Ep #184: Your Questions Answered: Pregnancy, Menopause, and Your Brain

This episode is a fun one because I’m doing something I haven’t done in a while: answering some of your listener questions! I’ve got some really good ones today about weight loss during pregnancy, peri-menopause, and menopause that will benefit you even if you don’t find yourself in any of those stages of life.

It’s always important to remember that our beliefs create our results, and if you want a different result you have to change your beliefs. So listen in to find out how to adapt to your ever-changing body as a woman, why it’s important to get curious about what your body is telling you, and how to nurture a solutions-focused mindset—no matter what life stage you’re in.


Listen To The Episode Here:

In Today’s Episode, You’ll Learn:

  • How to reshape your thoughts to avoid unnecessary weight gain.
  • Advice for adapting your thoughts to your ever-changing body as a woman.
  • How to get curious about what your body really needs.
  • Why we need to stop looking at weight gain as inevitable during peri-menopause and menopause.
  • How to avoid falling into the trap of believing we don’t have control.

Featured In This Episode


Get The Full Episode Transcript

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Read the Transcript Below:

Katrina Ubell:      You are listening to the Weight Loss For Busy Physicians podcast with Katrina Ubell, MD, episode number 184.

Welcome to Weight Loss For Busy Physicians, the podcast where busy doctors like you get the practical solutions and support you need to permanently lose the weight so you can feel better and have the life you want. If you’re looking to overcome your stress eating and exhaustion and move into freedom around food, you’re in the right place.

Welcome back, my friend. It’s so glad to have you here. Now if you’re new, of course, welcome for the first time. So glad to have you here. But if you’ve been a listener at all for any length of time, I’m so glad to have you back. I’m actually really excited about this episode because I’m going to answer some of your listener questions. I haven’t done this in a while, and I was thinking about what I wanted to talk about this week. And I thought, you know what? I need to go in there and dig in to some of the questions that you guys have sent. I think that this is going to be some really good information for so many people. So many of you, even if you’re not specifically dealing with the issues that I’m specifically addressing, I think you’re going to find that it is really, really helpful for you.

But before we dig in and get started, I did want to let you know that next Wednesday, July 29th, I’m hosting a free training. And I would love to invite you to come and join me. It’s at 8:30 PM eastern, 5:30 PM Pacific. And the title of it is How to Lose Weight For the Last Time. I’m going to reveal to you all the things, which is really just three things, that need to happen in order for you to lose weight and keep it off permanently. Because that’s really what we’re looking for, right? Nobody is like, “I would like to sign up for another diet where I can lose some weight, white knuckle my way down, and then basically regain it back and then some. Could we just sign up for that?” Nobody wants that. None of us are wanting that. We want it to come off and we want to just put this whole weight loss goal to bed.

We want to be done with it. And that way we can then move on to other things in our lives. And when you do weight loss permanently the right way, it really transforms you in a way that allows you to achieve way more in your life and to go after all those goals that have been kind of hanging in the eaves, hanging out there, just kind of what you in an ideal world would love to be able to do but haven’t been able to do it at all, starts happening, which honestly, if we’re being totally honest, is sometimes kind of scary for some people. But also, here’s the other news. You can lose the weight permanently and then do nothing else besides your usual life, and just enjoy the fact that you don’t struggle with your weight anymore.

So if you don’t have other big goals, that’s totally fine too. How about we just lose the weight and stop struggling with this? So if you have been on the road to gaining some weight since the coronavirus hit, since all the changes, I mean 2020, we’re halfway through. I’m like, what has happened? This is the longest year of my life so far. My family, we were sitting around the dinner table and we were thinking about what we did last summer, and we were like, all of us, the kids, everybody were like, that feels like a million years ago.

So if you, with all the changes in life over the last several months, if you find that you’ve maybe gotten your eating out of control again a little bit, maybe not even necessarily out of control, but you’re just having more wine or alcohol than you typically would have liked to do, just where the lines start blurring. You had things really dialed in. And now you’re like, “Man, I don’t know. I’m kind of having that weight creep up. I’m having to go up to my next size in scrubs. I’m finding that my clothes are starting to feel a little snug. Or maybe you’re up a size and your clothes.” Let’s just take care of it now. Let’s not wait until you gain a whole bunch of weight and it really becomes a big issue. Let’s just lose that weight. I’m going to teach you how to do that on this free training.

