Understanding GLP-1 Medications for Weight Management and Metabolic Health with Dr. Sara Tariq

Today's episode features Dr. Sara Tariq, an internal medicine physician at Northern Virginia Family Practice with over two decades of clinical experience. 

Dr. Tariq is a dedicated advocate for systemic transformation within healthcare, passionately addressing inequities and fostering cultural shifts through relationship-centered care, leadership development and active community engagement.

Dr. Tariq discusses the challenges of navigating midlife weight gain, body image, the stories behind our eating habits. She shares her countelss experiences coaching clients through starting on Glucagon-Like Peptide-1 (GLP-1), like Ozempic and Wegovy, to tackle increased stubborn weight that can occur in the menopause transition. These medications, initially developed for type 2 diabetes, are now being used to help non-diabetic women manage weight through appetite regulation and improved satiety. 

The conversation uncovers the misconceptions and stigma surrounding GLP-1s, the importance of addressing nutritional deficiencies, and the critical role of mental health and mindset in a patient's health journey. 

Key Takeaways:

• GLP-1s are evidence-based tools, not quick fixes, and should be used under professional guidance.
• Sustainable health in menopause requires nutrition, movement, sleep, and mindset—not just medication.
• Each woman’s journey is unique. Coaches and providers should listen, empathize, and support women’s agency and choices.
• Empowerment means letting go of shame, focusing on strength and vitality, and seeking credible, compassionate care.
• The power in shifting from a “skinny” to a “strong” mindset and embracing resistance training, self-compassion, and self advocacy.

Contact:

• Dr. Tariq’s clinic Northern Virginia Family Practice 
• Finbd Dr. Tariq on Instagram at drsaratariqnvfp

I would love it if you could support the show. Go into the show notes and click on the button where you read "support the show." You have the option to donate monthly, $3, 5, 8, 10. Be a loyal supporter for as long as you want with recurring fee as little of three as $3 a month, and opt out at any time. Each investment goes directly back into producing episodes with even better content, improved audio quality, and we'll go a long way in bringing great guests onto the show.

Transcript

That is because I feel, and I tell them, when you walk into the grocery store, you're automatically at a disadvantage.

The grocery store, the way that food is presented to us, automatically puts us at a disadvantage. And even as a physician who's interested in health and who can, who does a lot of reading of labels and looking at my fat and my protein and my, it's overwhelming. It's absolutely overwhelming. So for a lay person, I can only imagine.

And so if the patient is willing, because it is so overwhelming and because the nutrition part is so crucial, I offer nutritionist referrals to all my patients who wanna be on GLP-1s.

Welcome back listeners to the Menopause Disruptor Podcast, and this is the show that we explore what it truly means to thrive in midlife And today's conversation we're diving into a topic so many of us are thinking about, how to take charge of our health with confidence, how to manage weight changes.

And how to navigate the hormonal and metabolic shifts that come with perimenopause and menopause. And today's guest is Dr. Sara Tariq from Washington DCA primary care physician who does something rare in medicine. She blends deep clinical knowledge with a genuinely warm, supportive approach, personalized, individualized care.

Patient-centric care. Oh, I love it. She believes in treating every patient as a whole person and in helping women feel strong, capable, and empowered in their bodies. However, we're gonna talk about one important aspect of metabolic health 

And women's wellness. That has been, Hmm. Maybe over marketed without the appropriate amount of knowledge to break the stigma around it. I'm talking about GLP one medications and the mindset shifts. So many of us are craving from chasing skinny to embracing strength, resilience, and real vitality. 

Dr. Tariq will share her approach to her patient care, how important it is to have those initial conversations that are driving the desire for a client, a patient to wanna go on GLP ones. Is there a hidden story in the past that is leading to the poor eating habits and patterns that might be holding the weight on their bodies as opposed to giving them the empowerment to take lifestyle control into their hands, to manage weight as well as metabolic health?

We will talk about risks and benefits of GLP ones These things are important to consider What are GLP ones? Well, you may have heard their brand names like Ozempic,

wegovy, just a few of the brands that are on the market today Glucagon, like peptide one receptor agonist. why I wanted to have a talk on this subject. Specifically is because as a girl's gone strong woman's specialist coach, 

I received micro learning around GLP ones and what every coach needs to know about her clients who maybe on medications 

and I care so much about women's health that I am sharing my GLP one cheat sheet given to me from the Girls Gone Strong Organization. You'll find a whole wealth of information On that cheat sheet that you can grab a link to in the show notes.

But I'm pretty certain that the information that Dr. Tariq is gonna share with you will inspire you to take a whole new approach to your health and feeling more empowered, but before we begin, here is something you need to know about Dr. Sara Tarik, Her work includes co-authoring initiatives focused on supporting women of color in professional settings, highlighting critical systemic issues, and offering actionable solutions.

