about the fact that on a body that is already producing more cortisol than it used to, in response to stress that's less equipped to buffer, adding more pressure, more restriction, more intensity is not going to get you where you want to go. It's actually going to make things harder. The women who come to me most frustrated are almost always the ones who responded to not getting results by trying harder, more restriction, more exercise, more rigidity. And they cannot understand why it's not working. Because in every other area of their lives, trying harder works. It works in your career. It works in your relationships. It works when you're solving a problem or coming up against a deadline. It does not work when the thing standing between you and your health is a body that is already maxed out on stress hormones and desperately needs recovery. That is a totally different problem. And it needs a different response. And so I want to talk about something that I think is genuinely one of the most damaging ideas in the health and wellness space. And it's not a fringe idea, it's the mainstream one, which is calories in versus calories out. The basic premise is simple. And overall, it's true. The idea is you eat less than you burn and you lose weight. And look, again, the math is not wrong here. Energy balance is real. But the way we apply that math to women in real bodies in midlife is where it all completely falls apart. Here's what calories in, calories out framework leaves out. It assumes that your body is processing food in a vacuum, that the only variable that matters is how much you ate and how much energy you spent through movement. And what we now know, and what I haven't explained clearly enough on this podcast, is that your hormones are running a parallel conversation that has enormous influence over what your body does with the food that you eat. When your cortisol is elevated, your body holds on to fat. When your insulin is elevated, your body stores fat and has a harder time burning it. Now, neither of those things shows up in a calorie count. You can eat at a deficit and still have your hormones working against you because the conditions inside your body are telling it to store body fat, not burn it. And here's the piece that most people don't know sleep deprivation and chronic stress are not just lifestyle factors that make you reach for bad food. Although they can do that as well. They are direct biological inputs that change how your body manages food and exercise. A night of poor sleep raises your cortisol. Elevated cortisol raises your blood sugar. Elevated blood sugar triggers insulin. We talked about this. And insulin, as I talked about earlier, promotes fat storage and makes it harder for your body to access fat for energy. Again, none of this is a willpower problem. That is a hormonal cascade that starts before you even open the refrigerator. So when a woman tells me that she is eating well and exercising and still not losing weight, and then I find out that she's sleeping five or six hours a night and running a life that would stress anyone out, I am not looking at her food log first, because the food log is not where the problem lives. The problem lives in the conditions that her body is operating underneath. And until those conditions change, the food log is only telling part of the story. And so this is why I always start with sleep when a client comes to me, even if she's not concerned about it. And not because sleep is a magic solution, but because without adequate sleep, your cortisol levels stay elevated, your hunger hormones get dysregulated, your body holds on to fat, and your ability to make any other change effectively is genuinely compromised. Sleep is not a nice to have. It is a biological foundation that everything else sits on top of. And I know that for a lot of women, hearing that is both a relief and probably very frustrating. A relief because it explains so much, but frustrating because sleep feels like one more thing to fix in a life that is already full. I hear that. And I'm not going to hand you a list of sleep hygiene tips and send you on your way. What I want you to take from this is a different way of thinking about your body, not as a math problem to solve, but as a system that is responding to conditions. And when the conditions change, the results change too. That shift in thinking is actually where the work begins. So let's talk about what this looks like in practice. Because I don't really want to leave you with a clear picture of what the problem is, with no idea of what to do with it. The first thing I do with every single client, regardless of what she comes to me for, is we look at her sleep, not her diet, not her exercise routine, but her sleep. Because everything that I just explained about cortisol, about insulin, about your body's ability to manage weight and stress, all of it is directly affected by how much and how well you are sleeping. And I want to be very specific about what I mean because I'm not talking about a vague intention to go to bed earlier. I'm talking about honestly looking at what is actually happening. How many hours are you getting of sleep on a typical night? Are you falling asleep easily? Or are you lying there running through your to do list for tomorrow? Are you waking up in the middle of the night not going back to sleep? Are you waking up exhausted even after a full night? Like those