What a Beta Fish Taught Me About Stress

Last weekend I had the privilege of leading my yearly retreat at Miraval in the Berkshires. By a turn of events, I released my brand-new Stress Rx content for the very first time.

It was an incredible three days of diving into our triggers, how we respond to them, and the tools that can help us be more emotionally regulated. The work is far from done — cracking the stress code has just begun.

My team is buckled up and hard at work analyzing data, making new hypotheses, and drawing conclusions. But in the meantime, I want to share a story about how my dominant stress subtypes showed up when I got home from the retreat…

A Fishy Stress Lesson

On Monday morning, I got to take my daughter to school. When I came back home, I noticed her beloved beta fish at the bottom of the tank. I thought he had passed.

Wanting her to have closure, I decided to leave him in the tank so she could say her goodbyes. She handled the news beautifully — until later that day when she told me, “Mom, he’s still alive!”

The next morning, he was still at the bottom. My plan was to give him a proper funeral and create a little memorial spot for her. But when I went to remove him, he suddenly started swimming all over the tank.

My ICU instincts kicked in. I made a quarantine ICU tank, medicated it, and moved him over. Within 8 hours, he was swimming and eating again.

What This Taught Me

This moment revealed two of my stress subtypes in action:

• Validation Distress: I wanted my daughter to know she had done everything right, but really, I was projecting my own need for validation.

• Impulsivity Distress: I wanted to bury the fish right away simply because I felt so uncomfortable having what I thought was a deceased pet in the tank.

These subtypes gave me such insight into how stress shows up, even in micro-stressors like this.

The lesson? Every day presents both big and small stressors. We need to honor them all, understand what triggers us, and become aware of how we respond.

And yes — I’m celebrating my ICU win.

What’s Coming Up

Transform® 10 – Early bird registration open until October 1st
Miraval 2026 Retreat – Deposits now being accepted

Sending you so much love,
Ali

The Shift I Didn’t Expect

During our last days in Portugal, I felt something stirring in my body that I couldn’t quite name. It was an uneasy heaviness.

Maybe it was the anticipation of returning home, or the thought of both girls starting at a new middle school. Maybe it was my lack of sleep. Or perhaps it was the quiet worry about following through on promises I had made to myself — like creating more structured workdays that truly end.

It was a lot.

Instead of pushing the feeling away, I stayed curious with it. I shared it with friends. But as the days passed, it began to drain me — leaving me mentally foggy and even a little sad.

Then we returned home this past Sunday.

> The girls had a beautiful start to their school year.

> Mark and I built — and honored — a real work schedule for me this week.

> I returned to recording fun workouts.

> I was reunited with our sweet dog.

And suddenly, that feeling was gone. The heaviness dissipated. In its place? Lightness, hope, and happiness.

Almost as if I was letting go of something I didn’t even realize I was holding.

And with that release, a shift happened. Ideas that had been seeds for months began sprouting. New projects came forward. Inspiration returned. And I cannot wait to share my new stress work at our upcoming retreat at Miraval Berkshires.

So if you find yourself in that strange, heavy, unexplainable space — stay curious. Stay present. I believe it’s often the sign that a shift is already on its way.

Sending love,
Ali

The Magic of Sintra

Dear Friends,

This week I had the joy of exploring Sintra — a place that truly feels like stepping into a fairy tale. From the colorful castles perched on hills to winding paths through enchanted gardens, every moment was touched by magic.

As much as I’m excited to return home, Sintra will always hold a special place in my heart. I know I’ll be back again — very soon. Every time I come to Europe, I discover something new about the world and about myself. And every time, I feel the pull to return; it’s strong. While I miss home, I also find myself missing here.

On my way back to the U.S., I’ve been reflecting:

How can I take the best of both worlds with me?

What would it look like to merge the familiar comfort of home with the inspiration I find abroad?

Lately, I’ve even been having dreams that seem to suggest something exciting is on the horizon. I don’t know what it is yet, and that’s part of the magic. Allowing experiences like this to open doors to new possibilities is one of life’s greatest gifts.

So here we go, back to the USA — with a heart full of hope, curiosity, and gratitude.

Sending you love and encouragement to keep dreaming, creating, and staying open to the magic all around you.

With gratitude,
Ali

From the Cliffs of Lagos to You

Hi my friends,

We just took a mini trip from Sintra down to Southern Portugal, to the magical town of Lagos — and it feels like a dream. The sun warms you up, the breeze cools you down, and you can walk for miles along the coast discovering tucked-away beaches filled with the most beautiful shells.

While here, I’ve noticed something powerful: whenever stress sneaks in through some random thought, everything shifts when I bring myself back to the present. The present moment really is the most incredible medicine we all have access to.

I also notice that I dream big when I’m inspired. And maybe — just maybe — the dream itself is the prize. I hold space for new ideas, but I also feel deep gratitude for where I am right now and what I’ve already created.

Do I need to accelerate? Or maybe slow down? Or maybe it doesn’t matter at all, because the pace that feels right today, in this very moment, is enough.

So here’s a gentle nudge for you: it’s okay not to do more or be more. You are already perfect, exactly as you are. Right now. In this moment.

Sending love from Portugal,
Ali

Finding Your Inflection Point

There are moments in life when it feels like nothing is going right.

You can’t get out of your own way. You wish things were different.

And deep down, what you really crave is peace…

Stillness.

Connection to the present moment.

The truth is, you’re standing at an inflection point — a choice between staying in the energy you’re in… or intentionally shifting toward one that serves you better.

But how do you shift into an entirely different energy zone when your mind feels stuck?

Here’s what I believe: while everyone’s process is personal, there are three constants.

1. Awareness – You have to recognize you want to shift.

2. Clarity – You have to know what you’re shifting from and to.

3. Strategy – You need a tool to help you move from where you are to where you want to be.

Here’s one simple strategy to try right now:

• Take a deep breath.

• Remind yourself that nothing that has happened in the past matters in this moment.

• Know that this moment is yours. Yours to take back.

Now ask yourself:

How badly do I want to take this moment back?
Then, is making this shift non-negotiable for me?

If the answer is yes…

Then allow yourself the peace of knowing this moment is available for you — without worry, fear, or overwhelm. Presence yourself fully, and you’ll find the inflection point.

Sending you love from Portugal, where I’m practicing this exact same skill.

xo,
Ali

PS: Last Chance: Genetics Program with The FIT Collective

This is your final opportunity to join our Genetics Program. Due to the rising costs and logistical challenges of sourcing the kits, we will not be offering this program again. We have just five kits left — once they’re gone, they’re gone forever. Don’t miss your chance to gain personalized, science-based insights into your health that you can use for a lifetime.

Click HERE for all the details!

Gratitude, Portugal, and Our Sweet Lilly

Just before we were scheduled to leave for Portugal, life threw us an unexpected curveball.

Our sweet dog Lilly was doing her usual backyard zoomies when she spotted a bird and bolted after it. Mid-sprint, she let out a yelp and immediately stopped putting weight on her back right leg. It was heartbreaking. The next day, she was diagnosed with a CCL tear and a possible meniscal tear.

Our trip was just days away… and we postponed it.

