The Livy Method Podcast - Health Care and Weight Loss with Dr. Jennifer Zelovitzky - Spring 2025

Episode Date: May 8, 2025

In this empowering episode, Dr. Jennifer Zelovitzky—Medical Doctor, Certified Menopause Practitioner, and host of the Medsplaining Podcast—joins Gina for a no-nonsense conversation about owning your health, trusting your body, and navigating weight loss with confidence. From understanding how your doctor can be a true partner in your journey to recognizing that medications aren’t a magic fix, Dr. Jennifer offers practical, science-backed insights on everything from aging and menopause to supplements and muscle health. This is a must-listen for anyone ready to shift their mindset, advocate for their own wellness, and make sustainable, meaningful change beyond the scale.Find Dr. Jennifer:Podcast: MedsplainingInstagram: @medsplainingwww.medcan.com/menopause-and-perimenopauseYou can find the full video hosted at: https://www.facebook.com/groups/livymethodspring2025To learn more about The Livy Method, visit www.ginalivy.com. Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livi and welcome to the Livi Method Podcast. This is where you'll have access to all of the live streams from my 91 Day Weight Loss program. With a combination of daily lives, guest expert interviews, and member stories, there is something new almost every day. Miss the Morning Live? Want to relisten to one of our amazing guest experts? Well, this is the place.

This podcast is hosted on Acast, but it's available on all podcast platforms, including the one you're listening to right now, Spotify, Apple, and Amazon music. This is an opportunity to become curious. To learn some things. How do we help you feel less overwhelmed so you can continue on your journey? Keep believing in yourself and keep trusting the process. Just be patient.

How can your family doctor or healthcare provider help you in your weight loss journey? That's the very serious conversation we're gonna have today with Dr. Jennifer Zalawitzki. She is a board certified family physician. She's a clinical director of women's health and vitality at MedCan. She is the host of the MedSplaining podcast. You definitely want to put that on your favorites list where she provides clear science-backed

medical information. She's just an all-around amazing person as well. So hello, hi. Hi, Gina. Well, thank you. I feel the same about you and it's great to be here. So you've been with us for a while now. Many of our members will know you from our Menopause add-on because you came in there, you talk about hormone replacement therapy. I mean, you talk about anything and everything and that's really a personal love and specialty to you. And Jennifer's gonna be back with us having that specific conversation

because it needs its own sort of time slot to discuss that. We'll touch on it a little bit here, but I wanna have a more generalized conversation because you know what people are trying to do in the program. They're trying to lose weight in a healthy way, physically, mentally. Where does their doctor come into the process? Well, I think your doctor will be engaged to the extent that you direct them to be. You know, family doctors are very busy.

They have a lot of things on their plate. Their main job is to make sure that you're up to date with all of your essential screening and to kind of put out fires, you know, deal with illnesses and issues as they come up. However, they often will note to you if they feel that you need to lose weight and it's often vague sort of recommendation that they make. And so I think that if you turn to them and say, okay, well, will you help me be accountable to this? Could I check in with you once every two to three months where we can see how I'm progressing, not just in terms of the number on the scale, in terms of the health manifestations of weight

loss? What is it doing to your blood pressure? What is it doing for your cholesterol levels, your sugar levels? Those are the things, those are the real parameters that can continue to motivate you, even if the scale seems a little bit stubborn and the scale could be stubborn for very valid reasons,

which I'm sure we'll get into, but the scale should not be the only metric that people are focused on. And your doctor can help you with that for sure. I love that you mentioned the conversations that we're having or not having with our doctors, because when I was at the obesity summit a few months back, I mean, these are obesity experts. These are doctors that specialize in obesity medicine. And even they are just trying to figure it out.

And especially the part of having conversations with their patients. And you're right, many of our family doctors, this is not their area of specialty. And they may just say to you, oh, just try this diet, try that diet, try to eat better, exercise more. And you walk away and you're like,

well, how do I even do that? And then I think a lot of people, if we break it down, they might not have had the best experience with their doctors. I think a lot of people, when they feel overweight, they feel maybe undeserving of the time that they need with their doctor because everything is just go lose weight. If you just went lost weight, if you lost weight, it'll take pressure off your knees.

If you lost weight, it'll help you through blood pressure. If you lost weight, that was the answer to everything. If we go back to our doctor having not lost weight or maybe we lost the weight and then we gained the weight back, that relationship could be a little bit strained. And so what's your advice for kind of building a respectful relationship with your family doctor? You know, I think that, again, doctors can sometimes look at this as a black and white issue as you've kind of indicated there. And it this as a black and white issue as you've indicated there.

