Perimenopause can feel like your body changed the rules overnight. As someone who spends their time working in Women’s Health, I see many women become discouraged when weight changes, fatigue, mood swings, sleep disruption, and shifting body composition appear during this transition. But supporting health in perimenopause should not center around shrinking your body. A weight-neutral approach focuses on improving quality of life, strength, energy, and long-term health behaviors instead of chasing a number on the scale.

As a Registered Dietitian Nutritionist in the Women’s Health realm, I hear this all the time: “My hormones are a mess.”

Irregular periods, intense PMS, anxiety, poor sleep, stubborn fatigue - many women assume these symptoms mean something is fundamentally wrong with their bodies. Hormones get blamed quickly, and understandably so. But in practice, I often see something else driving these issues: chronic under-fueling.

Fertility struggles can be physically and emotionally challenging, and they are far more common than many people realize. As a Registered Dietitian Nutritionist (RDN), I often work with individuals who feel pressure to “fix” fertility challenges through diet or body changes. It’s important to state clearly: fertility is complex, and challenges are rarely caused by a single factor. Although it is often a significant focal point when an individual is faced with struggles conceiving, body weight alone is not a reliable predictor of fertility. Subsequently, focusing solely on weight loss can distract from more meaningful, supportive changes.