Weight is only one part of your overall health, and there is no single approach to weight management that works for everyone. Body weight is influenced by many factors, including genetics, hormones, metabolism, medications, sleep, stress, nutrition, physical activity, and different stages of life. Weight and metabolic health can affect many aspects of women's health, including menstrual cycles, fertility, pregnancy, and health during perimenopause and menopause. At the same time, health cannot be defined by a number on the scale alone.
My goal is to provide practical, evidence-based information to support your health at every stage of life, whether you're interested in improving nutrition or fitness, managing your weight, understanding changes in your body, or exploring additional medical support.
Core Life: A comprehensive weight-management program that brings together nutrition, physical activity, behavioral health, and medication management
Virtual Weight Management: A convenient virtual option focused primarily on medical and medication-based weight management.
Bariatric & Weight Loss Surgery: Offers in-person consultation with weight-management specialists to discuss additional medical and surgical treatment options, including bariatric surgery.
For more individualized nutrition guidance, Nourish offers virtual visits with registered dietitians. You can choose a dietitian based on your specific needs and goals, including providers who specialize in areas such as weight management, perimenopause and menopause, PCOS, and other women's health concerns. Many insurance plans are accepted, although coverage varies. You can check your benefits and choose a dietitian who is a good fit for you through Nourish.
Weight can affect health, but weight and BMI are not complete measures of health. Body weight is influenced by a complex combination of genetics, biology, environment, medications, life stage, and behavior. Obesity is a chronic medical condition, not simply a reflection of willpower or personal choices.
Nutrition and physical activity are important for health regardless of whether they lead to significant weight loss, and sustainable changes are generally more valuable than restrictive diets or short-term programs. When weight loss is a goal, even modest changes can improve health; reaching a particular number or a “normal” BMI does not have to be the measure of success.
For some people, lifestyle changes alone are not enough. Medications and other medical treatments for obesity are legitimate evidence-based tools, just as medications are used to treat other chronic health conditions. The right approach depends on your health, goals, preferences, and stage of life.
Most importantly, conversations about weight should be respectful, individualized, and centered on your goals. You deserve thoughtful preventive healthcare regardless of your body size or whether weight loss is something you choose to pursue.
There is no single eating plan that works well for everyone. Some people do well with a structured program, while others prefer to focus on a few basic principles. Rather than following a highly restrictive diet, I generally encourage finding an approach that provides good nutrition, supports your health goals, and is realistic enough to maintain long term.
Some practical principles I recommend include:
Prioritize protein, particularly at meals. Protein can help with fullness while also supporting and preserving muscle mass.
Choose plenty of high-fiber, high-volume foods, including vegetables, fruits, beans, and whole grains. These provide important nutrients and can help meals feel more satisfying.
Limit highly processed foods when possible and build most meals around foods that are closer to their original form.
You don't necessarily need to eliminate carbohydrates. Instead, pay attention to portion size and the type of carbohydrate, and consider pairing carbohydrates with protein, fiber, and healthy fats.
Pay attention to portion sizes and hunger/fullness cues. Moderation matters, even without labeling particular foods as “good” or “bad.”
Stay well hydrated. Water needs vary, but drinking regularly throughout the day can support overall health and may also help with hunger and appetite regulation.
Make sleep a priority. Inadequate or poor-quality sleep can affect appetite, food choices, metabolism, and weight regulation. Getting enough consistent sleep is an important part of metabolic health.
Pay attention to stress, too. Chronic stress can affect sleep, eating patterns, and other behaviors that influence health and weight. Stress can't always be eliminated, but finding realistic ways to manage it can be helpful.
Think about what you can sustain. An approach that produces short-term results but leaves you feeling deprived is unlikely to work well over the long term.
I also like many of the practical strategies taught by Glucose Goddess / Glucose Revolution (see below), which focus on reducing large glucose spikes by changing how foods are combined or eaten rather than eliminating entire food groups. For some people, seeing their own glucose response can also be educational. Continuous glucose monitors and commercially available programs can provide real-time feedback about how different foods affect blood sugar, although this type of monitoring is not necessary for most people without diabetes.
The goal is not to eat perfectly. A sustainable approach should leave room for favorite foods, meals out, celebrations, and everyday life.
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Physical activity has important health benefits regardless of whether it leads to weight loss. Regular movement can improve cardiovascular and metabolic health, mood, sleep, mobility, and overall well-being. It can also help maintain weight after weight loss.
