Perimenopause and GLP-1 agonists

Why do cravings always seem to strike at the least convenient times? After a long, exhausting day, the thought of chocolate or crisps suddenly becomes irresistible. If this scenario sounds familiar, you’re not alone. Studies indicate that up to 70% of women experience emotional eating at some point in their lives, often turning to comfort foods in response to stress, boredom, or even loneliness. These cravings can feel overwhelming, and they’re not just about hunger—they’re often rooted in deeper emotional triggers, making them all the more challenging to resist.

Emotional eating may seem harmless at the moment, but over time, it can significantly impact both physical and mental health. For many women, emotional eating leads to a cycle of guilt, frustration, and self-blame, often leading to unhealthy weight gain and a negative relationship with food. Constantly giving in to cravings can also wreak havoc on blood sugar levels, sleep quality, and overall energy, making it harder to feel balanced and healthy.

Imagine approaching food with a sense of calm and clarity, choosing what to eat based on how it truly makes you feel, rather than how it might distract from stress or boredom. With the right techniques, cravings and emotional eating don’t have to be obstacles they can become opportunities to practise self-care, patience, and resilience. If you’re tired of giving in to your cravings, there’s hope: it’s possible to take back control, one mindful choice at a time.

Understanding Emotional Eating

Emotional eating is the practice of using food to cope with emotions rather than to satisfy physical hunger. This behaviour often manifests as a response to various emotional triggers, leading individuals to consume food in order to alleviate feelings of stress, boredom, loneliness, or sadness. Understanding the nuances of emotional eating is essential for developing healthier coping mechanisms and improving overall well-being.

Definition and Triggers of Emotional Eating

Emotional eating is characterised by the tendency to eat in response to emotional states rather than physiological hunger cues. This can occur during both negative and positive emotional experiences, although it is most commonly associated with negative feelings such as stress, anxiety, and sadness. A study found that about 40% of individuals tend to eat more when stressed, while others may eat less or show no change in their eating habits under stress.

Common triggers for emotional eating include:

• Stress: High-stress situations can lead individuals to seek comfort in food. The body's stress response increases cortisol levels, which can heighten appetite and cravings for high-calorie foods.
• Boredom: Many people turn to food when they have nothing to do. This behaviour can become habitual, leading to mindless snacking during periods of inactivity.
• Loneliness: Emotional voids often lead individuals to seek solace in food, particularly comfort foods that evoke positive memories or feelings.

The Connection Between Emotional Eating and Comfort Foods

Comfort foods play a significant role in emotional eating patterns. These foods are typically high in sugar, fat, or carbohydrates and are associated with positive feelings or nostalgic memories. For instance, a review found that individuals often crave specific comfort foods during times of distress, such as ice cream or pizza, which provide immediate gratification but do not address the underlying emotional issues.

The consumption of comfort foods can create a cycle of temporary relief followed by feelings of guilt or shame once the initial pleasure dissipates. This cycle reinforces emotional eating behaviours as individuals may continue to use food as a coping mechanism for their emotions.

Strategies for Managing Cravings

Managing cravings is an essential component of effective weight management. Various strategies, including mindful eating, healthy snacking, hydration, and maintaining regular meal patterns, can help individuals navigate their cravings and develop healthier eating habits.

Mindful Eating

Mindful eating is an approach that encourages individuals to focus on the present moment while eating, paying attention to the sensory experience of food and internal cues of hunger and fullness. This practice promotes a healthier relationship with food and has been associated with several benefits, including:

• Improved awareness of hunger and satiety cues: Mindful eating helps individuals recognize when they are truly hungry or full, reducing the likelihood of overeating.
• Enhanced enjoyment of food: By savouring each bite, individuals often find greater satisfaction in smaller portions, which can lead to weight loss or maintenance.
• Reduction in emotional eating: Mindful eating techniques can help individuals distinguish between emotional and physical hunger, thereby decreasing reliance on food for emotional comfort.

A review highlighted that mindful eating can be an effective tool for managing unhealthy eating behaviours such as binge eating and emotional eating, although it may not always result in significant weight loss outcomes due to varying study designs.