And it's obviously a multifactorial issue. My bread and butter is menopause, obviously, and I know that's a huge blind spot for doctors. So if you're not able to move more and eat less, because maybe you haven't slept well in five years, because maybe you're going through menopause and you're really struggling, you need to bring that to your doctor's attention. You know, I think sometimes we have to lead a little bit with our doctors, we have to let them know, we have to go into our appointments very organized, and understand for ourselves, the factors that

might be contributing to our struggle with weight loss and bring and maybe they can then help you in more concrete ways rather than these vague, you know, eat less, move more ways that that never move the needle. They never work for people because if you could just do that, you'd be doing it. If it was that simple, you'd be doing it. But it's not that simple. There are hormonal factors, there are digestive factors, there are lifestyle factors, there are real life stressors that interfere with our ability to lose the weight. And I think the more information you can provide your doctor, the more you can help them help you. Okay, let's talk about that because as I was at this obesity conference, there was a panel

and they were talking about the importance of putting together your healthcare team, but how you go to see your psychologist once every maybe three months, six months, or you're on a wait list and can't even get in. And then maybe you need a physiotherapist because you do have a bad hip or knee and it's, you know, it's impacting your ability to move, but that takes a while to get in. And then you have this doctor that's checking your hormones and this doctor. And, you know, every few months you're going to see a doctor,

but you're getting piecemeal of information. What is the best way to start? It's such a big conversation. I go to my doctor and say, Hey, I'm going to try to lose weight here. How is the best way to start? It's such a big conversation. I go to my doctor and say, Hey, I'm going to try to lose weight here. How can you best support me? But that's really like a loaded. That's a loaded question. It's a lot. It is. I think that's where you have to be your own quarterback. So if you feel you can do that on your own, where you can keep track of all of the different factors and see how maybe there's overlap in the advice that you're getting, like what are the things that kind of work together that you can do to create your own cohesive

plan of attack. But I think for the vast majority of people that would be very confusing and very challenging. And this is perhaps asking your doctor for a referral to a medically guided weight loss program that's holistic would be more beneficial because many of the programs they can introduce pharmaceutical weight loss if that's necessary or recommended, but they also often include targeted psychological supports, physical supports, and then they're sort of aware, they're more aware because it's their

specialty of the various factors that can play in here and can perhaps give you a more holistic approach to your weight loss journey. I mean that's really great. I love the Libby method, right? It's a great, super effective science-backed, proven method that helps people lose weight in a healthy way, physically, mentally. We give you sort of the roadmap, the blueprint. We bring in amazing experts. And I think sometimes people think,

well, you're not going to ask your doctor for that kind of specialized help because you're just gonna do it on your own and You they can set you up with a team of people that can help you on your journey It's not about just I just I'm doing the living method and that's it. Some people need more than what are you know? Dollar a day program can offer them and it's really great what we provide here But putting together the right team for you can be make or break really. Yes, because I can't stress enough how much we have to look beyond the scale. You want to be getting your body composition measured because if you are doing things the

healthiest way, you will be gaining muscle, right? And muscle is denser than fat. And so maybe you're not seeing the scale moving, but perhaps you have brought, like I said, you've brought your muscle mass up, you've brought your blood pressure down, you've brought your cholesterol down. These are all way more important than the scale.

So these are the types of additional information pieces that you can get from engaging your healthcare provider and your healthcare team in your journey. Yeah, I see a comment here from one of our members, the help is always a pill, right? But this is sort of where, and this is why I love Dr. Jennifer, cause she's like, okay, the pill is not the deal end all,

especially when it comes to hormone therapy, when it comes to menopause as well. This is sort of where, and this is why I love Dr. Jennifer, because she's like, okay, the pill is not the be all end all, especially when it comes to hormone therapy, when it comes to menopause as well. We'll get into that later. But I think that's sort of like, you're gonna get what you give from your doctor. Yeah. Yeah, if they're automatically offering a pill

without any lifestyle components of advice, that's where you ask for a referral to an expert because they just, they're not aware of the lifestyle component, which is, you know, a massive part of it. I put it at 75 to 80%. I can give you hormone therapy, for example. It's not going to lift the weight for you. It's not going to change your alcohol intake. It's not going to change the amount of protein you eat. And the same with, you know, the weight loss medications, they're not going to ensure that you maintain your muscle and bone mass. So I do agree. I do agree with whoever made that comment. If their answer is the pill, ask for someone else.

Yeah, I mean, especially with the GLP-1s. If you've been prescribed GLP-1s, you should also be prescribed some sort of lifestyle counseling along with that lifestyle program like the Living Method, which is a great program. Is the conversation different for men than it is for women? A little bit, because andropause is a gradual process. Yes, over time, over decades, men will experience a gradual decline in their testosterone and

thereby in their muscle mass and in their bone density. density, but it's a very gradual decline, which is why, which is why for men, lifestyle factors just work exponentially, you know, like they, if they make those changes, they are really going to notice results much more quickly often than women will. And that's because when we go through the menopause transition, everything goes off a cliff. Menopause is a very steep decline in our ovarian hormones. And that's, I think, where the difference lies. And that's why women feel so frustrated. You always hear that old joke,

like my husband just cut cream out of his coffee and lost 20 pounds and here I am, sweating every day and limiting myself to everything. And I can barely lose a pound. You know, this is where this joke is very sort of a realistic thing. It's not to say it's easy. It's just that the dividends are a little higher for men because the decline in their hormonal levels is a little more gradual. Yeah. So, you know, so for men, let's talk about men specifically wanting to lose weight, because

I think when it comes to men, their idea of weight loss is, okay, I'm going to go exercise really hard, like I used to train when I played hockey or football or whatever, and I'm just going to not eat junk food. And our issue with men when they do the program is they can lose quite a bit of weight quite quickly. And if they are taking blood pressure medications, cholesterol medications, they will need to come off those. And so do you find that men will show up with the same kind of like list of,

this is what's going on with me. Like what in particular should men, what's the conversation with men when they go to their doctor and they're like, listen, I'm trying to lose weight. And they may not be up to speed on all the latest weight loss programs and things going out there. What's the conversation for them?

