106. GLP-1s in Perimenopause: What Most Providers Are Missing
Don’t Miss An Episode!
GLP-1 medications and peptides are everywhere right now – but the conversation around them has become loud, polarized, and often missing context.
In this episode, I share why I intentionally waited to talk about GLP-1s, how I think about them through a functional and midlife lens, and why tools like peptides or hormones can’t replace foundational health work.
This is a grounded, non-shaming conversation for women who want clarity (not hype) when it comes to weight, metabolism, muscle, and long-term health after 40.
You’ll learn:
- What GLP-1s and peptides are – and why they’ve become so popular
- Why I’m neither “for” nor “against” GLP-1s, especially in perimenopause
- The real risks of rapid weight loss without protein and strength training
- What women on GLP-1s need to prioritize: muscle, nutrition, gut health, and nervous system support
- Why no medication or peptide replaces lifestyle, hormones, and metabolic context
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Why I Took My Time Talking About GLP-1s
I’ve intentionally waited to talk about GLP-1s because I’m not reactive by nature, and I think that matters—especially when it comes to health.
In conventional medicine, we’re often reactive. A symptom shows up, we take medication. And sometimes that is appropriate—I’m not anti-tools.
But they’re often given without comprehensive support – and that’s where things start to go sideways.
But the way I practice functional health, and the way I live my life, is by always asking why. Why is this happening? What’s driving it? What’s the context?
And before we go any further, I want to be very clear about something. If you’re currently on a GLP-1, this episode is not meant to shame you or scare you. That is never my intention.
In fact, if you are on one—or you’re considering starting one—this conversation should help you think more clearly about how to support your body while using it.
Today’s episode isn’t about whether I “believe” in GLP-1s. This isn’t a religion; i’s a tool—one that does have data and research behind it.
I care about evidence and physiology. And I care about helping women slow the conversation down instead of reacting to whatever health trend is the loudest at the moment.
Because reactivity often gets people into trouble. And my goal here is to add context so you can decide what actually makes sense for you.
And part of why I wanted to do this episode is because I’m seeing more women come to us already on these medications—but without the support they actually need.
Because just like with HRT—the real issue isn’t the tool, it’s the lack of context.
The Problem With Trend-Based Health Conversations
If the whole GLP-1 narrative feels like déjà vu, it should.
We watched this exact thing happen with hormones. Suddenly everyone was either “HRT fixes everything” or “HRT is dangerous.”
GLP-1s are following the same path.
And when health becomes black and white, women lose.
Most women I talk to are exhausted by the messaging.
It feels like overnight everyone is on something.
Not enough people are talking about food or muscle. Or what happens after the weight comes off.
And when that context is missing, of course people get skeptical.
My Perspective on GLP-1s
Here’s where I land.
I don’t think GLP-1s are bad, I also don’t think they’re a magic solution.
In my opinion, they aren’t a first step.
And they certainly do not make lifestyle changes optional.
The biggest issue I see isn’t the peptide—it’s how casually it’s being prescribed.
High doses. No food guidance. No protein targets. No strength training conversation. No discussion of thyroid, minerals, gut health, etc.
That’s when side effects happen—and women start feeling awful.
Not because the tool is inherently bad—but because it’s being used without that support.
What GLP-1s Actually Are
Let’s dig into what GLP-1s are.
But first, a quick clarification, because the language around this can get confusing.
Peptides are the umbrella. They’re short chains of amino acids that act as signaling molecules in the body. We naturally make many of them.
GLP-1s are a specific category of peptides—and the ones mostly being talked about right now are prescription medications – the Semaglutide, Tirzepetide, and Retatrutide.
Then there are other peptides you may hear about like BPC-157, Sermorelin, PT-141 and so on. Some are prescription-only and commonly offered through medical or telehealth practices.
Others are sold through supplement companies, which is where things get a little murky in terms of quality and regulation.
This is why I tend to be cautious. I like to look at what’s been studied in humans, and what’s being prescribed—or sold—responsibly.
