The Jamie Kern Lima Show

#1 Menopause Doctor Masterclass Pt 4: GLP1s, Losing Belly Fat + Live Longer & Stronger Now! Dr. Mary Claire Haver

34 min
Jan 20, 20264 months ago
Listen to Episode
Summary

Dr. Mary Claire Haver discusses GLP-1 medications (Ozempic, Wegovy, Majaro, Zepbound) for weight management during menopause, explaining how they work, addressing misconceptions like 'Ozempic face,' and emphasizing the importance of muscle preservation, protein intake, and strength training alongside medication use.

Insights
  • GLP-1s are natural peptides that have been safely used for diabetes treatment for 20+ years; the shift to obesity treatment represents a significant expansion of an established drug class rather than a novel intervention
  • Menopause causes predictable metabolic changes: dramatic muscle loss and visceral fat gain (8% to 23%) independent of total weight, making hormone therapy and targeted interventions necessary for many women
  • Insurance coverage for GLP-1s is becoming increasingly restrictive and cost remains a major barrier ($1,000/month in US vs. $100/month in UK), creating equity issues despite government recognition that widespread access would bankrupt state budgets
  • GLP-1s work by rewiring brain chemistry and hunger signals, not through willpower; obesity has genetic components (obesity genes), making medication a legitimate medical tool rather than a moral failing
  • The 'Ozempic face' phenomenon is caused by rapid weight loss and skin elasticity lag, not the medication itself; proper nutrition, protein intake, and strength training can mitigate muscle loss during GLP-1 use
Trends
Shift from weight-centric to strength-centric health metrics in women's wellness, particularly post-menopauseGrowing recognition of menopause as a significant medical condition requiring specialized practitioner training and patient educationIncreasing telehealth accessibility for GLP-1 prescriptions as traditional insurance coverage becomes more restrictiveRising awareness of visceral fat as distinct health risk factor separate from subcutaneous fat and BMIDemand for evidence-based menopause treatment protocols combining hormone therapy, nutrition, exercise, and pharmacological interventionsPolicy-level discussions around pharmaceutical pricing and government negotiation power for medication costsEmergence of weighted vest fitness trend as evidence-based tool for bone density and muscle preservation in aging populationsReframing of obesity from personal responsibility/willpower issue to complex biological condition with genetic and environmental factors
Topics
GLP-1 medications (mechanism, safety data, efficacy, side effects)Menopause and perimenopause physiology (hormonal changes, muscle loss, visceral fat gain)Visceral fat vs. subcutaneous fat and cardiometabolic disease riskHormone replacement therapy (HRT) for menopause managementProtein intake and muscle preservation during weight lossStrength training vs. cardio-only fitness approaches for womenInsurance coverage and pharmaceutical pricing for GLP-1sObesity genetics and biological drivers of weight gainMental health benefits of GLP-1 medicationsWeighted vest training for bone density and osteoporosis preventionDiet culture and body image impact on women's participation in life activitiesTelehealth access to GLP-1 prescriptionsSkin elasticity and collagen management during rapid weight lossCulinary medicine and nutrition counselingPatient advocacy and finding menopause-informed healthcare providers
Companies
Novo Nordisk
Manufacturer of GLP-1 medications; discussed regarding pricing negotiations and cost differences between US ($1,000/m...
Amazon
Platform where Dr. Haver sourced weighted vests for personal use and research into bone density benefits
People
Dr. Mary Claire Haver
Board-certified OB/GYN and certified menopause practitioner; guest expert discussing GLP-1s, menopause physiology, an...
Jamie Kern Lima
Podcast host and interviewer; author of 'Worthy' book; facilitates discussion on GLP-1s and menopause health
Alexandra Soa
Author of 'The Ozempic Revolution'; recommended resource for GLP-1 information, history, obesity causes, and clinicia...