Yeah, I find with men, they tend to, tend to, I'm generalizing, they tend to be less drawn to sort of fad diets. And they always seem to be more drawn to the general principles that we know are just that work, that eating more protein, eating more vegetables are things that are obviously always going to be effective. One thing that I will say is stress seems to play a huge role for men in most cases. They'll often point to their stress levels and their workload.

And that's not to say women can't also have that heavy workload, but I'm just saying this seems to be the barrier for men, more so than I see it with women, is that, well, I don't have time. I don't have time to take care of myself because my job is very demanding, I'm traveling a lot, I have to entertain clients, this is another big one, or socially, I just go out with the guys and I have to be drinking

and I have to be eating the nachos and the wings. So there's a little bit more social pressure I think for men to keep up with each other, whatever it is, but alcohol can often be a factor because one thing I will say that is common in women and men, there's two things. Our ability to metabolize alcohol declines at midlife and our microbiome declines at midlife and these are two things that impact our ability to metabolize alcohol declines at midlife and our microbiome declines at midlife. And these are two things that impact our ability to digest. Alcohol is a carbohydrate and also our macronutrients. And this is something that is equivalent

in men and women at midlife that can also interfere. Really, with men too, because we're hearing this a lot with women, obviously, with the whole conversation of menopause exploding. But same for men. Yes, yes. The alcohol dehydrogenase is our enzyme

that our liver produces that metabolizes alcohol. And it's not that we have less of it, it's that it becomes less metabolically active at midlife for men and women. And women are often acutely aware of this because they'll get hot flashes if they have alcohol. Men don't get the hot flashes, but they might notice their sleep is more disrupted if they have alcohol at night. And this is because our liver, whereas when we were in our twenties or thirties,

if we could drink, we could drink a few drinks at dinner and it would be fully metabolized by the time we'd go to bed. Now it's taking the liver the whole night to metabolize that alcohol. And because alcohol is a carbohydrate load, essentially, you're working on the furnace is working all night long to metabolize that, which prevents you from getting into a deep restorative sleep, which then sets you up the next day to have more carbohydrate cravings and more irritability and less willingness to move your body. And it ends up being a cascade. And then with respect to the bio, you know, men and women experience a loss of volume in the healthy bacteria in their digestive tract as they age.

Women have an extra hit, which is that we lose the variety of bacteria, and that's related to our estrogen levels, but men and women both experience this loss of volume. So a probiotic, as I know you recommend, is really important for our digestive integrity. I want to talk to you about supplements right now because talking about your microbiome and probiotics prebiotics, they are on our list of basic supplements that we just posted on Tuesday. And we had Dr. Paul, he's a naturopathic doctor.

Obviously he knows a lot about supplements. It's totally his jam. And he's trying to convince people the benefit of them, the science behind them. Now, as you know, we do omega-3, vitamin D, magnesium, B complex, probiotics, prebiotics, talking about creatine, collagen as well. What's your stance?

Just to say out loud as a medical doctor who's all about being science-based, your stance on supplements here? So here's my stance. We know that unfortunately supplements are not regulated by Health Canada or the FDA. So this is where the conundrum comes in. I could create a supplement for anything, say it does anything, say it has anything in it. I do not have to prove that, right? I don't have to do a clinical trial. I don't have to submit my list of ingredients to any regulatory body to confirm that I'm giving you the same amount of the same things every single

time you buy a bottle of that supplement. So this is what a lot of people don't understand. Having said that, of course, we know that all of the supplements you named are very beneficial and very important, especially at midlife. And they are the ones that I generally recommend, although collagen, we don't have as much evidence for. And creatine, I recommend it for people who are actually actively trying to build muscle. Like again, it's one of those things where it's like, if you just take creatine and sit on the couch, it's not, it's not helping you build muscle. If you're taking creatine because you're going to the gym and you're lifting a weight or you're using body weight or whatever it is, it will help you. So that's a targeted one. But the rest are absolutely essential for us.

It's just a bit of a buyer beware. I'm going to give you an example. There are a lot of menopause supplements on the market. None of them are proven. And I had a patient who was post menopausal, so long past her final period, who started one of these menopause supplements before she came to see me because frankly, she was desperate for some relief from her symptoms. She started bleeding. She started bleeding. And she had to go through an extensive workup, biopsies, ultrasounds, sonograms, everything. And she found everything to be benign. And she stopped the supplement and the bleeding stopped. And then she spoke to a friend

who had had the exact same experience. And my theory is, and this has happened before, they were sneaking a bit of estrogen into that supplement. Oh. A little bit of estrogen so that, first of all, people would feel better, obviously, when they took it. They don't have to disclose

that they've included some estrogen in it because it's not regulated. And the estrogen without progesterone to counteract it would explain why they were bleeding and why they stopped when they stopped the supplement. And I can't prove it, but this is an example of buyer beware, right? So I always recommend if you're looking for brands, look for the tried and true brands that you know you see them every time you go to the drugstore for decades because they clearly are doing something right and trustworthy because people are buying them over and over

again. They're clearly having the results that they're looking for and they've stood the test of time, but that's really the best we can do when it comes to supplements. Okay. And we're going to put, people have been asking us for a brand list forever. So we're going to actually put together a brand list for people of ones that you can feel like confident in purchasing and buying. Generally they tend to be the more pricey, pricier brands, but that's not always the case. So we're going to do that for people.

