The Livy Method Podcast - Meet Dr. Jennifer Zelovitzky - Winter 2025

Episode Date: January 23, 2025

In this episode, Gina chats with Dr. Jennifer Zelovitzky. An MD, Certified Menopause Practitioner, and host of the Medsplaining Podcast, Dr. Jennifer is the clinical director of women's health and vitality at Medcan and leads its perimenopause and menopause program. Together, Gina and Dr. Jennifer unpack the often-overlooked connections between health and weight loss, starting with how to approach your doctor as a resource when making changes. For those hesitant to bring up weight, they share tips to navigate those conversations with confidence. They also explore the gender divide in healthcare, why menopause is such a hot topic for weight loss, and how it differs from andropause. Plus, they break down how hormonal shifts impact weight, the role of HRT in managing expectations, and discuss why alcohol in midlife can be more trouble than it’s worth for your goals.Find Dr. Jennifer:Podcast: MedsplainingInstagram: @medsplainingwww.medcan.com/menopause-and-perimenopauseYou can find the full video hosted at: https://www.facebook.com/groups/livymethodwinter2025To 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. I wanna stop right here and take a minute to hear from our new sponsor. It's a good one, and they are offering a promo code, so you're gonna wanna listen up.

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for more intense workouts, a fabric that helps you power through every rep. However you choose to move, Joe Fresh has you covered. And here is the promo code. It is LivyMethod25. Just use the code when you check out online at joefresh.com or through the Joe Fresh app. 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 doctor help you on your weight loss journey? What are some of the questions you can ask, the conversations that you can have? How often do you check in? Is there a difference between men and women? Joining me today to have that conversation and so much more is Dr. Jennifer Zalawitzki.

She is a board certified family physician. She's a certified menopause practitioner. I know so many people right now are sitting up in their seats and listening because they're itching to have that conversation. She's also the director of women's health and vitality at MedCan Toronto. Hello, hi, welcome. Thank you so much for joining me today. Gina, hi everybody. Thank you for having me back. It's

wonderful to be here today. So many of you may remember Jennifer from our menopause add on, which is a whole separate kind of self guided course. It's six weeks program. You came on, you talked to us about menopause in all stages, perimenopause, menopause, postmenopause. You broke that down. You explained it to us. You also talked about, you know, what can be done, HRT conversations with your doctor.

So you're gonna be back later on in the program. So we will touch on that today, but we will build on that and expand on that conversation in the weeks to come. But you're familiar with the program and in being a doctor, what is your suggestion to anyone setting out to make change in their lives?

We've all gone to the doctor, a doctor says you need to eat better, you need to lose weights. What is your suggestion for people? Where's a starting point? Should they be checking in with you as their doctor? Any advice there? Yeah. So I do have a background in family medicine and I know that family doctors typically are not as well educated in this area of care as most patients wish they were. So as much as I would

like to say that your family doctor is the best partner for you in your weight loss journey, sometimes that's not the case. Although it can be very useful to have your doctor there for regular check-ins and accountability. Now, if you're in a medically managed weight loss situation, so you're using something like Contrave or a GLP-1 agonist, then you will be checking in with your doctor, and they might have better advice for you in terms of your goals for tracking, they're watching your cholesterol levels, they're doing all of those check-ins. But if you're doing it through a lifestyle approach,

I would say the best way to engage your doctor is for regular check-ins, more for accountability, for somebody to be measuring your blood pressure, checking your blood work, making sure that from a metabolic perspective, things are going in the right direction. But it can be very useful if they can point you in the right direction of an endocrinologist, for example, if you're struggling with your thyroid or you're struggling to manage your diabetes properly, or a nutritionist, if that's something

that you want somebody to help you beyond what you're doing with the Libby method, maybe just that accountability piece of somebody that's weighing you, measuring you, looking at your day-to-day diet plan and making adjustments for you. And things like that. Or if you're struggling with physical pain, you know, that's getting in the way of your ability to remain active, you might want to check in, get a referral for a physiotherapy assessment.