So please put this on your calendar, next Wednesday, July 29th. And it’s at 8:30 PM eastern, 5:30 PM pacific, How to Lose Weight For the Last Time. I will teach you all of that. And the way that you get the information about how to join me on this training, I should probably tell you, and that is by going to KatrinaUbellmd.com/loseweight, L-O-S-E-W-E-I-G-H-T. So if you go to that page, then you’ll be able to enter your information and we’ll be able to send you everything you need to know to be able to join us live on that call. So again, KatrinaUbellmd.com/loseweight. Now, if you can’t join me live for any reason, then still register and we will send you the replay and all that information. So again, one more time, KatrinaUbellmd.com/L-O-S-E-W-E-I-G-H-T.

All right, lovely. Okay. Let’s get started. So, we’re going to cover kind of two important times in many women’s lives, and the first is pregnancy and the second is perimenopause and menopause. So I’m not going to dig in here on the hormones and the science of everything, because first of all, as a doctor, you can do that on your own. And also I’m not really an expert in that. I’m not a gynecologist, I’m not an obstetrician. That kind of stuff is not really my wheelhouse, but it doesn’t need to be my wheelhouse in order for me to really give you some good help. So I figured let’s just go kind of in order, because typically we are having our babies first, if we’re going to have babies, and then we’re going to move on into perimenopause and menopause.

So let’s start with the first question, and I don’t have a name for this person, so I can’t credit the person who sent this to me. But she writes, “I was wondering if you would be able to talk in your podcast about what to do when your body changes on you, specifically pregnancy, though I think this can apply to anyone with a major illness or depression. I lost 20 pounds after my last baby listening to your podcast, following the hunger scale and with thought downloads.” Did you guys notice that. She lost 20 pounds listening to this podcast and doing what I tell her to do. So good. Just know you can get a lot of progress just from listening, doing what I suggest here.

Okay. “I found an eating plan that works and got into a good rhythm of timing when I was eating at work, with my somewhat crazy schedule. Now, I’m pregnant again. And it’s like I have to relearn it completely different body. My hunger cues are different and I’m full all the time. I’m struggling with these changes after feeling like I was in a good groove. Do you have any tips for how to reshape my thoughts and recognize these differences? Are they even different or is that just a thought? Thanks so much.”

Okay. This is so good. So if you are someone who has never been pregnant, doesn’t plan to be pregnant, has been pregnant but doesn’t want to be pregnant again, still listen. This is still going to apply to you because what she’s saying is she found a way to eat that was working really, really well for her. And then something changed in her body. In this case, she became pregnant again. And now the rules have changed. Now, I want to suggest that this is the story of a woman’s life.

This is how things go. Your body is always adapting and changing. And even for men, I think that it’s also similar that just as they age, their bodies change. But for women, it’s definitely like that but on steroids. I think there’s just so many more changes. And what I’ve been saying for years is I felt like there was so much education for me, I mean, when was this, the late ’80s, early ’90s, about getting my period and my body changing through puberty. And there are just very few people out there who are educating us women on what happens when you’re on the other end of that and you’re going into menopause. Your body’s changing, right? There’s a lot of help I think with pregnancy. But even with that, I found a lot of the books I read around pregnancy the first time I was pregnant weren’t especially helpful, didn’t feel like for me either.

So there’s just a lot of changing. There’s a lot of adapting. And this is the story of what it’s like to be a woman. So, we can struggle against those changes. What we do is we’re like, “Hey, I would like to figure out a way that works for me. And then I would like that to work for me for the absolute rest of my life.” And I am right there with you. And if that was the way that it worked or we could make it work that way, I would be all in with you. Like, let’s do it. I’m right on board. But that is not the reality of what our experiences are as women. And so I want to suggest to you that when you have that mindset of, oh, phew, I figured it out.

Now, all I have to do is this for the rest of my life. Then when something changes, you will resist that, and that’s what’s happening here. She writes, “I’m struggling with these changes after feeling like I was in a good groove.” And so the only reason that’s a struggle is because she’s like, “Wait, now I have to figure out a different good groove, and I don’t want to do that.” That’s basically what that is. It’s like, everything’s different, and now I have to figure it out. And I don’t want to do that. Now, I want to offer to you that it’s also possible to believe, “Well, hey, I figured out a good groove last time. I wonder if I could figure out a good groove this time. I could figure out a different good groove that actually works for my body in the current state that it’s in.”

