Shift Happens - Hormones Unfiltered

Why Midlife Weight Hits Different

Melissa and Johanna Season 1 Episode 6

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0:00 | 34:24

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If your body feels different in midlife — even though you haven’t changed much — you are not imagining it.

In this episode of Shift Happens: Hormones Unfiltered, we unpack why weight, metabolism, blood sugar, and body composition shift during perimenopause and menopause, and why the old “eat less, move more” advice often stops working.

Hosted by a Women’s Health Nurse Practitioner & Functional Medicine Provider, Johanna Lancaster, and a National Board-Certified Health & Wellness Coach, Melissa Gaskin, this conversation breaks down the science behind:

  •  metabolism changes in midlife 
  •  insulin resistance 
  •  blood sugar balance 
  •  A1C and cholesterol markers 
  •  muscle loss and metabolic health 
  •  GLP-1 medications and the conversations surrounding them 

We also discuss the emotional side of midlife weight changes — including frustration, shame, confusion, and the pressure women feel to “fix” their bodies.

This episode is about moving away from punishment and toward understanding, support, and sustainable health.

Because your metabolism didn’t fail you.
 Your body’s needs simply changed.

In This Episode We Discuss

• Why midlife weight gain is about more than calories
 • The role estrogen plays in metabolism and fat storage
 • How muscle supports blood sugar and long-term health
 • Signs of insulin resistance women often miss
 • What A1C actually tells us
 • Why cholesterol and lipid markers may change in midlife
 • The truth about GLP-1 medications
 • Why sustainable habits matter more than extremes
 • The connection between stress, sleep, hormones, and weight

Key Takeaways

✨ Midlife metabolism changes are real and multifactorial
 ✨ Muscle is protective for metabolic and long-term health
 ✨ Blood sugar stability matters more than restriction
 ✨ Insulin resistance can begin long before diabetes develops
 ✨ GLP-1 medications are tools — not moral failures
 ✨ Women deserve education and support, not shame around weight

Work With Us

If you’re navigating perimenopause, menopause, or unexplained hormone symptoms, we offer a unique approach that combines clinical hormone care with personalized health coaching.

Together we support women with:

✨ Functional medicine hormone insight
 ✨ Root-cause testing and individualized care
 ✨ Sustainable lifestyle and nervous system support
 ✨ Coaching for lasting health behavior change

👉 Learn more or book a consultation:
https://www.omniyou.me/

https://www.melissagaskin.com/


Connect With Us

Follow along for more conversations about hormone health, midlife wellness, and advocating for your body.

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Disclaimer

This podcast is for educational purposes only and does not replace personalized medical advice. Always consult your healthcare provider regarding your individual health needs.

SPEAKER_00

Welcome to Shift Happens, Hormones and Filters, the show where we decode the wild, wonderful and occasionally WTF moments of perimenopause, menopause, and everything in between. We're your host. I'm Johanna Lancaster, a women's health nurse practitioner and functional medicines provider at Omni Youth, specializing in empowering women to understand the root cause of your hormone imbalance and helping you feel like yourself again.

SPEAKER_01

And I'm Melissa Gaskin, a National Board certified health and wellness coach at Cursus End, supporting clients through sustainable lifestyle changes for root cause healing. Together we are your Science Meets Soul, clinical meets real life, hormone dream team.

SPEAKER_00

Around here, nothing is off limits. Hot flashes, mood swings, sleep that disappears like your favorite pair of jeans? Yeah, we're talking about all of it.

SPEAKER_01

Our mission is simple cut through the noise, ditch the chains, and help you understand what's actually happening in your body with zero judgment and a lot of laughs.

SPEAKER_00

So whether you're shifting, pausing, or wondering why your hormones feel like they're in a group text without you, you're in the right place.

SPEAKER_01

Grab your tea, your electrolytes, and your secret midlife snack, no judgment, and let's get into today's episode.

SPEAKER_00

Hi guys. Today we're talking about a topic that so many women are frustrated and confused by, and it's about why weight feels different in your 30s, starting in your 30s, up to your 50s, 60s, beyond. Today's episode of Shift Happens Hormones Unfiltered is focusing on hormones, weight, and we'll talk about GLP1s as well.