Melinda French Gates
Referenced in podcast introduction as praising Jamie Kern Lima's interviewing style and presence
Quotes
"Menopause is inevitable, but suffering is not."
Dr. Mary Claire HaverClosing remarks
"Just to demonize a patient and tell her it's her willpower is one of the biggest tragedies in the history of medicine."
Dr. Mary Claire HaverMid-episode discussion on obesity and genetics
"GLP-1s are far superior to metformin when you look at visceral fat loss and diabetic control."
Dr. Mary Claire HaverMedication comparison section
"It's not just take this medication, woo, go be thin and off you go. It is really rewiring your brain."
Dr. Mary Claire HaverGLP-1 mechanism discussion
"91% of girls and women literally opt out of meaningful activities in their life when they're worried about how they look."
Jamie Kern LimaBody image and diet culture discussion
Full Transcript
This has been one of the most shared series in the history of the Jamie Kern Lima Show and brand new today, backed by popular demand. She's often called the top menopause doctor in the world. Dr. Mary Claire Haver is here in this part four menopause masterclass episode, where today we're talking all things GLP-1s. Those are the weight loss and weight management drugs that are taking the world by storm, are they right for you? What are the risks versus rewards? All the things your doctor might've forgotten to mention. We are going there today. And whether you're listening for yourself or because someone you love shared this episode with you, I want to welcome you to the Jamie Kernley Michelle podcast family. Ozempic, Wegovi, Majaro, Zepbound. GLP-1s are a class of medications that are peptides found naturally in the body. They've been around for over 20 years. We have all of that safety data. They're blocking the things that drive us to eat. It's also blocking things that drive us to drink, or drive us to gamble, kind of these compulsive behaviors. Wonderful studies coming out on the mental health benefits of GLP-1s. It slows the food emptying from the stomach. It's really, for my patients, been miraculous. Muscle mass has a dramatic loss through perimenopause. Body fat has seized a tremendous uptick and increase in the percentage of body fat across the menopause transition. We're losing muscle and gaining fat just from being menopausal people. Right now, 1.2 billion women are in perimenopause or menopause. And whether or not you're experiencing this personally in your life right now, I guarantee you someone in your life is. Can you get GLP-1s covered by insurance if you're not obese? It's getting harder. Cost of these medications is outrageous. It's like a thousand dollars a month. It's ridiculous. More coupons are coming. But just to demonize a patient and tell her it's her willpower is one of the biggest tragedies in the history of medicine. Which now with the obesity genes, all these other things, they're proving it's not willpower. No, it's not willpower. And I was taught in that generation of it's her fault. Yeah. She's just lazy until. Yeah. I believe that my whole life. Like, oh, I'm gaining weight. It's definitely my fault. You know, I've been tested for the obesity genes now and I actually have two of them. And I'm like, oh, you know, and then your brain works differently. Right. There's so much science. The entire biological drive. Yeah. Is working against you. GLP-1s are far superior to metformin. Do you prescribe both to your patients or you predominantly do GLP-1s? If somebody's doctor says no. No. If somebody's like, if they go to their doctor and say, I'm really, really interested in GLP-1s and they go, oh, you should just work out and eat better. And then you turn around and tell them, I'm doing that. And they say, no, you can't be. Therefore, you wouldn't be obese. Then you need to find a new doctor. What are some of the resources that exist online? Because there's now through telehealth, you can get prescriptions in other ways. Because it's not just take this medication. Woo, go be thin and off you go. It is really rewiring your brain. A lot of people worry about like ozempic face or ozempic. Is that simply just you've lost weight? Massive weight loss. You've lost weight fast. Right. And when you lose weight fast, the elasticity of the skin struggles to keep up. Yeah. And so we see more of the hanging skin. So GLP-1s don't change your face or your body. No. That's more the result of your skin from weight loss. Yeah. Okay. I think there's a misconception out there. They're like, wait, I don't want to get that. With GLP-1s, the risk of losing muscle. Because if we're not eating enough, we might not be eating enough protein. We might not be lifting weights. And you talk about how critical it is. Prioritize your protein. Focus on strong over skinny. Okay. They're bawling, crying in my office. When I'm like, you're amazing. Oh my