Practical Tips for Mindful Eating

1. Eat Slowly: Take time to chew food thoroughly and savour the flavours. Research shows that slower eating is associated with reduced calorie intake as individuals feel fuller sooner.
2. Pay Attention to Hunger and Fullness Cues: Before eating, ask yourself if you are genuinely hungry or if you are eating out of habit or emotion. Reflect on how you feel during meals.
3. Avoid Distractions During Meals: Set aside time to eat without distractions from phones, television, or computers. This allows for greater focus on the meal and enhances the overall experience.

Healthy Snacking

Healthy snacking can play a crucial role in managing cravings and maintaining energy levels throughout the day. Healthy snack options include: 

• Fruits: Apples, berries, bananas
• Vegetables: Carrot sticks, cucumber slices, bell pepper strips
• Nuts: Almonds, walnuts, pistachios (in moderation)
• Yoghourt: Full fat or Greek yoghourts for protein

Portion Control and Timing of Snacks

Portion control is vital for healthy snacking. Using smaller plates or containers can help manage serving sizes effectively. Additionally, timing snacks appropriately such as mid-morning or mid-afternoon can prevent excessive hunger that may lead to overeating at meals.

Hydration

Staying hydrated is essential for overall health and can also help reduce cravings. Often, feelings of hunger can be misinterpreted as signals of thirst. Research indicates that drinking water before meals can lead to reduced calorie intake. A study published in Obesity found that participants who drank water before meals consumed fewer calories and lost more weight over 12 weeks compared to those who did not .

Regular Meals

Maintaining regular meal patterns is crucial for managing cravings and preventing binge eating episodes. Skipping meals can lead to increased hunger later in the day, often resulting in overeating or poor food choices.

Regular meals help stabilise blood sugar levels and prevent extreme hunger that triggers cravings for high-calorie foods. A study published in Nutrition Journal found that individuals who ate regular meals experienced fewer cravings and better appetite control compared to those who skipped meals .

Addressing Emotional Triggers

Emotional triggers can significantly influence eating behaviours, often leading to emotional eating. Understanding and addressing these triggers through various strategies, including stress management techniques, emotional awareness, and seeking professional help, can empower individuals to develop healthier coping mechanisms and improve their overall well-being.

Stress Management Techniques

• Yoga: Yoga combines physical postures, breathing exercises, and meditation to reduce stress. A study found that participants who practised Hatha yoga three times a week for four weeks experienced significant reductions in stress, anxiety, and depression levels. The practice promotes relaxation by activating the parasympathetic nervous system, which counteracts the stress response and lowers cortisol levels .
• Meditation: Mindfulness meditation encourages individuals to focus on the present moment, which can help alleviate stress and anxiety. Research indicates that mindfulness meditation can lead to reductions in emotional eating behaviours. A systematic review in the British Medical Bulletin concluded that mindfulness practices effectively reduce emotional eating by enhancing emotional regulation and awareness .
• Deep Breathing: Deep breathing exercises are effective for immediate stress relief. Techniques such as diaphragmatic breathing involve inhaling deeply into the abdomen rather than shallow breaths into the chest. A narrative review found that participants who engaged in deep breathing exercises reported lower anxiety levels and improved autonomic function .

Benefits of Physical Activity

Physical activity is a powerful tool for reducing stress. Regular exercise releases endorphins, which are natural mood lifters. A study demonstrated that individuals who engaged in regular physical activity reported lower levels of perceived stress and better overall mental health compared to sedentary individuals . Furthermore, exercise can serve as a constructive outlet for managing emotions, reducing the likelihood of turning to food for comfort.

‍Emotional Awareness

Developing emotional awareness is crucial for identifying triggers that lead to emotional eating. Individuals are encouraged to:

• Identify Emotions: Keeping a journal to track emotions and eating patterns can help individuals recognize when they are eating out of emotion rather than hunger.
• Find Healthier Coping Mechanisms: Instead of turning to food, individuals can explore alternative coping strategies such as talking to a friend, engaging in a hobby, or practising relaxation techniques.