SPEAKER_01

So, Johanna, this is probably one of the biggest things we hear from women. I'm eating the same, I'm doing the same thing.

SPEAKER_00

Suddenly my body feels different. Absolutely. And the first thing we want women to know is midlife weight changes are not just about laziness or you're lacking willpower. There are some real physiological and hormonal shifts that are happening in your body. Yeah.

SPEAKER_01

And it's important to know, and that's why we're having this episode today, is because many women just blame themselves of, oh, I need to do this better or do this differently or go back on this diet, or I need a tool to fix me, or some external factor to make them feel like they're not crazy.

SPEAKER_00

Um, yeah, yeah, but hormones really do play a big role, and of course, this is very multifactorial, but hormones uh affect how we store fat, how sensitive we are to insulin. It affects our muscle mass, our metabolic organ, right? The muscle. Um it affects uh appetite signaling, energy levels, and recovery as well. Um so really uh we have we have um multiple hormones that are declining and play a role. So estrogen, progesterone are are the big ones. And when estrogen fluctuates and declines, um, we often start noticing those first um signs of especially abdominal weight gain. That's probably one of the biggest complaints that I get. Um, and and body composition changes, you know, you're seeing that there are more pads in areas and and muscle is is being lost, you're having more cravings, especially I think carb cravings, lower energy, and slower recovery.

SPEAKER_01

Yeah, so if you are telling yourself something's gotta change, my old strategies are not working, listen up because we're gonna dig deep really into what our metabolisms mean, and then this insulin, cholesterol, lipid correlation, and why some of our labs do change during these seasons of life.

SPEAKER_00

Yeah, so let's talk a little bit about what metabolism actually is. And it's really um, this is multifactorial again, right? It is a combination of your hormonal balance, it is a combination of how much muscle do you have, how well are you sleeping? Are you is stress a factor? Um, your nutrition movement um all play a role, inflammation levels play a role.

SPEAKER_01

Absolutely. And that's where women typically focus on this weight loss number instead of muscle protection, because our muscle really is vital. And when that muscle is strengthening and maintained, that's where there's this correlation to the weight loss, too, because the metabolism begins to function better as well.

SPEAKER_00

Yeah. I think it's uh a basal metabolic rate, is what we call this. You know, how much energy are you burning in a resting state? And that really depends on your muscle tone, right? Um, so how much basically how much you can consume in calories depends on the muscle. Um, but muscle is not just important for burning energy, we also um need much muscle for glucose metabolism, so hugely important in signaling um insulin sensitivity. It it takes up glucose and uses it. Um, it supports your bones. Um, it is a really your metabolic and longevity um organ.

SPEAKER_01

Yeah, and that's why strength training, which we talked a little bit about on our previous episode, it's it's important for women as we age for these because of these factors, right? So this optimal three times a week getting in weightlifting, you know, resistance training and lifting weights is is very important.

SPEAKER_00

Absolutely. And and we also have um see this a lot. I think that women um try to lose weight fast with just eating less. And so we have this problem of undereating and especially um not getting enough protein in, and then this this can really backfire because then they're losing muscle and they're not gonna lose much weight in general, and they're gonna the the body senses that it needs to hold on to energy, they're storing more fat, losing muscle in this vicious cycle. So eating less does not work anymore when we're in perimenopause, menopause.

SPEAKER_01

Absolutely not. And I've even gone through personal, like my history of of like restrictive dieting. And I did a Weight Watchers thing many years ago where you know you're counting the points, and I know that the whole Weight Watchers has evolved since then, but back in the day, you were counting points, and it didn't matter to me how I got my points. I could eat a Snickers bar and a Dr. Pepper for lunch, and I was still within my point range. But was my and was I losing weight? Yeah, it was effective, but I was in restriction, but not restriction with the proper nutrition, you know? And so what was I creating? A metabolic backfire, truly, because I was giving my body sugar and carbs only, and not nutrient dense fiber and heavy protein. And so that that is something that I think is important for women is being aware of this nutrient density too, as you're facing these changes and understanding that it's there's so many pieces to the puzzle that's very bioindividual to every person of you know, genetics and and predispositions and all of that as well. Um, so let's talk about insulin resistance because this one is something that pops up online. You see, you know, influencers that'll be like, oh, this will fix it. And oftentimes people don't realize that they have it because maybe your labs are quote unquote normal, right? Um, but it's something what what insulin resistance is your body's just becoming less responsive to insulin over time. And so you're you need to produce more insulin for stabilization in your blood sugar. And what I love about our body, it's really cool, is that you're we're trying to constantly find homeostasis and your body is working for you. And so this is the what it's designed to do is if you need more insulin, it produces more insulin so that you stabilize your blood sugars. Um, and so I think a shocking factor is that this insulin resistance can be underlying prior to markers of prediabetes or diabetes with the A1C. And so that's why tracking those and having that at various points in your even like 20s and 30s, if you, you know, pregnancies, postpartums, like to really note where you at um as well, because you have that, you get you gather that data over time.