If there are, you know, psychological barriers for you, then you can really like if weight loss is just a struggle for you, or you've struggled with body dysmorphia, often family doctors have really good access really good resources for mental health counseling. So I think that using your family doctor as just the center hub of a network of providers who can help you stay accountable and stay on that successful journey to weight loss. Yeah, I love that. And that's what that's what it's all about. So we have a lot of conversations here where we have experts like yourself come on, share your

knowledge, we are really informing our members. And it's really about giving them the power and the knowledge to then go talk to their health healthcare providers, whether it's their family doctor or it's their therapist or if they're seeing a specialist. What is your advice for people going to see their doctor? We've heard so many times here, and I think very similar to menopause. And I want to be mindful not to get too far into that conversation today, but there's been a lot of lack of knowledge or doctors taking their clients seriously. I mean, that's out there. That's a real thing. And I'm not knocking

doctors. We love doctors. We need doctors. Obviously you are a doctor. But I think there's some similarities when it comes to an overweight person or someone's carrying extra weight where their doctor is just like, you just got to go, you got to lose weight, that's going to basically fix everything. And a lot of times people feel if they failed at dieting in the past that they're not worthy of going to see their doctor. You want to wait until they're healthy to see their doctor. So any advice there in terms of like, if you're hesitant to have a conversation with your doctor or your healthcare provider, how to do that and the importance of doing it?

I'm going to let you in on a little secret. When your doctor is being a bit dismissive, you've probably stumbled into an area of care where they have a lack of education and a lack of confidence in managing it. So if we kind of flip it on its head, I know I can speak for sure to these two particular topics, menopause and weight loss. We do not get enough education and the factors that affect obesity especially have changed and our understanding of weight loss has changed dramatically in the past, you know, 10, 20, 30 years. It's not as simple anymore as calories in, calories out. And it's definitely not a one size fits all approach. So even if your physician has an understanding of what might work in general, they may not have as good an understanding

of what may impact weight loss in a woman going through the menopause transition. And so sometimes the dismissive aspect is really coming from their own discomfort because they really are afraid to say, I don't know, that's a really vulnerable thing for a physician to say to a patient. But unfortunately, there are areas of care that are sort of black holes in the education system. And my hope is that will change in the future. But for now, I think you have to meet your doctor where they're at and ask them to refer you on to someone that can better support you. There are lots of weight loss physicians out there who do have specific training in this area of

care. And they are available by referral. And don't be afraid to just directly ask your doctor for a referral. You shared with us that there was a time that you weren't as informed on menopause. And so you're speaking from personal experience. Absolutely. Yeah, I learned nothing. Allegedly, we had about half a day of menopause training in our education and I don't even remember that. And I actually had lunch last week with my friends from my residency program because we all keep in touch.

And I asked them, you know, we just did a round table. Do any of you remember learning anything about menopause? And they, none of us could remember anything. So they, they often connect with me if they have a patient that they are wondering what they should do with, because I had to go after residency and even after being in practice for many years, I went back and I certified as a menopause practitioner through learning for years and years about this particular area of care. What do you think is on you as a doctor versus me as a patient in my health and wellness? Hmm. Well, it's a partnership and you know, your doctor can't be at your house with you, right?

Making sure that you're doing all of the things they they recommend that you do. So I would say the onus is more on you as the as the person whose life it's directly impacting, but your doctor is certainly going to be a major player in that because they do want you to be successful. I still look back on patients I had who successfully met their health goals. Maybe they lost that weight permanently or they tackled a really impactful health problem that they were facing, a pain issue or something, and they went and they did the therapy and they put the work in. I still remember those and I celebrate those victories, but as much as I could help point them in the right direction,

they're the one that actually had to go and do the exercises and do the follow-ups and commit their energy and their efforts into improving their health. I couldn't do that for them. Yeah, it's occurring to me as I have this conversation, I can even see in the comments that it's not so easy for people just to go see a health care professional, just the accessibility. We are people coming from all over the world.