I just love that you back up the fact that taking supplements can be really beneficial, especially the, you know, ones like vitamin D, magnesium and whatnot. I'm going to ask you, what do you do if you don't have access to a medical doctor? And then I want to get into the menopause conversation for those that want to hear that. But I have this conversation from Kim. My doctor has gone over my lifestyle and blood work and is happy with what I'm doing, but the weight isn't moving down. He said, my next step is meds like Ozempic or Contrave. I'm scared to go that route. What advice would you have for Kim? Well, I have great, great news because like I said, I think

75% of weight loss is lifestyle, which is completely within control. We do not need a doctor for, right? And I don't know what Kim is specifically doing, but my principles that I know that are based on evidence are it starts with sleep. Studies show women who get seven to eight hours of sleep, definitely lose more weight than women who get less than seven.

And if you are somebody who kind of quantifies your sleep, 20 to 25% of your sleep should be deep sleep or REM sleep. So there are people that wear devices or use their watch or whatever to monitor. I personally don't monitor. I just go based on how I'm feeling during the day, right? If you are able to make it through the day, you have energy to sustain you. You're reasonably well-mannered

in terms of your irritability and you're able to fight the cravings. You're not craving carbs like crazy because that's a sign that you didn't get enough restorative sleep. Yes. Then you're doing well, but you need to aim for that. A lot of us burn the midnight oil, right?

We wanna, I know I'm guilty of this sometimes. I feel like when I get into bed late at night, it's my only time to myself that I've had all day and I wanna read and I wanna catch up with emails and I wanna do all the things, but we really need to honor our need for sleep. So that's one. Step two, of course, is nutrition. And I know you've got this on lock, but it's, are you getting the fiber that you need? Are you getting the protein that you need? Are

you getting your complex carbohydrates? Are you over restricting your calories? Because that can backfire and lead to a struggle with weight loss for, you know, more complicated reasons, right? Like your body thinks it's in hibernation mode, right? So it will sort of start to slow your metabolism down. Are you moving your body? And are you moving your body in the right way? We're often drawn to cardio. We think that if we're running and sweating, that is what leads to weight loss. But as we get into middle age, 40s, 50s and beyond, it's actually the loss of muscle mass that is driving our weight gain. And unless we replace the muscle mass, we are not gonna increase our metabolic rate.

So every ounce of muscle that you have increases your metabolic rate. And so strength training, 90 minutes a week if you can get to it, that's a goal, but everyone should strive for 90 minutes a week of some activity that's making you stronger and putting on muscle mass. of some activity that's making you stronger and putting on muscle mass.

Yeah, of course, the one I've touched on, alcohol reduction. Alcohol is an absolute killer when it comes to weight loss goals. If you're having more than two standard drinks a week, first of all, you're putting yourself at higher risk of cardiovascular events and cancer. Secondly, you're giving your body a carbohydrate load. You would never sit and eat a loaf of bread, right? If you're trying to lose weight. So sitting and having two or three drinks is counter intuitive to your goals. Yeah. You know what I'm gonna do?

I'm gonna, I'm just gonna say out loud for everyone who's listening and joining us right now. I think tomorrow I'm gonna host a live specifically for the 9 a.m. on people who are just can't get the scale to move, that are having a hard time, that are like, it's not working for me, and I'm gonna get in and go through all of the things.

I used to do this troubleshooting conversation and take people through all the things that they could be doing. Because I find someone, people really go back to, well, before I ate less and didn't exercise at all and it was really easy for me to lose weight. And I'm doing all that now and I'm not losing weight. I'm sleeping decent, sleeping long hours.

Are you actually waking up feeling well rested? That's a big one. Stress, everyone's like, I'm sleeping, sleeping decent, sleeping long hours. Are you actually waking up feeling well rested? That's a big one. Stress, everyone's like, I'm fine. I'm doing all the things, but yet they haven't taken time to do some deep breathing exercises. Or I'll say to someone, and I used to get people to score themselves at a 10

on like, how's your water? And they would give themselves a 10. And how's your exercise? Give themselves a 10 themselves a 10. And how's your exercise? Give themselves a 10. Just to say, I'm working really hard at it. And then when I sat down with them, I'm like, okay, what are you doing for exercise? And they're like, well,

I'm taking my dog for a walk three times a week. I'm like, okay, are you like getting your heart rate up? Are you going up hills? Oh no, it's an old dog. So that's the best I can do. And I'm like, well, you gave yourself a 10. 10 would be like doing resistance training, lifting some heavy weights for 90 minutes,

getting your heart rate up, where you're sweating and huffing and puffing, maybe doing some yoga, stretching to help with mobility. And people think, okay, well, I'm doing all these things, but are you actually doing them in a way that you need to do them? And I'm not saying that, Kim, I'm not saying that you're not, but what I'm saying is,

are you doing the right things for you? A lot of people tend to fixate on the food when it's other things. I never met anyone that I couldn't help lose weight, as long as they were willing to put the time in to do the things for as long as it was gonna take. And for some people, it took a lot longer because of whatever health issues they were dealing with, muscle mass being a big one and whatnot.