SPEAKER_00

Yeah. And and maybe breaking that down even more is you know, some some people might not know what insulin is. So insulin is a hormone released by your pancreas, um, and and it is released in response to glucose coming into your system. So let's say you eat a cookie or a potato or some rice or a piece of bread, right? We're eating some carbs, um, they get broken down, the body senses, hey, there's carbs coming in, pancreas makes insulin, releases it into the system. And insulin is like the key to your cell's door to let glucose into the cell. Once it's in the cell, we make energy with glucose. So carbs converted to glucose, insulin lets it into the cell, we make energy with that. Um, now insulin resistance means that your cells, those doors have seen way too much of this insulin around because you are there are too many carbs coming in. So you're eating overall, on when we look at your your daily intake, you're getting too many carbs. And the the cells start start kind of shutting down these these uh locks on their doors, and there's no more insulin won't fit anymore and won't let the glucose into the cell. So deep dive here. But what happens is glucose in your blood rises, inflammation rises with all that glucose floating around in your bloodstream, and your your cells, the mitochondria that make energy are depleted and they can't make ATP, which is energy. Um, so we're tired, right? We're drained, we feel like you know, that that slump after you eat, or all those, and then weight gain, of course, that glucose then needs to be put away somewhere because we can't use it. So it gets put into fat cells in your body, and you're just gonna gain weight. Very difficult to lose weight when you are insulin resistant. So we'll talk a little bit more about how we can make our bodies insulin sensitive again.

SPEAKER_01

Absolutely. And not something that I think is often overlooked. You have these specific symptoms, but everything in labs are fine for a good period of time, right? Um, which is frustrating, right? It's frustrating for women, it's frustrating for anyone that's navigating um these changes where you're like, why can't I?

SPEAKER_00

Right. Absolutely. Yeah. And insulin resistance is one of the um possible symptoms of PCOS. So that that happens earlier, right? That's not just women in their in their 40s and 50s. This is women's in the women in their 20s and 30s who experience insulin resistance. And and now, of course, with ultra-processed foods, never mind PCOS. We see that in kids, right? Yeah. Um, yeah, that's a that's a big thing.

SPEAKER_01

Yeah, so let's talk a little bit about like the hormonal impact too of glucose, insulin, progesterone, estrogen, all of that.

SPEAKER_00

Yes, so um, I'm menopausal, and just talking uh a little bit about my recent lab results, I had an A1C of 5.6, which in functional medicine that's your pre-diabetic. Really, you know, most conventional medicine says over 5.7. So if you're 5.8, you're you're starting to see an issue. We see that a little bit different, and anything over 5.3, you're probably having some issues with responding to insulin. I am, you know me, right? I exercise, I eat my salad, my protein, I'm good, but this still happens to me. So I'm I'm a little bit baffled at that too, and and looked into this a little bit deeper of what is happening in my body, why is this happening? And when we're um in in perimenopause menopause, as estrogen declines, estrogen is a key player here because estrogen helps you um use glucose via the muscle, it helps you really keep visceral fat at bay. So when lower estrogen levels are there, you're starting to use less glucose, you're making more visceral fat, that's making you more inflamed. You're then also gonna have more glucose released by the liver. So a bunch of glucose that just kind of doesn't get used as well as it did before, and your visceral fat increases, and that's um, you know, the inflammation. You're also gonna have impaired clearance of cholesterol as your estrogen goes away. So a lot of women see their lipids creep up when all their lives they've been completely fine and normal, and then all of a sudden progesterone plays a huge role because progesterone is very involved in fat burning. So as we have less of that, we're gonna see weight gain and visceral fat gain. And it's our sleep supporter, and as we all know, sleep is hugely important in our metabolisms and how well we burn energy and how we are sensitive to insulin too. So sleep suffers as well, and then cortisol levels, of course, contribute. You know, if we're having high cortisol levels, we're more likely to hold on to fat. It's this um running from the tiger fight or flight. You're you're constantly releasing glucose and holding on to that, packaging it into fat cells. Yeah.