Research shows that enhancing emotional awareness can lead to better self-regulation of eating behaviours. A study found that participants who engaged in emotional awareness training exhibited reduced emotional eating tendencies compared to those who did not participate in such training .

Seeking Professional Help

Therapy and counselling play a vital role in managing emotional eating by providing individuals with tools and strategies to cope with their emotions effectively.

• Cognitive Behavioral Therapy (CBT): CBT is an evidence-based approach that helps individuals identify and change negative thought patterns related to food and emotions. A meta-analysis and systematic reviews found that CBT significantly reduces binge eating episodes and improves emotional regulation among individuals with eating disorders .
• Support Groups: Participating in support groups can foster a sense of community and provide shared experiences that normalise struggles with emotional eating. Research indicates that group therapy can enhance motivation for change and provide accountability, leading to improved outcomes for participants .
• Individual Counselling: Working with a therapist allows for personalised strategies tailored to individual needs. Therapists can help clients explore underlying emotional issues contributing to their eating behaviours, facilitating long-term changes.

Conclusion

Addressing emotional eating and cravings is crucial for successful weight management. Emotional eating can significantly hinder progress by leading to unhealthy eating patterns that are often driven by stress, boredom, or other emotional triggers. Recognizing these patterns and implementing effective strategies is essential for achieving and maintaining a healthy weight. To support this journey, readers are encouraged to practise mindful eating. This involves being fully present during meals, paying attention to hunger and fullness cues, and savouring each bite. 

Mindful eating not only enhances the enjoyment of food but also helps reduce the likelihood of overeating. Choosing healthy snacks, managing stress effectively, and seeking professional guidance, you can foster a healthier relationship with food and enhance your overall well-being. 

It is important to remember that seeking professional help is a valuable option for those struggling with emotional eating. Therapy and counselling can provide personalised support and effective strategies for managing emotional triggers and developing healthier eating habits.

Finding it hard to stop emotional eating—even when you’re determined to lose weight?

You’re not alone, and it’s not just about willpower. Emotional eating is incredibly common, especially when stress, fatigue, or hormonal shifts make cravings feel impossible to ignore. At SheMed, we understand how tough it can be—and we’re here to help.

Our medically guided weight loss programme is designed specifically for women like you, offering not just treatments like Wegovy and Mounjaro, but also practical tools and compassionate support to manage weight. Check your eligibility today and let SheMed support you with a programme that works with your life—not against it.

Frequently Asked Questions

1. Why do I always crave sweets or salty snacks during stressful times?

Cravings for sweets or salty snacks are common because these foods can temporarily boost serotonin or dopamine, which are "feel-good" chemicals. During stress, the body also releases cortisol, a hormone that can increase cravings for high-calorie foods. Recognizing these cravings as emotional can help you make healthier choices or try stress-relief techniques.

2. Are there any strategies for stopping emotional eating once it starts?

Yes, there are several strategies. One is to pause and check in with your emotions before eating—ask yourself if you’re feeling hungry or experiencing an emotional trigger like stress or boredom. Another is to try alternative activities, such as going for a walk, doing a quick mindfulness exercise, or having a glass of water. Replacing the habit with a new routine can help break the cycle.

3. Does emotional eating affect weight loss efforts?

Emotional eating can make it harder to lose or maintain weight, as it often leads to consuming high-calorie, low-nutrient foods in response to emotional triggers rather than hunger. By addressing the emotional side of eating, it’s easier to make balanced food choices that support weight management goals.

4. Are there support resources in the UK specifically for women dealing with emotional eating?

Yes, there are several resources available. The NHS provides access to mental health and dietary support, including therapy options such as Cognitive Behavioural Therapy (CBT) and support groups. Charities like Mind and Beat also offer resources for emotional eating and body image issues.

5. What can I do if I experience cravings every night?

Night-time cravings are often linked to habits or emotional triggers. Try eating balanced meals throughout the day, with protein, healthy fats, and fibre to keep you fuller for longer. Establishing a relaxing night-time routine that doesn’t focus on food—such as reading, stretching, or enjoying herbal tea—can also help reduce the urge to snack.

