This Isn't Just About the Scale
When patients come to me wanting to lose weight during perimenopause, the first thing I tell them is: what you do during this window matters more than most people realise — not just for how you look, but for your long-term health.
Done right, addressing body composition during perimenopause can protect your bones, preserve your muscle mass, and reduce your risk of insulin resistance, metabolic dysfunction, and fatty liver disease. Done wrong — through over-restriction, crash diets, or detoxes — you can cause real damage that is genuinely hard to reverse later in life.
This is why I don't think of this as a weight loss conversation. I think of it as a health conversation that happens to involve body composition.
The Two Risks Nobody Talks About
Most people understand that being overweight carries health risks. What they don't hear enough about is the harm that comes from trying to lose weight the wrong way during perimenopause.
If you over-restrict calories, you don't just lose fat. You lose bone mineral density. You lose muscle mass. Both are extremely difficult to recover later in life — and both become increasingly important as you move through menopause and beyond.
On the other side, if you do nothing when weight management is genuinely affecting your health, you increase your risk for metabolic conditions like insulin resistance, type 2 diabetes, and non-alcoholic fatty liver disease.
Neither extreme is neutral. Both have real consequences.
Quick Fixes and Detoxes: The Problem Isn't Just That They Don't Work
I see a lot of patients who've tried cleanses, detox programs, or very low calorie approaches before coming to me. The issue isn't just that these don't produce lasting results — it's that they can actively set you back.
Rapid weight loss through restriction tends to come with muscle loss, nutrient deficiencies, and worsened perimenopause symptoms. Then when the diet ends, weight returns — often with additional fat gain — and the patient is left with less muscle than when they started. That cycle is not harmless.
What This Series Is About
Over the next two posts, I'll be going deeper into why weight loss is so difficult during perimenopause (hint: it's not just your hormones), and what a sustainable, evidence-based approach actually looks like for this stage of life.
If you've been trying hard and not seeing results, or if you're worried about doing this safely, you're in the right place.