Before joining North Virginia Family Practice, Dr. Tariq spent more than two decades at the University of Arkansas for medical sciences, mentoring, emerging physicians, and holding key leadership roles.

She has contributed significantly to medical education and organizational culture, publishing influential research on addressing bias, racism, and inequities in healthcare. please join me in welcoming Dr. Tariq to the Menopause Disruptor Podcast. 

Dr. Sara Tariq, , I am so thrilled to have you here because we're gonna talk about something that has come up in My Women's Coaching Certification, GLP one medication. But before we dive in, welcome to the Menopause Disruptor Podcast.

Thank you so much. It's lovely to be here.

 the work you're doing in women's health is really important. I wanna give a little bit of background, your story. 'cause I find that when we understand the person's backstory, that creates an intimate relationship with who that person is. So tell us about your journey 

Sure, sure, sure, sure. I am originally from the south. I was born and raised. I was born in Alabama and raised in Arkansas. Um, very much come from a family, originally from India, so a family of immigrants who. And we saw quite a lot of illness, and, and a lot of low health literacy, uh, in my family and then in, in my state in Arkansas, where there is so much poverty and lower education.

And so I sort of grew up around that and became very interested in medicine. My desire to be a doctor was really solidified because I was in college when the AIDS epidemic came out, That was in a time when people were dying of AIDS left and right, and in the south. I mean, it was probably all over the nation as well, but in the south there was a lot of misconceptions and misunderstandings and fears around HIV to the point where doctors and nurses weren't.

Touching and taking care of the patients adequately. Some in healthcare were not, and the, it was so painful to see the stigma, and particularly the stigma and the pain of the L-G-B-T-Q community because they obviously bore the brunt of it at the beginning of the epidemic. so that's really what solidified my desire to become a doctor.

and then that led to medical school at, in Arkansas at UAMS and then residency in Rhode Island. And that's, and by the time I was a senior medical student, I knew I wanted to do women's health, didn't think I wanted to do OB GYN, but really wanted to do the thinking part and the, the really.

Manage long-term management and prevention part of women's health. And that's what I've been fortunate, able to, to do fortunately, over the last 25 years. And I've spent most of those 25 years in academics. have recently moved to Washington DC area, purely for family reasons and joined a concierge practice here, Northern Virginia Family Practice, about a year ago.

And I'm really, really enjoying it.

 balanced, ethical, woman-centered care. You are a rare commodity. We all want one of you. As

you.

I, I do wanna get into the academia side, the education around GLP ones. Just let's

Yeah.

off, us what they are, what the AK acronym stands for, and what they are mostly used for.

So the, the GLP ones, are really medications that were originally created to treat type two diabetes. And these are fairly new medicines, right? they're fairly new medications. They were originally used to treat type two diabetes to really lower the blood sugar. And again, these are fairly, fairly recent medications.

They haven't been around for a long time. And, um. What we noticed when we had people on the medications, sorry, GLP one, glucagon-like peptide, which we'll talk about in a minute. So glucagon-like peptide, are these medications that secrete, that secrete a hormone that. When food enters a particular part of the stomach, and the intestine, it releases its hormone that lowers the blood sugar, 

It also works to increase satiety, which means you feel fuller earlier and you end up eating less. Now. and so what we noticed was as these diabetic patients were taking these me the medications, the GLP ones, they were also losing weight, which led to further studies looking at people who had elevated BMIs and looking at people who had obesity.

And then you see the tsunami effect in the country of everybody, starting to use GLP ones, for not only type two diabetes, but also weight loss. Incidentally, we've also, and there are studies that are ongoing right now, so I'm really interested to see what the next three to five years of data shows us.

But I think there's preliminary data that shows improved outcomes in cardiovascular outcomes, in terms of reduced heart disease, complications of heart disease, some. Studies are now looking at memory. There's maybe improvement in memory with people who are on GLP ones and prevention of dementia.

Um, and another area that I'm really interested in but may or may not be relevant to our conversation is the finding that the GLP ones shut down an area of our brain that makes us want to eat right. that regulates appetite. But what we're also finding is that it also shuts off that same area that might be regulating addiction.

And so they're looking at the use of GLP ones in patients who are addicted to alcohol or narcotics, opiates, other drugs. So I think the data that's emerging is absolutely fascinating.

Yes.

 I have to agree. this was some of the information that came out in the literature when I took this little micro learning course. was largely designed to help us break the stigma around it. I am one guilty of that. I saw the these ads coming out in its use, and I thought, are we not manipulating a drug that should be used for type two diabetes? So from a primary care perspective, then, what is the missing piece in the public conversation around GLP ones in terms of its efficacy, and just why women in particular. Would wanna turn to GLP one medication to help them with their weight loss.