SPEAKER_01

So when you mentioned that less clearance of cholesterol because of this lowering estrogen, um, that's me. So let's talk about cholesterol for a little bit. Yeah. Because I've seen personally this gradual increase of it. And yes, I have multiple factors of family history, genetics, etc., but there's more to that too, right? It's it's also these, you know, changes at 40 that I am navigating.

SPEAKER_00

Yeah. I think it's just really um, this is one of the key reasons why in in perimenopause and menopause our chronic disease risks go up exponentially, right? We we have this together with this declining uh hormone level curve, we have this increasing chronic disease risk curve of cardiovascular disease, of diabetes, of dementia, Alzheimer's, cognitive uh decline, bone loss, of course, is one of them too. Um, and and those are very, very closely related to hormone shifts.

SPEAKER_01

Yeah, so we really want to look at this whole picture together because, like I mentioned, genetics, but there's the stress layer, the nutrition layer, the movement layer, the inflammation. And inflammation can also be brought on by stress, but it can also be bought up brought on by like external toxins and environmental factors and and all of those things as well. So there's there's just so many factors. Um, but it doesn't mean that you're failing. I think that's an important point that we want to push is that our bodies are constantly trying to create homeostasis again. And so when something is elevated, it's a cue, it's a sign that something else is shifted. And so being in tune with that and using, you know, your your lab, functional labs as like this, I understand this is this is the tweaks because this is not, this is declining, so this one's increasing, etc. Um, and having providers to really break that down in into bite-sized pieces of what to do, I think is an integral piece to this.

SPEAKER_00

Yeah. Shall we chat about GLP ones? Yeah, let's talk about it. And everybody's talking about this right now, right? It's it's uh all over um social media and we everywhere. GLP ones are everywhere, and everybody's using them. Um, and there are a few things to consider, I think. And yeah, yeah.

SPEAKER_01

That's well, and I think like the conversation online is very black and white, right? It's this polarity of yes or no, and we want to bring in a conversation and and really help you see this from all angles, but not have any shame or any extremes around it as well. So, Johanna, I know you see a lot of clients come in and say, I just want to take this GLP one.

SPEAKER_00

Yes, and we have a we have an open conversation, you know. I I use GLP ones, but I use them with great caution, and they can be amazing for some people, and I think they can be really great for people who have a huge problem with with their metabolism. Let's say they have prediabetes or diabetes, they they're really overweight, they've got high cholesterol, they have high inflammation, and they really struggle with motivation. When in those people, a GOP1 can provide that initial motivational boost, you know, to get going, and they start seeing the weight shift on the scale, and then they really get into okay, let me eat better, let me go to the gym and do all the things that you're also telling me to do.

SPEAKER_01

Like an energy burst there because they do feel better, and it's kind of a catch-22 in that situation.

SPEAKER_00

Yeah. Um, on the other hand, we have to really be cautious about GLP1s. At the moment, we have no long-term data on um, you know, long-term effects of using this medication for weight loss. And um, the other part is that people, the the effects of a GLP one is really that we have less appetite, right? It affects our hunger cues, so we are gonna eat less and we're most likely gonna be a little bit nauseous, at least, some people very nauseous, and have a slowed-down digestive digestion. Um, so when this happens and you don't have a good diet, this is detrimental, right? People eat um crackers and uh chocolate as a meal or french fries or something like that, because that's all they can stomach or all they feel like. And we're we're not only gonna have huge nutritional deficiencies and inflammation and gut problems, but we're we're also taking away the we're not getting the protein that we need to maintain muscle, because with the GLP1, you will lose muscle along with the fat. That is the biggest concern, really, because muscle, as we just talked about, is your metabolic organ. As that declines, your metabolism is a mess even more than it was before. So it it's it can be really detrimental for people that you know don't fix their diet and don't do strength training. So I really recommend that in making sure that that that's a big piece of the um diet and lifestyle coaching.