I think when you think about it, you’ve already figured it out once. Why couldn’t you figure it out again? You totally can. So when you say, “Do you have any tips for how to reshape my thoughts and recognize these differences?” Yeah. The difference is your body is different. And so you can take what you’ve learned from getting into that good groove the first time and apply it to what’s happening right now. So here is an example. You said that you had lost the baby weight following the hunger scale and with doing thought downloads. So I’m assuming that when you say with doing thought downloads, what you were doing is you were getting in touch with your emotions so that you are not emotionally eating. And so when you say you’re following the hunger scale and now your hunger cues are different and you’re full all the time, it’s really not that different.

Your body’s still telling you when it needs to eat and when it doesn’t, and you can still follow that. When you’re pregnant, it’s just as important if not more important for you to be doing thought downloads and for you to be getting really in touch with what’s going on with your brain, how you’re feeling emotionally. Now, I do just want to touch on when you are ill to the point of really not being able to eat foods that would typically be on your food plan. So this can be sometimes in pregnancy, especially in the first trimester, but there are people who are physically sick for all three trimesters of their pregnancy. And it’s not until they get that baby out that they actually stop vomiting or feeling really ill. But it also could be that maybe you’re undergoing cancer treatment or you’re undergoing treatment for some other illness, and you just can’t tolerate food physically.

So, I just am thinking of saltines as an example. I’ve definitely worked with tons of pregnant women in my program. And what I always tell them is if you need to eat some sort of refined flour based food so that you’re not vomiting in the middle of every patient encounter, then that is medicine. Eating that food is not something that you’re doing for emotional reasons. You’re doing that because you need to so that you can get through your day. So rather than looking at, I’ve had clients who are feeling so bad about themselves or like they’re cheating on themselves because they’re eating that way. I’m like, no, no, no, no, no, listen, no. We don’t beat ourselves up here. And there’s no reason to look at it that way. If you have looked at all other options and tried a whole bunch of different things, and this is all that works, then this is what we’re going to do.

But that’s not the way that most pregnant women who are feeling sick or people who are feeling sick are dealing with eating those foods. What they’re doing then is they’re like, “Well, I need to eat all day long so that I don’t feel sick.” And so by doing that, they end up overeating. So whether you’re feeling ill, whether your body has changed, whatever’s going on, you never have to overeat. When you’re thinking, “Well, I should eat some more food so I won’t feel nauseous later,” but are you actually hungry right now? Is your body asking for food? That’s like eating to try to stave off hunger that you might have in the future. If I eat now, then maybe I won’t feel nauseous later, except still you do sometimes. So I think of course each individual is different and you may find out like, hey, you know what, I do.

I need to eat three crackers within the course of every hour so that I’m not barfing my guts out or something. Okay, great. But that’s not a whole sleeve of crackers. That’s three crackers. Actually get curious about what does your body need? What is it asking for? It will tell you if you pay attention. And I know that this listener who submitted this knows this because she said she lost 20 pounds by following the hunger scale. That’s how I lost my first 10 was just following the hunger scale. So if you pay attention to what your body’s telling you, you will be able to figure that out. And if you look at pregnancy as like, oh, this is interesting, my body has changed again, it would make sense. I mean, most people will say that every pregnancy was different for them.

Very few people, I feel like, are like, “Oh, every single pregnancy I had, I felt exactly the same. My body responded the exact same way each time.” You’re always just going to be figuring it out. And the same goes for just as you age or things like that. So if you’re open to figuring it out and coming up with what the solution is and having that solutions focused mindset, going, “Okay, well, I’m pregnant. Things are probably going to be different. I know what I did last time. I know what works and what doesn’t work for me. And I’m just going to keep experimenting and listening to my body to know what it needs this time. And I will follow that plan. And I know that that is the best that I can do for my body.” Then there really is no struggle here.

You and your body are on the same team. You both want to grow a healthy baby. So when you listen to your teammate, your body, you can work together to create that outcome that you’re wanting. So really, this isn’t that different. It’s like, yeah, your body’s different. So what? In the most loving way. So what, and I don’t mean so what like this is stupid that you’re even asking this question. I mean, so what like and? Right, of course it’s different. Let’s just figure it out. It’s totally no big deal. So this is where we have to manage our mind. This is the belief that it shouldn’t be different that is the problem, but it is. So let’s move into acceptance on that. And then knowing that even the way you lost the weight last time after the baby might not work. Maybe you’re going to have to do something different this time.