Aim for a combination of aerobic activity and strength training, but don't underestimate everyday movement. Walking, taking the stairs, gardening, active hobbies, and simply spending less time sitting all count.
Strength training is especially important for women. Building and maintaining muscle supports bone health, strength, mobility, and metabolic health, and becomes increasingly important as we age. You don't need a gym or heavy weights to get started. Body-weight exercises, resistance bands, dumbbells, or structured classes can all be effective.
Most importantly, choose activities that you enjoy and can realistically continue. Consistency matters more than finding the “perfect” workout, and starting with even small amounts of movement is worthwhile.
A good general goal: Work toward at least 150 minutes of moderate-intensity aerobic activity each week, along with muscle-strengthening activity at least 2 days per week. If you're not there yet, start where you are and gradually build up.
The New Rules of Lifting for Women: Lift Like a Man, Look Like a Goddess (Lou Schuler)
Sharona's Hill (easy at-home workout videos)
Kyra Pro (easy at-home workout videos)
Weight and metabolic health can influence several aspects of reproductive health, including menstrual cycles, ovulation, fertility, and pregnancy. Conditions associated with insulin resistance, including PCOS, can also affect both weight regulation and reproductive health.
If you're planning a pregnancy, improving your health before conception can have benefits for both you and your future pregnancy. This does not mean that you need to reach a particular weight or BMI before trying to conceive.Depending on your individual circumstances, changes in nutrition, physical activity, metabolic health, or even modest weight loss may improve ovulation, fertility, and pregnancy-related health.
During pregnancy, people with obesity have higher rates of certain complications, including gestational diabetes, high blood pressure and preeclampsia, cesarean delivery, and some fetal and pregnancy complications. Your healthcare team may recommend additional monitoring or other changes in your prenatal care based on your individual risk factors.
Weight is only one part of reproductive health. Decisions about whether, when, or how to pursue weight loss should be individualized, particularly when fertility, pregnancy timing, or weight-management medications are involved.
Changes in weight and body composition are common during midlife. Many women notice that maintaining their previous weight becomes more difficult and that fat distribution shifts toward the abdomen, even when their overall weight has not changed dramatically.
These changes are not caused by one thing alone. Aging, declining muscle mass, changes in activity and energy needs, sleep, stress, and hormonal changes during the menopause transition can all play a role. Menopause itself appears to have a particularly important effect on where fat is stored, while aging contributes significantly to overall weight gain and loss of lean muscle.
This is one reason I emphasize adequate protein, regular movement, and strength training during midlife. Preserving and building muscle becomes increasingly important for metabolic health, bone health, strength, and maintaining function as we age. Good sleep and attention to nutrition also matter.
Hormone therapy is not a weight-loss treatment, and it should not be started solely for weight management. However, treating bothersome menopausal symptoms may make it easier to sleep well, stay active, and maintain other healthy habits.
For some people, nutrition and physical activity alone are not enough to achieve or maintain meaningful weight loss. Obesity is a complex, chronic medical condition, and medications can be an appropriate evidence-based part of treatment. Using medication is not “taking the easy way out,” just as using medication to treat other chronic health conditions is not a failure.
Weight-management medications work in different ways. Some may be used for a shorter period of time to reduce appetite and support changes in eating habits, while others, including GLP-1–based medications, are generally used as long-term treatment. With medications intended for chronic treatment, weight regain can occur after the medication is stopped.
Medication works best as one tool within a broader approach to health. Paying attention to nutrition, adequate protein, physical activity and strength training remains important, both for overall health and for helping preserve muscle during weight loss.
The right treatment depends on your medical history, goals, other medications, pregnancy plans, potential side effects, cost, and insurance coverage. If you're interested in medical treatment for weight management, a dedicated weight-management provider can help you review the available options and decide what may be appropriate for you.
Looking for treatment options? See the Novant weight-management programs listed above for multidisciplinary, virtual medication-management, and in-person treatment options.
Bariatric or metabolic surgery is another evidence-based treatment option for some people with obesity. These procedures can result in substantial and durable weight loss and may improve obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea.
Surgery is not the right choice for everyone and requires long-term attention to nutrition, vitamin supplementation, and medical follow-up. A bariatric specialist can help determine whether surgery may be appropriate and review the benefits and risks of the different procedures.
Pregnancy after bariatric surgery requires some additional planning. We generally recommend allowing time for weight to stabilize after surgery before becoming pregnant, and nutritional needs and vitamin levels require particular attention before and during pregnancy.