 I think one of the really interesting, there's a couple of things that happened very early on that I think. Influence the conversation and there's something else in the background, The first thing is that when you look at the literature on shame, and this is peripherally connected, But when you look at the literature on shame, men harbor a lot of shame around their financial success or their job.

Interestingly, despite all the feminist movement, despite everything, all the progress that we women have made. The major area where we women harbor our shame is our body image. And that hasn't changed at all. Right? That's. it just continues to be so, so I think number one, the GLP one somehow got connected to that part of, there's a shame connected to why, to needing medications.

Why can't you just exercise and diet and why can't, you must not be that disciplined. You must not be that hardworking if you need a medicine to lose weight. That's for thing. and then what also I think influenced the conversation is at the beginning, I'm saying six, seven years ago, we saw a lot of, uh, celebrities and personality, you know, famous people start to take Ozempic.

They weren't. They didn't pro, they probably did not meet the criteria to use Ozempic in terms of their weight, or BMI. But they did it for vanity purposes and They were a size, you know, eight and they were a six, and they wanted to be a size two, so that also kind of got compounded in it.

Oh, you know, this is clearly some vanity related thing. And so I think there was a, there was the shame in the background. This. Somewhat inappropriate use. At the beginning when we didn't have a lot of the medications, and I'll be honest, as a primary care doctor, I kind of needed it for my type two diabetic patients and we didn't have it back then, or it was in low supply.

But now that's not the case. the equation has changed. We have a lot more supply insurance and has come out and there's slowly, slowly more coverage of it for obesity and not just type two diabetes. And so I think the tide is changing, but our public opinion has not. and so as a physician.

I'll be honest with you, seven years ago I was a little hesitant, like, okay, I really would like to save this for my type two patients. But now that we are seeing much more manufacturing, I'm using it a lot in my patients who have A BMI over 27 or who have a BMI over 30. So we're using it a lot in our non-diabetics.

So when it comes to the increased manufacturing of these. Brand name products that we know of, like Ozempic being one of them. Are we seeing a little bit more of a knockoff? Is that a risk we should be taking into consideration from the pharmaceutical side, that there's such an increased demand that there are trying to find maybe shortcuts to, to match the demand that's out there?

That's a really good question. I do know, so I wouldn't. I would probably reframe it as sort of these, compounded, right? There's compounded versions and,the, what I've seen in the compounded versions, they're also regulated by the FDA. They're also regulated by their state pharmaceutical boards.

So really. I've seen a lot of patients on the, the compounded versions. I haven't seen a whole lot of problems associated with it. I've seen the same side effect profile. I've seen the same improvement in their weight. So while there was a shortage, we had quite a few patients who wanted to be on the compounded version.

And so as long as. Physicians do the background research and make sure that the compounded version is listed, under certification of their state medical board and the pharmaceutical board. and as long as we know where the medicine is coming from, IE the United States, to be honest with you, I feel more comfortable that way.

 I think it's okay. I haven't, I haven't had that fear of, that fear has not come to fruition. In terms of the knockoffs, although I'm seeing a lot of advertisement about, well, if you eat this certain combination of foods, it mimics ozempic, right? And there's that, and there's just no data to to support that at all.

That's actually a nice segue into my next question with one of its, primary roles is to suppress appetite or turn off that part of the brain that tells us that we're hungry. emotional eating, addictive eating, addictive behavior. Do women run the risk of. By lacking the, desire to eat that they're going to impact their nutrition.

It's like, I'm just not hungry. So I might nibble on a, something small, indulge in maybe like snack on a, a muffin all day long and miss out on her vital macros like protein and

I will be very honest with you, may. Thank you for asking that question. I have been alarmed at the number of clinics that have emerged. Some of them are very good. Some of them are very detailed. They have a dietician, they have a primary care doctor who's looking at these things and counseling patients.

There are some places out there where they're just basically, I know patients who will walk in, they go to the clinic, they're not seen by a healthcare provider, or a nurse practitioner or a physician or a dietician or anyone, and they're just given the prescription. And that I find really alarming.

 I feel I've been involved with GLP ones primarily because I felt like the nutrition piece was missing. There were too many women taking this medication without any guidance in terms of what is adequate protein intake, right? What is your, what do you need to be consuming so that you don't have the constipation and the GI side effects that so many people have?

Right? And so we've seen, pictures on the internet of people with the ozempic face, where all of a sudden they've lost it. Ton of weight very quickly. They haven't consumed adequate amounts of protein, and they do develop nutritional deficiencies, and all of a sudden they look like they've aged 10 or 15 years.