Lilly had her surgery, and it went beautifully. But that first night? It reminded me of my time in the Neonatal ICU mixed with those blurry days of having a newborn. I barely slept, we were changing chucks (yes, dog version), and I even moved a bed into the kitchen so I could sleep right next to her. It was all hands on deck — and all heart.

We’re incredibly lucky to have amazing people in our lives. A beautiful family who owns Misguided Mutts (truly the best) takes care of Lilly whenever we travel, and they treat her like one of their own. With her movement on firm restriction, and two energetic kiddos at home, we realized rehab boarding might actually be best for her. Still, when we dropped her off, I felt stress, guilt, all the feelings.

But here’s what helped me most: gratitude.

I leaned into one of my top stress tools: naming what’s good, what’s working, what’s supportive. I thought about the people who step in when we can’t do it all. I thought about the care Lilly’s getting, the love around her, the privilege of traveling, and the space to hold it all — joy, grief, worry, and wonder.

Now, we’ve arrived in Portugal. Lilly is recovering. And my heart is full.

I’ll be sharing our adventure soon, but for now, thank you. Thank you for being here. Thank you for reading. Thank you for being part of my journey.

Sending you love — and a big dose of gratitude.
xo,
Ali

Redefining Stress, One Subtype at a Time

We love keeping you in the loop — not just on what we do at The FIT Collective, but why we do it.

Over the past 8 years, I’ve made some big observations about stress. And honestly, it all started at home.

Our family was navigating a tough season, and we knew we needed help. We found an incredible DBT therapist, and the emotional regulation tools we learned truly changed our lives. That experience opened my eyes to something bigger.

I began noticing patterns in our coaching community. Women physicians were responding to stress in different — but predictable — ways. Some isolated, some pushed harder, some froze in analysis paralysis.

I kept thinking: What if we named these? What if we gave people a map — and tools — for their unique stress signature?

That question became a mission.

The Evolution of Our Stress Framework

• It started with an assessment tool to identify distress subtypes — the six primary ways women doctors experience and respond to stress.

• Then I developed a full curriculum to teach each stress type and offer personalized, effective coping mechanisms.

• From there, I dove deeper into the relational dynamics — how each subtype interacts with the others in both regulated and dysregulated states.

• And now, we’re exploring how stress shows up in the body, behavior, and emotions, and how each subtype is impacted.

We're currently running a study inside our Transform® physician coaching program, and I’m thrilled to share that early data is coming soon. What we’re learning is already changing how I practice.

Why Emotional Regulation Comes First

I no longer start a weight loss plan by handing someone their macros.

Because here’s the truth:

• Why do we eat poorly? → Stress is part of it

• Why do we skip exercise? → Stress is part of it

• Why do our relationships or jobs suffer? → Stress is part of it

So... what if we fixed it at the core first — then layered on the tools?

That’s exactly what we’re doing.

What’s Coming in January: Transform® 10

Our upcoming Transform® 10 program (starting this January!) is rooted in this philosophy. It’s a revolutionary approach to healing burnout, optimizing health, and building sustainable change — by starting with emotional regulation, not willpower.

We believe that understanding your stress subtype and learning to regulate from within can change everything: your body, your brain, your relationships, your work. And ultimately, your life.

I’m more inspired than ever about what this means — not just for individuals, but for systems.

Want to Learn More?

If this resonates, check out our blog post on the six stress subtypes:
Understanding Stress Through Six Distress Subtypes: A Guide for Women Physicians

Stay tuned — there’s so much more to come.

With love and transformation,
Ali

Emotional Regulation: The Missing Prescription That Could Save Women Doctors

Medicine is hard. But for women doctors, it’s more than hard — it’s isolating, exhausting, and often unsustainable. Burnout isn't just a buzzword. It’s the slow unraveling of a brilliant, compassionate person whose light was never meant to burn out.

We see this every day in our physician coaching group, Transform. That’s why we’re doing more than offering nutrition and fitness guidance — we’re helping women doctors understand the emotional patterns keeping them stuck. We’re conducting research on stress and building a revolutionary curriculum. Because medicine won’t heal until we do.

Why It’s So Hard for Women in Medicine Right Now

Burnout Isn’t a Personal Failure — It’s a Systemic Setup

Women physicians are expected to do it all — with less support, less pay, and less time. Many of us entered medicine with a calling to help, to heal, to serve. But instead, we’re buried in EMRs, constantly interrupted, and silently absorbing microaggressions, caregiver guilt, and hormonal shifts that no one warned us about.

Keywords: burnout, poor mental health, perimenopause, menopause

• You're expected to smile while charting until midnight.

• You're supposed to manage everyone's emotions but never show your own.

• You’re tired, angry, and considering non-clinical jobs — but feel ashamed to say it out loud.

The Impact of Chronic Stress on Our Bodies and Minds

• Weight gain and inflammation (yes, stress messes with cortisol and insulin)

• Emotional eating and adrenal fatigue

• Increased reactivity: anger, irritability, or total shutdown

• Poor sleep, worsening hot flashes, and libido loss

• A shrinking window of tolerance before everything feels like too much

Keywords: weight loss, stress reduction, anger management

This isn’t about willpower. It’s about wiring. You don’t need to be told to “self-care harder.” You need to understand your stress response — and how to regulate it.

Emotional Regulation Is the First Step to Healing

Why We Must Understand Our Stress Response Implicitly

When stress hits, we don’t think — we react. We disconnect from ourselves. Our default settings take over: people-pleasing, perfectionism, productivity addiction. These are stress adaptations, not personality traits.

And while affirmations and breathwork help, they won’t touch the deeply conditioned responses living in our nervous systems. That’s why we must teach implicit regulation:

• Recognizing your unique stress signature

• Creating safety in your body before creating change

• Using emotion-based tools before cognitive strategies

• Building capacity before asking more of yourself

Until we address this, no macro count or workout plan will stick. Emotional dysregulation sabotages health goals from the inside out.

How We’re Leading This Movement — And How You Can Join

Transform: 72 CME Hours of Deep Personal and Professional Healing

At The FIT Collective, we built Transform®, a coaching program for women doctors that starts with core transformation. Then we layer: nutrition, movement, body composition, identity, emotional regulation, and legacy.

It’s where science meets self. And we’re now enrolling our January cohort.

Research-Backed Tools, Designed for Women Doctors

We are:

• Conducting active stress research in our coaching cohorts

• Launching a full Stress RX Curriculum in 2026

• Working with institutions to scale this work to residency and faculty

• Empowering non-clinical career exploration without shame or stigma

This isn’t just coaching. It’s a clinical intervention for a broken system. And it starts with the person in the mirror.

You Deserve Support That Sees All of You

If you’re navigating menopause symptoms while charting on your phone in the dark after bedtime…
If you’re wondering if leaving medicine is the only option left…
If you’re craving a community of women doctors who understand the emotional weight of this profession…

We’re here.

Transform enrolls now for January.
And the future of medicine starts with you.

WORK WITH ME THIS YEAR IN TRANSFORM®

Ultra Responders to GLP-1 Agonists: Who They Are and What You Should Know

GLP-1 agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have revolutionized obesity and metabolic health treatment. While many experience steady improvements, a unique subgroup—the "ultra responders"—see dramatic changes in weight, appetite, and metabolic markers. But what defines an ultra responder, and what should patients and clinicians watch for?

