When we choose our experts at MPOWDER, we take our time to seek out those with the deepest in-field experience not the most instagram follows. The people that remain curious as science evolves but categorically anti-trends. And those that respect individual agency too.
Dr. Michelle Gordon is one of those people. With more acronyms at the end of her full title than I can squeeze in here, she has practiced medicine since 2000. Originally trained as a surgeon, she is now board-certified in Obesity Medicine and Lifestyle Medicine, and specialises in metabolic adaptation in midlife women.
Her work focuses on predictable biological patterns — adaptive thermogenesis, insulin resistance, fat mass defence, lean mass decline during the menopausal transition. Not motivational theory. Not cultural commentary. Not diet plans. Not prescriptions.
But, before I continue, one important note: What follows is my personal reflection on one very experienced expert’s perspective on a fast moving space. It is not a substitute for personalised medical advice. Or your practitioner or MD. They know you. This is about the bigger picture.
So let’s get to it. What I didn’t want to hear. And why I’m so glad I listened.
Five Things I Didn’t Want to Hear — And Why I’m Glad I Did
1. My body has a defended weight range.
Set point theory challenges everything we’ve been taught about weight. More research is needed, but increasingly experts believe that our bodies defend a range. When weight drops below what it perceives as safe, hunger rises. Energy expenditure subtly adapts to protect us. The system pushes back. It’s why many of us lose and regain the same 10 pounds. Why we couldn’t get back to our pre-baby weight. And part of the story of why it’s so hard to lose weight in midlife too.
I’m glad I have heard it. There is a beauty in knowing our body is always looking out for us. And reassurance in knowing we’re not imagining it when it feels harder. It’s biology doing what it was designed to do.
2. Oestrogen quietly runs more of the show than many of us know.
We talk a lot at MPOWDER about the hormonal orchestra of midlife. I know intellectually that every cell is influenced by our menopause transition.
But I hadn’t fully appreciated how deeply oestrogen is involved in appetite regulation. Oestrogen interacts with leptin and ghrelin — the hormones that influence satiety and hunger. It plays a role in insulin sensitivity. It influences where fat is stored and how readily we access energy. As levels decline, signalling shifts. Cravings can increase. Satiety can feel delayed. Blood sugar responses can change.
That subtle sense of being hungrier — or less satisfied by the same meal — isn’t imagined.
It’s biochemical.
I’m glad I understand that now. Because it removes the quiet self-criticism. Again, it’s our body’s way of trying to ensure we have the energy we need to push on through. Now it’s about what we have agency to address. More protein. More fibre. Good fat. And real intention around blood sugar balance.
3. Metabolism adapts — even when you do everything “right.”
Adaptive thermogenesis means the body becomes more efficient when weight drops. It conserves energy. It recalibrates output. Hunger signals rise. Reward pathways light up more brightly. The system nudges us back toward safety.
I’m glad I heard this. Not because it means we should therefore eat less. In fact, repeated restriction can reinforce the very defence system we’re trying to work with. What it means is that strategy matters more than force.
4. GLP-1s alter signalling - until we stop.
GLP-1 medications amplify satiety and quiet appetite pathways. For many people, they reduce food noise dramatically.
But they operate within a regulatory system. It’s increasingly believed that, when treatment stops, weight can trend back upwards because of our body’s desire to return to its defended range (that set point again).
This is not a failure of the medication. And it’s certainly not a failure of us. But it does highlight why wrap around support is critical to maintaining weight loss - and why the conversation about whether the future will mean people stay on some protocol forever is taking place across the medical community.
5. Shame dissolves when physiology makes sense.
This may be the most important one for me. So often we’re made to feel like weight gain is our fault. Weakness. Greed. And, at this lifestage particularly, ‘simply letting ourselves go’. The truth is there is not enough research into female health. But, what we’re learning is that hormone shifts, set points, the very process of ageing - all impact our weight. And, regardless of whether weight loss medication is appropriate for us, we all need to learn to adapt to new ways of eating, moving and nourishing our bodies and minds. To plan for healthspan. Joyspan. To stay well.
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