God, look at all this muscle. I can think about the times in my life where I've been the thinnest. I've felt the worst. Yeah. I have felt the worst. And I've also felt the least confident. The least confident too. I feel like the more we're focused on the wrong things, the more insecure we feel. You look at the data, it's like 91% of girls and women literally opt out of meaningful activities in their life when they're worried about how they look or they don't like how they look. And I just feel like we've bought into diet culture in the wrong way for so long. It's just a hack. It's such an easy hack that almost anybody can do. I want to just announce it to the world. You're hearing it first here that menopause is ineffable, but suffering is not. and you can make a change, but you're going to have to advocate for yourself and you're going to have to educate yourself. There's so many incredible resources that you share. A lot of them are free. Whether you're a man or a woman, menopause is going to affect you because it's going to affect 50% of our society. Right now, whether you or someone you love is experiencing perimenopause, which can start at 30 or even younger, or menopause, which can typically start in your 40s, 50s or 60s. There is so much conflicting information about the subject. So few doctors are well-trained, and there's so many things our mothers didn't tell us or even know about it. And it's time that you feel informed about what's going on with your body, your brain, and your hormones. Today is your menopause masterclass, and you're going to leave this episode with your own menopause toolkit equipped with the info and tools you need that I know are going to impact your life today. Whether it's how to sleep better, understand what's a menopause myth and what's the truth, lose belly fat, or stop suffering finally. My guest today, many call her the top menopause doctor on the planet, Dr. Mary Claire Haver is going to take us from feeling powerless to powerful on everything your doctor forgot to mention on topics, including the exact tests you need to ask your doctor for during your next visit, the three stages of menopause, on what's actually happening in your body, on your changing hormones, on hormone replacement therapy, including the risks versus the benefits, should you do it, how and when, on belly fat and weight gain linked to menopause and what you can do about it right now, and on the surprising symptoms happening to so many women that go untreated and overlooked by the majority of doctors who just aren't as well-informed as they could be. Today is a master class from the master of menopause herself. Dr. Mary Claire Haver is a board-certified obstetrics and gynecology specialist and certified menopause practitioner from the Menopause Society. She's also a certified culinary medicine specialist from Tulane University, a bestselling author of multiple books, including her brand new book, The New Menopause. She's also the founder of the Marie Claire Wellness Clinic. She's a mom of two, a wife and a woman on a mission who says that while menopause is inevitable, suffering doesn't have to be. And she is here to help you and me today. And for everybody new to this episode, can you do me a favor? If you like the show and the guests that I bring you, please hit the subscribe or follow button on the app you're listening or watching on. It truly means the world to me. And thank you. And I want to remind you, this episode is not just for you and me. Please share this with every single woman that you know, because what you are about to hear will change your life and hers. Welcome to the Jamie Kern Lima Show. Oprah, how have you defied the odds? Her show is unlike any I've ever done. A revelation. When you listen, it feels like a hug, but your brain and your spirit and your heart is like, wow. Melinda French Gates. When I look into Jamie's eyes, I feel like I am on some other cosmic level with her. I could see the light around her. She's infused with light. Imagine overcoming self-doubt, learning to believe in yourself and trust yourself and know you are enough. Welcome to the Jamie Kern Lima Show. Jamie Kern Lima is her name. Everybody needs Jamie Kern Lima in their life Jamie Kern Lima Jamie you so inspiring Jamie Kern Lima When it comes to belly fat, weight gain, visceral fat, all of the symptoms associated with weight gain that come with perimenopause and menopause, and when it comes to GLP-1s, I want to ask you about this because this is an issue facing so many people. And one of the biggest questions I get, and I am not a doctor, I get people asking me about GLP-1s all the time, meaning Ozempic, Wegovi, Majaro, Zepbound, all of them, semiglutide. So GLP-1s are a class of medications that are peptides found naturally in the body. So when I was researching for the Galveston diet, my first book, and I was