“What a GLP-1 agonist does is teach us about our weight health hormones.” - Ashley Koff

GLP-1 medications are everywhere right now, and for many women in perimenopause, they feel like the only thing that can finally move the needle. But for practitioners, this landscape is far more nuanced. In midlife, women’s weight is tied to shifting sex hormones, gut peptide function, nutrient status, nervous system load, inflammation, and life experiences. When GLP-1s enter the picture, they can help, they can harm, and they can reveal underlying issues we might otherwise miss.

Understanding how these medications work inside the full weight ecosystem is an essential part of responsible, trauma-informed care. GLP-1s impact digestion, vagal tone, appetite signaling, bowel motility, and cardiometabolic markers, and they interact with stress physiology and immune activation in ways that can either support or destabilize clients already navigating complex chronic conditions. When practitioners rely on GLP-1s as a standalone tool, we risk overlooking the deeper patterns driving weight changes in perimenopause.

Today, I’m joined by registered dietitian Ashley Koff, author of Your Best Shot, for an evidence-informed conversation about GLP-1s in midlife. Together, we explore when these medications can support whole-body health, when they create new problems, how to evaluate your clients’ readiness, red flags that practitioners often miss, assessments to determine whether your clients’ weight health hormones are functioning as intended, low and microdosing strategies, how GLP-1s influence pain and immune activation, why a multidisciplinary approach is essential for sustainable outcomes, and more.

Enjoy the episode, and let's innovate and integrate together!

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Learn more or watch the video version of this conversation at https://integrativewomenshealthinstitute.com/ashley-koff-on-glp-1s-and-weight-in-perimenopause-when-they-help-when-they-harm-and-the-red-flags-youre-missing/.

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