There’s a new buzzword sweeping through conversations around perimenopause and weight loss: microdosing GLP-1s. As a nutritionist, wellness author, and woman who's living through perimenopause myself, I get it. When you're battling stubborn midlife weight gain, energy slumps, sleepless nights, and a metabolism that feels like it's packed up and moved to another country, the idea of an easy fix is enormously tempting.
Suddenly, GLP-1 drugs like Ozempic, Wegovy and Mounjaro are everywhere, promising rapid weight loss by blunting appetite and recalibrating blood sugar levels. Now, the trend is to microdose, taking tiny amounts of these drugs to supposedly lose weight without suffering the infamous nausea, vomiting and side effects that come with full doses.
I want to be honest: I completely understand the appeal. I’ve been in the trenches myself, staring down a pair of jeans that no longer fit, wondering if maybe, just maybe, there’s a shortcut to feeling like myself again. But as a professional, and as someone deeply passionate about helping women thrive through midlife, not just survive it, I have to say it loudly: microdosing GLP-1s is not the magic solution we are being sold.
© AlamyThe hype vs. the truth
While GLP-1 medications were originally developed to treat type 2 diabetes, they have taken on a celebrity glow thanks to their impressive short-term weight loss results. In clinical trials, participants lost up to 20 per cent of their body weight over about a year. But here's the problem: these studies mostly looked at people who were diabetic or severely obese, not healthy, perimenopausal women just trying to lose a few stubborn kilos.
More concerning is how little we know about the long-term effects of GLP-1s, especially when they’re used off-label and at subclinical doses. Leading researchers from places like the University of Chicago warn that we simply don’t have the data yet. What happens to your body after years of dulling your appetite with synthetic hormones? What happens to your gut health, your metabolism, your natural hunger signals?
© ballyscanlonWe are already seeing signs that it’s not all rosy. Dermatologists are reporting an uptick in what’s been dubbed "Ozempic face", where rapid weight loss causes the face to sag and hollow out, adding years to your appearance. Not exactly the youthful glow we were promised. And more worrying still are reports of muscle wastage, hair loss, gallbladder issues, and thyroid complications.
When something seems too good to be true, it usually is.
Why food will always be the real medicine
What frustrates me most is how conversations about GLP-1s are drowning out something much more powerful, sustainable, and life-changing: the incredible potential of nutrition.
When women reach perimenopause, their bodies are crying out for support — not suppression. Falling estrogen levels mean we lose muscle faster, store more fat around our middles, and become more insulin-resistant. But we don't need to hack our bodies into submission. We need to nourish them back to balance.
The right foods can do that, and the research is rock solid.
© GettyFirst and foremost, protein is critical. Most women simply aren't eating enough of it. As we age, protein becomes essential for maintaining muscle mass, fuelling metabolism, balancing blood sugar, and even boosting mood. I recommend aiming for a portion of protein at every meal, whether it’s eggs, organic chicken, wild salmon, tofu, or lentils. Not only does this keep you fuller for longer, it actively works against the metabolic slowdown of perimenopause.
Then there’s fibre, the unsung hero. Fibre from vegetables, fruits, legumes and wholegrains doesn't just aid digestion, it feeds your gut microbiome, stabilises blood sugar, and reduces inflammation, all of which play a direct role in hormonal weight gain. I always tell my clients: if there’s one thing to add to your plate today, let it be a rainbow of plants.
Healthy fats are vital too. Omega-3 fatty acids, found in foods like salmon, walnuts, chia seeds and flaxseeds, can help reduce hot flushes, protect heart health, and even ease depression symptoms during perimenopause. These are the real superheroes, not something you inject once a week.
And don’t underestimate the power of food synergy. Certain foods contain phytoestrogens, plant-based compounds that gently mimic the effect of estrogen in the body. Think soybeans, chickpeas, flaxseeds and sesame seeds. These humble foods have been shown in studies to ease perimenopausal symptoms naturally and safely, without the risks that come with hormonal drugs.
© Jacob WackerhausenMovement, mindset, and magic
Of course, food is only one piece of the puzzle. Moving your body, especially strength training, is non-negotiable. We must actively preserve the muscle we naturally lose with age if we want to keep our metabolism lively. Strength training two to three times a week, combined with moderate cardio and a good daily step count, is a far better prescription for long-term vitality than any injection.
Stress management is another huge factor. Chronic stress raises cortisol, and elevated cortisol encourages the body to store fat around the belly. I always advocate for mindfulness, yoga, meditation, or simply carving out moments of calm in a hectic day. A stressed-out body is a fat-storing body — no GLP-1 will fix that.
The truth women deserve to hear
What makes me saddest about the rush to microdose GLP-1s is the way it sells women short. It suggests that our bodies are broken, that we must be chemically altered to fit an outdated ideal. I reject that. Perimenopause is not a disease. It's a natural, powerful transition. Yes, it requires adjustments. Yes, it can be challenging. But it is not something to be fought with a pharmaceutical silver bullet.
Instead, we should be reclaiming this time as a second spring, an opportunity to reset, reframe, and realign with what truly makes us feel alive.
Real food. Real movement. Real self-care. These are not buzzwords. They are the bedrock of health, vitality and true confidence.
I’m not here to shame anyone who chooses a different path, every woman has the right to make the best decision for her body. But I do believe passionately that we deserve all the information. We deserve to know that real, sustainable, joyful change is possible without needles, nausea, or mystery side effects.
Your body is not your enemy. It is not a project to be fixed. It is an ally, a messenger, and a miracle, and it deserves better than a quick fix.
Faye James is author of her latest book The Perimenopause Plan, The Menopause Diet and an Accredited nutritionist and member of the Australian Menopause Society.