6. How can I tell the difference between a craving and real hunger?

True physical hunger comes on gradually and can be satisfied with a variety of foods. Cravings, on the other hand, are typically sudden and specific, such as wanting something salty or sweet. Practising mindful eating can help you become more aware of these cues and make decisions that align with your actual needs.

7. Are there specific foods that help reduce cravings?

Yes, certain foods can help manage cravings. Protein-rich foods, high-fibre vegetables, and whole grains help stabilise blood sugar, which can reduce cravings. Foods rich in magnesium, like leafy greens and nuts, are also thought to reduce chocolate cravings, as magnesium deficiencies are sometimes linked to cravings for sweets.

8. What should I do if I feel guilty after emotional eating?

Feeling guilty is common, but it’s important to practise self-compassion. Acknowledge what happened without judgement, and consider what triggered the emotional eating. Remind yourself that occasional slip-ups are normal. Focusing on positive actions, like planning a balanced meal for the next day, can help you move forward without guilt.

References

• Konttinen, H., van Strien, T., & Mannisto, S. (2020). Emotional eating and obesity in adults: The role of depression, sleep, and genes. Proceedings of the Nutrition Society, 79(3), 335-343. https://doi.org/10.1017/S0029665120000146
• Vitousek, K., & Mervosh, K. (2019). Mindful eating: What we know so far. Nutrients, 11(4), 793. https://doi.org/10.3390/nu11040793
• Van Strien, T., & Herman, C. P. (2019). Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies. Appetite, 143, 104409. https://doi.org/10.1016/j.appet.2019.104409
• Van Strien, T., & Koenders, D. (2016). Individual determinants of emotional eating: A simultaneous investigation. Eating Behaviors, 22, 1-7. https://doi.org/10.1016/j.eatbeh.2016.02.001‍
• Rahati, S., Qorbani, M., Naghavi, A., Nia, M.H., & Pishva, H. (2024). Genes involved in susceptibility to obesity and emotional eating behavior in a Romanian population. Nutrients, 16(16), 2652. https://doi.org/10.3390/nu16162652

Have you ever felt like no matter what you do—whether it’s cutting carbs, exercising more, or trying every weight loss trend—the scale just won’t budge? Or perhaps your weight fluctuates unpredictably, leaving you feeling frustrated, exhausted, and unsure of what’s really going on with your body. If this sounds familiar, you’re not alone. For many women, weight loss isn’t just about calories in versus calories out it’s deeply tied to hormonal balance. 

Hormones like insulin, estrogen, and cortisol play a powerful role in metabolism, appetite regulation, and fat storage. When they’re out of sync, the usual weight loss advice can feel impossible to follow, and progress can seem painfully slow. This is where GLP-1 receptor agonists medications like Mounjaro and Wegovy are changing the game. Originally developed for diabetes, these medications have shown remarkable success in helping women not only lose weight but also regain control over their metabolic health.

But how exactly do GLP-1 medications influence hormones? Can they help restore balance to a system that often feels unpredictable whether due to PCOS, menopause, or insulin resistance? And most importantly, what does this mean for women struggling with stubborn weight gain despite their best efforts? Let’s explore how these medications interact with key hormones and what this means for long-term success in managing both weight and overall well-being.

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GLP-1 Agonists and Hormonal Balance

Potential Effects on Menstrual Cycle Regularity

GLP-1 agonists have shown promising effects on menstrual cycle regularity, particularly in women with PCOS. Research indicates that these medications can help restore regular ovulation, which is often disrupted in women with PCOS due to hormonal imbalances. 

Research Insights

A meta-analysis found that treatment with GLP-1 receptor agonists resulted in a significant improvement in menstrual regularity among participants, with a standardised mean difference (SMD) of 1.72 (95% CI 0.60 to 2.85, P < 0.001) compared to control groups. This improvement is crucial for women seeking to conceive, as regular ovulatory cycles are directly linked to fertility .

Impact on Hormone Levels During Menopause

While specific research on the effects of GLP-1 agonists during menopause is limited, the role of these medications in managing weight and improving insulin sensitivity can have positive implications for menopausal symptoms. 