looking at the hormones that affect where and how we gain weight. And I was kind of astounded. Not only is it insulin, but things like leptin and ghrelin that control our hunger and drive fat to certain areas. And then things like GLP-1s and hormone PPY. So what science has been able to do is pull out that, you know, make the GLP-1, which is a natural peptide, and get it into a form that it actually lasts longer in the body. So natural GLP-1s actually only have a half-life of a few minutes. You know, your body creates it. And within like two or three minutes, it's out of your system. It gets used and done. With the commercially available JLP ones in the medication form, they've been able to tag them where they can last for about a week. So we're seeing the benefits of what they do for us in a very short term when we create them in the body and they can extend the life of that benefit forever. They've been around for over 20 years. They've been using the treatment of diabetes for 20 years. They've known about these medications forever. So we have all of that safety data. What happened was we've known forever that people who are adequately treated for their diabetes lose weight. And they were starting to do testing to see if people who were non-diabetics, would they lose weight as well who were obese? Okay. And as we know now, yes, it worked very, very, very well. And so then the frenzy kind of started. It was the next like WHI study, right? And what was the bigger medical news story last year or year before than the use of what was ozempic for the treatment of obesity and how would that help? You know, and it turns out when we, you know, GLP-1 seem to have independent action in the brain, they're blocking the things that drive us to eat. It's also blocking things that drive us to drink or drive us to gamble, kind of these compulsive behaviors, wonderful studies coming out on the mental health benefits of GLP-1s. Also on, it slows the food emptying from the stomach. So food stays longer in the tummy longer, which is why we see some of the nausea and some of the other issues with GLP-1s. But when you slow food down, you're not as hungry, right? The tummy is feeling full and is feeding back other chemicals to the brain saying, we're good, we don't need to eat. That drive to eat the next meal decreases. When we slow things down, we also decrease how fast the food is being absorbed into the system, blood system. So we're seeing lower insulin spikes. I mean, everything kind of gets better when you've struggled with those things before that were driving people's obesity. And it's really, for my patients, been miraculous. Absolutely miraculous. So when I first opened, GLP-1s were not kind of a thing back then. I knew about them because I went to medical school, but it was another, anything I ever considered learning about or introducing into my practice because that was for diabetes and we treat menopause and not diabetes. But the majority of my patients were coming in with either new or continuing issues with weight, especially the new fat gain. So what happens across the menopause transition, a beautiful study done in 2019, studied 1,200 women across the transition, tracked their hormone levels and tracked their body fat, their visceral, their total body fat and their muscle mass and their BMI. And what they saw is this S-shaped curve. So when they were, their muscle mass has a dramatic loss through perimenopause and then it continues to decline, but that stabilizes the loss. But their body fat has seen a tremendous uptick and increase in the percentage of body fat across the menopause transition. And then, but the weight gain is steady state. So we're losing muscle and gaining fat just from being menopausal people. If you look at visceral fat distribution, which is where I kind of zone in on, a woman can expect to have 8% of her body fat is visceral fat when she's pre-menopausal and we take her twin who doesn't go through menopause until five years later, okay? Her risk increases to 23%. And that's the dangerous fat in your midsection. That is the fat that is dangerous, inflammatory, and linked to hypertension, diabetes, high cholesterol, stroke, all of the cardiometabolic diseases. That is the fat that is dangerous. Subcutaneous fat is actually not that harmful. It gives us curves. We're cosmetically distressed by it. We've been conditioned to think it's bad. It's horrible, but it really more represents just our beautiful genetic expression of our bodies, our natural curves. It's the intra-abdominal fat where I get nervous and I start talking about diabetes. And so when my patients are coming in with elevated visceral fat, we start them on hormone therapy. We give them a nutrition plan. We do all the things and for about 60% of our patients, they do great with that. That's all they needed, especially if they'd never had a