Well, the way you've brought up for me is the mythology of the 10,000 steps. So this whole idea of 10,000 steps was actually part of a marketing campaign by Kellogg's cereal. What? Yeah, they included a pedometer in the boxes of cereal and they're like, eat our cereal and then take 10,000 steps a day and you'll be healthy. I don't know. It was all a marketing gimmick. And people have taken 10,000 steps to mean

you're crushing it if you're doing 10,000 steps. 10,000 steps just means you're moving it if you're doing 10,000 steps. 10,000 steps just means you're moving at a reasonable level to sustain your metabolism. It doesn't, it's what you do beyond the 10,000 steps that constitutes exercise. And I think it created, same as the whole snack wealth trend in the 90s created an explosion of obesity by blaming carbs rather than or blaming fat rather than sugar for weight gain. I think the 10,000 steps has to go away because it's the bare minimum to show that you're moving, which is what humans are meant to do. It does, it's not enough. It will, you will never lose weight doing 10,000 steps. humans are meant to do. It's not enough. You will never lose weight doing 10,000 steps. I hate to say that. I really do. I have three dogs. I walk them.

I don't count that as my exercise. That's not my exercise. They're stopping every two seconds. There's no muscle building in it for me. It's a slow pace. I do my exercise on top of walking my dogs. So this is, it's not easy. I'm not saying it's easy. This is a habit for me that I've only had for five years, but it's become non-negotiable to me that I have to do something for myself every day

that makes my body feel active and good. Sorry, I know know it's shocking. A lot of people don't know that. That was yet another marketing ploy to make people think that, you know, let's eat a lot of cereal and then let's walk. And I'm not saying 10,000 steps is easy to do, it isn't. But we're so much less active in this day and age than our forefathers were, you know, and that's what it's really getting at. Yeah, I like Shoshana said, and not all steps

are created equal. I've been inside and I'm laughing because I am guilty. I'm like, I got my 10 steps in today, someone give me a prize, I have arrived, I am amazing. And I'm not going to take that away from people. However, I've been doing my steps inside on I am amazing. And I'm not going to take that away from people. However, I've been doing my steps inside on my walking pad and yesterday all winter long. And while I'm watching TV and yes, I do weights and stuff. I do that. I went for a walk outside yesterday. I was dying. I was dying because there was like little hills and things I had to step over. And I was like, what the actual I am not in shape.

What is happening here? Huffing and puffing. And I was like, okay, the walking I've been doing inside is not the same as the walking I'm doing outside. A weighted vest can be a great thing. I know they're really trendy now and then there's some controversy of blah, blah, blah. It is great because that automatically adds

a component of resistance training to your walks. So it's a good idea. It really is to do that because that is building back strength, core strength, leg strength, anything you're doing that's adding resistance because that's like walking uphill, right? If you're walking on flat land, but you're wearing a little weighted vest, you're automatically adding a hill. Yeah. I do have a weighted vest. It tends to sit in the corner. I'm going to start getting back to that. I'm going to start getting back to that. Well, do some sort of fitness challenge. What are your thoughts on BMI? I know it's like so old, but just say it out loud. Yeah, it's going the way of the dinosaur in the medical community. We're no longer really looking

at it. It tells us nothing about your body composition. I had a patient, I was about to meet him, I saw his BMI was, you know, 35 and I'm like, oh, we're gonna have a discussion about this. And then he walks in and he's literally like Arnold Schwarzenegger, you know, he's like a serious bodybuilder and his body fat percentage was 17. And I'm like, oh, okay. This is a perfect example of why BMI, it's the best we had before we had body composition skills and DEXA scans. Now that we can do all of these other more precise measures,

I always tell people go based on how your clothes fit. Don't go based on your BMI or what the scale says. Okay, I wanna get into the menopause part of this conversation. Cause I mean, this is an area of specialty for you. And this is what a lot of our members wanna talk about it. So Dave, if you wanna check out or all the men joining us, you guys can. However, I do still think it's an important conversation

if you have women in your lives, especially going through perimenopause, menopause, postmenopause, especially if they're doing the program with you, it might give you an understanding of why it's a little bit harder for them and why they get frustrated and all of that. But I digress. To each his own, pick up what we're putting down.

You're gonna be coming back, I think, I think, I don't know the date, I think on the, I don't know what the date is now. I can't remember the date, but you're gonna come I don't know what date is now. I can't remember the date, but you're gonna come back and talk about menopause and weight loss specifically. And then you're gonna be joining me in our weight loss and menopause learning series.

So this was previously our menopause add-on. We've turned it into a four week learning series. Dr. Jennifer is gonna be there with us every single week, kind of leading the conversation. If you're interested in that, you can go to our website and find more information and I'll share more on that later. It's starting June 2nd.

