Nuance: discussing weight loss with patients

Welcome to 2026, where it suddenly feels harder than ever to talk about menopause, health, and nutrition without the conversation getting hijacked by weight loss. In this longer-than-usual episode, I’m joined by family physician and writer Dr. Mara Gordon (who proudly describes herself as an “anti-diet doctor”) to talk about the question that's been on my mind lately: Is a weight-neutral menopause still possible?

Mara and I unpack what weight neutrality actually means in real-world healthcare, why the “weight loss fixes everything” narrative has gotten louder again, and whether GLP-1 medications can fit into an informed, values-based, body-autonomy-first approach to care.

In this episode, we talk about:

• What I mean by “weight neutral” (and why it’s not the same as “anti-weight loss”)
• Why menopause weight changes can create so much urgency, fear, and pressure
• How to support weight-neutral conversations even when cholesterol, blood sugar, or blood pressure change
• The “Mediterranean pattern,” and why nutrition strategies can help without turning into restriction
• GLP-1s: what they can do well (and what they cannot do)
• Why a lot of expectations about weight loss are shaped by culture, not medicine
• Why “I want to avoid meds” is often about something deeper than the medication

About my guest, Dr. Mara Gordon
Dr. Mara Gordon is a family physician in Camden, New Jersey. She’s also a writer, including NPR’s Real Talk with a Doc column, and she writes a Substack newsletter called Your Doctor Friend, about healthcare being a mess and how we can figure it out together. She’s also working on a book about diet culture and medicine, expected in 2027.

Links & resources

• Dr. Mara Gordon’s Substack: Your Doctor Friend
• NPR column: Real Talk with a Doc
• My website + free resources + coaching: menopausenutritionist.ca

If this episode hit home
Share it with a friend who’s feeling the pressure to “fix” her midlife body. And if you have a question you want me to tackle on a future episode, send it my way.

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