As oestrogen levels decline during menopause, many women experience weight gain and increased insulin resistance, which can exacerbate symptoms such as hot flushes and mood swings. By promoting weight loss and enhancing metabolic health, GLP-1 agonists may help alleviate some of these symptoms. 

Interactions with Hormonal Contraceptives

The interaction between GLP-1 agonists and hormonal contraceptives is an area that requires careful consideration. While there is limited data on how GLP-1 agonists affect the efficacy of hormonal contraceptives, it is essential for women using these medications to consult healthcare providers regarding potential interactions. 

Clinical Insights

A study suggests that the weight loss associated with GLP-1 agonist use may enhance the effectiveness of hormonal contraceptives by improving metabolic parameters that influence hormone levels. For example, improved insulin sensitivity may optimise the conditions under which hormonal contraceptives operate effectively.

Potential Effects on Thyroid Function

Impact on Thyroid Hormone Levels

The relationship between GLP-1 agonist and thyroid function has garnered attention due to concerns about their potential impact on thyroid hormone levels. A meta-analysis found that the use of GLP-1 agonists was associated with an increased risk of overall thyroid disorders, although no significant effects were observed on specific conditions such as hyperthyroidism or hypothyroidism . This suggests that while there may be an association with thyroid disorders, the exact nature of this relationship warrants further investigation.

Potential for Thyroid Dysfunction

Concerns have been raised regarding the potential for thyroid dysfunction associated with long-term use of GLP-1 agonists. Some animal studies have indicated that chronic exposure to these medications may lead to thyroid C-cell hyperplasia and tumours; however, evidence from human studies remains inconclusive. 

A large-scale study involving over 145,000 participants treated with GLP-1 agonists found no significant increase in thyroid cancer risk compared to those treated with other diabetes medications. This highlights the need for ongoing research to clarify the potential risks associated with GLP-1 agonists and thyroid health.

Benefits of GLP-1 Agonists for Hormonal Health

The Link Between Weight Loss and Hormonal Balance

Weight loss plays a crucial role in restoring hormonal balance, particularly for women suffering from conditions like PCOS. Excess body weight is often associated with increased insulin resistance and elevated androgen levels, which can disrupt the delicate hormonal equilibrium necessary for regular menstrual cycles and overall reproductive health. 

Research Insights

A study shows that even a modest weight loss of 5-10% can lead to significant improvements in metabolic health and hormonal balance. It demonstrates that GLP-1 receptor agonists effectively promote weight loss in women with PCOS, leading to improved insulin sensitivity and reduced androgen levels .

How GLP-1 Agonists Can Help Regulate Insulin Levels

GLP-1 agonists work by mimicking the action of the hormone GLP-1, which stimulates insulin secretion in a glucose-dependent manner. This means that they help lower blood sugar levels while also enhancing insulin sensitivity. 

A systematic review and meta-analysis conducted on obese individuals with insulin resistance found that treatment with GLP-1 agonists significantly improved insulin signalling in adipose tissue, leading to better glucose metabolism and reduced fat accumulation. By improving insulin sensitivity, GLP-1 agonists can help mitigate the effects of insulin resistance, thereby fostering a more favourable hormonal environment.

The Role of Androgens in PCOS and Other Hormonal Imbalances

Androgens, such as testosterone, play a significant role in various hormonal imbalances, particularly in women with PCOS. Elevated levels of these hormones can lead to symptoms such as hirsutism (excessive hair growth), acne, and irregular menstrual cycles. In PCOS patients, high insulin levels often stimulate ovarian androgen production, exacerbating these symptoms. Research indicates that managing insulin resistance is key to reducing androgen levels and alleviating related symptoms.

How GLP-1 Agonists May Help Reduce Androgen Levels

GLP-1 agonists have been shown to have a positive effect on reducing androgen levels in women with PCOS. A systematic review comparing the efficacy of GLP-1 agonists to metformin found that GLP-1 receptor agonists were more effective at lowering testosterone levels and improving menstrual regularity among obese women with PCOS . Specifically, the review reported that GLP-1 agonists resulted in a significant reduction in body mass index (BMI) and waist circumference, which are critical factors influencing androgen production.