It's because they've lost the buccal fat in their cheeks, or they've lost the fat in important areas of their body that are protected, right? Like their bottoms. And so. I feel it is really important to, if someone is going to get on this medication, to do it under the care of a physician and or a nutritionist so we can give adequate advice on how much protein, how, what nutrients you need to be eating, how much you need to be eating, and the rate of weight loss.

I think in America, I feel like we always have this conversation around how quickly can I lose the weight? Losing too much weight too quickly is so not healthy, The mantra is slow and easy for sure.

Yes. And in fact, in our, our training, nutritional deficiencies had come up and some of the research suggesting that, these medications, the GLP ones we'll eat 16 to 39% fewer calories each day, and that can really add up in a month, in a couple of months. You talked about the nutritional deficiency such as the protein. What other deficiencies? In terms of our vital nutrients, our B vitamins, for example, that are crucial for women's health, particularly in the menopausal transition

 you know, the main thing that I counsel my female patients on is a, for sure, as we mentioned, protein, really, really important. we're looking at muscle mass, the interesting thing around the menopausal transition is a lot of women complain about weight gain, about, you know, average woman will probably gain about 10 pounds around menopause.

Okay? Some women don't like that, I get it, but there's an. It was meant to be an evolutionary advantage, right? Because we know that after menopause, we lose our, our risk of osteoporosis goes up because our estrogen falls, right? And as our, when our estrogen falls, we, it affects the blood flow to cerebellum, which affects our balance, which makes us fall, right?

And so

Yeah.

Vitamin D and protein are crucial. Crucial. And if you think about it, what are the foods that are rich in vitamin D and calcium dairy products. Eggs are very rich in vitamin D, and these tend to be, have a little bit more fat in them. And so what do women do? Oh, it's too high calorie. I'm not gonna, I'm, they just stop consuming those, right?

So you're on a GLP one, you're on this medication, your appetite is low, you start cutting out things like. The heavier foods like the dairy and the eggs and the protein, and you've really got a recipe for. I don't wanna sound a little bit overly dramatic, but disaster, right? Because, because we know for women over 50, particularly over 60 and 70, as we age, the one of the greatest cha areas of high mortality is any kind of fracture, a hip fracture, right?

Exactly.

we've got to protect the bones and the muscles, and those are the two things that kind of go on the wayside.

That's right. Yeah. three big heart, brain, bone, heart, brain, bone, and of course, building muscle to support the metabolic health of the body. this is really good information. Again, the GLP ones might seem like an absolute turnoff to some because it has been over advertised as weight loss and I felt initially that you're robbing those who really need it.

Those who are suffering type two diabetes, really need it the most. We've talked about supply and demand, we've talked about some of the risks. What are other, side effects such as, and I have

Yeah.

nausea can be some of the side effects.

 that's a very common one as well. What these medicines do, among many things besides suppressing appetite in the in, in the brain, they slow down digestion. So the food that you eat stays in the stomach longer, So you feel fuller, which is. Part of the goal, right? You, we want you to feel, you want to feel a little bit more full so you eat less.

 That's a result of delayed gas, what we call delayed gastric emptying. So the food that you eat just stays there. Well, if you start, let's, for example, if you start your GLP one, like Ozempic or Tirzepatide on Monday and. It'll probably start to feel, you'll feel the effect on Wednesday, but you haven't changed your diet.

In other words, if you're still eating cheeseburgers and fries and high fatty foods. What you're going to feel is a market nausea because fat foods that are very high in fat content foods that are fried fast food, automatically slow down gastric emptying. So you've got a medicine that's slowing down gastric emptying.

You consume a lot of fatty fried foods that also slow down, gastric empty, and your stomach does not like it. It wreaks havoc on your system, right?

constipation being

Constipation. So nausea, vomiting, and constipation are really kind of common side effects. Less common, thankfully, is it can get really severe, which will land you in the hospital with the severe, intractable nausea and vomiting and inflammation and irritation of the pancreas.

So it's not, it's not a risk-free kind of situation. You do have to, again, it goes back to your comment. Very important comment about. Managing the diet appropriately, an adequate balanced diet of fruits and vegetables and healthy proteins, which will really hopefully help mitigate this in the majority of people.

So if a woman comes to you and says, Dr. Tariq, I'm desperate. I have tried calories. back calories. I'm doing cardio ad nauseum, or I've tried strength training, resistance training, and I'm just not seeing the results. 

 what would be your first piece of advice to unpack in this woman's situation before you would prescribe the medication?

So I ask a very detailed, I sit with them for about an hour and I ask very detailed history questions.

Amazing.