details matter because they tell me. What your cortisol is doing while you sleep and what kind of foundation you're working from every single day. And so once we have a clearer picture of sleep, we can start working on what I call brain-body integration. And I know that that sounds kind of woo and something that you would see in a wellness blog. So let me tell you exactly what I mean by that. Your brain and body are in constant conversation. Doesn't seem like it sometimes, but they are. Your thoughts affect your physical sensations. Your physical sensations affect your emotions. And your emotions affect your actions. And most of us, especially high-achieving women who have spent decades operating from the neck up, have lost touch with that conversation. We override our physical signals constantly. We eat because it's lunchtime. Not because we're hungry. We keep going because there's more to do, not because we have the energy for it. We ignore the tension in our shoulders and the tightness in our chest because we don't have time to deal with it right now. And what that does over time is disconnect you from the information that your body is giving you. Information that is directly relevant to your health. So the tools that I use are designed to rebuild that connection. Body scans are one of the tools that I use. A body scan is simply the practice of checking in with your physical sensations on purpose. Where do you feel tension? Where do you feel ease? What does hunger actually feel like in your body right now, as opposed to what you think it should feel like based on what you ate last? The hunger scale is another tool. It's a way of learning to recognize and trusting your body's actual hunger and fullness signals rather than just eating by the clock or by the rule of what the plan says. And the think-feel-act cycle is something that I use to help women understand the connection between their thoughts, their emotions, and their behavior. Because a lot of patterns that look like food problems or habit problems are actually thought patterns that are driving everything else downstream. And when you can see that connection clearly, you have a lot more choice about what you do next. Now, none of these tools are complicated, but they require you to slow down enough to actually use them. And that slowing down, that intentional recovery and reconnection is itself a way of working with your cortisol instead of working against it. And that's not a coincidence. That's the entire point. And so here's what I want to leave you with. What you've been experiencing in your body is real. The weight that won't move, the exhaustion, the feeling that you're doing everything that you're supposed to do and still not getting anywhere, that is not a personal failing. It is what happens when a body that has changed significantly is still being managed with tools and advice that were never actually designed for it in the first place. You're not broken. There's nothing wrong with you or your body. You're not lazy. You are operating in a body that is more sensitive to stress than it used to be in a life that has not slowed down to magic. And the gap between those two things is where most of the struggle lives. Understanding that is genuinely useful. I hope this episode gave you some of that. But I also want to be honest with you about something. Knowing why something is happening is not the same as being able to change it. I have worked with enough smart, capable, informed women to know that understanding the biology does not automatically translate into knowing what to do first or how to do it in the context of your actual busy life, with your actual busy schedule, with your actual over-the-top stress load and your actual history with all of this. That gap between knowing and doing is exactly what my work is about. And it's also why I built the quiz at elisabethsherman.com/slash quiz. This quiz is specifically made for the woman who knows what to do, but keeps running into the same wall. The quiz takes about three minutes. It asks you a handful of questions about your patterns and your habits and where your follow-through tends to break down. And what it gives you back is not a generic result. It identifies your specific pattern. The real reason your follow-through keeps breaking down and what to address first. Your results go directly to your inbox. And if anything in today's episode resonated with you, if you recognized yourself in any of it, that quiz is the best next step. Not because it's going to hand you a perfect plan, but because it's going to show you something specifically about what's getting in your way. And that is always where the real work starts. Again, go to elisabethsherman.com/slash quiz. I will make sure that that link is also in the show notes. And that is all I have for you today. Have an amazing day, and I will talk to you next time. Bye-bye. Hey, before you go, if today's episode resonated with you, I want to invite you to take a free quiz I created called Why Do Your Healthy Habits Keep Falling Apart? Because here's the thing. If you've been stuck in the starting over cycle, it's not a willpower problem. It could be something a little bit deeper than that, like your system. And this quiz will show you exactly which part of your system is getting in the way. It takes about three minutes, and you can find it by going to elisabethgerman.comslash quiz. I'll see you there.