Tag: weight loss

Weight-loss medications can be powerful tools for women 40+, but they’re not magic and stopping often brings weight regain unless lifestyle fundamentals are in place. Midlife physiology (menopause transitions) adds insulin resistance and body-fat redistribution that meds don’t “fix.”

Rapid loss without lifting risks losing muscle: the very tissue that protects metabolism and healthy aging. Side effects are real and dose-dependent, including GI issues and a higher risk of gallbladder problems.

The most durable outcomes come from pairing medication with lifestyle medicine: strength training, protein-forward whole foods, sleep, stress tools and community.

Think of the drug as a bridge you use while you build skills you’ll keep for life and make simple environmental swaps (glass over plastic, more crucifers) to reduce daily load on your system.

Here are 5 things to consider before starting GLP-1:

They Don’t Fix the Root Cause.

GLP-1s and other anti-obesity meds help regulate appetite and glucose signaling but they don’t teach skills (protein-forward eating, strength training, stress/sleep hygiene). In the STEP-1 trial study, people who stopped semaglutide regained about two-thirds of the weight they had lost within a year off-drug; net loss shrank from −17.3% at 68 weeks to −5.6% at 120 weeks. That’s physiology, not failure—remove the tool and old drivers return unless habits have changed. Source: PMC

A broader meta-analysis across anti-obesity meds also shows significant regain after discontinuation again reinforcing “medication + skills” over “medication only.” Source: BioMed Central

Coach’s take: If you choose a med, build a parallel lifestyle plan from day one so your post-med life is sustainable.

Muscle loss can happen if you’re not lifting and eating enough protein.

Rapid weight loss without resistance training risks losing lean mass right along with fat. Body composition studies show absolute lean mass decreases on GLP-1s and tirzepatide (though fat loss is greater, so the ratio may improve). In SURMOUNT-1 (tirzepatide), DXA data showed significant reductions in both fat mass and lean mass. A 2024 review reports meaningful lean-mass decreases across GLP-1 and tirzepatide trials (e.g., −5–6 kg in some cohorts). Source

Semaglutide data also show shifts in lean:fat ratio with overall lean reductions. A good reminder to protect muscle with training and protein. Source

Coach’s take: Treat muscle like a non-negotiable asset. Progressive strength training (2–4x/week) + ≥1.6–2.2 g protein/kg lean mass/day is your insurance policy.

Hormones still matter in midlife. Meds don’t erase menopause physiology.

Perimenopause and menopause shift body composition (more visceral fat), insulin sensitivity and resting energy expenditure: independent of the scale. Reviews link estrogen decline with greater central adiposity and insulin resistance; midlife women often see fat redistribution even without big weight changes. Source

Mechanistically, estrogen has protective effects on insulin signaling; its decline contributes to metabolic friction. Source: American Journal of Pathology

Coach’s take: Pair any medication with habits that support hormones. Strength training, high-quality sleep, fiber-rich carbs, stress regulation. For some, evidence-based menopause care (e.g., HRT when appropriate) can improve insulin resistance markers. Source: The Menopause Society

Side effects are real. Know them & have a plan.

GI symptoms (nausea, vomiting, diarrhea/constipation, decreased appetite) are the most common and dose-related. Meta studies confirm increased GI adverse events and discontinuations versus controls; higher doses = higher risk. Source: Nature

There’s also a documented increase in gallbladder/biliary disease risk with GLP-1 RAs, especially at higher doses and longer duration (including weight-loss trials).

Coach’s take: Titrate slowly, eat smaller meals, prioritize hydration/electrolytes and loop your prescriber in early if symptoms escalate.

Lifestyle medicine wins the long game. Meds work best as a bridge, not a replacement.

High-quality studies and trials show durable risk reduction when people change habits. In the Diabetes Prevention Program, lifestyle intervention cut diabetes incidence by 58% (vs. 31% with metformin) and maintained benefit for 15+ years; Look AHEAD demonstrated sustained weight loss and broad cardiometabolic improvements with intensive lifestyle coaching  Source

Coach’s take: Use meds to create breathing room. Then use that window to install skills: protein-centric nutrition, strength training with progressive overload, walking, sleep, stress tools and community/accountability.