weight problem before. You know, if fat distribution was not a problem before menopause, we give them hormones, we teach them all about nutrition and things we need to change in menopause and they do great. But another 30%, the last 30 to 35% are still struggling, still have elevated risk factors for, you know, chronic disease. And then we start the GLP-1 conversation with them. Now, what's happening is GLP-1s are becoming widely available, and I don't think patients are getting the right counseling. We spent another hour with her talking about muscle mass and loss and what happens with when your hunger cues go down and really making yourself eat enough protein and it's time to get to the gym. But with the mental health changes going along with the medication, I have never seen my patients more motivated to stick to a plan. They get it. passionate about GLP-1. Yes. They get it. They get it. They get it. It's happening. They're going to the gym. They're focusing on their muscle mass. They're buying the home scales and measuring their muscle mass at home, which aren't quite as accurate as my fancy machine in the office, but it's something. And they're learning to track health and not weight. And it is absolutely miraculous. So we do use them in clinic judiciously. We give incredible amounts of guidance. We're tracking muscle mass and fat loss through the process. And our patients who are choosing to do it or doing really well. Can you get GLP ones covered by insurance if you're not obese? Um, it depends on the insurance company. And what's happened is the generosity and generosity that it's getting harder. So I was having patients being who had prediabetes and things and having it covered, but that is getting harder and harder. The cost of these medications is outrageous. And when you look at the, the like global economics of it to get it in the UK is like, I want to say like $100 a month. Like it is, you know, what the UK is able to get it for, because they negotiated with Novo Nordisk is so much less than what the, in the US, we're just the cash cow. It's like $1,000 a month. It's ridiculous. And most of my patients, that is a really, really hard thing for them. Right now, again, more coupons are coming. I just had a patient call me and say she was able to get the pens for 500. And that was a lot more affordable, but still for, you know, the, the sweet lady listening on Ohio, she's like, what do I do? Okay. So good news is that what, you know, things in administration with the government, it's all about government contracts and how much they can get it for, you know, the, the, the head of the treasury for, I think, North Carolina, this wonderful man came out and said, if we were able to give every patient who deserved it, a GLP one, it would bankrupt our state at the current cost, it cost them about $2 to make those pens and put the medicine in it. And they're charging over $1,000. The markup is outrageous, but this is a supply and demand issue. So I'm hopeful that whatever the new administration and all the policy changes that are happening, one of the things hopefully that we'll see is better negotiation to get these prices to come down so we can make this medication available to more patients. Do I wish we lived in a world like 50 years ago when only 10 of people would need this medication to be healthier You know there so many things that feed into why this country is struggling so much with obesity and multiple other countries not just us You know we live in an obesogenic society The most readily and cheap food available is the food that is trying to kill us You know they're heavily processed foods, you know, and so all of this is feeding into it, but just to demonize a patient and tell her it's her willpower is one of the biggest tragedies in the history of medicine. Which now with the obesity genes, all these other things, they're proving it's not willpower. No, it's not willpower. And I was taught in that generation of it's her fault. Yeah. She's just lazy until it happens. I believe that my whole life. Like, oh, I'm gaining weight. It's definitely my fault. You know, I've been tested for the obesity genes now and I actually have two of them and I'm like, oh, you know, and then your brain works differently. There's so much science. The entire biological drive is working against you. And it's really the rare person without cutting everything else in their life. How can you be a balanced human being and a mother and do carpool and do all the things and fight these two genes. Okay, this is big. I got to ask you this with all the studies on GLP-1s because so many people now are saying, oh, I really, really want to try to do ZepBound or Ozempic or any of those drugs out there. For a lot of the studies on them, I've heard that we need to pause for a super brief break. And while we do, take a moment to share this