Sometimes that's a financial drain, something that they can't afford. I know here in Canada where we are, we're always talking about the shortage of doctors available. So any advice, I mean, I think this is why being an advocate for yourself and doing the things that you can do and why the Living Method is so great because beyond weight loss, it is helping you to make your body healthier, but most importantly, helping you to get in tune to your body's needs

so that when you are experiencing things, you can better articulate what you think is going on and how you're feeling. But anyway, so what if I, my only option is going to a walk-in clinic or I don't know, telehealth or I just don't have the access. What do you say to people about that? Yeah, well, telehealth is a great option these days because they are usually connected to their own network where they can make a referral for you to a particular allied health professional. The other thing is most allied health professionals, although we get requested, you know, the request

is put on us to make a referral. Some of these are covered by insurance and they don't actually require a doctor's referral to access that care. I know for myself to see a physiotherapist, I don't actually need a doctor's referral, right? If I were to see a registered dietician or I don't know, a weight loss counselor, a therapist, I wouldn't need a

referral for that. Now, the physician-led weight loss clinics, you do typically need a referral. But those are things that I feel most telehealth providers or even a walking clinic would likely feel comfortable making that referral to, especially if you appeal to them that it's really dramatically affecting your quality of life. The issue becomes when you are getting a referral, the doctor making the referral is responsible for any follow up that arises as a result of that referral. And that's why walk in clinics are hesitant often to make referrals, because they're not your primary care provider. And so they can't take responsibility for the rest of your life for anything that arises out of that referral. I understand we're in a terrible

situation with the health care system right now that there is a crisis in family medicine, there is a shortage of family doctors. The government is trying their best to improve things for family physicians. Well, not going to say trying their best, they're trying. I think there's more work to be done. And I think that one useful tool is called Healthcare Connect, which is a matchmaking service. And you can go on their wait list and they'll connect you with a provider in your geographic area when one arises.

And summer's often the best time where you see doctors setting up their clinics in July or taking on new positions when they graduate. And so often that's a good time to be on that list because some spots do open up, but it is a challenge. I wish I had a great answer for it. I don't. Well, this is why I just want to acknowledge it,

to sit up here and be like, oh, go check in with your doctor and have these conversations when, for some people, that's just not even accessible to them. And again, this is why the conversations that we have here are so important, is to help educate people on what they can do on their own to make a difference in their health and wellness and how to reach out and whatnot.

Is there a difference between men and women's healthcare? In a sense, would a man approach their conversations with their doctor differently than a women? Should they check in more often, less often? Are they less important, more important? What's the difference? What's the difference? Oh, goodness. Well, I think that the factors affecting women are at a different age, maybe that's really

where the difference comes in. Men are basically always at a higher risk for cardiovascular disease, so heart attack, stroke, than women. One of the main reasons is that women have the advantage of estrogen until menopause. And estrogen helps keep blood vessels nice and calm and relaxed and helps keep our blood pressure a little lower, helps prevent cholesterol buildup. But then when women go through the menopause transition, they start to catch up to men

in terms of their cardiovascular risk. So bearing that in mind, the factors that will affect the women's health are start to accelerate after the menopause transition. Whereas for men, they always from, let's say, 40 on, have a higher risk of developing disease than women. But we do catch up. So I would say for men, they should be intervening if they're starting to notice things slipping in their 40s, especially. women likely have a bit more of a protective window until they reach menopause. But generally speaking, it's different for every person. So I can't make a hard and fast rule around that.

There are obviously other metabolic disorders that can affect women at an earlier age, like PCOS, for example, that would put them at a higher risk of cardiovascular disease and diabetes earlier than the menopause transition. That's interesting. I want to ask that again in a different way in a sense of when would so a man signing up for the program about to make all these changes versus a woman signing

up for the program, trying to make change, trying to lose weight, trying to be healthier, all of that? Well, what would the conversation for men be versus women? Yeah. And you're talking like any age. So you're talking. Yeah. I mean, yeah, I realize it's like, I love to throw out these questions that are like, these encompass everything. I want to get an answer within a few minutes. So I apologize about that. But yeah, let's say that let's speak to the men in the group and let's speak to the women in the group. And I know I want to be all inclusive for all genders for the sake of the conversation. Um, it's just drive what happens within our body,

right? Like our body is more biologically driven, right? So it's going based on what your genetic code is. And that, that comes from not only your biological sex, but your genetic predisposition. What did you inherit from your mother? What did you inherit from your father? Yeah, thank you for that. I really have to say I don't distinguish between men and women. Okay. I think the same factors for the most part are going to affect them. There are certain generalized differences that we notice with respect to men and women when they come in. sometimes tend to enjoy more red meat, more saturated fatty foods than women. They tend to drink maybe a little more alcohol than women, although not always. Again, these are not hard and fast rules.