What was their childhood like? What was your relationship with food? What was your weight during, um, puberty? What was your weight as a baby, right? How did what was exercise like in your household?

What kind of foods were on your table

Oh.

in your household, right? And so that can be really illuminating because I think when we give the GLP ones without knowing these things, I ask a very detailed dietary history. Tell me what you eat on average for breakfast, lunch, and dinner. What about snacks? What about drinks?

Tell me about alcohol, all of these things. So I need the full picture of this patient's lifestyle in terms of diet and exercise. And once I get that, I still will probably give them the GLP one, right? But it gives me, taking a personalized history gives me the opportunity to also give them a personalized plan, right?

To say, okay, you know what? I get it in your childhood that you grew up on mac and cheese and cereal and chicken nuggets and fries. Totally get that. How much of that is in your adulthood now? Oh, well you're, I'm still eating that way. Okay, so let's talk about this. Now. You're probably, here's what you're gonna need to change.

Otherwise, the GLP ones will probably cause you a lot of, side effects. You probably, if you're gonna be, you know, eating like that, it's probably gonna put you at risk. It also helps me. Clue in to if the patient has a eating disorder as an overeating, right? as in are they overeaters? Do they eat, um, when they're anxious?

Do they eat large amounts of food? Is there any, I also like to, discern is there evidence or history of bulimia? Do they have they had an eating disorder? So really trying to get a sense of what is their relationship to food. And I, in those questionings, I will often will, it'll often reveal, oh yeah, this patient, this person may be addicted to food.

This patient does have an unhealthy relationship with food. And how do the GLP ones affect that? It may help, it's probably going to help them immensely, but they also need to change along with the medication, along with changing their. Dietary habits slowly 'cause it's hard to do that. You can't do it overnight.

They also might need mental health intervention. They might need therapy. They might need to speak to a professional. So I really don't wanna just throw a medicine at them. I really wanna make sure that I have a good sense of their lifestyle and their habits. I have a good feeling about their mental health, their approach to food, their relationship with food, and that can improve the outcomes for success long term.

So in that hour long, and I applaud you for that. That's something we just don't see in our healthcare system. I mean, 10 minutes telehealth and then you're out the door kind of thing.

I.

to afford that full hour with your patients, do you find. That in that process of unpacking the story behind the food, they have aha moments where they feel I can build trust in my own body again, I can gain confidence to take agency over my health again.

I see that more than you would imagine. I see it a lot, right? I'm not a therapist, I'm not a mental health professional, but just having, oftentimes people haven't shared this ever, ever in their life until the moment that they speak about this, right? And we know that shame dies when we share stories and knowing that they have somebody on their team knowing that.

I can give them that. I try to give them that personalized care, I think is really helpful. it also allows me to figure out, okay, how quickly am I going to have them increase the dose? how well or how often do I have to see them? Is this somebody I can see once a month or is this somebody I need to see every two weeks for a short bit?

So it, their history and all of those things that are revealed in that hour help me formulate a really personalized plan so that we can prevent the nausea, the vomiting, the horrible constipation, any ER visits, all of those things. So that's what's I find what, and hopefully they find very helpful.

so it's, it's like a three pronged approach, if you will. The GLP ones, of course, to address the immediate. Weight gain that main goal to shed some pounds, get them on track for,

Yes.

some weight. And then there's the healthy lifestyle, the lifestyle choices, the lifestyle protocols. But the other one is a lot of, and as you said, you're not counseling and therapy, but there is the mindset, A huge piece of that is mindset

Yes.

and working with them.

And that's the challenging part, the mindset part, and that's something that a primary care doctor can do.

Okay,

They might need a therapist, right? If there's a mental health issue, they might need a therapist. But like you, I'm also a coach, uh, I'm a leadership coach as well, and I use some of those skills and health coaching, 

And oftentimes it's really looking at the mindset and helping them reframe how they view food, their body image, their health. and that's challenging, but it's also the fun part.

It truly is, it's the aha moments when they start to connect the dots and didn't realize that Big brother bullying them actually led to an eating habit, for example, connecting

Absolutely. Absolutely.

So in your coaching, your leadership coaching, do you encourage the lifestyle protocols that would include the things that help brain, bone, heart and not being resistance, training to fuel the muscles Let's talk about that.

Yeah. again, a lot of the work starts with the mindset. There's like, we have this, we have an obesity epidemic in our country. We also have. Interestingly, an epidemic of, like I said, shame around our body image, whether you are thin, healthy weight, or overweight, or obese.

And so there is that consistent mantra that I always tell my patients protein. Is key for sure. Protein is key. what is the benefits of protein? It's the benefits on the brain. It's the benefit on the muscle. It's the benefit on your energy. Right? calcium and d, the benefit on the bones. And you'll, it's amazing to me, even after all the work, I feel like the healthcare community has made.