episode with every single woman that you know, because this information can truly change your life and hers. In life, you don't soar to the level of your hopes and dreams. You stay stuck at the level of your self-worth. When you build your self-worth, you change your entire life. And that's exactly why I wrote my new book, Worthy, How to Believe You Are Enough and Transform Your Life for You. If you have some self-doubt to destroy and a destiny to fulfill, Worthy is for you. In Worthy, you'll learn proven tools and simple steps that bring life-changing results, like how to get unstuck from the things holding you back, build unshakable self-love, unlearn the lies that lead to self-doubt and embrace the truths that wake up worthiness, Overcome limiting beliefs and imposter syndrome. Achieve your hopes and dreams by believing you are worthy of them and so much more. Are you ready to unleash your greatness and step into the person you were born to be? Imagine a life with zero self-doubt and unshakable self-worth. Get your copy of Worthy plus some amazing thank you bonus gifts for you at worthybook.com or the link in the show notes below. Imagine what you'd do if you fully believed in you. It's time to find out with Worthy. Who you spend time around is so important as energy is contagious and so is self-belief. And I'd love to hang out with you even more, especially if you could use an extra dose of inspiration, which is exactly why I've created my free weekly newsletter that's also a love letter to you delivered straight to your inbox each and every Tuesday morning from me. If you haven't signed up to make sure that you get it each week, just go to jamiekerlima.com to make sure you're on the list and you'll get your one-on-one with Jamie weekly newsletter and get ready to believe in you. If you're tired of hearing the bad news every single day and need some inspiration, some tips, tools, joy, and love hitting your inbox, I'm your girl. Subscribe at jamiekernlima.com or in the link in the show notes. Do you struggle with negative self-talk? Living with a constant mental narrative that you're not good enough is exhausting. I know because I spent most of my life in that habit. The words you say to yourself about yourself are so powerful. And when you learn to take control over your self-talk, it's life-changing. And I wanted to give you a free resource that I created for you if this is something that could benefit your life. It's called Five Ways to Overcome Negative Self-Talk and Build Self-Love. And it's a free how-to guide to overcome that negative self-talk to build confidence and develop unshakable self-love so that you can dream big and keep going in the pursuit of your goals. Don't let self-sabotaging thoughts hinder your progress any longer. It's time to rewrite the script of your life when filled with self-love, resilience, and unwavering belief. If you're ready to take charge of your narrative, build unwavering confidence, and empower yourself to persevere on the path to your dreams, you can grab your free guide to stop overthinking and learn to trust yourself at jamiekernlima.com slash resources, or click the link in the show notes below. And now more of this incredible conversation together. Okay, this is big. I got to ask you this with all the studies on GLP-1s, because so many people now are saying, oh, I really, really want to try to do ZepBound or Ozempic or any of those drugs out there. For a lot of the studies on them, I've heard that a lot of the people studied were actually also on metformin when they got those results. Is that true? I'm not sure. I'd have to ask my endocrine friends. Metformin, so when I talk to my endocrine gurus. They say metformin is a very poor man's GLP-1 that when you look at visceral fat loss, when you look at, you know, diabetic control, that GLP-1s are far superior to metformin. Do you prescribe both to your patients or you predominantly do GLP-1s? If somebody, if somebody's doctor says no, if somebody's like, if they go to their doctor and say, I'm really, really interested in GLP-1s and they go, oh, you should just work out. and eat better. And then you turn around and tell them I'm doing that. Right. And they say, no, you can't be, therefore you wouldn't be obese. Then you need to find a new doctor. You need to find a new doctor. And what are some of the resources that exist online? Because there's now through telehealth and through other ways you can get prescriptions in other ways. Alexandra Soa has written an incredible book called The Ozempic Revolution. And it's not just about Ozempic, but she goes through the history, the causes of obesity, and, you know, she has resources on how to help you find a clinician who's educated. And she's absolutely, she also goes through nutrition, exercise, you know, she goes through her toolkit as well, because it's not just take this