But for the people right now today, and maybe they're new members and they've just signed up and they're just like sitting here thinking, I'm not sure about this Libby method. I'm in perimenopause, menopause, I'm postmenopausal, I've tried all the things, maybe the scale isn't moving for them yet. And although that's totally normal, they're thinking,

is this gonna help me? And everyone thinks the answer is, I need to be on hormone therapy. And if for whatever reason they can't take hormone therapy, they think nothing is gonna work for me. So can we just talk quickly about weight loss and menopause, keeping in mind our members who are just starting the program and have a lot of questions about it that we're not going to be able to answer all today.

Yeah, no, basically what I will say is 80% of women who go through the menopause transition have symptoms, right? The cardinal symptom is hot flashes and night sweats. But sleep waking up in the middle of the night multiple times is a huge one. Chronic fatigue, irritability, carbohydrate cravings, brain fog, dry eyes, joint pain, bone density loss, all of these things, they're all happening at a time. What's happening in the background is starting at age 35, we start losing our muscle mass. Muscle mass declines and it starts to decline a little more rapidly

as we go through the menopause transition. So this unfortunately sets up a situation where as muscle declines, those cells, they have to do something. They can't just evaporate. They convert to visceral fat. And this is why women notice this creep of weight gain around the midsection, the belly fat, the bulge that we get.

That's the visceral fat, which is a very unhealthy type of fat. It's not the nice insulating kind of fat that we have when we're young. It's metabolically active, but in a negative way. So it is driving up insulin resistance, inflammation, cholesterol. It does one thing that's somewhat positive, which it is capable of making a tiny bit

of a weak estrogen for our body. And this is really the key because this is likely why it's happening. Now, this does contribute to weight gain, but you know, other things contribute to genetics, digestive hormones like leptin and ghrelin. We know leptin is decreasing and that's what makes us feel full and satisfied and ghrelin, which drives cravings, is increasing. These are all problematic. So as much as I would love to say hormones fix weight gain, they don't. But what I will say is if you're symptomatic, you need to address the symptoms, whether that be through hormonal or non-hormonal options. Because as I say, I see sleep as the top of the pyramid.

And sleep disruption and hot flashes and night sweats are one of the number one things that occur for women in this phase of life. And if you do not address that, if you are not getting a good night of sleep, everything else falls apart from there. You are moving less, you're expending less energy, you're losing more muscle mass, and thereby losing more bone mass, you're going to maybe be drinking a little bit more, you're going to be more irritable, and on and on and on. So sleep is the cardinal thing, and if the only way to get your sleep under control is by talking about some solutions for that

with your doctor, then I wholeheartedly recommend it. Hormones are not recommended for women who are asymptomatic because we have no evidence that women who are asymptomatic are going to experience the same downstream sort of health consequences as women who are symptomatic are going to experience the same downstream sort of health consequences as women who are symptomatic. So it's certainly an area that I could see evolving in the future as we have more information. But for the time being, we know the women who are most impacted by menopause are the ones that have symptoms.

Yeah. So we're going gonna be talking more about this when Dr. Jennifer joins us again here, the weight loss program in the learning series that we're doing, we're gonna talk about HRT options, non-HRT options, we're gonna talk about a lot of things, specifically focused on weight loss and menopause, but it is the things that you're doing in this program. One of the big sort of aha moments that I've had in my conversations with Dr. Jennifer was you take

HRT, we think that it's just going to fix our menopause. It doesn't. It addresses your symptoms. And your symptoms are why you're having a hard time losing weight. If you're not sleeping, it makes your body less sensitive to insulin. You crave more. If you also have stress levels and you're not sleeping, it can throw your hormones out of whack. It's really about managing the symptoms, but there's a lot you can do lifestyle-wise, like making sure you're following proper sleep hygiene, like not being on your phone at night, managing your stress, taking deep breathing exercises throughout the day. you're following proper sleep hygiene, like not being on your phone at night, managing your stress, taking deep breathing exercises

throughout the day, making sure you are eating the foods that you are eating, getting in tune with your hunger levels and whatnot. And if you add years and years of dieting, going into menopause, where you have starved and you have deprived, there's a big difference between weight loss and fat loss. So you're already going into menopause with that decline in muscle mass.

And then as age, you tend not to be as active, so then you have that decline in muscle mass. And so that's where maybe before you did the diet and you lost the weight real quick, and that vestral fat that Dr. Jennifer's talking about, that's not, you can't just like diet that off like you used to diet your fat off. So it seems like it's impossible

and it seems like it's so much harder. And I'm not to say that it isn't, but it's absolutely possible. But it's the things that you're doing, the lifestyle part of it, eating is important. But it's that lifestyle part of it that is really the answer when it comes to weight loss. And if hormone therapy or even the medications they have now

for those that can't take the hormone therapy, because there are some that are out there, that's gonna help with the symptoms and help you get a handle on all of that. Did I say that properly? 100%. And you know, another thing that we need to touch on is the grief of grieving your old body.

You know, we will have some changes. The same as when we had, if we had children, we know our body changes when we have children and it never goes back. 100% we'll have stretch marks or we'll have slightly different, you know, proportions in our body than we had before we had children. Menopause is the same. We will not necessarily look the same as we did, menopause is the same. We will not necessarily look the same as we did before menopause. And there is a psychological component to that.