We’re just going to have to see. But when you know, when you believe 100% that weight is coming off, then you get to work figuring it out versus like, “Oh, I hope I can lose it this time. I’m just going to have to see.” No, of course you’re going to lose it. You’ll lose it every single time. And that is if you just had a baby two weeks ago, or if your baby is eight years old. I always love when people are like, “Well, I’m still wearing my nursing bra.” Oh. When did you stop nursing? Six years ago. Oh, okay, well might be time to update and move forward from there. So now we’re going to move to the other side of the spectrum. And this is from Ruth. And so Ruth, thank you so much for sending this in.

She says, “Hi Katrina. I’ve been listening to your podcast for a while. So helpful.” Thank you. So glad that you have, Ruth. She says, “Wondered if you had covered the weight gain that seems to come with the beginning of perimenopause. Thanks.” Okay. So here’s what I want to say about perimenopause and menopause. And I speak from experience because at 44 years old, my body 100% for the last couple of years has already been going through some perimenopausal symptoms. So here’s the thing with menopause and perimenopause. I think that it, just like I said before, the way it affects every woman’s body is totally different. And we know this because some women have terrible, crazy hot flashes, and other women it’s not that bad. And some women experience a whole lot of weight gain and other women don’t. And there’s just so many different symptoms of your body going through that change.

Everybody is different. So you have to identify what seems to be the case for me, and then how am I going to address those issues? So here’s what I want you to consider though. On multiple occasions, I have known women to say, “Well, I went to see my gynecologist. And he told me that on average women gain about 15 pounds as they go through menopause. And so here I am on the back end of menopause, and guess how much weight have gained? 15 pounds.” Hm, pretty interesting how that works. And so what a lot of us will think is that’s what the data shows. When we look on average at women’s weight gain throughout menopause, it’s 15 pounds. But we also know that our beliefs create our results. What we think is true will determine what our results are. What you think determines how you feel. How you feel drives your actions. And your actions create your results. So when you believe that there’s weight gain that comes with the beginning of perimenopause or going through menopause, you will create that result.

So I just want to share a little story, and I’m a little hesitant to because I do understand that this is strange, but just follow me here. When I was in medical school learning about how people’s bodies worked, I often just really didn’t feel like my body worked that way. I know this makes no sense. But when they were describing all these different things that were happening in the body, I just felt like, yeah, that’s what everybody else’s body does. Mine doesn’t do that. And not like in a bad way, like my body is defective. It wasn’t that way at all. It just felt like that wasn’t happening inside of me. It was more just like of a curiosity to me that I kept believing like, yeah, that’s just not how it works inside my body.

I know this makes no sense. But what I’m showing you here by telling you this story is that you can believe whatever you want. I mean, of course we know that my body is doing the same thing that every other human body is doing inside on the cellular level and hormonally and all of those things. But to me, it just felt like somehow that was very complicated, or I don’t know, it was kind of like an existential thing or something. I don’t know what it was, but it just felt weird to me to think that that was happening inside my body. So what I want to suggest to you is that you could say what other women, what happens to them with menopause and perimenopause is they gain a bunch of weight, but it’s not going to happen to someone like me.

That’s not how my body works. My body knows exactly how much food it needs. And if it needs less food or it needs to be more active during a time when there’s big hormonal shifts and changes, I know it’s going to let me know that. And all I have to do is pay attention. All I have to do is listen to the message that it is sending me. And then I won’t have a problem with weight gain. So I find this a lot with doctors and data. We want the data to be the truth and the facts. What I want to suggest is that if that serves you, that’s great. But in a scenario like this, I don’t think that it does. You can be that exception. Make sure you’re that exception. Work very hard to be that exception. If you notice weight is coming on, don’t just blame it on perimenopause and menopause like most people do.

Oh, this is just what happens. Instead, get to work sorting yourself out. What do you need to do? How do you need to clean things up? I often find that many women who struggle with that are not exercising. They don’t have a lot of muscle mass. If they are exercising, it’s usually like a lot of walking or yoga or things that for a lot of people don’t develop a lot of muscle mass, which keeps your metabolism going. Just think about like, what is your body asking? Does it want to be strong? Does it want to be more active? Does it want to have more energy? And then how can you support it in creating that rather than looking at it like I’m doomed, this is the way it is? I’ve see this with multiple clients as well.

We’re like, well, I’m 60 or older, and you know it’s harder for us to lose weight as though that’s a fact. And they cling to that belief so tightly, and their brains do not want to recognize that when you believe that it’s harder and slower to lose weight when you’re older, you will create that result. And then, of course, the weight loss is extremely slow. But when we look at what they’re eating, it’s usually because they’re not totally staying on track with their food. Your brain will do everything it can to create the result that is in line with what you believe. It wants to confirm what you believe. This is just psychology. This is what our brains will do. When you can recognize this, you can say, “Well, you know what? For most people, when they’re perimenopausal or post-menopausal, or in their late 50s or 60s, weight loss is really slow. I wonder if I could figure out a way where it wasn’t like that for me.”