Who Are the Ultra Responders to GLP-1 Agonists?

Ultra responders are individuals who experience rapid, significant, and sometimes disproportionate results when starting a GLP-1 receptor agonist. These results can include:

• Weight loss exceeding 15–20% of total body weight in under 6 months

• Dramatic appetite suppression, sometimes verging on food aversion

• Improved glucose control and insulin sensitivity within weeks

• Increased energy or cognitive clarity due to metabolic shifts

Common Traits of Ultra Responders

While ongoing research is still exploring predictors, ultra responders often have one or more of the following:

• Higher baseline insulin resistance or visceral adiposity

• Strong GLP-1 receptor sensitivity, which may be genetic

• Metabolic inflexibility that rapidly corrects with GLP-1 initiation

• High baseline inflammatory markers that improve quickly

• Certain gut microbiome profiles favoring rapid hormonal response

Why Do Some People Respond So Strongly?

The exaggerated response often comes down to biological sensitivity. GLP-1 medications work by slowing gastric emptying, decreasing hunger signals, and improving insulin signaling. If an individual has:

• A hyperactive GLP-1 receptor profile

• Severe pre-treatment metabolic dysfunction

• A compromised hypothalamic hunger regulation loop

…then even low doses may yield outsized clinical outcomes.

Neurobiology also plays a role: GLP-1s interact with reward pathways in the brain, meaning patients with food addiction or emotional eating patterns may find sudden relief in their food thoughts or cravings.

Pros of Being an Ultra Responder

Being an ultra responder isn’t inherently negative. In fact, it can offer several clinical benefits:

• Rapid metabolic correction: blood sugar, A1C, and inflammatory markers often improve fast

• Motivation boost: early results can drive long-term lifestyle changes

• Lower medication burden: some may reduce or eliminate other prescriptions

• Better joint function and energy: due to early fat loss, especially visceral and intramuscular fat

Cons and Considerations

However, rapid change can have downsides. Key concerns include:

1. Muscle Loss Risk

Without adequate resistance training and protein intake, fast weight loss may come with disproportionate lean mass loss—affecting metabolism and function long-term.

2. Food Aversions and Malnutrition

Some ultra responders report extreme satiety or nausea, leading to low-calorie intake and potential micronutrient deficits.

3. Psychological Impact

The sudden shift in body image, hunger patterns, and relationship with food can be emotionally disorienting, especially if weight has been a long-standing identity issue.

4. Medication Tolerance & Rebound Risk

Over time, some ultra responders become less tolerant to the medication, or experience weight regain if the drug is stopped without a strong behavioral foundation.

What to Watch For as a Clinician or Patient

If you're working with—or are—an ultra responder, consider these monitoring and strategy tools:

• Track body composition, not just weight—InBody scans, DEXA, or even tape measures

• Assess strength and energy levels monthly to ensure muscle preservation

• Encourage resistance training at least 2–3x per week

• Use a mindful macro strategy to maintain nutrition even when appetite is low

• Offer psychological support, coaching, or group support for identity shifts and emotional regulation

Conclusion

Ultra responders to GLP-1 medications demonstrate the potential power of these drugs, but they also require a strategic, multidisciplinary approach. When supported with nutrition, exercise, and emotional wellness, ultra responders can harness their early gains into sustainable, long-term health.

The Clinical Value of Stool and Hair Mineral Testing in Nutrition Management

A Precision Approach to Micronutrient and Gut Health Assessment

As the demand for personalized nutrition rises, clinicians are turning to functional diagnostic tools like stool and hair mineral testing to uncover deeper insights. These tests provide a non-invasive window into a patient's nutrient status, detoxification potential, and gastrointestinal function—making them a compelling adjunct in evidence-informed nutrition management.

What Can Stool and Hair Mineral Testing Tell Us?

Stool Testing: Functional and Microbiome Insights

Stool analysis offers valuable data beyond standard digestive symptoms:

• Microbiota Composition: Identifies imbalances in beneficial vs. pathogenic flora.

• Digestive Enzymes: Detects insufficiencies in pancreatic elastase and bile acid production.

• Inflammation Markers: Calprotectin and secretory IgA levels flag intestinal immune activation.

• Parasitology & Pathogens: Screens for yeast, parasites, and bacterial overgrowth.

• Short-Chain Fatty Acids (SCFAs): Indicates prebiotic effectiveness and colonic health.

• Beta-glucuronidase: Assesses estrogen detox and cancer risk biomarkers.

Hair Mineral Testing: Long-Term Mineral Trends

Hair mineral analysis offers a retrospective look into mineral deposition and heavy metal exposure:

• Macrominerals: Calcium, magnesium, potassium, and sodium levels reflect adrenal and metabolic trends.

• Trace Minerals: Zinc, selenium, copper, and chromium give insights into immunity, oxidative stress, and glucose regulation.

• Toxic Metals: Identifies exposure to mercury, lead, arsenic, aluminum, cadmium.

• Ratios and Patterns: Zinc/copper, Ca/Mg, and Na/K inform stress and thyroid/adrenal patterns.

Pros and Cons of Stool and Hair Mineral Testing

Advantages

Non-Invasive & Patient-Friendly
Long-Term Trends (especially in hair testing)
Useful for Chronic, Unexplained Symptoms
Supports Functional and Lifestyle Medicine
Complements Blood Labs for Deeper Insight

Limitations

Not Diagnostic Alone
Variability in Lab Standards and Interpretation
Hair Testing Affected by Hair Products or External Contamination
Limited Insurance Coverage—Often Out-of-Pocket

How Do Clinicians Use This Data?

Stool and hair mineral test results can directly inform treatment protocols:

• Targeted Supplementation (e.g., correcting zinc/copper imbalance or low selenium)

• Detox Protocols (supporting liver pathways in heavy metal burden)

• Microbiome Restoration (using probiotics, prebiotics, or antimicrobials)

• Stress and Adrenal Support (based on Na/K and Ca/Mg ratios)

• Diet Customization (modifying intake based on digestive and absorption profiles)

Are There Alternative Assessment Methods?

Yes, clinicians may also use:

• Serum/Blood Testing: Best for acute changes (e.g., serum magnesium, ferritin).

• Organic Acids Testing (OAT): Metabolic intermediates for nutrient deficiencies.

• Micronutrient Testing (e.g., SpectraCell): Lymphocyte-based long-term nutrient status.

• DEXA or InBody Scans: For body composition changes related to mineral status.

Each has its strengths, and multi-modal testing often yields the most clinically relevant picture.

Is This Testing Cost-Effective?

For the right patient—yes.

• Hair Mineral Testing: ~$100–$150 per test, often done annually.

• Comprehensive Stool Testing: ~$250–$450, depending on markers selected.

Considering the cost of chronic unresolved symptoms and unnecessary treatments, these tests can be cost-effective tools in:

• Complex fatigue syndromes

• Chronic gut dysfunction

• Weight plateaus despite dietary adherence

• Hormonal imbalance investigations

• Detoxification planning in high-risk patients

Final Thoughts: A Functional Lens for Deeper Patient Insight

Stool and hair mineral analysis offer physicians a functional, systems-based lens to examine nutritional and toxicological imbalances. While not replacements for standard labs, they can reveal hidden contributors to chronic dysfunction and offer actionable data for personalized interventions.

