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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