medication, woo, go be thin and off you go. It is really rewiring your brain. Right. With this new tool, it's a tool, it's nothing more than to help you kind of reconfigure your life. So you live in a less obesogenic world. A lot of people worry about like Ozempic face or Ozempic. Is that simply just you've massive weight loss, you've lost weight fast, right? And when you lose weight fast, the elasticity of the skin struggles to keep up. Yeah. And so we see more of the hanging skin and I've seen in some of my patients, you know, they're coming in complaining. And what we're hoping is that, you know, once your weight stabilizes, as long as you feed that collagen and, you know, nutrition and everything's on point, you're not malnourished, that the elasticity will kind of catch up and we won't see as much as the sag. So GLP-1s don't change your face or your body. That's more the result of weight loss. And from weight loss. Yeah. Okay. I think it's a misconception out there. They're like, wait, I don't want to get that. I don't want my face to change. And then they're putting other things in to fill and, And it is a little bit of a catch, but when people, we know from the Astro Bypass patients who had massive weight loss quickly, this is the exact same phenomenon. That was the same thing. You talk about both with GLP-1s, the risk of losing muscle, because if we're not eating enough, we might not be eating enough protein. We might not be lifting weights. And you talk about how critical it is to focus on strong over skinny. Okay. Share all this with us. I grew up in the eighties. Everything was about aerobics I was teaching step aerobics I didn pick up a weight Jamie until I and it was little tiny hand weights right For Zumba I didn even think about my muscle mass I was always thinking about be thin, be thin, be thin. It was the whole reason I moved my body to work out was to be thin because thin was healthy, right? I had thin privilege. I wanted to hang on to it. Now what I realized is that this whole generation was chipping away at their bone and muscle strength, unless you were like a unicorn college athlete or something, you know, and that women, when I put them on the body scanner and they're athletic and they're like really muscular and they've been told their whole life they were obese and overweight. They're bawling, crying in my office when I'm like, you're amazing. Oh my God, look at all this muscle. They're like, I've always felt that. Like, no, you're so healthy. So like helping people develop habits and it's a really a mind shift to get away from eating for strength, eating for strong, eating for your old lady body, rather than eating to have some random diet, you know, thin body that is cosmetically appealing to a certain percentage of the population is a really huge gift I am giving to my patients. It's so good. And I know you've talked about this with younger women, but it's really all women. I mean, you know, so often I can think about the times in my life where I've been the thinnest, I've felt the worst. I have felt the worst. And I've also felt the least confident, the least confident too. I feel like the more we're focused on the wrong things, the more insecure we feel. You look at the data, it's like 91% of girls and women literally opt out of meaningful activities in their life when they're worried about how they look or they don't like how they look. And I just feel like we've bought into diet culture in the wrong way for so long. I love that you talk about how critical it is to focus on being strong over skinny and how it not only It changes all parts of your physical and your emotional and mental health and your joy. So is that what you focus on now in your life personally? So mostly when I do cardio, I just throw on my weighted vest and I jump on the treadmill and I'll do a Zoom call or I'm just walking and reading or I'm doing internet stuff. And I've turned my treadmill at home into a walking desk. So that's my cardio. Or I'll go walk with my girlfriends on the weighted vest. Tell us about that. So when I was seeing all my, you know, I'm recommending earlier DEXA scans for my patients. And so I was looking to see what do we know works? What works for women who to avoid osteoporosis or to help with their osteoporosis? And I ran across two or three articles talking about using weighted vests on women in nursing homes and how they're seeing improvement in their bone and muscle strength, their balance and decreased fragility. And I was like, what do these things look like? So I go on Amazon and find one. I order one. I start wearing it all around Galveston and I start talking about it on the internet. And then suddenly I become the queen of the weighted vest, you know, wrote about it in a newspaper article. And all my friends have them. We see people on the seawall in Galveston. Hey, you know, we're walking