And just being all in. Like I talked about on a recent podcast about being willing, willing to just figure it out, willing to create some totally different possibility for yourself. The more you cling to those beliefs that don’t serve you, the more you will create the results you don’t want. It’s just how it works in the world. So, this is where thought work is so important. Doing those thought downloads. What do I really think about my ability to lose weight? What do I really think about me being at a certain stage in the menopausal cycle? Where do I think I am in there? And what do I believe that means about my ability to lose weight or to maintain weight and not gain? What have the messages been around me about that?

What have doctors told me? What have I read? What have I heard from my friends? What have I heard from my mother and my aunts and other women who are ahead of me? And then what have I decided to believe because of all that information? And when I believe that, what is the result it creates? So you figure out what your beliefs are. And then when you put them through that model, you figure out how you feel when you think that. Then when you do, you’ll figure out what your results are. This is the power of the model. The model shows us what the result is of us believing certain things and thinking certain things. So, I would just suggest, Ruth, that you don’t even think about it like there’s weight gain that seems to come from the beginning of perimenopause, because that sounds like it’s completely out of our control.

It’s just happening to us. Is it though? I don’t know that it’s a good way to think about it. I don’t know that it serves us to think about it in that way. It’s very defeatist. It’s very passive, in my mind. It’s just like, well, let’s just see what happens while I pour myself another margarita. I mean, that’s like, let’s just see if my body gains that weight. Oh, it did. Fascinating, huh. This is the real power of this work, figuring out what you believe and how that’s creating your current results, and then deciding if you want to think a different way so you can create a different result. Not every woman gains weight going through perimenopause and menopause. I suggest that you decide to be one of those women and to figure it out and to keep trying and failing until you figure it out.

On that note, so fun answering your questions. If you would like to send me a question that I may answer on a future Q&A episode, then there’s a couple of ways you can let me know. You can just go to this podcast episode and leave a comment. And you can go to that episode by typing in KatrinaUbellmd.com/184, the numbers 184. And you can just put it right in there. Or on my website, KatrinaUbellmd.com, there’s a contact form. And you can just click on that and submit your question there. I would love to answer your questions. And then I also will be able to answer your questions more directly and much sooner if you come live to the free training I’m hosting next week. So again, it’s Wednesday, July 29th. It’s called How to Lose the Weight For the Last Time.

And it’s at 8:30 PM Eastern, 5:30 PM Pacific. Now, if that is the middle of the night for you or the crack of dawn early morning for you and you can’t attend live, then I will send out that replay. The way to sign up for that is to go to KatrinaUbellmd.com/loseweight, L-O-S-E-W-E-I-G-H-T. All right. Thank you so much for listening and I hopefully will see you next week on that training. Otherwise, I’ll talk to you next week on the podcast. Have a great day.

Did you know that you can find a lot more help from me on my website? Go to KatrinaUbellmd.com and click on free resources.



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Showing 3 comments
  • Kathryn V

    This was a great Q&A session- thank you! As a high risk OB I am always looking for ways to help my pregnant patients who have had bariatric surgery or done big time work to lose weight get in a mindset to accept what changes their body is about to throw at them. This was helpful for me and helpful for my patients!

    Quick question- I’ve heard you talk about not exercising during weight loss. Can you elaborate on why? I know we cannot outrun our fork, but I worry I’ll lose muscle mass and endurance if I slow down my workouts. And I am curious about how best to fuel workouts. Eat before or after? Do you add anything to your planned intake on workout days? I love working out (Spinning is my fave) for my brain- it is like meditation or yoga for me and I don’t want to slow my roll with fitness or weight loss. Thanks for help on the balance!

    Thanks so much!

    • Team Katrina

      Hi Kathryn,

      We’re glad you enjoyed the episode.

      There are a couple other Q&As where Katrina talked about exercise:
      Episode 42
      Episode 105

  • Laurie G

    This podcast has been one of the factors in helping me lose and maintain a 72 lb weight loss. This is the first time in my adult life that I have been this think. I listen to a podcast almost everyday. The new transcripts of the podcasts are an amazing addition to mind work. Thank you so much, Katrina. You dont know it but we are BFF’s. At 54, I am finally feeling positive about my body.

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