Additionally, GLP-1 agonists may help regulate hormone levels by improving insulin sensitivity. As insulin resistance decreases, the overproduction of androgens can also diminish. 

Effects of Liraglutide on Body - A Randomized Controlled trial

A study indicated that liraglutide, a type of GLP-1 agonist, treatment led to decreased serum testosterone levels and improved ovulatory function among women with PCOS. This dual action promoting weight loss while simultaneously improving insulin sensitivity underscores the potential of GLP-1 agonists as an effective treatment option for managing hormonal imbalances associated with PCOS.

Potential Side Effects and Considerations

Common Side Effects of GLP-1 Agonists

GLP-1 agonists are generally well-tolerated, but they can cause several common side effects, particularly gastrointestinal symptoms. These include:

• Nausea: This is one of the most frequently reported side effects. Studies indicate that approximately 20-30% of patients experience nausea when starting treatment with GLP-1 agonists, especially during the initial titration period. The nausea often diminishes over time as the body adjusts to the medication.
• Vomiting: Alongside nausea, vomiting can occur in some patients. In clinical trials, about 5-10% of participants reported vomiting as a side effect, particularly with higher doses of the medication.
• Diarrhoea: Diarrhoea is another common gastrointestinal issue associated with GLP-1 agonists. Research shows that around 10-15% of patients may experience diarrhoea, which can also improve with continued use.

Other gastrointestinal symptoms can include abdominal pain, constipation, and dyspepsia (indigestion). In rare cases, more severe adverse events such as pancreatitis and biliary colic may occur, necessitating discontinuation of the medication.

Importance of Consulting with a Healthcare Provider

Given the potential for side effects and individual variability in response to GLP-1 agonists, it is crucial for patients to consult with healthcare providers before starting treatment. A healthcare provider can help assess whether GLP-1 agonists are suitable based on an individual's medical history, current health status, and specific needs.

• Individual Susceptibility: The onset and severity of side effects can vary significantly among individuals. Factors such as existing gastrointestinal conditions, other medications being taken, and overall health can influence how well a patient tolerates GLP-1 agonists. For example, patients with a history of gastroparesis (delayed gastric emptying) may be more susceptible to nausea and vomiting when taking these medications .

• Titration and Dose Adjustment: Healthcare providers often recommend a gradual dose escalation to minimise side effects. Starting at a lower dose and gradually increasing it allows the body to adjust more comfortably to the medication. This approach can help mitigate gastrointestinal symptoms and improve overall tolerance.

• Monitoring for Severe Symptoms: Patients should be aware of potential severe side effects that require immediate medical attention. For instance, persistent nausea or abdominal pain could indicate pancreatitis, which is a serious condition that necessitates discontinuation of the medication and further evaluation. Regular follow-up appointments are essential for monitoring progress and managing any adverse effects effectively.

Conclusion

GLP-1 agonists represent a significant advancement in the management of weight and metabolic health, particularly for women facing challenges related to conditions like PCOS. These medications not only promote weight loss and improve insulin sensitivity but also help regulate hormonal balance by reducing androgen levels. Effectiveness of GLP-1 receptor agonists in improving menstrual regularity and reducing testosterone levels in PCOS patients is substantial. 

Consulting with a healthcare provider is crucial to assess individual needs and determine the suitability of GLP-1 agonists based on personal health history and circumstances. Healthcare providers can offer invaluable insights into managing side effects, adjusting dosages, and ensuring that the treatment aligns with the patient’s health goals. 

Reach out to us at SheMed for personalised support and guidance, and don’t forget to share our blogs with friends and family who might benefit from this information.

References

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4. Taha, D., & Seibert, T. (2022). GLP-1 receptor agonists in type 2 diabetes management: Current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 2881–2892. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9405922/
5. Hernandez, A. F., Green, J. B., Janmohamed, S., et al. (2019). Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): Available at: https://pubmed.ncbi.nlm.nih.gov/31593246/
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