with our weighted vest on. But, you know, the body responds to resistance in a positive way. And that weighted vest will put pressure on the axial skeleton. And so what we worry about in osteoporosis is spinal fractures and hip fractures. So we're putting the weight where we need it to put that little extra stimulus to get stronger for the, both the bones and the muscles. So it's just a hack. It's such an easy hack that almost anybody can do. I love seeing you on Instagram with your weighted vest of doing, doing all your content. You know, I want to thank you for the force for women, the force for health, the force for awareness that you are into the world. I want everyone to check out and get their copy of the new menopause, your book. And I want to just announce it to the world. You're hearing it first here that your upcoming book, your upcoming book, The New Perimenopause is on its way, which I'm really, really excited about in closing. What final words of wisdom, what words of wisdom do you have for someone listening right now who may be having symptoms on her journey to figuring out, oh, wow, am I in perimenopause, menopause, you know, what should she know that maybe we haven't covered? That suffering is not a normal part of life. Menopause is inevitable, but suffering is not. And you don't have to accept what life is throwing at you that you can make a change. And, but you're going to have to advocate for yourself and you're going to have to educate yourself. And that's why I wrote the new menopause. There's so many incredible resources that you share. A lot of them are free. We're going to link to all of them in the show notes. Dr. Mary Claire Haber, thank you so much for being on the Jamie Kern-Lima Show podcast. And if you loved today's episode, please click the follow or subscribe button for the show on your app and give it a five-star rating or review. And again, please share this episode with everyone you believe in. Share it with another person in your life who could benefit from it. Post it and share it with others online or in your community who just might need the words and tools and lessons in this episode today. You never know whose life you're meant to change today by sharing this episode. And thank you so much for joining me today. Before you go, I want to share some words with you. Couldn't be more true. You right now, exactly as you are, are enough and fully worthy. You're worthy of your greatest hopes, your wildest dreams, and all the unconditional love in the world. And it is an honor to welcome you to each and every episode of the Jamie Kern Lima Show. Here, I hope you'll come as you are and heal where you need, blossom what you choose, journey toward your calling, and stay as long as you like because you belong here. You are worthy. You are loved. You are love and I love you. And I can't wait to join you on the next episode of the Jamie Kern Lima Show. In life, you don't soar to the level of your hopes and dreams. You stay stuck at the level of your self-worth. When you build your self-worth, you change your entire life. And that's exactly why I wrote my new book, Worthy, How to Believe You Are Enough and Transform Your Life for You. If you have some self-doubt to destroy and a destiny to fulfill, Worthy is for you. In Worthy, you'll learn proven tools and simple steps that bring life-changing results, like how to get unstuck from the things holding you back, build unshakable self-love, unlearn the lies that lead to self-doubt and embrace the truths that wake up worthiness, Overcome limiting beliefs and imposter syndrome. Achieve your hopes and dreams by believing you are worthy of them and so much more. Are you ready to unleash your greatness and step into the person you were born to be? Imagine a life with zero self-doubt and unshakable self-worth. Get your copy of Worthy plus some amazing thank you bonus gifts for you at worthybook.com or the link in the show notes below. Imagine what you'd do if you fully believed in you. It's time to find out with Worthy. Who you spend time around is so important as energy is contagious and so is self-belief. And I'd love to hang out with you even more, especially if you could use an extra dose of inspiration, which is exactly why I've created my free weekly newsletter that's also a love letter to you delivered straight to your inbox from me. If you haven't signed up to make sure that you get it each week, just go to jamiekernlima.com to make sure you're on the list and you'll get your one-on-one with Jamie weekly newsletter and get ready to believe in you. If you're tired of hearing the bad news every single day and need some inspiration, some tips, tools, joy, and love hitting your inbox, I'm your girl. Subscribe at jamiekernlima.com or in the link in the show notes. And please note, I'm not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional.