June 11, 2025 • 37 mins
Menopause isn’t just a physical transition—it can stir up a lot emotionally, and those emotions often show up in how we eat. In this episode, we’re talking about what really happens during menopause, including the hormone shifts and weight gain.
We get into:
- How emotional changes in this stage can influence your eating habits
- What to do when your usual strategies for “eating healthy” stop working
- The trap of trying to “fix” everything with restriction or discipline
- Lifestyle shifts to prioritize
- The basics of menopause nutrition
If you’ve ever wondered why you feel so off lately—or why eating feels harder than it used to—this episode will help you feel seen and give you a starting point for handling menopause with more patience and self-understanding.
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More from Dr. Kahan:
- website: shemdny.com
- Instagram: @shemd_ny
- Facebook: @shemdny
Dr. Meryl Kahan, a board-certified gynecologist and Menopause Society Certified Practitioner, founded SheMD, a direct care women’s health practice based in NYC. She provides affordable, personalized gynecology and menopause care with longer visits, no insurance hassles, and telehealth options across New York State and Florida. Her patients are often women in their 30s, 40s, and 50s who are frustrated not only by unexplained weight changes, low energy, mood swings, and cravings, even though they’re doing “everything right", but also by being dismissed by their regular doctors that their symptoms are all "normal". After years in the traditional medical system, Dr. Kahan left to create a practice that actually supports women through the hormonal shifts that impact how they eat, feel, and function.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
This is the Eat Well Think WellLive Well podcast.
(00:02):
I am Lisa Salisbury and this isepisode 151, menopause Weight
Gain, HRT And Your Emotions withDr.
Meryl Khan.
Welcome to eat well.
Well, the podcast for busy womenwho want to lose weight without
constantly counting, tracking,or stressing over every bite.
I'm Lisa Salsbury, a certifiedhealth weight loss and life
(00:24):
coach, and most importantly, arecovered chronic dieter here.
You'll learn to listen to yourbody and uncover the reasons
you're reaching for food.
When you're not truly hungry,freeing you to focus on a
healthier, more fulfillingapproach to eating.
Lisa (00:41):
Welcome back to The Eat Well Think Well Live Well
podcast.
I'm so excited to have Dr.
Merrill Kahn here today.
She is a board certifiedgynecologist Menopause Society
practitioner And the founder ofSHE md.
So welcome Dr.
Kahn.
Why don't you introduce yourselfa little bit more beyond that
and tell us a little bit aboutwhat you do.
Dr. Meryl Kahan (01:00):
Hi.
Thank you for having me today.
So I am, as you mentioned, boardcertified gynecologist.
I was practicing OB GYN forabout a decade before I opened
SheMD in New York City, andSheMD is a direct care
gynecology practice where Ihelp.
(01:21):
Women with all of theirgynecology needs, and I have a
particular interest in hormonalmanagement, so whether that's
perimenopause or menopause oreven weight management, because
it's something that I had notedin my, you know, decade of prior
experience that a lot of womenjust weren't getting the help
(01:42):
that they needed.
And so prior to opening SheMDIbecame a Menopause Society
certified practitioner.
I did training in bioidenticalhormone replacement therapy as
well as weight management.
And because it all kind of fallsinto the whole anti-aging and
wellness theme, I also, um.
(02:06):
Did a of training and got aboard certification in medical
aesthetics So I'm much a onestop shop for women, um, in the
New York City area.
Um, and I love what I do and Ialso do telehealth where
appropriate, um, in New York andFlorida.
Lisa (02:25):
Awesome.
Well, I know I have listeners inNew York, um, so well, and
Florida that, so that.
That's available for, uh,telehealth, but also just thanks
for sharing your wealth ofinformation and, um, I hope the
sound is okay because myneighbors are doing yard work
and you just can't control that.
So, oh, there, there, they'regoing away.
Okay, so
Dr. Meryl Kahan (02:47):
I'm in the heart of New York, so believe
me,
Lisa (02:49):
yeah.
Dr. Meryl Kahan (02:50):
lots of sounds at all times.
Lisa (02:53):
Well, let's talk about, I, I get lots of requests to talk
about menopause perimenopause,uh, just the struggles that we
have.
Some to do with weight, but youknow, there's a lot of other
symptoms.
Um, but let's start there.
Why does weight loss feel somuch harder in this midlife
time?
And I hear a lot, like thethings I used to do don't work.
(03:16):
I mean, we've all heard thisand.
It's like this weight came outof nowhere.
Um, what else do I commonlyhear?
Just like I started havingsymptoms or like sometimes the
weight, weight gain is the firstsymptom that they notice that
they're kind of in thatperimenopause time.
And a lot of them too.
A lot of my clients andlisteners have been chronic
(03:39):
dieters and so.
As much as they wanna get awayfrom that fad dieting, which I
totally encourage, they alsokind of have a knowledge of like
what to do and what does work.
and so they're like, why is thisnot working?
It's so frustrating.
Dr. Meryl Kahan (03:54):
Yeah.
definitely the things that,worked for them in the past seem
to overnight, no longer workanymore.
Um, this is so common.
Women will complain that, Um,you know, they haven't changed
anything with their diet or ifanything, they're eating even
healthier now and they'reworking out.
(04:14):
Just as much, but they cannotget rid of this stubborn five to
10 pounds usually in theabdominal area.
Um, no matter what they do, andnothing's changed and they've
never had to deal with thisbefore.
And it's, it's very frustrating.
And with all the other symptomsgoing on with menopause, whether
(04:35):
it.
Lack of sleep or hot flashes ormore irritability or brain fog,
you know, you name it.
But then having to deal withthis too, which affects how they
feel, but also now how they'rephysically seeing themselves.
Um, so it's, it's a lot tohandle.
It's a big change.
And so, you know, one of my jobsis to really talk with them
(04:58):
about it.
Also dig deep to try to figureout is this something that is
due to an underlying hormonalissue?
We can talk about the hormonalchanges that happen, that
contribute to this inparticular.
Um, and then work to try tobalance everything so that
they're able to get back to howthey were.
Lisa (05:22):
So What I have noticed is that getting on, um, menopause
horal re hormonal replacementtherapy or there's a lot of
words.
Most people just call it HRThormone replacement therapy, um,
bioidentical hormones.
All of these are kind of really,we're talking about the same
bucket of, of.
Medication, pharmaceuticals, ifyou will.
Um, it's my understanding thatgetting on those is not really a
(05:45):
weight loss plan.
That even when you get onhormone replacement therapy, it
doesn't tend to shift weight.
Would you agree with that?
Dr. Meryl Kahan (05:53):
So I definitely wouldn't put somebody on hormone
replacement therapy if their onegoal is weight loss.
It's not a treatment.
For that, it's not approved forthat.
That's a really, uh, morein-depth conversation, what it
is approved for.
Um, but what we do know is thatwhen you are on hormone
(06:14):
replacement therapy, It canchange your body composition
that was altered when youentered perimenopause or
menopause.
and it can also improve your,muscle mass.
We all lose muscle mass as weget older, and the muscle mass
is so important for us to remainfunctional.
(06:34):
It helps with our, you know,basal metabolic rate.
Um, and so when we replace ourdepleted hormones.
It can certainly help with thebody composition.
Um, I would say that more sothan weight loss per se.
Um, that being said, there is astudy that shows that for women
(06:57):
on semaglutide, um, also knownas Ozempic, that the women who
are also on hormone replacementtherapy do lose about 30, 35%
more weight.
Than if they're on Semaglutidealone.
Um, and so, you know, they dowork together.
(07:22):
But it is not in itself really atreatment.
I mean, you might lose a fewpounds on it alone.
Sure.
Um, but it's not a, quoteunquote treatment for weight
loss.
Lisa (07:34):
Yeah.
I think that's just so importantto realize that just because
we're going to like replacethose hormones doesn't, yeah.
That is not, it's not really inthe class of weight loss drugs
by any stretch of theimagination, but that's, that's
fascinating that, um, inconjunction with the
semaglutide, that, that, Um, Imean, 30 to 35% is a significant
(07:55):
number.
Dr. Meryl Kahan (07:56):
It is, I mean obviously it depends, like if
you're going on semaglutide tolose 10 pounds, I don't know
that you really need to be onSemaglutide, but you know, that
would be an extra three pounds.
Um, but if you do have asignificant amount to lose 30%,
that is a lot.
Yes, for
Lisa (08:14):
Yeah.
That's, that's really good news.
okay.
So what do you think the, someof the things, symptom wise that
legitimately make it harder tolose weight in midlife?
Um, because there are somechanges that happen, I mean,
right off the top of my head, soI'm gonna kind of stare you a
little bit here because.
I know for one thing it's sleep,right?
We're not sleeping well.
(08:35):
And um, progesterone has reallyhelped me with that.
But, you know, it's not perfect.
It's helped, but I'm still like,you know, still have a lot of
awakenings in the night andthings like that.
Um, but when we're not sleepingwell.
It really can affect our weightloss because number one, we
maybe don't have the energy.
We're gonna move less during theday.
Number two, you're gonna mess upyour hunger hormones, leptin,
(08:57):
ghrelin.
So, you know, there's a lotreasons why sleep contributes to
our inability, like poor sleepcontributes to our inability to
lose weight.
So, along those lines, what elsechanges?
And feel free to add more on thesleep aspect as well, but what
else is happening in thismidlife time that makes it
harder?
Dr. Meryl Kahan (09:15):
You took that one.
Literally right outta my mouth.
I mean, I think number one,well, number one is sleep.
It is so important.
Exactly as you're saying.
If you're not getting enoughsleep, you just cannot function.
You can't be functional.
And so if I wanna tell someoneto out Even half an hour a day
(09:36):
when women are already busy.
Whatever they're doing, takingcare of their home, taking care
of their kids, going to work,you know, whatever it is so
busy.
So define the time to work out,either let's say at the end of a
busy day or wake up even earlierto work out, you know, it's
nearly impossible if you're notfeeling rested or you're up
(09:59):
throughout the night.
So that one is so veryimportant.
Absolutely.
Um, and then another thing thatcan affect the sleep too is the
cortisol.
Um, that's a stress hormone anda lot of times we don't really
think about how the cortisol canimpact our sex hormones and
(10:21):
menopause, but It's reallyimportant to remember that these
hormones are all connected andrelated, and cortisol is so
important to help us manageacute stress so that you know
back in the day if we cameacross a saber tooth tire, our
(10:42):
cortisol is going to.
Spike and that will help us runaway.
I'm sure we've all heard thatbefore, but the problem then
becomes when we're chronicallyexposed to high levels of
cortisol, then it's no longersuiting us.
But because we need thatcortisol to survive, what
happens is that, the sexhormones and progesterone and
(11:03):
cortisol have the sameprecursor.
So if we need the cortisol tosurvive.
That precursor is going to getshunted towards making more and
more cortisol to keep us aliveas opposed to going down the
pathway of making the sexhormones.
and so it's really important to.
(11:24):
That we manage our stress levelsto keep the cortisol in check so
that we don't have to keepproducing more and more of it.
And cortisol can also beresponsible for us waking up in
the middle of the night or notsleeping very well.
Um, absolutely it can beresponsible for like the sugar
(11:49):
cravings.
And mood swings and all that.
It relates to insulin as welland the thyroid.
'cause again, all of thehormones are connected and so
it's very important thateverything is balanced.
And unfortunately with cortisol,there's no quick, I mean, I
can't really give someone aprescription like I can for
(12:11):
progesterone to fix it.
So it is something that.
Really takes a lot of, I wouldsay, buy-in, you know, from the
woman to work on things,whatever that may be for her
that she finds will help, withstress reduction.
So that could be going on awalk, that could be listening to
(12:33):
relaxing music, that can bejournaling, meditating, yoga,
you know, you name it.
But that's another thing.
I mean, there's also somesupplements.
There's differing opinions onsupplements.
But they exist and they'rehelpful for some people, but by
no means are they going to besufficient on their own.
So cortisol as well.
Lisa (12:53):
I think it's so, um, tricky for a lot of us in
midlife because we haveteenagers.
I don't know if you do, but, um,I do.
And so our brains don't have theability to distinguish the
stress of the saber, the stressand this, and the danger of a
saber tooth tiger and a meangirl.
And, um, some of us have meangirls living in our houses.
(13:14):
Yeah.
You know what I mean?
So, you know, it's like thisstrange case of, you know,
you've got, um.
Uh, perimenopause symptoms.
And then you also have a childor children in, um, my case with
two teenage daughters.
One's out of the house now, but,you know, going through puberty
and it's kind of a mean turn ofevents where we're at this age
(13:35):
where we have, children, youknow, that are also struggling
with their hormones.
And so and I'm not throwing my,my girls under the bus if you
know me personally, you know, mygirls are delightful, but we all
have our moments.
but I have talked to otherclients who, you know.
We have teenagers.
And so it is, it's hard to belike, reduce your stress and
you're like, what am I gonna do?
Kick'em out.
(13:55):
So, I find that to be, um, justof a, a challenge with this age
range know, a, a challenging andoften you're at the height of
your career.
Like there's just a lot ofreasons that stress can be high.
And so it's um, kind of one ofthose easier said than done
things as far as reducingstress, but there some great
(14:18):
tactics.
Dr. Meryl Kahan (14:19):
yeah, like you said, I mean, for most women,
when body goes through all thesechanges for women is the same
time, you know, if you have kidsthat you happen to be, they
happen to be in that stabletooth tiger or mean girl.
So it's, everything's likepiling on all at once for sure.
And I know it's definitelyeasier said than done and that's
(14:41):
why so many women do strugglewith getting the stress portion,
um, under control.
I will say though, that whenwomen are on hormone
replacement, especiallyprogesterone, they tend to
report back that they findthey're able to manage the
stress better though, so theystill have it.
(15:02):
You know, the goal is not toremove all stress from your life
because that will never happen.
Um, but it's able to calm themdown a bit more so that they're
better able to manage it.
Maybe not be as short, not be asirritable.
Um, and so, you know, that helpstoo.
But another thing in terms of,what changes can happen is the
(15:27):
estrogen also, we all knowestrogen drops tends to drop
vader, then the progesterone.
And one thing estrogen does isit really helps with the insulin
sensitivity.
And so insulin sensitivity helpswith your blood sugar.
And so when you have lessestrogen, then your body's not
(15:48):
as sensitive to insulin.
It doesn't react as well atkeeping your blood sugar steady.
And so then you have these sugarcravings.
Also, you can have crashes, andit's just everything you can see
as we've been talking about.
Really has to kind of be workingin perfect harmony and if not,
(16:10):
even if one thing's off, it justaffects everything else.
And that can really affect yourenergy, your diet, your glucose,
your body capita.
And so yeah, it's, it's a lot.
Lisa (16:27):
It is.
So I get a question a lot, whichis like, what can I do?
I don't wanna be on hormonereplacement therapy.
What can I do from a lifestylestandpoint?
And I'm always like, why?
Like, first of all, why like,ask your doctor you're a
candidate.
I'm not telling you everybodyis, but.
there's really nothing scaryabout hormone replacement.
We're not going for, extra highdoses.
(16:48):
We're trying to just replacewhat was lost.
I think it's interesting becausethere aren't other hormones in
the body that were afraid toreplace.
If you had your thyroid cut out,you would take thyroid hormone.
If your insulin doesn't work,you know you're diabetic, you
take insulin.
Like that's why if you have atype one diabetic child, like
you would never be like, well, Idon't know why that hormone's
(17:09):
not working, but it's too scaryto replace it, so it's.
It's interesting to me thatthere is some fear based around
it.
So I'm always like, why?
Like, let's have a conversationwith your doctor and see maybe
if, if you could be a candidate,but if for some reason you're
not a candidate, or even if youare, even if you're on it, they
don't work in isolation.
Like we still need to have somelifestyle components.
(17:32):
And, um, I talk, I talk to mymom about this a lot.
Um, my listeners know I takecare of all of her healthcare.
I'm always at the doctor withher.
Because she has dementia, shehas a hard time following
through with the lifestyleaspect of the things they ask
her to do.
And I'm like, these medicationsdo not work in isolation.
You can, like, if you're on ahigh blood pressure medication
(17:54):
and you still eat fast foodthree times a day, like that
medication cannot just like.
Work magically, they don't workin isolation.
And so we do have lifestylefactors that are gonna affect
even if you're on medication.
So even if we're on hormonereplacement therapy, what are
the like main lifestyle changesand things that we need to do
(18:15):
outside of just, you know,popping that patch on, rubbing
on our cream or gel or howeveryou are taking it.
Dr. Meryl Kahan (18:23):
I mean, I think I've touched on some of them
already.
Really as it relates to stressmanagement.
But as far as certain dietarychanges, we need to really be
mindful of what we're eating.
Of course.
I mean, we've heard so muchlately about how terrible
(18:44):
processed foods are.
But protein is so, so, so veryimportant.
And I would recommend aiming foraround a hundred, grams a day of
protein, and that could bedivided up among your meals, and
that's really important to helpus maintain our muscle mass.
(19:07):
And also fiber is superimportant too.
One of the things it does is ithelps keep us full longer.
So we don't feel like we have tobe eating at all times.
You wanna maintain hydration, sobe drinking water throughout the
day.
And I just tell patients like,an easy way to know if you're,
(19:30):
if you're drinking enough water,is if your urine is light in
color.
So if it's yellow or brightyellow, then that's a very easy
way to tell that you are likelynot taking in enough.
And so that's super important.
Going on walks even after ameal, doesn't have to be
(19:50):
anything long, but take a 10minute walk, can help with your
blood sugar also.
And.
Working out, especiallyresistance training.
A lot of people are afraid ofresistance training.
I mean, when we hear that orweight training, we just kind of
picture, a bodybuilder orsomething like that.
(20:13):
But that's not what it isnecessarily.
Don't worry.
Even if you're on testosteronereplacement, you're not going to
look like that.
but resistance training can beanything as simple as even body
weight exercises, or resistancebands.
so things that don't necessarilyinvolve heavy weights.
(20:34):
I mean, you can certainlyprogress.
but that is so important tomaintain our functionality too
as we get older.
I mean, you mentioned helpingyour mom.
I also am.
you know, dealing with my momright now who has having issues
with balance and falling and soit's so important to do what we
(20:56):
can at this stage to preventthat.
Um, and so you don't have toworry later on about how you're
gonna manage, right?
Just something as simple aswalking.
Right.
and so it's so important to belooking ahead and prevention is
so much more helpful than.
Treatment after the fact.
(21:17):
I mean, I can prevent so manythings, not everything,
obviously, but you're way betteroff now than down the road when
you're, you know, you miss yearsor decades of being able to set
yourself up for success.
And so just incorporating likethose little things in, whether
(21:38):
you do go on hormones or not,it's only gonna benefit you.
Lisa (21:44):
That is like, perfect.
I couldn't have scripted youranswer any better because this I
just wanna recap for, for thelisteners, like Dr.
Kahn said, manage your stress,eat protein and fiber, drink
water, strength, train, andwalk.
That's essentially the list thatyou gave us.
And it is like the boring stuff.
And this is what I,
Dr. Meryl Kahan (22:05):
Yeah.
Lisa (22:07):
this is what is so like maddeningly frustrating is I
get, I get questions like, youknow, what, what can I do?
And people want like the superfoods of menopause and you know,
they're on Instagram or socialmedia and they see videos of
like, do this one thing.
And I'm like, I'm sorry.
It's not that sexy.
(22:28):
It's just this same boring list.
And if you've heard this listfrom me before, it's because
it's evidence-based it, theseare the
Dr. Meryl Kahan (22:37):
Right and true.
Yeah.
Lisa (22:39):
and true.
Yes.
It's the boring stuff.
I just, I had a message from afriend the other day.
I have started to be friendswith a group that is
significantly younger than me,so she's asking me for advice,
um, for her mother-in-law who'slike my age.
And she's like, she's having ahard time menopause and, And I
was like, she's not missing thesuper food.
(22:59):
Like that's what kind of whatthe, what the question centered
around.
And I'm like, I just wannaremind you guys, you're, you're
not missing some secret somebodyon Instagram that tells you that
you're missing that one secret.
They're wrong unless this istheir secret strength.
Walking protein fiber.
So, um, real quick, you did giveus a recommendation on protein,
(23:22):
which is about a hundred grams.
That's what I generally do shootfor as well.
Um, what is your fiberrecommendation?
Dr. Meryl Kahan (23:30):
Fiber, I would say about 25 to 30 for the day.
Lisa (23:32):
Yeah.
Okay.
Dr. Meryl Kahan (23:33):
Um, and if you find that you're unable to get
that in your diet, um, you know,you could do supplements as
well.
I think you really need to focuson your diet primarily.
but one thing I like to tellpeople to do, I mean, I'm not a
dietician, I'm not anutritionist.
(23:54):
But I find that using somethinglike chat, DPT honestly, can be
helpful in terms of coming upwith meal suggestions or
recommendations, especially ifyou're looking, at these goals
in terms of how much you wannaget in.
And you can therefore put inmaybe the foods you like or what
you have on hand, or what youhate, you know, and it can
(24:16):
really come up with some.
Very quick and easyrecommendations for you.
Um, you know, you can put yourbudget in, how many people you
wanna feed, whatever it is.
And that just really gets sortof that barrier for saying like,
like I say all the time, like, Ijust don't know what to make.
I'm not creative.
(24:36):
Well now you don't have to be,you know, so it's just getting
easier to be able to do this.
but of course you still have toput in the work.
to actually make sure you'regetting in the, the proper food,
but it, it really is doable.
Yes, it may be boring, but let'snot forget about the, the OGs of
(24:58):
health, I would say.
Lisa (24:59):
Yeah, I, I've been focusing on protein for so many
years.
That protein just feels easy.
And it's not that I hit ahundred grams, every single day,
but I know why.
When I don't, I'm like, well,yeah, it's obvious.
I'm not confused about protein,but fiber has been my new thing
that I've been focusing on thelast couple of years, and.
(25:21):
It is trickier because protein,you get a serving and you're
counting in kind of like tens.
You know, this is 10 or 20 or 30grams of protein for this
serving.
Whereas fiber, you're countingin ones and twos and so you're
like, oh, I'm going to eat thiswhole mango, and you're like.
Five grams.
Five grams.
What?
I just thought this was gonnameet my entire daily
recommendation for fiber.
(25:41):
You think that the food has morefiber than it does, and so don't
get discouraged.
It's okay that you're countingif you're just,'cause I notice
that people that are used tocounting protein grams, when
they start to count fiber grams,they're like.
It's like nothing, like, keepgoing.
It's just a couple, couple hereand there.
It all adds up.
I found the easiest way for meto meet my fiber goals is to
(26:01):
have a serving of beans.
last week I did like a cabbageand bean and all kinds of
different vegetable salad.
Like sturdy kind of vegetables,put it in the refrigerator and a
ate that for lunch every day.
And I was like, ES on my fibergoal every day that, that week.
'cause I'm like, okay.
Yeah, that's, so find somethinglike that that you like, that
you can incorporate, as often asyou can.
(26:22):
What's your favorite way to getfiber?
Dr. Meryl Kahan (26:25):
I do like beans.
I don't have them enough.
I'm someone who I could dobetter on it.
I've been taking fibersupplements myself for several
years.
Um.
Because I have Celiac and thatwas ConEd to me.
So, and but to your point,actually recently, don't ask why
I hadn't done this sooner, but Ilooked at the bottle to see
(26:46):
like, how much fiber am I takingand just with this, and I was
like, why is it so low?
It's like five grams, right?
So, um, yes, you do need to takein more absolutely through the
diet, which again, I'm notalways so good at, but.
Beans.
I do enjoy, air filling andprotein also, but meal prepping
(27:12):
too, right?
Like if you prepare things forthe week, then you don't have
to, you know, take it off yourplate for the rest of the week.
You don't have to wander likeevery night, like, oh my
goodness, it's another night.
I have to go through thiscooking again.
Or what am I gonna take for.
For lunch every day, which is astruggle for sure.
Um, especially for me living inNew York.
(27:34):
I'm surrounded by like foodeverywhere I go.
Um, so if you take like a littlebit of time on the weekend,
that's another way just to likeplan in advance to ensure that
you're getting and what you needto.
Lisa (27:47):
Yeah.
Um, so I talk a lot aboutmindset for eating.
We talk a lot about, Reallythinking about why you're eating
when you're not hungry andsometimes is really important
rather than like specificallywhat you're eating.
Obviously today we're talking alittle bit more about what
you're eating, but, when we'rethinking about why we're eating
when we're not hungry, and Iwork on that mindset shift, you
(28:09):
were telling me that, sometimesthere are signs your body needs.
More than just the mindset shiftthat I teach.
What are those signs that younotice that we need to get
beyond the thought work?
Dr. Meryl Kahan (28:21):
I think that, If you are struggling with
weight changes and the thingsthat have been working for you
are no longer working again, itcan be really frustrating.
You might end up being hard onyourself, like, obviously I'm
doing something wrong and thisused to work for me.
Why isn't it working anymore?
But I think if you look at thewhole picture.
(28:46):
See what else is going on.
Whether that is changes in yourmood, maybe you're more
irritable or more anxious.
If you're just exhausted all thetime, you're having the sugar
cravings, you're not sleepingwell, maybe your libido is off
or your memory isn't as good,you know, any of those other
(29:06):
symptoms.
That could be very suggestive ofhormonal changes.
I would really take those aslike messages from your body
that, there's something elsegoing on that goes beyond a
mindset problem, you know?
And so that's why, especially ifyou're doing everything right, I
(29:28):
think it's really worth.
Looking into your hormones andfinding a provider that is open
to helping you with that.
because again, they're allrelated.
All the hormones are related andhormones are responsible for how
our entire body functions.
And so if those are out ofbalance, like no amount of
(29:50):
mindset shift or motivation oranything is, is going to help
that, unfortunately.
and so again, I think that'swhen it would benefit you even
if you decide not to.
Move forward in terms of anysort of hormone replacement.
You know, some people need it,some people don't.
Some people want it, some peoplecan't have it, whatever it may
(30:12):
be.
But definitely worth, um, adeeper dive to see what is going
on.
Lisa (30:17):
Yeah, definitely.
And I think, um, I, I always amrecommending my clients like,
check with your doctor on that.
'cause obviously that's not myscope.
I do think it's so important tomake sure everything's working
medically and you are inintegrative women's health more
than just, uh, traditionalmedicine.
So if somebody's looking for,you know, somebody to help them
(30:41):
with their hormones.
Can you tell us like how to findor what to look for?
Like what are we looking formaybe on their website that
tells you that it's more of anintegrative or personalized care
that you do?
If they're not in New York,obviously.
Dr. Meryl Kahan (30:56):
Sure, sure.
Yeah.
So integrative, reallyintegrates kinda like the best
of both worlds with thetraditional medicine, um, which
we all know as.
Typically you go in, you'resick, you get treatment,
medication, and then hopefullyyou're better.
Combining that with moretraditional, like lifestyle
(31:17):
changes, using nutritionsupplements.
So things that really complimenteach other.
And then looking at the wholebody as one, as opposed to
looking at your heart versusyour reproductive system versus
your brain health.
And really seeing how likeeverything's connected.
And so.
(31:39):
I think what's so important, ifyou're looking for that kind of
care, is of course, it dependswhere you're looking for it.
There's so many ways to findcare.
But there are certain keywords Ithink are helpful and those can
be helpful whether you'relooking on social media, if
you're looking on Google now,even in the ai, models, there is
(32:02):
becoming more and more, Of a usefor those, even in terms of
searching for businesses ordoctors or whatever it may be.
So I think looking up likeholistic, whether it's um,
gynecology or doctor provider.
Um, but holistic wellness,integrative.
You can look up functionalmedicine though it is not really
(32:25):
quite the same thing though.
There's some overlaps.
Um.
Bioidentical hormone replacementtherapy.
I think just having that termbioidentical, um, is important
and it will likely find you moreof that, um, integrative
approach as well.
Um, full body complimentary.
(32:47):
So those are some words I thinkcould be helpful in, in your
search.
Lisa (32:53):
Good because it's, it's tricky.
You know, not all of us haveinsurance where we can go
wherever we want.
For years, I, I think almost adecade I was with, Kaiser, if
you're familiar with,California.
Healthcare.
It's, it's like a HMO, you know,and so everything's in one
building and which, you know,there's some good and some bad,
but fairly limited on, doctorChoice where I am at.
(33:16):
You know, it, it depends, butour insurance just shifted and
so now I am.
It's more of a PPO, I have moreaccess.
And so it is delightful to justreally get to search for a
provider that you want look atrecommendations.
also the Menopause Societypractitioner, do they have lists
that you can look at?
Dr. Meryl Kahan (33:35):
Yes.
Yes, they do have a directory,that is for the public, of
course, on the Menopause Societywebsite.
I think it's menopause.org.
And, yes, so anyone who is acertified member, or provider
will be on that directory.
So you can search by location aswell.
Lisa (33:56):
I, I think that's how I found, found my current provider
because I really was interestedin someone that could really
work with my hormones.
'cause I ended up working with anaturopath as well as my Kaiser
doctor.
And then they were just sayinglike two completely opposite
things and it was veryconfusing.
So it's been nice this year,this calendar year, to
consolidate my care into one.
Office that really does thisintegrative healthcare for
(34:19):
women.
So I've been appreciative of it.
I know that's how you run yourpractice.
And so, um, yeah, I think it'sreally super, super helpful.
Alright.
Any last words of wisdom onthose that are struggling with
some of these symptoms withmenopause that you would, um,
tell, tell your patients?
Dr. Meryl Kahan (34:41):
Definitely, first and foremost is, you know,
you best, so advocate foryourself.
I've had so many.
Patients in their thirties, andolder who, you know, they come
to me after their doctors, justtell them either you're too
young to be in perimenopause oryour hormones look fine, or just
(35:03):
take this birth control, tobalance everything, you know,
whatever it is.
If something isn't feeling rightwith you, then let's have it
looked at.
there's no shame in findingsomeone else who you feel like.
fits you better.
it is a personal relationshipand so it is important that you
feel comfortable wherever you'regoing.
(35:24):
It's not a one size fits allapproach.
So really just advocate foryourself.
educate yourself, and there areplenty of, very well qualified
doctors out there who areavailable to help you.
Lisa (35:39):
Great.
Thank you so much.
And I would love to put yourlinks in the show notes if you
are in New York or Florida.
Is there anything else that youwant to direct people to?
I.
Dr. Meryl Kahan (35:49):
so my social media, um, and my website, I'm
gonna have a new website soon,but for now it is gmd ny com.
And yeah, I'm always available.
Um, follow me on social.
You can DM me or again, ifyou're in New York or Florida,
(36:09):
reach out.
Lisa (36:11):
Okay, great.
Thank you so much.
Dr.
Khan and I went on to chitchatabout GLP ones and the trend of
microdosing.
I ended up asking her if I couldsend that section out just to my
email subscribers, she said yes.
So it's a little less formal,but I think you'll get a lot out
of it.
The link to that download is inthe show notes.
If this episode hit home for youand, you want support working
(36:33):
through your perimenopause ormenopause symptoms and weight
gain, I'd love to talk with you.
I have two free resources rightnow that I know will help
download the What to Do When YouOvereat Course.
If you find yourself overeatingtoo many times in a week to see
lasting weight loss, Or you cangrab my brand new GLP one
success.
Starter kit.
This is for anyone already onGLP ones, but don't have any
(36:54):
support or structure around whatto do or if you're even remotely
considering medication.
Grab this so you know what toexpect.
You can also schedule a freeconsult session to see if my
Premier 12 week one-on-onecoaching program is right for
you, or my brand new GLP oneconfidence method that I've
recently developed to see ifthat is the perfect fit.
So all the links are in the shownotes for both of these free
(37:16):
resources as well as the link toschedule an appointment with me.
Remember, it's not just aboutthe food, it's about empowering
yourself.
With the choices that trulyserve you Have a great week and
as always, thanks for listeningand sharing the Eat Well Think
Well Live Well podcast.
This is the Eat Well Think WellLive Well podcast.
(00:02):
I am Lisa Salisbury and this isepisode 151, menopause Weight
Gain, HRT And Your Emotions withDr.
Meryl Khan.
Welcome to eat well.
Well, the podcast for busy womenwho want to lose weight without
constantly counting, tracking,or stressing over every bite.
I'm Lisa Salsbury, a certifiedhealth weight loss and life
(00:24):
coach, and most importantly, arecovered chronic dieter here.
You'll learn to listen to yourbody and uncover the reasons
you're reaching for food.
When you're not truly hungry,freeing you to focus on a
healthier, more fulfillingapproach to eating.
Lisa (00:41):
Welcome back to The Eat Well Think Well Live Well
podcast.
I'm so excited to have Dr.
Merrill Kahn here today.
She is a board certifiedgynecologist Menopause Society
practitioner And the founder ofSHE md.
So welcome Dr.
Kahn.
Why don't you introduce yourselfa little bit more beyond that
and tell us a little bit aboutwhat you do.
Dr. Meryl Kahan (01:00):
Hi.
Thank you for having me today.
So I am, as you mentioned, boardcertified gynecologist.
I was practicing OB GYN forabout a decade before I opened
SheMD in New York City, andSheMD is a direct care
gynecology practice where Ihelp.
(01:21):
Women with all of theirgynecology needs, and I have a
particular interest in hormonalmanagement, so whether that's
perimenopause or menopause oreven weight management, because
it's something that I had notedin my, you know, decade of prior
experience that a lot of womenjust weren't getting the help
(01:42):
that they needed.
And so prior to opening SheMDIbecame a Menopause Society
certified practitioner.
I did training in bioidenticalhormone replacement therapy as
well as weight management.
And because it all kind of fallsinto the whole anti-aging and
wellness theme, I also, um.
(02:06):
Did a of training and got aboard certification in medical
aesthetics So I'm much a onestop shop for women, um, in the
New York City area.
Um, and I love what I do and Ialso do telehealth where
appropriate, um, in New York andFlorida.
Lisa (02:25):
Awesome.
Well, I know I have listeners inNew York, um, so well, and
Florida that, so that.
That's available for, uh,telehealth, but also just thanks
for sharing your wealth ofinformation and, um, I hope the
sound is okay because myneighbors are doing yard work
and you just can't control that.
So, oh, there, there, they'regoing away.
Okay, so
Dr. Meryl Kahan (02:47):
I'm in the heart of New York, so believe
me,
Lisa (02:49):
yeah.
Dr. Meryl Kahan (02:50):
lots of sounds at all times.
Lisa (02:53):
Well, let's talk about, I, I get lots of requests to talk
about menopause perimenopause,uh, just the struggles that we
have.
Some to do with weight, but youknow, there's a lot of other
symptoms.
Um, but let's start there.
Why does weight loss feel somuch harder in this midlife
time?
And I hear a lot, like thethings I used to do don't work.
(03:16):
I mean, we've all heard thisand.
It's like this weight came outof nowhere.
Um, what else do I commonlyhear?
Just like I started havingsymptoms or like sometimes the
weight, weight gain is the firstsymptom that they notice that
they're kind of in thatperimenopause time.
And a lot of them too.
A lot of my clients andlisteners have been chronic
(03:39):
dieters and so.
As much as they wanna get awayfrom that fad dieting, which I
totally encourage, they alsokind of have a knowledge of like
what to do and what does work.
and so they're like, why is thisnot working?
It's so frustrating.
Dr. Meryl Kahan (03:54):
Yeah.
definitely the things that,worked for them in the past seem
to overnight, no longer workanymore.
Um, this is so common.
Women will complain that, Um,you know, they haven't changed
anything with their diet or ifanything, they're eating even
healthier now and they'reworking out.
(04:14):
Just as much, but they cannotget rid of this stubborn five to
10 pounds usually in theabdominal area.
Um, no matter what they do, andnothing's changed and they've
never had to deal with thisbefore.
And it's, it's very frustrating.
And with all the other symptomsgoing on with menopause, whether
(04:35):
it.
Lack of sleep or hot flashes ormore irritability or brain fog,
you know, you name it.
But then having to deal withthis too, which affects how they
feel, but also now how they'rephysically seeing themselves.
Um, so it's, it's a lot tohandle.
It's a big change.
And so, you know, one of my jobsis to really talk with them
(04:58):
about it.
Also dig deep to try to figureout is this something that is
due to an underlying hormonalissue?
We can talk about the hormonalchanges that happen, that
contribute to this inparticular.
Um, and then work to try tobalance everything so that
they're able to get back to howthey were.
Lisa (05:22):
So What I have noticed is that getting on, um, menopause
horal re hormonal replacementtherapy or there's a lot of
words.
Most people just call it HRThormone replacement therapy, um,
bioidentical hormones.
All of these are kind of really,we're talking about the same
bucket of, of.
Medication, pharmaceuticals, ifyou will.
Um, it's my understanding thatgetting on those is not really a
(05:45):
weight loss plan.
That even when you get onhormone replacement therapy, it
doesn't tend to shift weight.
Would you agree with that?
Dr. Meryl Kahan (05:53):
So I definitely wouldn't put somebody on hormone
replacement therapy if their onegoal is weight loss.
It's not a treatment.
For that, it's not approved forthat.
That's a really, uh, morein-depth conversation, what it
is approved for.
Um, but what we do know is thatwhen you are on hormone
(06:14):
replacement therapy, It canchange your body composition
that was altered when youentered perimenopause or
menopause.
and it can also improve your,muscle mass.
We all lose muscle mass as weget older, and the muscle mass
is so important for us to remainfunctional.
(06:34):
It helps with our, you know,basal metabolic rate.
Um, and so when we replace ourdepleted hormones.
It can certainly help with thebody composition.
Um, I would say that more sothan weight loss per se.
Um, that being said, there is astudy that shows that for women
(06:57):
on semaglutide, um, also knownas Ozempic, that the women who
are also on hormone replacementtherapy do lose about 30, 35%
more weight.
Than if they're on Semaglutidealone.
Um, and so, you know, they dowork together.
(07:22):
But it is not in itself really atreatment.
I mean, you might lose a fewpounds on it alone.
Sure.
Um, but it's not a, quoteunquote treatment for weight
loss.
Lisa (07:34):
Yeah.
I think that's just so importantto realize that just because
we're going to like replacethose hormones doesn't, yeah.
That is not, it's not really inthe class of weight loss drugs
by any stretch of theimagination, but that's, that's
fascinating that, um, inconjunction with the
semaglutide, that, that, Um, Imean, 30 to 35% is a significant
(07:55):
number.
Dr. Meryl Kahan (07:56):
It is, I mean obviously it depends, like if
you're going on semaglutide tolose 10 pounds, I don't know
that you really need to be onSemaglutide, but you know, that
would be an extra three pounds.
Um, but if you do have asignificant amount to lose 30%,
that is a lot.
Yes, for
Lisa (08:14):
Yeah.
That's, that's really good news.
okay.
So what do you think the, someof the things, symptom wise that
legitimately make it harder tolose weight in midlife?
Um, because there are somechanges that happen, I mean,
right off the top of my head, soI'm gonna kind of stare you a
little bit here because.
I know for one thing it's sleep,right?
We're not sleeping well.
(08:35):
And um, progesterone has reallyhelped me with that.
But, you know, it's not perfect.
It's helped, but I'm still like,you know, still have a lot of
awakenings in the night andthings like that.
Um, but when we're not sleepingwell.
It really can affect our weightloss because number one, we
maybe don't have the energy.
We're gonna move less during theday.
Number two, you're gonna mess upyour hunger hormones, leptin,
(08:57):
ghrelin.
So, you know, there's a lotreasons why sleep contributes to
our inability, like poor sleepcontributes to our inability to
lose weight.
So, along those lines, what elsechanges?
And feel free to add more on thesleep aspect as well, but what
else is happening in thismidlife time that makes it
harder?
Dr. Meryl Kahan (09:15):
You took that one.
Literally right outta my mouth.
I mean, I think number one,well, number one is sleep.
It is so important.
Exactly as you're saying.
If you're not getting enoughsleep, you just cannot function.
You can't be functional.
And so if I wanna tell someoneto out Even half an hour a day
(09:36):
when women are already busy.
Whatever they're doing, takingcare of their home, taking care
of their kids, going to work,you know, whatever it is so
busy.
So define the time to work out,either let's say at the end of a
busy day or wake up even earlierto work out, you know, it's
nearly impossible if you're notfeeling rested or you're up
(09:59):
throughout the night.
So that one is so veryimportant.
Absolutely.
Um, and then another thing thatcan affect the sleep too is the
cortisol.
Um, that's a stress hormone anda lot of times we don't really
think about how the cortisol canimpact our sex hormones and
(10:21):
menopause, but It's reallyimportant to remember that these
hormones are all connected andrelated, and cortisol is so
important to help us manageacute stress so that you know
back in the day if we cameacross a saber tooth tire, our
(10:42):
cortisol is going to.
Spike and that will help us runaway.
I'm sure we've all heard thatbefore, but the problem then
becomes when we're chronicallyexposed to high levels of
cortisol, then it's no longersuiting us.
But because we need thatcortisol to survive, what
happens is that, the sexhormones and progesterone and
(11:03):
cortisol have the sameprecursor.
So if we need the cortisol tosurvive.
That precursor is going to getshunted towards making more and
more cortisol to keep us aliveas opposed to going down the
pathway of making the sexhormones.
and so it's really important to.
(11:24):
That we manage our stress levelsto keep the cortisol in check so
that we don't have to keepproducing more and more of it.
And cortisol can also beresponsible for us waking up in
the middle of the night or notsleeping very well.
Um, absolutely it can beresponsible for like the sugar
(11:49):
cravings.
And mood swings and all that.
It relates to insulin as welland the thyroid.
'cause again, all of thehormones are connected and so
it's very important thateverything is balanced.
And unfortunately with cortisol,there's no quick, I mean, I
can't really give someone aprescription like I can for
(12:11):
progesterone to fix it.
So it is something that.
Really takes a lot of, I wouldsay, buy-in, you know, from the
woman to work on things,whatever that may be for her
that she finds will help, withstress reduction.
So that could be going on awalk, that could be listening to
(12:33):
relaxing music, that can bejournaling, meditating, yoga,
you know, you name it.
But that's another thing.
I mean, there's also somesupplements.
There's differing opinions onsupplements.
But they exist and they'rehelpful for some people, but by
no means are they going to besufficient on their own.
So cortisol as well.
Lisa (12:53):
I think it's so, um, tricky for a lot of us in
midlife because we haveteenagers.
I don't know if you do, but, um,I do.
And so our brains don't have theability to distinguish the
stress of the saber, the stressand this, and the danger of a
saber tooth tiger and a meangirl.
And, um, some of us have meangirls living in our houses.
(13:14):
Yeah.
You know what I mean?
So, you know, it's like thisstrange case of, you know,
you've got, um.
Uh, perimenopause symptoms.
And then you also have a childor children in, um, my case with
two teenage daughters.
One's out of the house now, but,you know, going through puberty
and it's kind of a mean turn ofevents where we're at this age
(13:35):
where we have, children, youknow, that are also struggling
with their hormones.
And so and I'm not throwing my,my girls under the bus if you
know me personally, you know, mygirls are delightful, but we all
have our moments.
but I have talked to otherclients who, you know.
We have teenagers.
And so it is, it's hard to belike, reduce your stress and
you're like, what am I gonna do?
Kick'em out.
(13:55):
So, I find that to be, um, justof a, a challenge with this age
range know, a, a challenging andoften you're at the height of
your career.
Like there's just a lot ofreasons that stress can be high.
And so it's um, kind of one ofthose easier said than done
things as far as reducingstress, but there some great
(14:18):
tactics.
Dr. Meryl Kahan (14:19):
yeah, like you said, I mean, for most women,
when body goes through all thesechanges for women is the same
time, you know, if you have kidsthat you happen to be, they
happen to be in that stabletooth tiger or mean girl.
So it's, everything's likepiling on all at once for sure.
And I know it's definitelyeasier said than done and that's
(14:41):
why so many women do strugglewith getting the stress portion,
um, under control.
I will say though, that whenwomen are on hormone
replacement, especiallyprogesterone, they tend to
report back that they findthey're able to manage the
stress better though, so theystill have it.
(15:02):
You know, the goal is not toremove all stress from your life
because that will never happen.
Um, but it's able to calm themdown a bit more so that they're
better able to manage it.
Maybe not be as short, not be asirritable.
Um, and so, you know, that helpstoo.
But another thing in terms of,what changes can happen is the
(15:27):
estrogen also, we all knowestrogen drops tends to drop
vader, then the progesterone.
And one thing estrogen does isit really helps with the insulin
sensitivity.
And so insulin sensitivity helpswith your blood sugar.
And so when you have lessestrogen, then your body's not
(15:48):
as sensitive to insulin.
It doesn't react as well atkeeping your blood sugar steady.
And so then you have these sugarcravings.
Also, you can have crashes, andit's just everything you can see
as we've been talking about.
Really has to kind of be workingin perfect harmony and if not,
(16:10):
even if one thing's off, it justaffects everything else.
And that can really affect yourenergy, your diet, your glucose,
your body capita.
And so yeah, it's, it's a lot.
Lisa (16:27):
It is.
So I get a question a lot, whichis like, what can I do?
I don't wanna be on hormonereplacement therapy.
What can I do from a lifestylestandpoint?
And I'm always like, why?
Like, first of all, why like,ask your doctor you're a
candidate.
I'm not telling you everybodyis, but.
there's really nothing scaryabout hormone replacement.
We're not going for, extra highdoses.
(16:48):
We're trying to just replacewhat was lost.
I think it's interesting becausethere aren't other hormones in
the body that were afraid toreplace.
If you had your thyroid cut out,you would take thyroid hormone.
If your insulin doesn't work,you know you're diabetic, you
take insulin.
Like that's why if you have atype one diabetic child, like
you would never be like, well, Idon't know why that hormone's
(17:09):
not working, but it's too scaryto replace it, so it's.
It's interesting to me thatthere is some fear based around
it.
So I'm always like, why?
Like, let's have a conversationwith your doctor and see maybe
if, if you could be a candidate,but if for some reason you're
not a candidate, or even if youare, even if you're on it, they
don't work in isolation.
Like we still need to have somelifestyle components.
(17:32):
And, um, I talk, I talk to mymom about this a lot.
Um, my listeners know I takecare of all of her healthcare.
I'm always at the doctor withher.
Because she has dementia, shehas a hard time following
through with the lifestyleaspect of the things they ask
her to do.
And I'm like, these medicationsdo not work in isolation.
You can, like, if you're on ahigh blood pressure medication
(17:54):
and you still eat fast foodthree times a day, like that
medication cannot just like.
Work magically, they don't workin isolation.
And so we do have lifestylefactors that are gonna affect
even if you're on medication.
So even if we're on hormonereplacement therapy, what are
the like main lifestyle changesand things that we need to do
(18:15):
outside of just, you know,popping that patch on, rubbing
on our cream or gel or howeveryou are taking it.
Dr. Meryl Kahan (18:23):
I mean, I think I've touched on some of them
already.
Really as it relates to stressmanagement.
But as far as certain dietarychanges, we need to really be
mindful of what we're eating.
Of course.
I mean, we've heard so muchlately about how terrible
(18:44):
processed foods are.
But protein is so, so, so veryimportant.
And I would recommend aiming foraround a hundred, grams a day of
protein, and that could bedivided up among your meals, and
that's really important to helpus maintain our muscle mass.
(19:07):
And also fiber is superimportant too.
One of the things it does is ithelps keep us full longer.
So we don't feel like we have tobe eating at all times.
You wanna maintain hydration, sobe drinking water throughout the
day.
And I just tell patients like,an easy way to know if you're,
(19:30):
if you're drinking enough water,is if your urine is light in
color.
So if it's yellow or brightyellow, then that's a very easy
way to tell that you are likelynot taking in enough.
And so that's super important.
Going on walks even after ameal, doesn't have to be
(19:50):
anything long, but take a 10minute walk, can help with your
blood sugar also.
And.
Working out, especiallyresistance training.
A lot of people are afraid ofresistance training.
I mean, when we hear that orweight training, we just kind of
picture, a bodybuilder orsomething like that.
(20:13):
But that's not what it isnecessarily.
Don't worry.
Even if you're on testosteronereplacement, you're not going to
look like that.
but resistance training can beanything as simple as even body
weight exercises, or resistancebands.
so things that don't necessarilyinvolve heavy weights.
(20:34):
I mean, you can certainlyprogress.
but that is so important tomaintain our functionality too
as we get older.
I mean, you mentioned helpingyour mom.
I also am.
you know, dealing with my momright now who has having issues
with balance and falling and soit's so important to do what we
(20:56):
can at this stage to preventthat.
Um, and so you don't have toworry later on about how you're
gonna manage, right?
Just something as simple aswalking.
Right.
and so it's so important to belooking ahead and prevention is
so much more helpful than.
Treatment after the fact.
(21:17):
I mean, I can prevent so manythings, not everything,
obviously, but you're way betteroff now than down the road when
you're, you know, you miss yearsor decades of being able to set
yourself up for success.
And so just incorporating likethose little things in, whether
(21:38):
you do go on hormones or not,it's only gonna benefit you.
Lisa (21:44):
That is like, perfect.
I couldn't have scripted youranswer any better because this I
just wanna recap for, for thelisteners, like Dr.
Kahn said, manage your stress,eat protein and fiber, drink
water, strength, train, andwalk.
That's essentially the list thatyou gave us.
And it is like the boring stuff.
And this is what I,
Dr. Meryl Kahan (22:05):
Yeah.
Lisa (22:07):
this is what is so like maddeningly frustrating is I
get, I get questions like, youknow, what, what can I do?
And people want like the superfoods of menopause and you know,
they're on Instagram or socialmedia and they see videos of
like, do this one thing.
And I'm like, I'm sorry.
It's not that sexy.
(22:28):
It's just this same boring list.
And if you've heard this listfrom me before, it's because
it's evidence-based it, theseare the
Dr. Meryl Kahan (22:37):
Right and true.
Yeah.
Lisa (22:39):
and true.
Yes.
It's the boring stuff.
I just, I had a message from afriend the other day.
I have started to be friendswith a group that is
significantly younger than me,so she's asking me for advice,
um, for her mother-in-law who'slike my age.
And she's like, she's having ahard time menopause and, And I
was like, she's not missing thesuper food.
(22:59):
Like that's what kind of whatthe, what the question centered
around.
And I'm like, I just wannaremind you guys, you're, you're
not missing some secret somebodyon Instagram that tells you that
you're missing that one secret.
They're wrong unless this istheir secret strength.
Walking protein fiber.
So, um, real quick, you did giveus a recommendation on protein,
(23:22):
which is about a hundred grams.
That's what I generally do shootfor as well.
Um, what is your fiberrecommendation?
Dr. Meryl Kahan (23:30):
Fiber, I would say about 25 to 30 for the day.
Lisa (23:32):
Yeah.
Okay.
Dr. Meryl Kahan (23:33):
Um, and if you find that you're unable to get
that in your diet, um, you know,you could do supplements as
well.
I think you really need to focuson your diet primarily.
but one thing I like to tellpeople to do, I mean, I'm not a
dietician, I'm not anutritionist.
(23:54):
But I find that using somethinglike chat, DPT honestly, can be
helpful in terms of coming upwith meal suggestions or
recommendations, especially ifyou're looking, at these goals
in terms of how much you wannaget in.
And you can therefore put inmaybe the foods you like or what
you have on hand, or what youhate, you know, and it can
(24:16):
really come up with some.
Very quick and easyrecommendations for you.
Um, you know, you can put yourbudget in, how many people you
wanna feed, whatever it is.
And that just really gets sortof that barrier for saying like,
like I say all the time, like, Ijust don't know what to make.
I'm not creative.
(24:36):
Well now you don't have to be,you know, so it's just getting
easier to be able to do this.
but of course you still have toput in the work.
to actually make sure you'regetting in the, the proper food,
but it, it really is doable.
Yes, it may be boring, but let'snot forget about the, the OGs of
(24:58):
health, I would say.
Lisa (24:59):
Yeah, I, I've been focusing on protein for so many
years.
That protein just feels easy.
And it's not that I hit ahundred grams, every single day,
but I know why.
When I don't, I'm like, well,yeah, it's obvious.
I'm not confused about protein,but fiber has been my new thing
that I've been focusing on thelast couple of years, and.
(25:21):
It is trickier because protein,you get a serving and you're
counting in kind of like tens.
You know, this is 10 or 20 or 30grams of protein for this
serving.
Whereas fiber, you're countingin ones and twos and so you're
like, oh, I'm going to eat thiswhole mango, and you're like.
Five grams.
Five grams.
What?
I just thought this was gonnameet my entire daily
recommendation for fiber.
(25:41):
You think that the food has morefiber than it does, and so don't
get discouraged.
It's okay that you're countingif you're just,'cause I notice
that people that are used tocounting protein grams, when
they start to count fiber grams,they're like.
It's like nothing, like, keepgoing.
It's just a couple, couple hereand there.
It all adds up.
I found the easiest way for meto meet my fiber goals is to
(26:01):
have a serving of beans.
last week I did like a cabbageand bean and all kinds of
different vegetable salad.
Like sturdy kind of vegetables,put it in the refrigerator and a
ate that for lunch every day.
And I was like, ES on my fibergoal every day that, that week.
'cause I'm like, okay.
Yeah, that's, so find somethinglike that that you like, that
you can incorporate, as often asyou can.
(26:22):
What's your favorite way to getfiber?
Dr. Meryl Kahan (26:25):
I do like beans.
I don't have them enough.
I'm someone who I could dobetter on it.
I've been taking fibersupplements myself for several
years.
Um.
Because I have Celiac and thatwas ConEd to me.
So, and but to your point,actually recently, don't ask why
I hadn't done this sooner, but Ilooked at the bottle to see
(26:46):
like, how much fiber am I takingand just with this, and I was
like, why is it so low?
It's like five grams, right?
So, um, yes, you do need to takein more absolutely through the
diet, which again, I'm notalways so good at, but.
Beans.
I do enjoy, air filling andprotein also, but meal prepping
(27:12):
too, right?
Like if you prepare things forthe week, then you don't have
to, you know, take it off yourplate for the rest of the week.
You don't have to wander likeevery night, like, oh my
goodness, it's another night.
I have to go through thiscooking again.
Or what am I gonna take for.
For lunch every day, which is astruggle for sure.
Um, especially for me living inNew York.
(27:34):
I'm surrounded by like foodeverywhere I go.
Um, so if you take like a littlebit of time on the weekend,
that's another way just to likeplan in advance to ensure that
you're getting and what you needto.
Lisa (27:47):
Yeah.
Um, so I talk a lot aboutmindset for eating.
We talk a lot about, Reallythinking about why you're eating
when you're not hungry andsometimes is really important
rather than like specificallywhat you're eating.
Obviously today we're talking alittle bit more about what
you're eating, but, when we'rethinking about why we're eating
when we're not hungry, and Iwork on that mindset shift, you
(28:09):
were telling me that, sometimesthere are signs your body needs.
More than just the mindset shiftthat I teach.
What are those signs that younotice that we need to get
beyond the thought work?
Dr. Meryl Kahan (28:21):
I think that, If you are struggling with
weight changes and the thingsthat have been working for you
are no longer working again, itcan be really frustrating.
You might end up being hard onyourself, like, obviously I'm
doing something wrong and thisused to work for me.
Why isn't it working anymore?
But I think if you look at thewhole picture.
(28:46):
See what else is going on.
Whether that is changes in yourmood, maybe you're more
irritable or more anxious.
If you're just exhausted all thetime, you're having the sugar
cravings, you're not sleepingwell, maybe your libido is off
or your memory isn't as good,you know, any of those other
(29:06):
symptoms.
That could be very suggestive ofhormonal changes.
I would really take those aslike messages from your body
that, there's something elsegoing on that goes beyond a
mindset problem, you know?
And so that's why, especially ifyou're doing everything right, I
(29:28):
think it's really worth.
Looking into your hormones andfinding a provider that is open
to helping you with that.
because again, they're allrelated.
All the hormones are related andhormones are responsible for how
our entire body functions.
And so if those are out ofbalance, like no amount of
(29:50):
mindset shift or motivation oranything is, is going to help
that, unfortunately.
and so again, I think that'swhen it would benefit you even
if you decide not to.
Move forward in terms of anysort of hormone replacement.
You know, some people need it,some people don't.
Some people want it, some peoplecan't have it, whatever it may
(30:12):
be.
But definitely worth, um, adeeper dive to see what is going
on.
Lisa (30:17):
Yeah, definitely.
And I think, um, I, I always amrecommending my clients like,
check with your doctor on that.
'cause obviously that's not myscope.
I do think it's so important tomake sure everything's working
medically and you are inintegrative women's health more
than just, uh, traditionalmedicine.
So if somebody's looking for,you know, somebody to help them
(30:41):
with their hormones.
Can you tell us like how to findor what to look for?
Like what are we looking formaybe on their website that
tells you that it's more of anintegrative or personalized care
that you do?
If they're not in New York,obviously.
Dr. Meryl Kahan (30:56):
Sure, sure.
Yeah.
So integrative, reallyintegrates kinda like the best
of both worlds with thetraditional medicine, um, which
we all know as.
Typically you go in, you'resick, you get treatment,
medication, and then hopefullyyou're better.
Combining that with moretraditional, like lifestyle
(31:17):
changes, using nutritionsupplements.
So things that really complimenteach other.
And then looking at the wholebody as one, as opposed to
looking at your heart versusyour reproductive system versus
your brain health.
And really seeing how likeeverything's connected.
And so.
(31:39):
I think what's so important, ifyou're looking for that kind of
care, is of course, it dependswhere you're looking for it.
There's so many ways to findcare.
But there are certain keywords Ithink are helpful and those can
be helpful whether you'relooking on social media, if
you're looking on Google now,even in the ai, models, there is
(32:02):
becoming more and more, Of a usefor those, even in terms of
searching for businesses ordoctors or whatever it may be.
So I think looking up likeholistic, whether it's um,
gynecology or doctor provider.
Um, but holistic wellness,integrative.
You can look up functionalmedicine though it is not really
(32:25):
quite the same thing though.
There's some overlaps.
Um.
Bioidentical hormone replacementtherapy.
I think just having that termbioidentical, um, is important
and it will likely find you moreof that, um, integrative
approach as well.
Um, full body complimentary.
(32:47):
So those are some words I thinkcould be helpful in, in your
search.
Lisa (32:53):
Good because it's, it's tricky.
You know, not all of us haveinsurance where we can go
wherever we want.
For years, I, I think almost adecade I was with, Kaiser, if
you're familiar with,California.
Healthcare.
It's, it's like a HMO, you know,and so everything's in one
building and which, you know,there's some good and some bad,
but fairly limited on, doctorChoice where I am at.
(33:16):
You know, it, it depends, butour insurance just shifted and
so now I am.
It's more of a PPO, I have moreaccess.
And so it is delightful to justreally get to search for a
provider that you want look atrecommendations.
also the Menopause Societypractitioner, do they have lists
that you can look at?
Dr. Meryl Kahan (33:35):
Yes.
Yes, they do have a directory,that is for the public, of
course, on the Menopause Societywebsite.
I think it's menopause.org.
And, yes, so anyone who is acertified member, or provider
will be on that directory.
So you can search by location aswell.
Lisa (33:56):
I, I think that's how I found, found my current provider
because I really was interestedin someone that could really
work with my hormones.
'cause I ended up working with anaturopath as well as my Kaiser
doctor.
And then they were just sayinglike two completely opposite
things and it was veryconfusing.
So it's been nice this year,this calendar year, to
consolidate my care into one.
Office that really does thisintegrative healthcare for
(34:19):
women.
So I've been appreciative of it.
I know that's how you run yourpractice.
And so, um, yeah, I think it'sreally super, super helpful.
Alright.
Any last words of wisdom onthose that are struggling with
some of these symptoms withmenopause that you would, um,
tell, tell your patients?
Dr. Meryl Kahan (34:41):
Definitely, first and foremost is, you know,
you best, so advocate foryourself.
I've had so many.
Patients in their thirties, andolder who, you know, they come
to me after their doctors, justtell them either you're too
young to be in perimenopause oryour hormones look fine, or just
(35:03):
take this birth control, tobalance everything, you know,
whatever it is.
If something isn't feeling rightwith you, then let's have it
looked at.
there's no shame in findingsomeone else who you feel like.
fits you better.
it is a personal relationshipand so it is important that you
feel comfortable wherever you'regoing.
(35:24):
It's not a one size fits allapproach.
So really just advocate foryourself.
educate yourself, and there areplenty of, very well qualified
doctors out there who areavailable to help you.
Lisa (35:39):
Great.
Thank you so much.
And I would love to put yourlinks in the show notes if you
are in New York or Florida.
Is there anything else that youwant to direct people to?
I.
Dr. Meryl Kahan (35:49):
so my social media, um, and my website, I'm
gonna have a new website soon,but for now it is gmd ny com.
And yeah, I'm always available.
Um, follow me on social.
You can DM me or again, ifyou're in New York or Florida,
(36:09):
reach out.
Lisa (36:11):
Okay, great.
Thank you so much.
Dr.
Khan and I went on to chitchatabout GLP ones and the trend of
microdosing.
I ended up asking her if I couldsend that section out just to my
email subscribers, she said yes.
So it's a little less formal,but I think you'll get a lot out
of it.
The link to that download is inthe show notes.
If this episode hit home for youand, you want support working
(36:33):
through your perimenopause ormenopause symptoms and weight
gain, I'd love to talk with you.
I have two free resources rightnow that I know will help
download the What to Do When YouOvereat Course.
If you find yourself overeatingtoo many times in a week to see
lasting weight loss, Or you cangrab my brand new GLP one
success.
Starter kit.
This is for anyone already onGLP ones, but don't have any
(36:54):
support or structure around whatto do or if you're even remotely
considering medication.
Grab this so you know what toexpect.
You can also schedule a freeconsult session to see if my
Premier 12 week one-on-onecoaching program is right for
you, or my brand new GLP oneconfidence method that I've
recently developed to see ifthat is the perfect fit.
So all the links are in the shownotes for both of these free
(37:16):
resources as well as the link toschedule an appointment with me.
Remember, it's not just aboutthe food, it's about empowering
yourself.
With the choices that trulyserve you Have a great week and
as always, thanks for listeningand sharing the Eat Well Think
Well Live Well podcast.
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