Set point theory set me free (as a postmenopausal woman recovering from an eating disorder)

On Ozempic and postmenopausal weight gain and hibernating bears

Hi —

It’s Micah from Modern Hysteria. This newsletter is about the taboo truths of womanhood (mental health, menopause, motherhood, and more). I just recorded my first PODCAST episode … look out for more on than, coming soon! 🎧

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When my healthcare provider, Katie, asked me how I was doing during a particularly stubborn bout of depression, I responded truthfully:

“I don’t wanna die, but I would very much like some Ozempic, please.”

… to which she said:

“No.”

Good call, Katie. Good call.

Halloween costumes 2024! I was a gnome and Biscuit was a sparrow

I’m not a candidate for semaglutide (are you?)

Katie’s helping me recover from the restrictive eating disorder I very much thought I had under control for the past seven years, as well as the side effects that surfaced when I went through surgical menopause in 2023 (bone injury! muscle loss! metabolism probs!).

Katie was right to steer me away from Ozempic (a medication also known as semaglutide or Wegovy primarily used for type-2 diabetes, but now commonly for weight loss) because the appetite suppression effect could reignite unhealthy eating patterns and allow me to focus on weight over health.

But, lemme tell you, Ozempic is tempting. Especially because, last week, I got my first offer for an influencer collaboration from a semaglutide brand.

And I didn’t take it, but I kinda wanted to. 👀

I gained weight post-menopause.

And, as someone recovering from an eating disorder, I’ve found it difficult to cope with body changes, and I’m not the only one…

Here’s a reader comment from this post on ED recovery:

Ugh, I feel you on the sandwiches!

The long-term effectiveness of drugs like Ozempic are an important consideration:

If and when you stop taking it, your body will probably go back to its “set point.”

Do you know what your set point is?

If this ⬆ resonates with you, you need to know about set point theory.

You need to know about set point theory.

Set point theory says you have a “set point” weight range to which your body naturally gravitates. It will work to maintain this set poin.

Just like your body has a natural threshold for temperature (98.6deg F), and will work to maintain it, like by sweating or shivering, your body will resist major changes to your weight by adjusting your hunger, your energy, and your metabolic rate.

Our bodies are good at working toward balance and will do so even to our detriment.

Set point theory and eating disorders

I wrote recently about how I was diagnosed with RED-S — relative energy deficiency in sport — a result of long-term caloric deficit from fifteen years of restrictive eating disorders.

Though I considered myself “in recovery” from EDs, I still wasn’t fueling myself appropriately, and my body even metabolized my muscles and bones to maintain its set point.

Especially post-menopause, my body slowed its metabolism to conserve energy, which moved the set point. Now it’s really hard to maintain or return to whatever my optimal weight range may be.

But it’s not just me: Our bodies naturally slow our metabolic rate when we go through menopause.

Why do we gain weight post-menopause?

During menopause our bodies produce less estrogen, which is important for regulating appetite, fat distribution, and metabolism.

The body adjusts its set point during menopause as a survival mechanism. Lower estrogen levels signal the body to store fat around the abdomen as a backup energy source, like a bear going into hibernation.

Set point theory for postmenopausal women

Set point theory was a game-changer for me in navigating my eating disorder post-menopause because it liberated me from feeling like every calorie I ate was consequential.

Set point theory tells us that our bodies want to stick to a specific weight range. Fueled appropriately, they’ll do what what they need to do, so we don’t need to guilt and stress over every meal and snack.

Set point theory helps me:

1. Accept weight fluctuations. Hormonal changes cause weight changes. It’s natural and normal.

2. Avoid feeling guilt or shame. My body changes are not from lack of discipline.

3. Ignore societal beauty standards. There are SO MANY influences on our weight beyond what we eat, and it’s not entirely within our control.

4. Shift away from restrictive eating. Calorie restriction, like through dieting, especially for the long term, actually RAISES the body’s set point.

It can be frustrating to know that (due to many factors, some of which are outside our control) to a large degree our body weight is predetermined.

But, once we accept it, what if there’s more opportunity for peace and contentment? Or, at least, a focus on wellbeing at your set point instead of fluctuations in weight?

It is exhausting to live life feeling guilty, anxious, and ashamed of every bite of food you put in your mouth.

Set point theory (and better education about food in general) are helping me let my body do its thing. And, wow, do I have more space in my brain when I’m not obsessing about food.

I hope set point theory makes you feel the same way. Tell me what you think in the comments ↓ 🌈

Will write more soon on the best things I’ve learned in nutrition therapy.

Right now I’m gonna stock up on a feel-good snack because I’ve got mad election-eve nerves.

— Micah

P.S.

Join me for our upcoming Women’s Sharing Circle on Nov 13. It’s free and online, and our topic this month is “Letting Yourself Go.”

🗓️ Click here for more details or to get on the list

P.P.S.

I made a fun quiz for spooky season: Find out “which witch” you are in the Witchy Women of Folklore Quiz here (there are 12 possible results!).

🔮 Take the quiz

P.P.P.S.

Are we connected on Instagram, yet? We should be.