Majority of my patients still are not getting enough calcium. The majority are not, getting enough vitamin D. and so it's really interesting to me. I also feel, and I tell this to a lot of my patients, I want my patients to embrace a little bit of grace and. That is because I feel, and I tell them, when you walk into the grocery store, you're automatically at a disadvantage.

The grocery store, the way that food is presented to us, automatically puts us at a disadvantage. And even as a physician who's interested in health and who can, who does a lot of reading of labels and looking at my fat and my protein and my, it's overwhelming. It's absolutely overwhelming. So for a lay person, I can only imagine.

And so if the patient is willing, because it is so overwhelming and because the nutrition part is so crucial, I offer nutritionist referrals to all my patients who wanna be on GLP ones. I say, I think this would be really beneficial to you if you have the time. I really think you, you should.

And if they say, right, I just don't. I'm not, I don't have the financial right now. Whatever. Then we say, then I say, okay, then let's talk about nutrition. Let's spend extra time, and I'd like to see you back in two weeks and we're just gonna talk about nutrition. We're gonna talk about how much protein should you be taking on average, 70 to 90 grams for an average woman, right?

Per day. That, what does that mean? That's not easy, right? A a, a filet, a salmon filet is about 25 grams of protein. And I'll tell them that an average chicken breast, depending on the size is right, 25 to 40. and so we talk about that and, they're like, okay, got it right. It helps them. And so we really go good into detail about what are the kinds of protein, if you're vegan, if you're vegetarian, what kind of protein can you take?

 There's protein shakes that are really good. Let's talk about Greek yogurt. There's Greek yogurts now that you can buy that have 30, 25 to 30 grams of protein in a little thing. So it's really getting them to. F redirect on the kinds of foods that are really going to help them with longevity to help them with their health, to help them with their gut health, and their heart health.

Yeah.

you're speaking my language. Yes. How have you seen the menopause transition? Because might enter the menopausal transition perimenopause is early as the forties and start to see this increase in inflammation and the belly fat, which has a lot to do with our cortisol and the

Yes.

 imbalance of the diversity in the gut microbiome.

We could speak at that at great length, but there was never really, Any eating issues prior to perimenopause and suddenly they want to, they want the inflammation off their body 'cause it's uncomfortable joint pain. It affects so much because it's just that loss of estrogen, anti-inflammatory properties and the increase of cortisol.

The menopause being a stress on the body on itself, it's at a homeostasis. you find that you're seeing the age bracket of perimenopause menopausal women coming in. And it's their menopause that might be driving their desire to start on GLP ones.

We see it a lot. Menopause is a time. Of, as you very aptly stated, multiple changes in transitions in the body. and transitions are hard. Tolerance to change is quite, some of us are very tolerant to change, and some of us it's harder, right? And again, when it comes to our bodies, we still very much define our worth around that.

And so there's a balance of I need you to be healthy and I want you to be at a healthy weight. and yes, you're gaining a little bit of weight and how much of that is. are you willing to tolerate? But if for your heart health, I need you to be in this range. This is the ideal range for you.

Given your background. You mentioned cortisol, and so I spend a lot of time talking about sleep, the poor, the affected sleep pattern that results in menopause that is a consequence of menopause and perimenopause. Really wreaks havoc on not only our wellbeing, but our cortisol, which affects our weight, which affects our sugar cravings and our abdominal weight.

Right? And so I spend a lot of time talking about sleep, and I think

Fuck.

a lot of doctors don't talk too much about sleep. It's a little, sleep is underrated in American culture, right? there's this bravado about, well, I don't need that much sleep. I only need five hours of sleep and I work 18 hours a day.

Right? For me, it's really important education wise in getting my patients to understand the balance and how important sleep is really and truly. And now we have all these forces, social media and Netflix and all of these other things that really that's another form of addiction that we can, you know, talk about another day.

But, um, so I spend a lot of time talking about sleep regulation. If I can get your sleep better, I can get you to eat better. I can get the cortisol levels down. I can get you to feel healthier, you know, and there's more and more data coming out about in pro-inflammatory foods and, and what effects that have, not only on your.

Uh, dry eyes and the dryness that we feel in menopause. The constipation that might arise in menopause, the joints aches and the body muscle aches that arise in menopause. there's a huge potential role that, the kinds of foods that we consume plays here. So I think all of that is really tied in together, and I take a detailed history on what the nine or 10 symptoms of menopause, which of these symptoms do you have?

Which of these do you think is contributing to your overall sense of wellbeing and your weight? what can we do about this? It might be a conversation around systemic hormone replacement therapy. It might be right, a conversation around, all right, let's talk about strong over skinny. What does that mean?