When paired with patient history, symptom tracking, and clinical acumen, these tools can enhance outcomes in a cost-efficient, non-invasive way—bridging the gap between symptoms and solutions in modern integrative care.

Why Doctors Need Real Nutrition Guidelines—Not Just “Eat Less, Move More”

Medical Providers Deserve Better Tools to Guide Their Patients

As physicians, we’re trained to diagnose, treat, and manage disease—but when it comes to nutrition counseling, the tools we’re given are often outdated or vague. Telling patients to “eat less and move more” not only lacks specificity, it also ignores the complex physiology, psychology, and environment in which health behaviors occur.

The truth is: our patients need more from us, and we need more from our training.

With rising rates of obesity, metabolic syndrome, insulin resistance, and hormone-related weight challenges, the demand for evidence-based nutrition guidelines for doctors has never been higher. And while AI tools like ChatGPT can assist in formulating general nutrition plans, they are not a substitute for expert, physician-led education. These tools are only as effective as the knowledge base of the clinician using them.

Where to Get Evidence-Based Nutrition Training for Physicians

If you're a physician searching for “nutrition training for doctors,” “CME for obesity prevention,” or “how to counsel patients on nutrition”, you’re not alone. Thousands of providers are seeking clinical tools that go beyond generalized advice.

The Nutrition and Obesity Prevention Program by The FIT Collective® offers a comprehensive, ACGME-friendly training pathway with up to 48 CME credits, including 30 Group 2 credits toward Obesity Medicine board certification. It includes:

• A full year of progressive strength programming (10 min/day, 3x/week)

• Evidence-based longevity and metabolic health strategies

• Real-time provider scripts and clinical tools

• Step-by-step guidance for individualized patient care

Whether you're in primary care, endocrinology, pediatrics, or integrative medicine, this program gives you the confidence and clinical clarity to support patients in sustainable, science-based behavior change.

Why Training Matters More Than Ever

Today’s patients are asking more complex questions—and showing up with higher expectations. They’re Googling everything. They’re biohacking. They’re listening to influencers. And yes, they’re even bringing in AI-generated nutrition plans.

As physicians, we must meet this moment with credibility, clarity, and compassion. That starts by deepening our knowledge beyond our initial medical training. We cannot afford to be passive messengers of vague advice. We must be active guides rooted in science and empowered by real training.

The Nutrition and Obesity Prevention Program from The FIT Collective® can help fill the gap to allow medical professionals to help our patient’s best.

🔗 Explore the Program & Earn 48 CME Credits
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Redefining the Doctor-Patient Relationship — And Why It Matters Now

The landscape of medicine is shifting — and with it, the expectations, roles, and relationships at its core. If you’ve ever found yourself wondering:

Why doesn’t my doctor have time to truly listen?

Can physicians support me as a whole person, not just a diagnosis?

Is there a more empowering way to approach care?

You’re not alone. These questions aren’t just valid — they’re vital.

For many of us in medicine, the traditional doctor-patient relationship no longer fits the needs of modern life. We’re not just being asked to treat symptoms; we’re being called to connect, coach, and co-create health alongside our patients.

And that’s where the magic lies.

From Prescription to Partnership: A New Way to “Doctor”

People often ask me: “Are you still practicing medicine, or are you coaching now?”

The truth is, I’m still a doctor. But I’m not practicing medicine the way I was trained to in 2002.

Today, I define “doctor” by its Latin root: docere — to teach.

That means helping women:

• Understand metabolism and muscle physiology

• Tune into emotional signals with compassion

• Build physical and mental strength

• Reignite purpose, both in and outside of medicine

Yes, it looks a lot like coaching. But what I’m doing is doctoring at its deepest level — with presence, intention, and love.

Why the Doctor-Patient Model Is Evolving

We’re in a powerful paradigm shift.

Patients don’t just want prescriptions; they want partnership. They’re seeking integration between mind, body, and environment. They’re asking for care that:

• Listens without rushing

• Educates without condescension

• Guides without judgment

• Fosters agency over dependence

For many physicians — especially those who’ve faced burnout or disconnection — this approach is bringing us back to life.

Coaching as a Healing Extension of Medicine

Coaching isn’t a step away from medicine. It’s a step deeper into it.

Through my programs at The FIT Collective, I sit with women physicians, high-achievers, and health seekers to explore:

• Metabolic health during GLP-1 therapy

• Muscle strength and preservation in midlife

• Emotional resilience and distress tolerance

• Nutrition rooted in data and intuition

• Self-trust and mindset transformation

This is how I doctor now. And it’s profoundly humbling to witness how people begin not just to heal, but to understand their healing.

How We Reignite the Doctor-Patient Relationship

1. We Make Time for the Human Story
   Listening deeply reveals what’s often missed in a 15-minute visit.
   

2. We Educate, Not Just Diagnose
   Empowerment starts with understanding your own body.
   

3. We Create Safe, Shame-Free Spaces
   No one transforms under judgment. Safety is the foundation.
   

4. We Build Relationships of Reciprocity
   This is a partnership — not a power dynamic. We grow together.

A Return to Purpose

Some days, I still miss the white coat and hospital badge. But I’ve come to understand:

I didn’t leave medicine. I returned to it.

To why I became a doctor in the first place. To listen, to teach, to help others remember their strength.

If you’re a woman doctor ready to reconnect with your calling — or a patient seeking care that sees all of you — you are not alone.

We’re building something new.

And it’s exactly what medicine was always meant to be.

With gratitude and hope,
Ali 

Redefining the Doctor-Patient Relationship in the New Era of Medicine

Why the Doctor-Patient Relationship Needs a Redesign

The landscape of medicine is evolving—and so are the roles of those who practice it. Today, more people are searching “how are doctors changing?”, “why doesn’t my doctor have time to listen?”, or “can doctors coach me instead of just treating symptoms?”

These questions aren’t just valid—they’re vital.

For many of us in medicine, the traditional doctor-patient relationship no longer fits the needs of modern life. We’re not just being asked to treat diagnoses—we’re being called to connect, coach, and co-create health alongside our patients.

And I believe that’s exactly where the magic lies.

From Prescription to Partnership: A New Definition of "Doctoring"

I’m often asked, “Are you still practicing as a doctor? Or are you just coaching now?”

Here’s the truth:

I am a doctor first. I will always be a doctor.

But I’m not doctoring the way I was trained to in 2002. I’m not limited to 15-minute visits, ticking boxes on an EHR, or treating labs instead of people.

Instead, I’m reclaiming the full meaning of the word doctor—from its Latin root, docere, which means “to teach.”

Today, I’m teaching women how to:

• Understand their metabolism and muscle physiology

• Tune into their emotional signals with compassion

• Develop sustainable strength—physically and mentally

• Reignite their purpose, both in and outside of medicine

And yes, that looks a lot like coaching. But what I’m doing is doctoring at its deepest level—with presence, intention, and love.

How Doctors Are Changing to Fit the Needs of a New Generation

We’re in a paradigm shift. Patients aren’t just seeking information; they’re seeking integration. They want to understand how their body, mind, emotions, and environment all work together.

They want a doctor who:

• Listens without rushing

• Educates without condescending

• Guides without prescribing shame

• Offers tools that create agency, not dependency

In this new model, the best medical care feels more like a partnership than a power dynamic.

And for doctors like me—who’ve walked the tightrope of burnout, compassion fatigue, and system-induced disconnection—becoming more human in our approach has brought us back to life.

Coaching as a Healing Extension of Medicine

Let me be clear: Coaching isn’t a step down from medicine—it’s a step deeper into it.

Through my programs at The FIT Collective, I get to sit with women physicians, high-achievers, and health seekers and ask: What if we did this differently?

We focus on:

• Metabolic health during GLP-1 therapy

• Muscle preservation and strength in midlife

• Emotional resilience and distress tolerance

• Nutrition that honors intuition and data

• Self-trust and mindset transformation

This is how I doctor now.

And it’s profoundly humbling to witness what happens when we empower people not just to heal—but to understand their own healing process.

How We Reignite the Doctor-Patient Relationship

1. We Make Time for the Human Story

When we slow down, we hear the real concerns. We see the patterns. We offer compassion before we offer solutions.

2. We Educate, Not Just Diagnose

Education is empowerment. I teach my clients how to understand their health, not just follow orders.

3. We Create a Safe, Shame-Free Space

There’s no transformation in judgment. The modern doctor-patient relationship must feel emotionally safe before it can be medically effective.

4. We Build a Relationship of Reciprocity

Patients aren’t just recipients—they’re co-creators. And we, as doctors, learn and grow from every individual we serve.

Gratitude for the Calling That Keeps Evolving

Some days, I still miss the white coat and hospital badge. But I’ve come to realize:

I didn’t leave medicine. I returned to it.

I returned to why I became a doctor in the first place—to listen, to teach, to help others remember their strength.

I am profoundly grateful for the privilege of doing this work. Of guiding women who’ve spent their lives serving others to finally serve themselves with the same devotion.

To those still inside the traditional model: I see you. I honor you.

To those stepping outside the lines to redefine what doctoring means: I stand with you.

And to every patient, client, or colleague who has trusted me with a piece of their story—thank you. You have made me a better doctor than any textbook ever could.

What’s Next for the Doctor-Patient Relationship?

We’re not going backward.

As more people search for how the doctor-patient relationship is changing, the world needs more physicians willing to lead this evolution—with heart, humility, and hope.

If you’re a woman doctor ready to reconnect with your calling, or a patient looking for care that sees all of you—you’re not alone.

We’re building something new.
And it’s exactly what medicine was always meant to be.

A Doctor’s Journey to Redefinition: With Gratitude to Dr. Brooke Buckley

I want to take a moment to express my deep gratitude to Dr. Brooke Buckley, a physician leader whose influence helped me see that my current work—as a coach, teacher, and healer—is not a departure from medicine, but a powerful evolution of it.

Dr. Buckley’s courage, leadership, and bold voice in reimagining what it means to "doctor" gave me permission to fully embrace this new identity—not as a step away, but as a step deeper into service.

Thank you, Dr. Buckley

Brooke M. Buckley, MD, FACS is a Board-Certified General Surgeon and Diplomate of the American Board of Lifestyle Medicine. She earned her MBA from The Johns Hopkins Carey School of Business and currently serves as System Vice President of Medical Affairs for Henry Ford Health and Medical Director of the Command Center.

From 2020–2025, she was Chief Medical Officer of Henry Ford Wyandotte Hospital. Her prior leadership roles include Vice President and CMO of Meritus Health, and Associate Chair of Surgery and Medical Director for Acute Care Surgery and the Wound Center at Anne Arundel Medical Center in Maryland.

Dr. Buckley is a national thought leader on burnout, workforce wellness, and trauma-informed leadership. She serves on the Joint Commission Board, is Past-Chair of the Committee on Clinical Leadership for the American Hospital Association, and is a former Chair of AMPAC and past president of the Maryland State Medical Association.

She graduated from The Ohio State University College of Medicine and Public Health and completed her General Surgery residency in the Cleveland Clinic Health System.

Dr. Buckley doesn’t just lead hospitals—she leads movements. She reminded me that leadership in medicine doesn’t have to look one way. And for that, I am forever grateful.

Interested in coaching that honors the science and the soul?
👉 Explore my physician CME coaching programs

Cougar Puberty and the Physician Power Surge: Midlife Transformation for Women Doctors

Reclaim Your Health, Hormones, and Confidence with Transform®

There’s a new kind of puberty happening—and it’s not for teenagers. It’s for women in their 40s, 50s, and beyond. Some call it Cougar Puberty, others call it midlife reinvention. At Transform®, we call it a power surge.

For women physicians, this stage hits differently. We’re juggling patient care, leadership, teaching, parenting, caregiving, and invisible emotional labor—all while our hormones shift, our metabolism changes, and our nervous systems adaptto a new biological chapter.

Sound familiar?

If you’re feeling exhausted, reactive, or unsure what’s happening to your body—even as a doctor—you are not alone. And more importantly: you are not broken.

⚕️ Inside Transform®, We’ve Built a Whole-Life Framework for Women Doctors in Midlife

This isn’t a generic coaching group. It’s a curated experience blending:

• Physician-centered coaching & mindset work

• Nutrition strategies that evolve with your hormones

• Progressive strength training designed to maintain lean mass and VO₂ max

• Access to real-time menopause and hormone therapy guidance

• CME-accredited curriculum grounded in mental fitness and metabolic science

• A sisterhood of high-achieving women physicians who get it

🩺 Menopause Support from Our In-House Expert, Dr. Komal Patil-Sisodia

When it comes to perimenopause, menopause, and hormone therapy, we don’t guess. We guide.

We’re proud to have Dr. Komal Patil-Sisodia, a double board-certified family and obesity medicine physician, leading our menopause education. She keeps our community up-to-date on FDA-approved hormone protocols, metabolic shifts in menopause, and how to evaluate risks vs. benefits using real data—not myths.

Whether you’re curious about estrogen therapy, experiencing burnout-related hot flashes, or wondering if your emotional lability is hormonal or stress-driven—we cover it, normalize it, and support you through it.

🍽️ Nutrition That Honors Your Physiology (and Your Schedule)

The Transform® approach to midlife nutrition is rooted in metabolic flexibility, not meal plans.

We teach mindful macros, muscle-supportive fueling, and realistic strategies for busy clinicians who don’t have time to track every bite. Whether you’re on a GLP-1, practicing intuitive eating, or needing help with protein intake—we personalize without perfectionism.

And yes, we make room for joy foods and coffee snacks without shame. Because food is chemistry and culture, not just calories.

🏋️‍♀️ Science-Based Exercise for Muscle, Mood, and Longevity

Starting in week 25, our Transform® progressive training shifts into HIIT, endurance strength, and max strength blocks—strategically designed to:

• Preserve and build lean muscle

• Improve VO₂ max and heart rate recovery

• Support bone density and insulin sensitivity

• Reduce perimenopausal fat gain

• Enhance mood, confidence, and cognitive clarity

All workouts are 10–30 minutes. No gym or extensive equipment required. Just results.

🤝 The Power of Peer Community

Perhaps the most underestimated menopause medicine? Connection.

