The Reclamation of Self: How GLP-1s Helped Me Choose Me Over Food Noise

Four months ago, I made a choice that changed everything. But this story doesn't start with a prescription or promises of transformation. It starts with the slow erosion of joy—a symptom I didn't even recognize was connected to both my eating disorder history and the hormonal chaos of perimenopause.

As an eating disorder and lifelong anxiety survivor who had been balanced and healthy for over 20 years, I thought I was "fine." Midlife hormonal fluctuations turned my life upside down with the sudden, inexplicable expansion of my waist, new onset body dysmorphia, wild mood fluctuations, and relentless food noise that was stealing my capacity for happiness. 

Medical Disclaimer and Potential Trigger Warning:

I am not a medical provider, and everyone should seek the guidance of a trusted, qualified healthcare practitioner when considering changes to diet, exercise, or medication. This post will cover the topic of disordered eating which some may find triggering.

Research reveals a startling truth: by age 40, one in five women has dealt with an eating disorder, twice the proportion identified in women at age 21. Even more concerning, some studies show that between two and seven percent of women over 40 meet the formal diagnostic criteria for an eating disorder, while other research suggests that some 13 percent of women over 50 struggle with some form of disordered eating.

I was part of these statistics, though I didn't know it. After being in remission from anorexia and bulimia for over 20 years, I thought my eating disorder days were behind me. What I had instead was orthorexia—an obsessive fixation on eating "pure" and "healthy" foods. Orthorexia involves restriction of the amount and variety of foods eaten based on perceived healthfulness, making malnutrition likely. 

For too many years, I allowed my body and being to be ravaged by forces I couldn't control. First came the miscarriage—a loss that rewrote my relationship with my body in ways I'm still unpacking. Then perimenopause rolled in, and with it came something I didn't recognize: the gradual disappearance of joy.

Research shows that perimenopause is accompanied by psychiatric symptoms in over 10% of women, with symptoms commonly including depressed mood and anhedonia. Though if anecdotal evidence counts, the percentages of women suffering with mood disorders in perimenopause is likely much higher. 

Anhedonia—the clinical term for loss of interest and pleasure—was stealing my life one day at a time. Declining estrogen levels in midlife, during perimenopause and menopause, can reduce dopamine production and lower our resilience to stress, contributing to feelings of anhedonia.

The complex work culture I was navigating only amplified this perfect storm. By performing a role in ways that were misaligned to my core values, I found myself with chronic stress, and little time or energy to workout--adding to my rising cortisol levels and inability to think about much beyond my body dysmorphia.

Four months ago, I was at my wits end. I traveled to SXSW to speak at multiple events and when I arrived, I realized that none of my pants fit. Rather than prioritizing my unique needs, I followed the generic advice to eat lots of protein and lift heavy, leaving me swollen, miserable, and unnaturally fixated on food and exercise for the millionth time in my life. Lifting weights and eating protein are healthy parts of longevity, but every individual's needs are different. One size does not fit all!

To make matters more frustrating, I had failed an initial attempt at taking GLP-1s due to heavy side effects. Feeling helpless, I found my hand raised in a room of 450 women and asked a nationally renowned obesity and menopause specialist, if there was anything I could do? I was expecting the generic eat high protein and lift heavy weights. What I got instead, was something I'd never considered: women often benefit from microdosing GLP-1 medications.

At first this conversation felt illicit. The only microdosing I had ever heard of was LSD, ketamine and other mind altering therapies. I quickly learned that like most drugs that were researched and designed for men by men, GLP-1 receptor agonists, were dosed at a standard rate regardless of gender. 

Photo Credit: iStock

GLP-1 medications work by mimicking a hormone that helps regulate blood sugar and slows digestion, which can reduce appetite and food noise. Microdosing refers to taking smaller doses than the standard recommended doses for weight loss—often starting with the lowest 0.25mg dose and gradually increasing only as needed and tolerated.  

Under the careful supervision of my qualified medical provider, I was placed on a microdose of GLP-1—a dose that actually fit my body and my needs. This wasn't about following trends or taking shortcuts. This was about giving my body what it needed to function optimally, to quiet the noise that had been drowning out my joy for decades.

What happened next felt like magic, but it was really just science meeting self-compassion.

Gone was my 36 years of disordered eating. Gone was my orthorexia—that obsessive focus on "clean" eating that had consumed hours of my day. Gone were daily thoughts about what I was going to put in my body, the constant mental calculations, the rigid food rules that had governed my existence. Gone was much of my social anxiety that had been amplified by the constant mental noise around food.

In its place? I became a fully present version of myself. The confident woman I knew before the miscarriage returned. The loving, warm, joyous version of me who loves a party came back to life.

This return to joy isn't just about feeling better—it's backed by science. Research shows that sensitivity to estradiol fluctuations predicts stress-induced inflammatory responses in perimenopausal women. When estrogen levels fluctuate wildly during perimenopause, it can disrupt the brain's reward system, leading to that flat, joyless feeling that so many of us experience but don't understand.

Photo Credit: Gina Pantalone

For me, addressing the biological component allowed space for the psychological healing I'd been failing to achieve for years. When your brain isn't constantly hijacked by food noise and hormonal chaos, you have the mental energy available for connection, creativity, and actually living your life.

Could I have learned to love myself in a body that didn't feel like my own? Probably.

Do I only have one beautiful, precious life to live? Definitely.

I chose myself over endless food noise and worrying daily about the math of intake versus output. And I'd make that choice every day of the week. For many, choosing themselves has nothing to do with food or body image, and more power to them. Reclamation looks different to everyone.

In addition, for those with food noise and hormonal imbalances, GLP-1s are not always right or available. Sadly there are insurance barriers, high costs, and other challenges making these life-saving drugs inaccessible to many.

Here's what I wish I'd understood earlier: we've been sold a lie that struggling with our bodies and brains is a character flaw. That if we just tried harder, or wanted it more, we'd be happier and/or magically find peace with food and our bodies. In truth: perimenopausal hormone fluctuations and the increase in cortisol production midlife leads to a perfect storm not only for weight gain, but also spiraling thoughts, and anhedonia.

The research on perimenopause and depression is clear: this is a vulnerable period for psychiatric symptoms, including the loss of joy. When our hormones are in chaos and our brain's reward system is disrupted, "just think positive" and "eat healthy" isn't going to cut it. So if you haven't entered "The We Do Not Care Club," phase of menopause, that is both common and ok! If you are there with @JustBeingMelani that works too!

This isn't a fairy tale ending where everything is perfect now. The real work is ongoing. It's about continuing to choose myself daily. It's about unlearning decades of programming that told me my worth was tied to my weight. It's about reminding myself that medication and therapy help my mind function optimally. It's about accepting the peach fuzz from testosterone, because it helps me live my life in technicolor. 

My work, to model for other women that there are many paths to self-acceptance, and none of them require suffering. That's why healthspan is a part of my executive coaching process and lifestyle is a focus of The Fuchsia Tent. If we don't feel our best on the inside, we can't give our best to anyone or anything else. And "feeling our best" means something different to every individual we help.