When people say “peptides,” they’re often lumping different things together. And context matters —both in terms of safety and whether something is even appropriate for you.
GLP-1s were originally studied in people with diabetes and insulin resistance, and now they’re being used more broadly for metabolic health and weight loss.
We do have human data showing they impact appetite, blood sugar, and inflammation—but most of that research is in metabolic populations, not long-term use in midlife women.
And this is where nuance matters. Rapid weight loss often comes with loss of lean muscle—especially if protein and strength training aren’t prioritized.
After 40, muscle is currency. Bone density and mobility matter. And losing weight without protecting those things is not a win—no matter what the scale says.
If you’re currently on a GLP-1
There are a few non-negotiables that matter—and this is where most of the conversation online is incomplete.
First is eating enough protein. Not “whatever sounds good,” not skipping meals because you’re not hungry—but intentionally meeting your body’s protein needs so you’re protecting muscle. Because if appetite is suppressed, you have to be even more intentional.
Second is strength training. Ideally 2-4 times per week. Rapid weight loss without resistance training is one of the fastest ways to end up weaker and metabolically challenged. The biggest mistake I see when using GLP-1s is not supporting metabolism.
Third is gut support. Constipation is common on GLP-1s, and ignoring it isn’t benign. That’s where food choices, hydration, minerals, and gut function really matter.
And finally—this is the piece almost no one talks about—you still need to look at the bigger picture: thyroid, nervous system, stress, and sleep.
The medication doesn’t replace those things.
This is why, inside The Perimenopause Method, we don’t just look at one tool in isolation. Whether a woman is on HRT, considering a GLP-1 or on one, or not using either, we’re always looking at: nutrition, metabolic health, hormones, minerals, gut health, and stress —because that’s what determines whether something actually helps or creates more imbalances.
What GLP-1s Don’t Replace
I don’t care what new drug, peptide, supplement, or therapy comes out. You cannot bypass:
- Eating enough calories for your needs – a lot of women end up significantly under-eating on these medications, which might look like progress short term—but it’s one of the fastest ways to slow metabolism long-term.
- Restful sleep
- Stress regulation
- Blood sugar regulation
- Minerals – when appetite drops, so does intake—not just calories, but minerals and electrolytes are critical for energy, thyroid function, as well as
- gut + liver support
Tools can support the process – they don’t replace it.
Why Weight Often Comes Back
And this is often why women come off and gain the weight back.
Not because they did anything wrong—but because the foundation wasn’t there. And when the medication is removed, the body goes back to what it knows.
If you don’t support muscle, nutrition, and metabolism while you’re on it, your body will fall back to where it started.
Even within our team, we’ve seen both the clinical and personal side of this…
This is exactly why we don’t just focus on weight inside The Perimenopause Method. We’re looking at metabolism, labs, nutrition, hormones, and how your body is actually functioning—because no single tool works in isolation.
Final Thoughts: Stay Curious, But Be Disciplined
If you’re curious, stay curious—but be discerning.
Don’t let trends think for you. Be mindful of who you’re following online – influencers make a lot of money pushing some of these products.
But also don’t let fear or black and white thinking get in the way of a tool that may really benefit you.
Health isn’t about choosing sides—it’s about understanding your body well enough to use tools wisely.
And that’s where real change happens.
Alright, if this episode helped, please leave a rating, review and share it with another woman who needs to hear it. And if you’re a high-achieving woman dealing with exhaustion, mood changes and stubborn weight, apply to work with us in TPM, via the link in the show notes. Have a great week.
Claudia Petrilli is a Functional Health Coach, Integrative Nutrition Coach, Women’s Health Educator, and creator of The Perimenopause Method. Having experienced debilitating periods, digestive issues, a sluggish thyroid, a pituitary tumor, and perimenopause symptoms in her late 30s, she knows exactly what it’s like to get dismissed by doctors and spend years searching for answers.