And there can be a grief and perhaps a trigger for disordered eating, right? That we also wanna address. So you may even, you may find it necessary or beneficial to speak with a mental health counselor who's well-versed in reproductive life stages. To help you navigate that, it's a very real thing. We're going through a lot psychologically and physically

at this point in our life. I'm glad that you brought that up. I'm there right now. I'm kind of in this, like, I'm never gonna be able to get back to what I was before. And that's sad for me. So I'm making my goal the best I can feel right now, the best I can feel moving forward.

But there is that piece I think we don't talk a lot about. I think we talk about going to menopause. I'm not afraid of menopause. And I'm looking forward to when I get to the other side of it, where I really think I'm going to have this calm and this clarity and this even greater sense of self as my life's purpose changes, you know, as my kids get older and I'm, you know, discovering what do I really want in my life?

I'm not afraid of that. But when I do look in the mirror, sometimes I'm like, okay, I'm getting to that point where I am becoming an older woman. Like I'm no longer the 20 year old 30 year old 40 year old that I associate myself with. And I'm starting to see that there, there is a bit of like, I'm happy. And I'm like, I look great. And you can tell me that a million times over. And I know that but I am grieving it's it's brought up this like, oh,

I'm not sad about it but there is like this, there is this underlying like, I'm never, I can never go back to, I can never go back to it being easy peasy, felt great, looked amazing, la la la, and just it's not going to happen for me. Well, I guess if we start to look for different parameters like for me it's become I want to be I want to get really must I want to get not muscular but I want to get like strong and toned and I've been working I've been working really really hard for the last three years on building up my my my glutes and my thighs right um And the other day I was going through my closet and I can't get my skinny jeans on.

And of course your first instinct is, oh my gosh. And then I'm like, oh wait, I can't get my skinny jeans on because actually my thighs are bigger than they used to be because I've been squatting. I've been doing tons and tons and tons and tons of squats since I last wore these jeans.

And so I think that my initial instinct was like, oh my gosh, I can't fit into my jeans anymore. And skinny jeans, I'm told are out anyway by my kids. So it's all good anyway, but I think we have to strive for different goals maybe. My goals now are very different than they were when I was 20 or 30. I wanna stay out of a nursing home,

and be really honest. All of my movement and my nutrition now is centered around how do I avoid going to a nursing home when I'm 70? And this is another reason why I, I, I demand that my patients when they are starting a weight loss medication, that they also commit equally to maintaining their muscle mass, because I worry all the time that we're going to have an epidemic of very thin, frail women and men, nursing homes in 20 years. I can't stress it enough how they have to go hand in hand. It was never meant to be used in isolation.

It has to be the lifestyle will always be the cornerstone. Yeah. I love your truth prompts. Listen, Dr. Jennifer's like me where we're going to tell you how it is. I see this comment from Alan, discounting walking as a healthy activity isn't helpful. First of all, if your interpretation is that we're discounting how walking is a healthy activity, you just want to see it that way. Maybe you want to be angry. Maybe you can't walk or whatever that is. No one is discounting, but the reality is, and this is why people in blue zones, they walk 20,000 steps a day. That is just part of their healthy lifestyle. If you were sedentary. They mostly live in uphill. One of the things they said in the blue zones is they mostly live in towns that have a slope and a rugged terrain,

and they're doing everything. They're not automating things. I'm not discounting it. I'm saying it's, it's, it can be your cardio component, but it's not building muscle. My own physiotherapist reiterated this to me the other day. It's not building muscle. It is weight bearing and it is because it's, you know, you're using your own body weight, but it's not stressing your muscles to the point where they're breaking down to build up stronger. So yeah, it's not to discount it, it's to tell you the truth about where that mythology came from. Because it did harm because it once again was emphasizing that the cardio component is all that should

matter to people. Yeah, because you're right. Building muscle, like how is walking building your shoulders, your back stronger, your arms stronger, your core stronger? Or it's not, it's not contributing to muscle mass regain. And if it was going to work so well, you know, we'd be seeing the results of it. And instead, we're, we're seeing an epidemic of obesity. Again, the snap wells thing, right? Great, these are a little fat, I'm

going to eat a whole bag of them. We all did that in the 90s, thinking this was the best thing that ever happened. And all it did was lead to an epidemic of obesity. Because they were just putting tons of sugar in them. Right? So yeah, so it's not to discount it. It's a starting point. It's to say you need to do also do resistance training. Yeah, and it's just ridiculous to even say that we're discounting walking, because that's not it, but you do need a dose of reality. If the scale isn't moving for you, you're noticing weight gain in your midsection,

you have a history of dieting, starving and depriving, you are not lifting weights, you are not helping your body maintain that muscle or building more, then you can walk your fucking face off and it's not gonna help you lose weight. And then you're ragging on yourself and you're not helping your body maintain that muscle or building more, then you can walk your fucking face off and it's not gonna help you lose weight. And then you're ragging on yourself and you're saying, I'm doing all the things and giving yourself a 10 for exercise when you're walking.