But these are things that are general truths, let's just say. So if you're going to have a holistic conversation with your doctor about your health goals and your weight goals, you need to make sure that you're being really clear with them about what your lifestyle entails. How much movement are you getting? What does your work schedule look like? How much movement are you getting? What does your work schedule look like? Men and women both work equally hard, but often in different ways, and it takes a different shape.

We wanna be honest about smoking, drinking, our sleep habits. We wanna be honest about our family history and gather as much information as we can about our family history. Because that does impact your risk of cardiovascular disease. If you have an individual risk, just based on your blood work, your blood pressure, your lifestyle habits, if your individual risk of cardiovascular disease, so say a heart attack or stroke in the next 10 years is 2%, well if your

father had a heart attack at 40 or 45, your risk has just doubled. If you smoke cigarettes even occasionally or one or two a week, your risk has doubled. So if a doctor's not aware of that, they might be underestimating your cardiovascular risk. I find men, when even they approach weight loss, their idea of going on a diet is not eating junk food and then just working out. Like their concept is a little different.

They do approach things differently. Okay, before I move on, because there are questions just rolling in about menopause. Can you explain to the men in the program why this conversation of menopause is so prevalent? Why it seems like such a big conversation right now, because it might seem a little skewed in terms of the conversation happening in the group.

And now granted, we do have way more women doing the program than we do have men doing the program. But it occurred to me that this big conversation is happening, and maybe a little insight into why, especially when it comes to weight loss, that menopause conversation is really important. Because men and women have hormones. Obviously, there's cortisol and insulin, your hunger hormones, and all those other hormones.

But why do these sex hormones, the estrogen, progesterone, testosterone, why is that such a big conversation with women? And then when you're done answering that, I wanna talk about andropause for men. And then I promise we will spend the rest of the time talking about menopause for y'all. I wanna take a quick minute out here to introduce to you our new podcast sponsor,

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for so, so long because of really flawed information that came out about 20 years ago that turned out to be dramatically overstated, to say the least, about the dangers, the risks of hormone therapy. Where in fact, hormone therapy is very, very safe and beneficial for the vast majority of women in menopause. And so as more and more physicians like myself have become trained in this area and have had access to newer, better evidence and information, we are recognizing that we can dramatically improve not just the quality of life, but the health span of our female patients by providing them with

both lifestyle guidance and where appropriate hormone therapy to manage their menopause symptoms. But there's also been a recognition that the factors influencing weight gain and weight loss are quite different for women at midlife. It's partly hormonal and it's partly lifestyle and it's partly the downstream effects of the hormone deprivation.

The truth is with respect to andropause, this is not as prevalent as, you know, people would think. It's not the same thing. You know, I used to get this question like, do men have menopause? No. The truth is that for both men and women, our testosterone levels do not decline at midlife typically, or as dramatically as estrogen does for women. And we do at MedCan, we offer men the option to have their testosterone levels checked. And the vast majority of men, you know, do have a normal testosterone level. And the vast majority of men, you know, do have a normal testosterone level. I think there's an assumption that if you're having erectile dysfunction or you're really exhausted all the time, that that's because your testosterone is low. And more often than not, it's other factors. You might have cardiovascular disease, like diabetes or elevated cholesterol or some other,

something else affecting your small blood vessels, including those leading to your penis. So stress, relationship difficulties, extreme exhaustion, those are all things that can affect a man's ability to have an erection, to have a good sex life, to feel energized. So I would say it's worthwhile to explore with your doctor, whether your testosterone levels are in the normal range, but we have to look outside of just hormones when we're looking for solutions. And the same goes for women to an extent. You know, it, estrogen does lead the charge in menopause in terms of the things that will cause us to gain that midsection weight gain, the things that cause us to be exhausted and to be foggy and to be irritable. However,

it's not the only player in the game and you can't just replace estrogen and magically lose weight and magically be sleeping well and all of those other things that we wish it would do, but it's not a magic bullet. thank you so much for that. I think that's such an important conversation. So for men, they do, they can experience hormonal issues. So it's more of a gradual thing that they're experiencing. And men, most men who are obviously hugely generalizing, who go and get tested for their testosterone are probably totally fine.

Whereas all women will experience menopause. This is not some will and some won't. For all women, they are going to experience menopause. Now, some may have more extreme, for lack of a better word, symptoms, or dealing with different things compared to each other. But every single woman experiences menopause where there might be men here and there who might have a true hormonal issue.

Exactly. It's always worth exploring, but testosterone for men is produced in the testicles and men produce sperm on an ongoing basis throughout their life. That never stops. I always joke with patients, you know, men are the life insurance policy of the species, you know, they're always able to go out and fertilize someone. But for women with ovaries, the ovaries do run out of estrogen at midlife and they stop functioning and they sort of shrivel away. So it's not the same thing happening with men and with women. However, of course, men who have an injury to their testicles, who lose a testicle, who undergo testicular cancer treatment, that's

obviously something that can impact testicular production of testosterone. Let's get into the menopause conversation. Let's get into it. So I know you're going to come back. We will talk about HRT. We will talk about all of that. But before you get into that, there's a lot that you can do to address the symptoms that you have and especially help you with weight loss. As you know, the Libby method has always helped when it came to menopause all stages perimenopause, menopause, post menopause, when it comes to losing weight because it's beyond what you're eating and when it's also focusing on trying to get better sleep. It is moving your body. It is managing your stress. It is helping your body with any health issues that

you have. There's a lot, it's very holistic approach. But let's just start with menopause and weight loss. What say you about it? Yeah, well, here's what I say. There's several things that we know drive weight gain in the menopause transition. First and foremost is estrogen decline, estrogen deprivation. Because what that does is as that's subtly starting in our mid thirties to late thirties in the background, we're starting to lose our lean muscle mass and it's getting converted to visceral fat. And it's imperceptible at first.

This is that fatty tissue that's around your midsection. The reason part of the reason this is happening is that visceral fat can produce estrogen at low levels. And visceral fat becomes the main source of estrogen after the ovaries have packed up shop. So that's one thing and I wish it was as simple as saying great let's give some estrogen and we'll turn all that off but what happens is that visceral fat is highly metabolically active and it starts to create other hormonal changes in the body that perpetuate the weight gain, such as insulin

resistance, elevated cholesterol because visceral fat molecules carry more cholesterol, inflammation, so you're getting more aches and pains, so you're not moving as much, you're tired. And then there are the other factors beyond hormonal. There's the sleep deprivation. We have really good data to support the fact that women need about seven hours of sleep, of which 20% is deep sleep to promote a healthy weight maintenance and to promote weight loss. and to promote weight loss. And the downstream effect of that is we're more sedentary. Even if we go to workout, we're not able to expend as much energy as we would have

had we been well rested, were we not inflamed and in pain. So yes, you can encompass some sleep hygiene, which can certainly help. But at the end of the day, some women do need more support for getting sleep, you have to rule out things like, for example, sleep apnea, maybe that's a factor. Maybe it is hormonal, maybe you're up all night with with night sweats. and no amount of fans and no amount of leaving the window open will really help that. So those are some of the main criteria.

Now in terms of actual metabolic slowdown, really truthfully, we require about 250 to 300 fewer calories on a daily basis after menopause, according to studies. But that, you know, that can often, if you're then moving less, that's assuming a stable level of activity. If you're moving less, it goes up from there, the amount of calorie deficit that you need to engage in to actually see the needle move.

And then there's the microbiome. So the healthy bacteria in our digestive tract, which allows us to properly absorb nutrients from our food, but also it has an important role to play in our immune function and in our mood. It declines not only in number, but in the variety of healthy bacteria in our microbiome at midlife. And so using a probiotic can be a very, very helpful tool for this specific reason. You want to be maximizing the nutrient absorption from your diet to help you get those fatty acids,

to help you get that protein. And so those are muscle mass loss, estrogen deprivation, sleep deprivation, sedentary lifestyle. These are all factors and inflammation. These are all the factors that really lead to the weight gain in menopause and stand in the way of weight loss. Yeah. And I love that you mentioned all of that because so many of our members come into the

program and they want to know if they can lose weight in menopause and how does the Libby Method help. Obviously all the nutrient rich foods, the focus on things like stress and sleep and moving your body. We just had a supplement conversation the other day with Dr. Paul and we talked about vitamin D, omega-3, magnesium, your B vitamins, and then also probiotic and prebiotic.

And what I was saying is like, everyone wants to know, what can I take for menopause? And these are some really foundational supplements. And later on, we're gonna have a conversation of people are having a hard time getting their weight to move. It can be due to inflammation, food sensitivities, hormones, obviously, and then gut issues like your microbiome.

And that's where we introduced the probiotic and prebiotic. And it's really how it all works together. It's occurs to me that there is a lack of knowledge out there with healthcare professionals and with women in general and we should have a more robust, I know we're going to conversation on menopause. People are asking how long is menopause? So there is perimenopause that can start as early as 35, sometimes younger in some cases. There is menopause which is just one day.

This is where the conversation gets complicated because menopause refers to one day after you have a year of not getting your menstrual cycle, the one day, and then you go into post-menopause, which is the time after. Menopause is sort of the catchall term that we use to describe all of the time. Right. And I often say menopause transition because it is a transitional time and it's different for everyone. The average age is about 51 that you actually have your final period, but that's, it's sort of been a relevant factor. I know there are doctors out there

who will tell patients, you have to wait until you've had a full year without a period to start running therapy for menopause. And I'd say, what is magical about that one year, Mark, other than you've suffered for a year longer than you had to with your symptoms? You know, there's nothing magical about that. We just associate that with when we actually are officially in menopause, but the menopause transition or perimenopause is really what we're talking about when we're talking about managing the symptoms and when things start. Because you're right, it can start 10 years before that final period. You know, I think a lot of people think that HRT is going to be their solution to weight loss.

And if I just take HRT, and I think very similar to the GLP-1 medications, weight loss medications, it's not an easy fix. And it's not just taking the drug or not just taking the HRT that is necessarily going to be the magic pill for weight loss. Can you talk about that, managing expectations with weight loss and HRT? Yeah, I'm very blunt with patients. If they're coming to me purely to go on HRT for weight loss, I say it's not the right solution. The way I explain it is trying to lose the weight through doing all of the right things in perimenopause or menopause is like

driving with your parking brake on. You know, if I replace some of your estrogen, that might take the parking brake off, it's not going to move your car forward. You still have to move the car forward through building your muscle back, getting enough sleep, reducing your alcohol intake, increasing your protein and fiber intake. You have to be doing the right things or you will not experience the weight loss. Let me talk about alcohol for a second. Like how I know it's been a game changer for me and I've shared with many of our members that the last couple years of my life have been very stressful. But on top of that, I also was experienced, and I'm going to add hair loss because there

was like a point where I just thought it was stress. And my weight went up, it felt like 20 pounds in a month. It was close to that, it felt like. I had a frozen shoulder. I had vertigo. My cholesterol went up, even though I hadn't changed anything. I had a heart palpitations. I had acid reflux. I had a lot of things going on that I just blew off as stress. I'm just not walking enough, not doing enough. It sort of runs the gamut on what you can experience when it comes to menopause.

It is uniquely different for everybody and it's not any one thing that you're going to do to be able to address the things that you need to do. So what's your advice there? To alcohol? Yeah. So that's where I was going. Because what happened was I took out alcohol and it was a game changer across the board with everything. It was making me feel depressed. And it was making me feel bloated and just interrupting my sleep. And I don't know that it's attributed weight

loss, although I have lost weight, my weight is back down to where I was before. At no point when I was experiencing any of those symptoms did I think take alcohol out. This is true across the board for both men and women. What happens at midlife in our 40s and beyond is we start to see a decline in the enzyme our liver produces that metabolizes alcohol. Now, when do we drink alcohol? I mean, for the most part, people drink alcohol in the evening, later in the day, at night.

So when you consume alcohol after age 40, your liver is working overtime through the night to metabolize that carbohydrate load. And if it's doing that, it can't be doing other things. It cannot be synthesizing the nutrients from your food. And your body can't get into a state where it's ready for a deep sleep. So I always say alcohol is short-term gain for long-term pain. You do feel in the short term, maybe you're in a better mood, but in the long term, you're going to be depressed, right? You might feel in the short term, maybe you're in a better mood, but in the long term, you're going to be depressed, right? You may feel in the short term, like it's helping you fall asleep, but you're not actually

getting a deep, good quality sleep. So you will end up more fatigued, more irritable, more foggy in your brain. Guidelines currently suggest to stick with two or fewer drinks per week where a drink, a portion of serving is five ounces of wine, 12 ounces of beer or two ounces of spirits. I often find that my patients tell me they've noticed these things on their own. Like they'll say, I just can't, I just can't have two glasses of wine with dinner anymore. Yeah. I do feel it. I can't sleep. I'm sweating all night. It also, of course, it for women, it increases hot flashes

overnight. Um, and so it's just a good idea to look at the overall limits and then divide that up through your week how you want to. Yeah. So I'll say have a two and a half ounce glass four times a week. If you really enjoy that glass of dinner, a glass of wine with dinner Friday, Saturday, Sunday, do that. Put less in your glass. If it's about the ritual, then you don't wanna be completely depriving yourself of that ritual, but similar to chocolate cake, right? You know, you're not gonna eat the whole cake. You'll have a small slice and, and savor it.