SPEAKER_01

Definitely. And so what I'm hearing is like the foundational lifestyle factors of movement and nutrition and sleep hygiene and all of these components are foundational really for adding a GLP one. And that really is determining on if that is gonna be beneficial for you because the goal is that it's a tool for a period of time. And often what I have seen in in discussion with clients and others of this body dysmorphia of people that are on it and they've had great success, made you know, physical adjustments of losing, you know, 50 plus pounds, but there's fear of titrating off, there's fear of going back to where they were, there's also this lack of Seeing themselves for who they are in the mirror, they still see the old 50-pound heavier version. And so there's that is where this foundational lifestyle pieces are so important because it is telling and rewiring and training your brain that you are putting in the work alongside the medicine. And it's not just the medicine is doing it for you. So that it is easier to remove the medication and maintain those lifestyle factors so that the weight doesn't come back. And we're seeing that already in surplus as people stop them or they don't want to pay for them anymore, or whatever the fat the you know underlying factors because they're not cheap, then all of a sudden weight is returning and there's frustration about it. And it's another yo-yo diet, um, which isn't sustainable. Um, and thus we again, like you said, there's no long-term real studies to so to say, like, okay, if you've done this and yo-yo'd, you know, we know from other yo-yo dieting that you gain all the way back and more, you know, and and so what is gonna happen? Um, and that's that's kind of the long-term concerns where yeah where we both stand.

SPEAKER_00

Yeah, yeah. So in general, GLP ones can be really helpful um for some people, for for a few people. Um, but in general, we try to really work with nutrition, exercise, um, all the diet and lifestyle foundations um first. And then of course looking into things like your thyroid, your your cortisol, uh, your stress hormone levels, and your um your sex hormones as well. And if they're out of balance, that they can hugely um contribute to weight gain and metabolic shifts, and we can do a lot of things without a GLP one.

SPEAKER_01

Absolutely. So, besides looking at labs and hormones and helping support some balance, like what actually helps? Um, and this is where it comes back to personalized plan. So, this is foundational habits of nutrition, right? Eating in order, and what order I am always advocating for everyone, because insulin resistance is very common, um, especially in an American standardized diet, right? Like it's a very common um factor that we're navigating. And so starting all meals with fiber, those are your leafy greens, those are your you know, cruciferous vegetables, things like that, then adding your protein, then your fats, and then closing it out with the carbs. And the carbs could be the form of noodles or rice or quinoa, things along those lines as well. Um, that helps with blood blood sugar stability. Um, it also helps to go on walks after meals, get some movement instead of go from kitchen table to sofa and sit. It's more do something, get outside afterwards to help balance your blood sugar too. Um, one thing that I also lead every January, I do a sugar detox. Um, clients of mine also get a lot of the packs and the tools that I share within that group detox in January's. But what that also does is bring awareness to a being a sugar aware lifestyle. Um, because I'm a big advocate of don't just do a sugar detox and then go back to old habits and ways, but how can you sustain this in everything you do? And that starts with tracking your labels, reading what are the added sugars, monitoring um, because in that and that um sugar detox, right? We're we're removing added sugars and sweets and processed carbs and foods, and really eating a whole food clean diet with gluten-free grains. And it's it's no breads, it's it's things that we're eating like ferro and quinoa and um you know brown rice or whole grain rice, those types of um wild rice, those types of combinations that are better for our blood sugars. And we're also limiting a lot of the fruits that create these blood sugar spikes too during that window of time. Not saying fruits are bad, but because you do have the fiber with them, so it helps, but eating them solo can impact your blood sugar. So if this is already an issue, having, you know, a hard-boiled egg and then a watermelon slice or cantaloupe that's high sweet can help that blood sugar spike, giving your body the protein fat first. Um, and so just for awareness, American Heart Association recommends these like six tablespoons for women. And when you think about six tablespoons, we're we're not actually going to take six tablespoons of sugar and just eat it, but that creeps in so quickly. Um, I mean, there's more of that in one serving of a soda. And so it's how much is in wine? Oh tons, tons, right? And you think about oh, just a cookie or protein shakes. I mean, there's so many hidden places of sugar, yogurt, protein shakes, um, electrolytes, things that are quote unquote healthy or advertised as what we need. If we're not reading labels, we don't realize that. Um, protein bars are huge culprits of sugars as well. So, you know, being mindful of the six teaspoons, and that's like, you know, on labels, it's in grams. So that's 25 grams a day, and really honing in on awareness there. Um, but yeah, other foundational things, strength training, we've talked a lot about that already. Um, sleep stress, and if I could stress anything, it has to be sustainable. And so oftentimes if you start from I'm not exercising at all to I'm gonna exercise five days a week, it's not you're not gonna last. It's not gonna happen, right? It's gotta go from none to I'm gonna walk once a week and I'm gonna lift weights once a week. And then the next week I'm gonna add to that because I was successful. And so that's how our behavior change habits are enhanced and stacked over time because we can't just overnight wake up and I'm gonna have all these habits because then it won't you won't follow through with them and it's not a sustainable thing. So that is huge for nutritional changes and movement changes, sleep changes, things along those lines is one, you know, stack a different habit or remove and replace with something that is more beneficial to what your body needs um every week and focus on on those gradual changes in time.