Inside Transform®, you’ll find a protected space where you don’t have to code-switch or explain what it's like to chart after bedtime or cry in the bathroom after being dismissed in a meeting. Our women physicians come as they are—and are held fiercely in return.

• Weekly coaching calls

• Group-led challenges

• Stress workshops

• Written coaching support

Here, you're not "too much" or "not enough." You're seen, heard, and championed.

🧠 Midlife Stress and Mental Health: Why It Hits Us Differently

From imposter syndrome to ragey reactivity, midlife stress often gets misdiagnosed as personality flaws.

In reality? It’s a perfect storm of hormonal shifts, mental load overload, and outdated coping strategies. That’s why Transform® teaches you how to recognize your distress subtype—whether it’s Isolation, Assertive, Impulsivity, Control, Validation, or Catastrophizing—and gives you tools to shift in the moment.

From emotional regulation strategies to cognitive reframes, this isn’t therapy—but it’s definitely therapeutic.

💥 You’re Not Declining. You’re Evolving.

The world told us menopause was a slow fade.

Transform® says it’s a rewiring into power, clarity, and longevity—especially when supported by:

✅ Smart strength
✅ Science-backed hormone tools
✅ Peer connection
✅ Metabolic nutrition
✅ Targeted mindset coaching

You’re not too late. You’re exactly on time for your most aligned chapter yet.

Cougar puberty isn’t chaos—it’s code for reinvention.

Let us help you meet it with strategy, sisterhood, and strength.

Learn about Transform® and join the thousands of women physicians who have experienced the program. TRANSFORM®.

Understanding Stress Through Six Distress Subtypes: A Guide for Physicians

Stress Management for Doctors: The Six Distress Subtypes You Need to Know

Being in medicine means constantly juggling clinical pressure, leadership roles, home responsibilities, and often, an invisible mental load. If you’ve ever found yourself wondering why stress manifests differently for you compared to your peers, this guide is for you. We’ll walk you through six unique distress subtypes based on real data from women physicians—and show you how to recognize, manage, and transform each one.

1. Isolation Distress: The Quiet Spiral

How It Feels Mentally

• Racing catastrophic thoughts

• Mental shutdowns during overwhelm

• Persistent self-blame for perceived mistakes

Emotional Landscape

• Irritation and fear

• Emotional numbness followed by logic-mode

• Inability to express real-time feelings

Physical Symptoms

• Jaw clenching, muscle tightness

• Palpitations and heaviness

• Somatic freeze or dissociation

Workplace Patterns

• Avoiding collaboration

• Emotionally detached in meetings

• Withdrawing from team support

Home Patterns

• Need for extreme solitude after work

• Avoiding hugs or emotional conversations

• Feeling invisible yet resistant to asking for connection

2. Assertive Distress: Overdrive and Overcontrol

Cognitive Themes

• Overanalyzing and mental spirals

• Urgent need to fix or escalate

• Difficulty letting go or pausing

Emotional State

• Irritation masked as efficiency

• Hyper-focus under stress

• Compartmentalization of feelings

Bodily Cues

• Muscle tension, jaw clenching

• Racing heart, shallow breath

• Restlessness followed by fatigue

At Work

• Micromanaging or bypassing group processes

• Frustration when others miss details

• Emotional crash post-resolution

At Home

• Taking on all logistics

• Snapping at loved ones over small changes

• Feeling unsupported but unwilling to admit it

3. Impulsivity Distress: Racing Minds and Regret

Mental Patterns

• Obsessing over others’ opinions

• Inner critic and planning panic

• Need to act fast to escape discomfort

Emotional Experience

• Shame and guilt post-reactivity

• Frustration at emotional inconsistency

• Emotional outbursts followed by self-recrimination

Physical Impact

• Somatic panic and gut tension

• Racing sensations and breathlessness

• Mental fog outside of professional role

Professional Signs

• Impulsive communication

• Interrupting or shifting focus mid-task

• Productivity fueled by anxiety

Home Life Indicators

• Overreacting in minor conflicts

• Parent-child power struggles

• Rumination post-conflict

4. Control Distress: When Everything Must Be Just Right

Thought Tendencies

• Cognitive overdrive during plan disruption

• Self-blame and urgency to fix

• Obsession with order and timelines

Emotions Underneath

• Hidden panic covered by irritation

• Guilt when others don’t match urgency

• Emotional bottlenecking

Body Responses

• Flushed, pacing, tense shoulders

• Somatic crash post-stress

• Anticipatory stress before the actual issue

In the Workplace

• Hyper-organization masking panic

• Reluctance to delegate

• Resentment over always "being the one"

At Home

• Emotional rigidity in family dynamics

• Reactivity over changed plans

• Difficulty trusting peace or rest

5. Validation Distress: The Unseen Performer

Mental Habits

• Self-worth tied to feedback and titles

• Ruminating over approval or disapproval

• Avoidance of emotional visibility

Emotional Drivers

• Suppressed frustration

• Longing for reassurance

• Disappointment when unacknowledged

Somatic Signs

• Headaches, GI issues, heart palpitations

• Dizziness and emotional eating

• Chronic fatigue from unspoken effort

Workplace Indicators

• Overachieving for visibility

• Avoiding feedback unless perfect

• Feeling invisible despite high output

Home Environment

• Being the "giver" with unmet needs

• Overextending to avoid conflict

• Silence about internal hurt

6. Catastrophizing Distress: Always Bracing for Impact

Mindset Patterns

• Scanning for danger or mistake

• Obsessive detail-checking

• Belief that disaster is imminent

Emotional Flavor

• Anxiety layered with embarrassment

• Shame around "overreacting"

• Emotional shutdown from judgment fear

Physical Effects

• Tight chest, shallow breath

• Sleep issues and restlessness

• Sympathetic nervous system overactivation

At Work

• Triple-checking everything

• Fear of vague feedback

• Overcompensating with perfectionism

At Home

• Over-preparing for routine events

• Worrying without off-switch

• Emotional withdrawal if dismissed

Final Thoughts: Stress Isn't One-Size-Fits-All

Stress shows up differently in every physician. Whether you tend toward isolation, overcontrol, impulsivity, assertion, catastrophizing, or the need for validation, understanding your pattern is the first step to transforming it. You deserve a toolkit tailored to how your brain and body respond to stress—and permission to ask for support before you crash.

Start small. Pick one ritual from your subtype.

Then? Watch what begins to shift.

You are not broken. You are wired for wisdom. And you are never, ever alone in this work.

My Week in Paradise… Where Do I Even Begin?

It all started over a year ago when my dear friend, Dr. Erica Howe — the incredible founder and host of Women Physician Wellness (WPW) — began dreaming up her 50th birthday celebration. I remember her saying, almost casually but with that signature sparkle in her eye:

“I want my friends on a yacht.”

I never imagined I’d be lucky enough to be part of that dream. And yet… here we are.

This week, Erica brought together a small group of friends on one of the most beautiful yacht experiences I could ever imagine. And the most remarkable part? While it was her birthday, her dream, her moment — she poured so much thought, love, and care into making it special for each one of us.

That’s just who she is.