Yeah, right. Someone was saying, well, I don't drink alcohol and that's not the cause of my symptoms. And nor was I trying to suggest alcohol was the cause of my symptoms. There was a lot going on and I believe that alcohol really added to that. It definitely didn't help. And it doesn't help with weight loss either because studies now are showing that your body can't metabolize or utilize fat reserves when you are drinking alcohol.

So it can interrupt weight loss in a variety of different ways. But especially if you're coming in and you're worried about your hormones and your ability to lose weight and you are continuing to drink alcohol like so many of us have done before, you might want to consider minimizing it. Just like we know that your muscle mass starts to decline with age, but especially in menopause. So you might wanna consider adding in some resistance training with your workouts.

And then of course with sleep, it's so impactful in our health and wellness, menopause, but also weight loss. So you might want to pay attention to our sleep experts. So next week we actually have a sleep psychologist coming on joining us, a sleep expert to talk sleep hygiene and someone coming on and talking about how lack of sleep affects your hormones in general for both men and women, but especially when it comes to menopause. I'm excited about our conversation. I'm excited about the conversations

we are going to have. So we are going to do a deep dive into the topic of menopause in the next few weeks. But the takeaway for everyone who's like, I wanna have that conversation now is you are doing the things now to lay the foundation for that conversation. You are already doing so much just by showing up and doing the things that you are doing

every day with the program. Dr. Jennifer, final words for our members who've been listening to this conversation today. Yeah, I mean, I would say remember that it's really more about lifestyle changes, which I know you guys, I'm preaching to the choir. We always want to look to the blood tests, right? We always want to look to the, is it my thyroid? I always wanted to have a book called,

it's probably not your thyroid, you know, because the number of times that patients would come to me and say, I'm gaining weight, I need to check my thyroid, you know, and unfortunately I'd have to let them down and say, your thyroid's normal, let's look at other factors. The good news is the power's in your hands to start making impactful changes. The bad news is the power is in your hands to start making impactful changes.

The bad news is the power is in your hands to start making impactful changes because it's sometimes easier said than done. So definitely I want you to think about your muscle mass. That always is a crucial element. That seems to be a unifying element that can really help. Look, what do we all want? We want to stay out of a nursing home, right? We want to remain independent.

We want to remain healthy. We want to remain upright. So if you do one thing between now and when we next meet, I would say start doing something every day that makes your body stronger. I love that. And that's what our focus is on in maximizing all the other things besides the food and the water or any supplements that you're doing.

And there's so much you can do. And I don't mean to be a bummer about your alcohol y'all. You can totally enjoy your alcohol. Some people have alcohol, they lose weight just fine and don't have an issue. But if you feel like you're struggling and wondering what more can you do and you feel like your hormones are impacting you and you feel like you're not getting great sleep and you're stressed, you're not moving your body, it's all how it all works together.

Dr. Jennifer Zalawitzki, I'm so grateful that you have joined our team as one of our amazing guest experts, and that you will be back and continue the conversation for us. And I'm even more grateful that you've taken the time to share your knowledge and expertise. I know people are gonna ask where to find you. You have a great podcast. For those of you who are interested, especially in menopause, it's called MedSplaining. So you can find her also over on Instagram at MedSplaining and you can reach out to Dr. Jennifer at MedCan, I believe. And she also does run menopause

and perimenopause programs over there. If you are interested in hearing more from her, learning more, you can also sign up for our menopause add-on medcan.com. That's M-E-D-C-A-N for those listening, .com slash menopause dash and dash perimenopause. Dr. Jennifer Zalawitzki, thank you so much for joining us today. Thank you, Gina.

Thank you, everybody, and have a great day. Thanks everyone.