Where Your Medication Comes From Matters

There’s been a surge in online pharmacies and compounded versions of weight loss drugs. While they may look cheaper or more convenient, many aren’t regulated and the quality, purity and dosage of what you’re getting is questionable.

That’s why these medications should always be prescribed and monitored by a licensed physician who can:

  • Order baseline labs to check your liver, kidney and hormone health

  • Adjust dosage safely to minimize side effects

  • Monitor progress and protect muscle mass during weight loss

  • Ensure you’re not mixing the drug with something that could harm you

If you’re considering a weight loss drug, make sure your prescription is coming from a trusted, legitimate source and that you’re working with a provider who can monitor your health along the way.

✨ Bottom line: Weight loss drugs can be a great medication for many people, but they are not a magic solution.

Women over 40 need to protect their muscle, support their hormones and use lifestyle strategies as the foundation.

The medication should complement – not replace – those pillars.

Interested in Lifestyle Medicine Coaching: Connect with us here.

After months of being in a calorie deficit, you may find yourself at your goal weight—or close to it—but wondering: What now?

Most women fear what comes after dieting. The concern is real: “If I start eating more, won’t I just gain all the weight back?”

This is where reverse dieting comes in. Done strategically, it helps you restore your metabolism, regain energy, and maintain your results—without the rebound weight gain.

What Is A Reverse Diet?

Reverse dieting is the intentional, gradual increase of calories after a dieting phase. Instead of jumping straight back to your pre-diet eating habits, you slowly raise your intake to rebuild metabolism, balance hormones, and help your body adapt to a new “maintenance” level of calories.

Think of it as gently reprogramming your body to function optimally at higher energy levels—without the rapid fat regain that often comes with stopping a diet cold turkey.

Why You May Need a Reverse Diet

Reverse dieting is especially helpful if you:

  • Have been in a calorie deficit for 12+ weeks and are ready to transition out

  • Notice your energy, mood, or training performance dipping

  • Want to preserve your results after weight loss without rebounding

  • Are in perimenopause or menopause, when metabolic shifts make sustainability even more important

  • Feel anxious about returning to “normal” eating and want structure for long-term maintenance

The Benefits of Reverse Dieting

  1. Restores Metabolic Flexibility
    Long-term dieting can slow your metabolism (adaptive thermogenesis). Gradually increasing calories signals to your body that it’s safe to burn more energy again.
  2. Supports Training & Recovery
    More calories = more energy for workouts. Strength, endurance, and recovery all improve when you fuel your body properly.
  3. Reduces Food Anxiety
    Instead of fearing food, reverse dieting gives you a structured plan to increase intake, building confidence around eating more without spiraling.
  4. Balances Hormones
    Calories (especially carbs) help regulate thyroid hormones, sex hormones, and hunger hormones—leading to better mood, sleep, and energy.
  5. Creates Long-Term Sustainability
    Reverse dieting teaches you how to live at maintenance, making weight maintenance feel doable instead of fragile.

How to Do a Reverse Diet

  • Length: Typically 6–12 weeks, depending on your dieting history and response
  • Calories: Increase by 50–150 calories per week until you reach estimated maintenance
  • Macros: Keep protein high; slowly raise carbs and/or fats for energy and recovery
  • Training: Continue resistance training; increased energy often leads to performance gains
  • Monitoring: Track weight, energy, sleep, and hunger cues to adjust as needed

What Happens After a Reverse Diet?

Once you’ve successfully reversed, your calories should be back at maintenance—or even higher if you’ve built lean muscle along the way. This means:

  • A faster metabolism than when you started

  • Improved energy and performance in daily life and workouts

  • Confidence in maintaining weight without constant restriction

  • The option to continue in maintenance mode—or begin another fat loss phase later with a healthier, more resilient metabolism

Final Thought

Reverse dieting isn’t about losing more—it’s about protecting the results you’ve already worked so hard for.

It’s a bridge between fat loss and maintenance that allows you to keep your progress, rebuild your metabolism, and feel stronger, healthier, and more energized in the process.

If you’re ready to navigate a reverse diet with confidence, I can design a step-by-step plan customized to your body, goals, and lifestyle in my women’s weightloss and lifestyle coaching group.

This is where true sustainability begins.