Watching her in her element — so full of life and generosity — was something I’ll never forget. Erica has this quiet way of elevating everyone around her. Being on that boat, in the middle of the sea, surrounded by women I admire so deeply… I honestly just kept pinching myself. “How did I get so lucky to be here?”

I spent the week doing my best to stay present, soaking in every sunset, every conversation, every laugh. And through it all, I kept feeling this overwhelming sense of gratitude — not just for the experience, but for the people. For Erica. For the friendships. For the reminder that we rise higher when we lift each other up.

I’m so thankful to Erica — for her heart, for her example, and for including me in something so meaningful. She inspires me to lead with more kindness, more generosity, and more presence in my own life and work.

If you’re reading this, I hope you can carry just a little of that light with you today. I know I’ll be holding onto it for a long time.

Sending you so much love today… and every day.

Xoxox-
Ali

The Future of Nutrition Education in Medical Schools: Where We Are and Where We're Headed

Why Nutrition Training in Medical Schools Matters More Than Ever

As chronic diseases related to poor nutrition—like obesity, diabetes, and cardiovascular disease—continue to rise, the gap in nutrition education within medical schools is gaining urgent attention. Physicians are often on the front lines of patient care, yet many report feeling unprepared to counsel patients on evidence-based nutrition strategies.

What Are the Current Nutrition Training Requirements in Medical Schools?

Minimal National Requirements Still Dominate

Currently, there is no universal standard in the U.S. mandating robust nutrition education in medical schools. The National Academy of Sciences recommends a minimum of 25 hours of nutrition education, but most schools fall far short of this guideline. Studies show that over 70% of medical schools in the U.S. fail to meet this benchmark, with some offering as few as 10 hours of instruction across the entire curriculum.

Nutrition Education Is Often Fragmented

Rather than being integrated as a dedicated course, nutrition is often embedded in unrelated modules such as biochemistry or pathophysiology. This fragmented approach fails to equip future physicians with practical tools to address dietary interventions in clinical settings.

What Is the Most Common Nutrition Curriculum in Use Today?

Focus on Biochemistry Over Application

The most prevalent approach to nutrition in medical education centers on biochemical mechanisms (e.g., macronutrient metabolism, vitamin deficiencies) rather than clinical application. Students may memorize pathways but lack exposure to:

• Nutrition counseling skills

• Lifestyle medicine frameworks

• Obesity prevention strategies

• Food as medicine principles

• Culturally responsive nutrition care

Some progressive programs have introduced Lifestyle Medicine electives or culinary medicine workshops, but these remain optional or extracurricular.

What’s Coming Down the Pipeline for Medical Nutrition Education?

A Shift Toward Prevention, Application, and Accreditation

Forward-thinking institutions and accrediting bodies are responding to the call for change. Here are key trends shaping the future:

• Increased CME and Graduate Medical Education Options: More residency programs are embedding nutrition and obesity management into required training, particularly within Family Medicine, Internal Medicine, and Pediatrics.

• New CME-Credited Curricula for Attendings: Institutions are beginning to adopt structured nutrition training programs with continuing medical education (CME) credit for attendings, often delivered in modular formats that include strength training, GLP-1 medications, and behavior change tools.

• Integration with Obesity Medicine Board Prep: As more physicians pursue board certification in Obesity Medicine, the demand for evidence-based nutrition training continues to grow. Curricula that offer Group Two CME credits aligned with this specialty are increasingly sought after.

• Nutrition Training as a Quality Metric: Accrediting organizations are evaluating how well programs prepare students to address social determinants of health, with nutrition and food access emerging as key focus areas.

Who Is Leading the Charge in Medical Nutrition Education?

Several institutions and leaders are pushing the boundaries of traditional medical training:

• Harvard's Culinary Health Education Fundamentals (CHEF) Coaching Program: Offers a hands-on, evidence-based approach for clinicians.

• Tulane University’s Goldring Center for Culinary Medicine: A pioneer in integrating culinary skills into medical education.

• Stanford's Nutrition and Lifestyle Medicine Programs: Provide robust faculty development and residency-based initiatives.

• The FIT Collective’s Nutrition & Obesity Prevention Curriculum: Offers CME-accredited, clinic-ready programs designed for attendings, with an emphasis on muscle preservation, longevity, GLP-1 pharmacology, and patient-centered nutrition coaching.

Why the Future Belongs to Schools Prioritizing Obesity Prevention Through Nutrition

Medical schools that take the lead in obesity prevention through comprehensive nutrition training will not only improve population health outcomes—they will also position themselves at the forefront of modern medical education.

With chronic disease burden increasing and patients demanding more personalized, preventive care, now is the time for institutions to invest in structured, evidence-based nutrition education. Those that do will define the next generation of medical excellence.

Perimenopause Treatment in the Age of Anti-Obesity Medications

Redefining Women’s Health by Addressing Weight, Hormones, and Metabolism—Together

In the evolving landscape of women’s health, the intersection of perimenopause, obesity, and metabolic dysfunction is more relevant than ever. With the rise of GLP-1 receptor agonists and other anti-obesity treatments, we now have more tools than ever to support women through the often-complex transition of perimenopause. But here’s the key: treatment must be comprehensive—because perimenopause is about more than hormones, and obesity is about more than BMI.

Why Perimenopause Deserves a 360° Metabolic Approach

It's Not Just About Estrogen—It's About Everything

Perimenopause isn’t just about waning estrogen. It’s a physiologic shift in metabolic setpoint, inflammation, sleep, mood, insulin sensitivity, and body composition. Many women report:

• Increased abdominal fat

• Muscle loss

• Blood sugar instability

• Brain fog

• Cravings and energy dips

• Sleep disruption

These aren’t “just aging.” They’re clues that metabolic resilience is weakening—and it’s time for intervention.

The Role of Anti-Obesity Medications in Perimenopause

How GLP-1s Are Changing the Game for Women 40+

GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound) are transforming care for women with obesity, metabolic syndrome, and even PCOS. These drugs regulate appetite, insulin response, and gut-brain signaling—making them powerful tools in managing:

• Visceral fat gain

• Pre-diabetes and insulin resistance

• PCOS exacerbated by perimenopause

• Emotional eating patterns

However, GLP-1s should not be used in isolation. Without strength training, protein optimization, and micronutrient support, women are at risk of muscle loss, nutrient depletion, and hormonal destabilization.

Understanding “Normal Weight Obesity” in Perimenopause

Why BMI Can Be Misleading in Women Over 40

A woman can have a “normal” BMI and still have:

• High visceral fat

• Low skeletal muscle mass

• Metabolic dysfunction (insulin resistance, elevated triglycerides)

• Fatigue, brain fog, and poor recovery

This condition—known as Normal Weight Obesity (NWO)—is especially common during perimenopause, when hormonal changes reduce lean mass and increase fat distribution in a subtle, but metabolically dangerous, way.

The Lab Work Women Need in Midlife (That’s Often Missed)

Go Beyond TSH and Estrogen

To understand the full metabolic picture, clinicians should assess:

Hormones
Estradiol, Progesterone, Testosterone, DHEA-S, SHBG, LH, FSH

Thyroid
TSH, Free T3, Free T4, Reverse T3, Thyroid Antibodies

Metabolic
Fasting insulin, A1c, Fasting glucose, Lipid panel, CRP

Nutrient status
Vitamin D, B12, Magnesium, Ferritin

Body Composition
InBody or DEXA to assess fat vs. lean mass

This data guides an individualized treatment plan, especially for women who “look healthy” but are struggling metabolically.