It, right? It means what is what? Two pound dumbbells. Let's talk about two pound dumbbells, it means even a 20 minute walk. Post dinner after dinner can make a huge difference on your blood sugar and your digestion, right? it's really figuring out what's going to work for my individual patient based on their lifestyle, based on where they live and how they work and what's doable for them.

That's so perfect and I'm glad you mentioned the strong over skinny 'cause we're now seeing a big movement on this. thanks to the like of doctors like Dr. Stacy Sims, Dr. Vonda Wright, who really promoting strength training to build bone, to build muscle,

Yes.

longevity and vitality. this is definitely one of those areas where mindset and mindset.

Switch is so important. 'cause we are so fixated, particularly US gals growing up, eighties, early nineties, where if you weren't skinny, you weren't it. You weren't,

That's right.

worth. Yeah.

That's right.

and you've spoken about the mindset when it comes to that. What are some of the key things that you need to identify and to point out in the woman a better understanding that strength, being strong in body is more powerful over the waistline size or the

Absolutely.

Mm-hmm.

Um, during my, when I do my annual executive physicals on my patients, we talk about what you're putting in your body. How you're moving. And that's different for everybody, My husband climbed count Mount Kilimanjaro last year. I can't do that. Right? I could do yoga and Zumba, And so we really talk in detail about what kind of exercise do you like?

Ah.

Are you a social person or are you, an introvert? Do you like exercising with people? Does that help you be accountable? What kind of exercise do you do? That doesn't hurt the next day, So there's what you're putting in your body, how you're moving, how you're sleeping. Tell me what time you go to bed.

Do you wake up in the middle of the night to pee? How often does that happen? Are you able to go back to sleep again? So how you're, we go into the details. The fourth, does your mindset, are you a glass half empty kind of person or are you a glass half full? Are you always scanning the environment for threats or are you scanning the environment for opportunity?

Oh,

beautifully

and when we age, there's a certain anxiety and fear that comes in a after menopause where all of a sudden I see a lot of women, myself included, like I'm thinking about my mortality, I'm thinking about, wow, falls are something that's really important to me now. Whereas before, I never worried about that.

But when I think about my falls or potential or injuries, do I think about it from a problem focused? Approach or do I, and so then I'm constantly worrying about the problem or, can I make the mental switch and say, okay, it's a problem. it's, we're at higher risk for falls as women over 50.

Of course.

What's the solutions approach?

What's my solution? And the key is the challenge. And I'm not blaming physicians, Because I'm privileged that I have the time that I can take with my patients, A lot of doctors don't. They're rushed and they have to see a certain number of patients every day. I'm privileged that I, I really can personalize the care that I give, but for me it's like, okay, what kind of exercise can you do?

Most doctors have only time to say, you need to get an exercise 30 minutes a day,

Or,

Yeah.

what does that mean? You just opened up a huge door and I'm lost behind that door. I don't know what's there.

yeah.

then the next step is, and very few people can afford a personal trainer who can tell them exactly what to do.

So what I do is I say, okay, let's talk about exercise again. What can you do? Let's talk about weights. How much can you, do you have weights at home? How much can you lift? Is it something that you enjoy? Do you need structure around it? Do you have Instagram? Because Instagram has these great, I have four or five very quick references of places to go where you can do some quick 20 minute waits and there's a great person on there and it's free, 

 on YouTube. Do you like yoga? There's great yoga for strength and muscle building. there's these YouTube videos. can I connect you to these YouTube videos? So I try to be very concrete. Global. Yes, you need to exercise more or you know, the, you need to exercise more is not helpful to my patients or anybody.

It's not helpful to me either. But giving me concrete information, but my physician giving me concrete information, websites, YouTube, places, things to go and places to go can be really helping it probably, I haven't seen the data, but there it probably markedly improves compliance and adherence to the plans.

Right.

Absolutely. And what it also demonstrates. As the patient going to see her doctor is that you're aware of what resources are out there and you're aware of what is just noise and showboating to what is credible, valid resources that can be helpful at any fitness level,

Absolutely.

and that demonstrates that person personalized, individualized level of care that is so rare.

Once again, I'm gonna say it in our healthcare system.

My goal is to empower anybody. I wanna empower every single person who walks into my clinic to feel healthy, to feel empowered, to take over the world, to feel healthy, to feel like they can do whatever they wanna do, if they can. And that's a process.

We have just lightly touched on the surface of some of the sage wisdom and empowerment you can give to your patients, particularly the menopausal woman. I wanna. I wanna close with some rapid fire questions. We've heard this in podcasts before. It makes it exciting, 

First. One out muscle is the new what?

