Change is Human.

What a mess we find ourselves in. We are on one hand celebrating menopause and talking about this change more than ever before, and on the other hand selling weight loss medications on every channel possible so that we can all feel terrible about the bodies we live in. It is extremely confusing for many of us, particularly those of us who were raised to praise thin bodies, feel proud of ourselves for restricting our calories and fight weight gain. Many people in my practice have been working for a long time to heal this disordered approach to food and body, only to find themselves again being bombarded with messages that we need to lose weight.

We had a lovely phase of body positivity, with bodies of all sizes and shapes on the covers of magazines, in catalogues and on TV. It made me realize that growing up in the 70s and 80s there were ONLY thin models; there were very few strong or larger bodies to look up to as my body was forming. To see women with muscles, with some body fat, with varying shapes was incredibly inspiring for many people who did not see themselves typically represented in media.

With the advent of GLP-1 medications, it seems that we are slowly slipping back towards the goal of becoming skinnier as the only option. To be clear: I prescribe these medications and I think they are amazing! I encourage my patients to use them when they are a good fit! But they are moving the needle in a direction that I find disturbing. Some of the strength training content online is equally concerning. Promoters sell supplements and workout protocols to the average person, however train for hours daily to have the bodies they are displaying. This also sets unattainable goals for our bodies, and is another form of disordered body image.

So where does this leave us?

I want to promote, follow and support channels that are giving us honest feedback about the fact that our bodies are designed TO CHANGE WITH ALL PHASES OF LIFE. This is what it means to have a healthy body. When I hear someone say that GLP-1 medications helped her get back to the weight she was in high school, my head spins. A Woman at middle age is not supposed to weigh the same as a high-school aged Child. There is no ONE weight that is appropriate for one person. There are many reasons and seasons to lose weight, and there are many reasons and seasons to gain. There are often reasons to gain strength and all of these things should be discussed openly with your physicians.

Because the majority of my patients are middle-aged women, I spend a lot of time talking about metabolism and weight in my office. It is so important to talk openly and honestly about all of the concerns that these issues bring up, and to do so without shame.  I do not consider this my area of expertise, but it is front and center for many women approaching menopause so it is discussed in nearly every visit. Our bodies are designed to change with different life stages. Our bodies are not designed to stay the same. This causes a lot of frustration for my patients of all sizes, and I think part of this stems from the lack of discussion around how NORMAL change is for our bodies. Health looks different for every body, and you get to decide this for yourself. Here are a few reminders in case you are feeling torn and preoccupied with thoughts about weight:

• There is no shame in loving the body you are in.
• There is no shame in being frustrated with the body you are in.
• There is no shame in feeling conflicted about the above feelings.
• There is no shame in your body changing.
• There is no shame in wanting your body to stay the same.
• There is no shame in mourning the loss of a younger body.
• There is no shame in becoming a feral person living in the woods who never looks in the mirror again (speaking for a friend, of course).
• There is no shame in wanting to become stronger for the first time.

Everyone has a unique body and experience of his/her/their body. I focus on a healthy metabolism with my patients because that is what helps us remain vibrant and energetic so that we can enjoy our lives to the fullest. Beyond that, the decision about a body’s appearance is up to the individual. My job as a physician is to be a bridge to health for my patients- this means that I share information, help support folks in reaching their goals, and give honest feedback when I am concerned that choices might not be the healthiest for long term outcome. I hope this is a gentle reminder to be kind to yourself. Let’s talk about this openly, let the shame go, and find a balance that allows you to feel great now and for years to come.