And this is the real conversation that we're having and no one would discount ex walking. That's ridiculous. We would never do that, But you got to really face reality. Even me, I was sick a while ago. I was thinking about this morning in terms of my conversation with you and I was in the hospital for two weeks and I lost a lot of weight. So I lost like 30 pounds. And I remember Tony touching my body and being like, you have, where'd your muscle go? And I spent my entire life being a personal trainer and

exercising all of that. And I just didn't think about a personal trainer and exercising all of that. And I just didn't think about it. And this is sort of where perimenopause and I just thought, oh, I'll get back to, you know, building that muscle. And then perimenopause hit. My weight went way up because I had no muscle mass there to help me. And it was a hard road back. That was a moment of like, I exercised my entire life. I lost all of my muscle. And that was a direct cause of my weight

gain. Because when you eat foods, your body breaks them down into glycogen. They store them in your liver and it stores it in your muscle primarily. And if you don't have that muscle to store it anymore, it stores it in your fat and that's where it goes straight to that midsection. And the reality is you are losing that muscle mass every time you did a starvation diet as you're getting older, if you're not lifting weights and maintaining and building that muscle or lifting logs or doing anything active that people in those blue zones do, right? That's the reality of that. I know. I can see how it might have come across as being dismissive. I don't mean it to be. What I try to do is I wish, okay, I wish when I was 35, somebody would have said to me, did you know you're about to start losing your muscle mass?

Yes. Did you know you need to start focusing on this and you might as well do it while you're young and energetic and have, you know, still have your max, your peak bone, your peak muscle mass rather? I would have done things so differently had somebody just been really honest with me at that point in my life. But I'm here to say to you, I didn't start weightlifting till I was 48. I'm 51 now. And I'm not like, I'm not like going for any competitions, you know, I'm not going to try to win

any trophies for my muscle building. But I, I, I did get a body composition score recently, and I did gain a pound of muscle mass. And you know what, I looked at that as my like, pride and joy. I didn't care what anything because I just chose to have different goals. And everything good that comes from that. Great. Another example is I love my mother-in-law dearly. She's 77. She's very active. She prides herself on 20,000 steps every day. But she went to her doctor and she did a body composition score and he said, your muscle mass is terrible. Like you need to be doing something. Maybe it's, it's, it's okay in your legs, but the rest of your body, it's terrible. And you need to start focusing on your upper body too, because it's not going in the right direction for you. So it's just, you know, I hate that society has fallen for so many marketing gimmicks

that have made us less healthy instead of more healthy. It's not that you don't want to do that. It's not that you don't want to be walking. Oh my goodness. Of course we want to be walking. And if having a goal helps you, amazing. But you have to have other goals too. So that's, I guess, I am. I'm so excited about our upcoming conversations with you because I know this is not

just like weight loss. This is aging. Cause my mom's been, I hooked my mom up with a personal trainer. I'm like, you, I'm making her go, like making her have a personal trainer. And the change in her is amazing. Her energy, her body composition, all of it, because I wanted her to be around a really long time. I know we're going to talk about this in the learning series, but bone density, because of going through menopause is a real thing. And you really need to be mindful of bone density, breaking a hip, falling. And so that's where that being strong and building muscle, it's like, it's so much more important than just the weight loss part of that conversation, right? Like you can walk all the steps you want, but it also be frail, fall over, break a hip. And then

next thing you know, I think statistics are people die within the next five years. Like it's a big deal. That's right. 25% of women die within one year of a hip fracture when they're older. And yeah, I always tell patients muscle is the scaffolding around your bones. So it's not that exercise can necessarily make your bones stronger, but it can protect them and prevent you from falling, which is where you... Who cares how frail your bones are if you never fall. It's when you fall that we have a problem. So yeah, so I will definitely be touching on that. Listen, I adore you. Thank you so much for having this very frank, honest is how we roll around here conversations. We're not afraid to have the conversations. You're going to be back. We're going to talk specifically about menopause.

You're going to be joining us in our learning series. If you want to reach out to Dr. Jennifer, well, first of all, you should be following series. If you wanna reach out to Dr. Jennifer, well, first of all, you should be following her podcast because you get more of the same. She covers a variety of topics. She wants you to look and feel your best and she wants to give you the real deal and she's all about being science-backed.

She don't mess around. Medsplaining, you can follow her over on Instagram at Medsplaining and you can download and favorite the podcast, MedSplaining as well. If people wanna reach out to you at MedCan or where can they find you? Do you have a contact? I do see patients in my private practice there.

They can check it out online or call MedCan, 416-350-5900 is the number. And I see patients in Ontario. And yeah, that's my credentials. That's me. I love it. I adore you. Thank you so much. Everyone's saying, I wish I could go see, wish you was my doctor. I know me too. I wish you was my doctor as well. I wish you was my doctor. I know me too. I wish you was my doctor as well. Oh, well, you know what?

I can at least spread the information. So we'll get it out there so you can advocate for yourself. I mean, that's what these conversations, they're all about awareness. That's what these conversations are. And we appreciate you taking the time that you spent with us today to help us be more, you know, empowered, knowledgeable and aware. Thanks everyone who's joining us live. empowered, knowledgeable, and aware.

Thanks everyone who's joining us live. Dr. Jennifer will be back. Thank you. Have a great day, everyone. Bye, everybody.