Empowerment.

What is one metric that you care about more than weight in midlife.

 energy,

 Love it. One thing midlife women should stop apologizing for in their health journey.

taking up space and owning a little bit of weight. It's okay.

What is one non-negotiable for sustainable weight and metabolic health?

Movement.

Beautiful. That is so good. Uh, so love to bring you back. We've talked a great deal, but we, we touched on that one topic of GLP ones helped frame it in a more understanding, empowering way. And without alienating anyone. Uh, but it was great to talk about the benefits and the, and the side effects which all women need when they are using critical thinking and discernment in their healthcare.

absolutely. It's a great tool. It's a great tool.

Great tool. So tell us all about your clinic where people can find you.

 I am at

I

Northern Virginia Family Practice. there's an Arlington clinic and I'm at the Washington DC clinic. And, if you go to nva family practice.com. You can find us and I would love to be your doctor.

wonderful. And you are accepting new patients. I saw it on the website.

I am accepting new patients.

Thrilled to have shared your knowledge, your passion for healthcare, and just how much empowerment you're giving women.

I, I love it. Well, all your patients, but certainly for the menopausal women, Thank you for being on the show . It was a beautiful conversation.

you so much. So enjoyed talking to you.

 This podcast is all about education and empowerment, and I will tell you, I'm well educated now like I never thought I would be. 

GLP one medication, which was originally de developed for type two diabetes, is now so widely used for weight management, It works on mimicking a natural gut hormone, which is the GLP ones in the GIP.

And this helps regulate hunger, appetite and blood sugar levels helping people feel fuller, longer, and sooner, and helps 'em manage cravings. And these medications are not cheating or shortcuts like I used to think until I had this amazing conversation with Dr.

Sara Tarek. These medications are evidence-based tools that can support metabolic health, particularly during menopause, when hormonal changes, gravely impact, weight gain, insulin resistance, and cardiovascular disease, which is the leading cause of death in women. There is still so much stigma and secrecy though around GLP ones for weight loss, and this is why I purposefully wanted to do a podcast episode on this.

And when the micro learning course came up from the Girls Gone Strong Organization on GLP ones, I knew that there was more to the topic than just what we see on those commercials, right? But unfortunately, many women feel shame or fear judgment. 

So that is why open science-based conversations like I had with Dr. Tarek today are crucial for breaking down these barriers and supporting informed choices. Now, GLP ones are not the magic solution. Your health and weight management still requires a sustainable approach that depends on the foundational habits, such as a balanced nutrition, especially paying attention to protein, for muscle and bone and regular movement resistance training in particular.

Quality of sleep a positive mindset, and having someone to talk to, to start unpacking those stories that led to some of those poor eating habits, stories that could have began as early as our childhood leading to addictive behavior or emotional eating. But when you lose weight rapidly and unsupervised, this can be risky, and that's why.

An individual response to the desire to take GLP ones and being on GLP ones is the most appropriate step forward. Now, some women will experience digestive side effects or changes in alcohol tolerance, and even nausea. And about 20% of the people who are on these medications may not lose significant weight at all.

This underscores a need for personalized care and realistic expectations when wanting to lose weight using such tools as these medications. Now, as a coach and also other healthcare providers, our role is to meet each woman where she's at, listen, empathize, and help the client explore 

What their needs and wants are on their health journey. And that's why, again, open dialogue is so encouraged to unpack these goals, these in experiences, as well as explaining the benefits and the risks involved. And that goes for any medication. And as we well know, the transition from menopause brings unique challenges like increased belly fat, 

More inflammation throughout the body, and we'll see changes in appetite and satiety signals. GLP ones therefore can be a helpful tool, but they always work best as part of a holistic, individualized approach. One of the best approaches though, is to take the emphasis off being skinny and put it back onto being strong and resistance training.

Fueling our muscles with adequate amino acids. IE proteins, as well as having self-compassion are non-negotiables for long-term vitality, as well as our metabolic health.

bottom line empowerment means letting go of shame, advocating for yourself and prioritizing energy and strength. over the number that we see on the scale. 

So if you or someone you know is toying with the idea to start on GLP one medications, or may already be on GLP one medications, let this episode be informative, empowering, educational,

and permission to stop shaming yourself.

the more we unpack hormonal health, particularly in women, we start to understand some of the nuanced approaches to weight loss. It has a lot to do with our hormones and has a lot to do with mindset. So when mental wellbeing and medications can coexist In a personalized care approach, such as the ones that Dr. Sara Tarek delivers, then we're on the right track. you can find Dr. Tarek in her clinic at nva family practice.com. She's also on Instagram.

at Dr. Sara Tarek , NVFP. All those links will be in the show notes.