SPEAKER_00

Yeah, and even the the little habits can make a huge impact on your metabolic health. So um we have studies that show 10 squats um three times a day, you know, is is gonna lower your A1C by, I don't remember, 0.3 or something. It's significant, and we don't always need you know hour-long CrossFit sessions, you know, that's not necessary. And um, throwing those little bite-sized um movements into your day can can make a huge impact, especially if you have a sedentary job and you're in your car or you're in front of your computer a whole lot. Um yeah, I do squats in my office all the time.

SPEAKER_01

More many breaks, get on my vibration plate, do squats, all the things. Exactly. Yeah. So women don't need more punishment around food, more judgment around decisions, things like that. We need education, we need support and realistic custom protocols and strategies to gradually stair step into an enhanced lifestyle. And so it's it's really not about extremes or this, you know, trendy choices. It's really the consistency with personalization.

SPEAKER_00

Yeah, personalization is really key. Um, I think I get asked um a lot of times, you know, hey, I my blood sugar was going up. So I started this carnivore diet, and is that good? You know, I get a lot of questions about types of uh new types of diets that that get a lot of hype on social media, and um, we have to really look at that in detail because carnivore, first of all, I will say this just as a side uh branch here, but carnivore um never good for anybody long term, definitely not as a short therapeutic intervention, maybe. But um what we have to do is really personalize nutrition, exercise, lifestyle, everything, right? We have to take a very close look at your hormones, we have to look at your A1C, your insulin, your fasting glucose, but also looking at insulin resistance scores like an LPIR or an HOMO IR. Lipid panels alone are not enough to determine your cardiovascular risk. So we really want to look at an advanced lipid panel that shows us particle sizes. We want to look at an APO lipoprotein B, an LP little A, genetic markers, um, Apol E. Those are really key components to determine, you know, yes, your your LDL cholesterol was a little bit high, but what does that mean for you? Are you at risk of making plaque? What's your family history? You know, sometimes imaging is important to check on do you have any plaque already? Um, so so that together with your symptoms, your diet and lifestyle, all has to be taken into account to make a really personalized treatment plan for you. And often hormones, bioidentical hormones can play a big role there and have a big impact on these metabolic uh risk markers. Um, together with um, you know, Melissa's coaching on all the nutrition and lifestyle things, of course.

SPEAKER_01

Yeah, so one thing that we want to close out with for today is that your body's not betraying you, it's adapting, and it likely needs different support than it did 10, even 20 years ago. So we're we're advocating to not chase the trends, to really get functional testing, dig deep, and be open to some support and gradual nutritional medication or supplement adjustments into your daily routine. Um, because you do deserve that informed, compassionate care.

SPEAKER_00

Yes, thanks for joining us today for another episode of Shift Happens Homes Unfiltered, the metabolic episode. If this episode resonated with you, share it with a friend, leave a review, and connect with us through the links in our show notes. All right, friends, that's a wrap for today's episode of Dift Happen, hormones unfiltered.

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