Integrative Treatment Options for Perimenopause + Obesity Risk

Combine Hormonal, Nutritional, and Movement Strategies

✅ Hormone Therapy (HRT/MRT): Supports sleep, mood, bone, and muscle health
✅ GLP-1 Medications: Use when appropriate for appetite regulation and insulin sensitivity
✅ Strength Training: 3x/week to maintain lean mass and metabolic function
✅ Protein Timing: 30–40g per meal to support anabolism
✅ Mindful Macronutrients: Balanced meals to avoid crashes and support satiety
✅ Stress + Sleep Support: Cortisol elevation worsens metabolic markers
✅ Micronutrient Repletion: Especially magnesium, B vitamins, and vitamin D

Final Takeaway: Metabolic Health Is the Missing Link in Perimenopause Care

The old model of treating women in perimenopause with “a little estrogen” and generic lifestyle advice is outdated. Today, we must treat the whole picture—with evidence-based tools like anti-obesity medications, lab-guided interventions, and body composition-aware strategies.

Whether your patient is struggling with visible weight gain or silent shifts like normal weight obesity, now is the time to address hormones, metabolism, and lifestyle in harmony.

I want to direct you to a recent podcast that I did. Navigating weight gain in perimenopause and menopause. You can listen HERE.

Is 30 Minutes of Strength Training Per Week Enough to Preserve Muscle During Fat Loss?

The Truth About Muscle Maintenance and Time-Efficient Workouts

If you're a physician or wellness coach advising patients on fat loss strategies—especially those on GLP-1 medications—you’ve likely encountered a key concern:

“Is 10 minutes of strength training, 3 days a week, enough to maintain muscle mass?”

The short answer is yes, if the goal is muscle preservation during fat loss, not hypertrophy or muscle gain. Here’s the science and strategy behind why the “minimum effective dose” of resistance training—30 minutes per week—is both sufficient and sustainable for most.

Muscle Maintenance vs. Muscle Gain: Two Very Different Goals

Why Most Fat Loss Clients Don’t Need a Bodybuilder's Routine

When designing strength programs, many overreach by applying muscle gain protocols to fat loss clients. The physiology, hormonal demands, and metabolic requirements of these goals are very different:

• Muscle gain requires a caloric surplus, progressive overload, and significant time investment.

• Muscle maintenance during fat loss, by contrast, focuses on preserving lean tissue in a calorie deficit, which doesn’t require long gym sessions.

Why 10 Minutes, 3x/Week Is a Clinically Sound Recommendation

The Math: 30 Minutes/Week x 52 Weeks = 26 Hours of Training a Year

When patients hear they need to “train for 3 hours per week,” they often fall into all-or-none thinking—especially those juggling careers, families, and burnout. The result? They do nothing.

Now compare this to a 10-minute plan:

• 3 sessions/week of strength training = 30 minutes

• 52 weeks/year = 26 hours of strength training annually

That’s 26 hours of muscle signaling—enough to preserve muscle, support metabolism, improve insulin sensitivity, and counter muscle wasting risks from GLP-1 medications or rapid weight loss.

The Science Behind the Minimum Effective Dose

Progressive Overload, Consistency, and Rest Matter More Than Duration

Even brief bouts of strength training (especially with full-body compound movements) generate a muscle-preserving anabolic signal. Research supports that time under tension and intensity, not duration alone, are what matter most when preserving muscle in a deficit.

• 10 minutes of targeted strength work, done with proper form and consistency, yields substantial return.

• Short workouts also improve adherence, lowering dropout rates.

Tailor It to the Patient’s Body Type and Recovery Capacity

One Size Doesn’t Fit All—But 10-Minute Training Works for Most

Every patient’s body type, baseline muscle mass, and stress/recovery balance must be considered. But most adults, including those with obesity or sedentary habits, benefit from starting with micro-dose training.

• It builds confidence.

• It creates habitual consistency.

• It sets up a foundation for progressive overload later, without burnout.

Final Takeaway: 30 Minutes Per Week Can Preserve Muscle—If That’s the Goal

This isn’t about bulking up or maximizing hypertrophy.
This is about preserving lean tissue while losing fat—the cornerstone of long-term metabolic health.

For the average patient (or physician), 30 minutes of weekly strength training is the entry point to success. And when multiplied by consistency, it becomes a powerful longevity tool—especially in GLP-1-supported weight loss programs.

Let’s stop prescribing protocols no one can stick to.
Let’s start empowering people with realistic, research-backed strength plans that actually get done.

✅ Ready to Get Started?

Introducing my Beginner Strength Training Program — designed specifically for fat loss and muscle maintenance:

• 3 new 10-minute strength workouts released weekly

• 3 difficulty levels to meet you where you are

• No repeats — 52 weeks of progressive strength content

• Just 30 minutes per week to build consistency, confidence, and metabolic strength

👉 Join today and commit to 10 minutes, 3 times a week.
Let’s build sustainable muscle from the inside out.

Get All The Details Here

👉 Want to bring strength training in house to your practice or institution? I offer that too!
Learn More Here

We Have SO Many Ways to Support You

We’ve been thinking about you — and how many incredible ways we now have to support your growth, vitality, and fulfillment.

Whether you’re ready to transform your practice, prioritize your health, or reclaim your time and energy, we’ve got you covered. In fact, we thought it was the perfect time to put everything we offer in one place… so you can easily find the right next step for YOU.

Here’s how we can support you:

TRANSFORM® Coaching Program
A 12-month CME experience for physicians with a focus on mindset, metabolism, and muscles.
72 CME Credits

Nutrition Training & Obesity Prevention Program
Learn to confidently support patients with lifestyle-based obesity care, strength, and nutrition.
48 CME Credits

I.M.P.A.C.T. Curriculum
A full-circle leadership and wellness program rooted in identity, mission, and mindset.
72 CME Credits

Genetics Series
Personalized, precision-based coaching using your unique genetic blueprint.
Learn how your genes influence health, performance, and longevity.

ACGME-Aligned Nutrition CME for Physician Groups
Bring our proven, practical nutrition and strength curriculum to your residents or team.
Scalable training for institutional support

Clinical Strength Rx
A progressive strength training program designed specifically for practices, clinics, and hospital-based providers.
Backed by science, designed for clinics and institutions.

Berkshires Retreat (Live!) 2026
Reconnect, recharge, and reimagine what’s possible for your life and work.
12 CME Credits + luxury retreat experience.

Total Fitness Program
Year-long access to expert-designed workouts (includes our most successful programs).
Perfect for lasting results with minimal time commitment.

Beginner Strength Training
New to strength or getting back to it? This program is simple, doable, and effective.
Gentle entry into a lifelong habit.

Private Coaching
Work 1:1 to break through blocks, reconnect with your purpose, and create personalized action.
Intensive, individualized support.

Or, you can book a consult HERE

We’re here to walk beside you, wherever you are on your journey.

Let us know what resonates, or reply to this email and we’ll help you find the perfect fit!

With deep gratitude and excitement for what’s next,
Ali + The FIT Collective Team