How many times have we heard that weight loss and maintenance is simply “calories in, calories out?” Well, the equation may be rooted in thermodynamics, but the reality is biology, history, hormones, and a whole lot more. This week, endocrinologist and Harvard obesity researcher Dr. Jody Dushay breaks down why this concept is far more complex than the numbers on a food label or how many calories our devices tell us we’ve burned. From how your body actually absorbs calories to how (or not) it expends them, we explore how and why weight gain and loss anything but straightforward—especially during menopause, when shifting body composition, gut microbiome changes, altered insulin responses, and evolving hormone levels, create a whole new metabolic landscape. As you’ll see, your body isn’t a calculator—it’s a dynamic, adapting system. We also revisit GLP-1 drugs, which are increasingly popular with midlife women, and where they fit in this whole equation (so to speak).

Jody Dushay, MD, MMSc, is an endocrinologist at the Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School. She is also the founder and director of Well Powered, a comprehensive wellness and weight management program. Dr Dushay has studied the effect of pharmacotherapies and dietary interventions on body weight for years, including a large single-site study examining the effects of a glucagon-like peptide receptor agonist on body weight in obese women without diabetes. As a triathlete, she has qualified for Kona 3 times and came in 2nd in her age group at the 2020 Ironman World Championship in St George. You can learn more about her and her work at wellpowered.org.

Resources:

Dr. Jody Dushay’s research:

Short-term exenatide treatment leads to significant weight loss in a subset of obese women without diabetes

Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women

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For the longest time, endurance athletes avoided the weight room, afraid unwanted muscles would weigh them down, while strength athletes all but kicked cardio to the curb. Now we know that no matter if you’re running an ultra or competing in a CrossFit competition, the right blend of cardio and strength is the secret sauce for success–especially once you hit midlife and menopause. This week, renowned exercise physiologist Dr. Alyssa Olenick dives in on how our hormones impact our muscles, metabolism, and general physiology, and how the right blend of hybrid training can help you stay strong, fit, healthy, and injury free during and beyond the menopause transition.

This episode originally dropped on January 8, 2025.

Dr. Alyssa Olenick holds a PhD in exercise physiology and is a certified sports nutritionist and CrossFit Level 2 Trainer. Alyssa completed her doctoral training in exercise and human metabolism, sex differences, and menstrual cycle physiology. She also completed a postdoctoral research fellow investigating the areas of menopause and metabolism. As a coach she specializes in the areas of endurance, strength, and hybrid training. She runs her online business ‘Doc Lyss Fitness’ and training programs ‘The Lyss Method’. She is also a strength athlete, ultra-marathon runner, and all-around fitness lover who is passionate about educating people on science-based fitness to get them into the gyms and on the roads/trails — or often, doing both at the same time! You can learn more about Dr. Alyssa Olenick and her programs at www.doclyssfitness.com

Resources

How to exercise for menopause with Dr. Alyssa Olenick on YouTube

Menopausal Women Need Unique Muscle Making Guidelines, Feisty Menopause Blog

Resistance training alters body composition in middle-aged women depending on menopause - A 20-week control trial, BMC Women's Health

Effect of Concurrent Training on Body Composition and Gut Microbiota in Postmenopausal Women with Overweight or Obesity, Medicine & Science in Sports & Exercise

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This episode originally dropped on February 12, 2025.

Bill Campbell, PhD, has spent his entire career as a fat loss researcher. So when his wife hit menopause and wanted help with body composition changes, he thought it would be easy. Spoiler alert: It was not. Which made him realize his field had a lot to learn, especially about active women whose bodies change even when their training and nutrition has not. Now he’s on a mission, diving into the literature and conducting research of his own to further our understanding of body composition changes during this time of life. We talk all about it, what he’s learned, and his work developing a Female Fitness Menopause Survey to learn more.

Bill Campbell, PhD is a Professor of Exercise Science and Director of the Performance and Physique Enhancement Laboratory at the University of South Florida. He is also a Certified Strength & Conditioning Specialist from the National Strength & Conditioning Association and former president of the International Society of Sports Nutrition (where he is also 1 of 35 individuals to be recognized as a ‘Fellow’ of the organization—an honor reserved for those individuals who have outstanding contributions to the field of sports nutrition). He has published over 200 scientific papers and abstracts, three textbooks, and 20 book chapters in areas related to physique enhancement, sports nutrition, resistance training, and dietary supplementation. You can learn more about him and his work at www.billcampbellphd.com

Resources

Estrogen modulates metabolic risk profile after resistance training in early postmenopausal women: a randomized controlled trial, here

Transdermal Estrogen Therapy Improves Gains in Skeletal Muscle Mass After 12 Weeks of Resistance Training in Early Postmenopausal Women, here

Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism, here

Powerpenia Should be Considered a Biomarker of Healthy Aging, here

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