22: Reclaiming Your Body in Midlife with Dr. Caissa Troutman
Ep. 22
"I always felt like I was broken. I always felt that there was something wrong with me and I should have more willpower."
If this thought has ever crossed your mind as you've watched the scale creep up despite your best efforts, you're not alone. Dr. Caissa Troutman, quadruple board-certified physician and founder of Midlife reMDy, speaks these words from both professional expertise and personal experience—and her insights are revolutionizing how we understand midlife weight changes.
In a culture obsessed with the "calories in, calories out" model, women in perimenopause and menopause are told that weight gain is simply a matter of eating less and moving more. But what if everything we've been taught about midlife weight management is fundamentally flawed?
Listen to the full episode:
The "Willpower" Myth That's Keeping Women Stuck
For decades, we've been sold the same simple formula: calories in, calories out. Eat less, move more. It's mathematically perfect, which makes it feel logical and achievable. But here's the problem: when this approach inevitably fails, we blame ourselves instead of questioning the model.
The truth is, this oversimplified approach completely ignores what's actually happening in our bodies during perimenopause and menopause. We're not broken. The system we've been using is broken.
The Perfect Storm: What Really Happens to Your Body in Midlife
Midlife creates the perfect storm for metabolic changes. Multiple biological systems shift simultaneously, creating a cascade of hormonal disruption that has nothing to do with your character or discipline.
The Four Hormones Controlling Your Weight
While we often focus on estrogen, progesterone, and testosterone, there are four metabolic hormones that directly control weight management:
Ghrelin - signals hunger
Leptin - signals fullness
Insulin - manages blood sugar
Cortisol - responds to stress
When estrogen levels decline during perimenopause and menopause, it doesn't just affect our reproductive system—it fundamentally disrupts how these metabolic hormones communicate with each other.
The Body Composition Shift
You've probably noticed that weight doesn't just increase, it redistributes. Instead of gaining weight in our hips and thighs like we did when we were younger, it now settles around our midsection. This isn't just a cosmetic change; it's a metabolic one.
Central adiposity drives insulin resistance, creating a cycle that makes traditional weight loss approaches increasingly ineffective. It's not that we're doing something wrong—our bodies are literally responding differently than they used to.
The Missing Piece: Sleep, Stress, and Energy
Here's what no one tells you: when you're sleep-deprived from hot flashes, exhausted from juggling work and family, and dealing with joint pain that makes exercise uncomfortable, your body responds by holding onto weight. It's a survival mechanism.
We're often managing our careers, caring for aging parents, supporting teenagers, and dealing with our own physical changes—all while being told we just need more willpower. It's no wonder we feel defeated.
But we have to remember that weight loss isn't natural. We're literally fighting biology. Instead of beating ourselves up for not having enough willpower, we need to arm ourselves with tools that work with our changing bodies, not against them.
This means addressing the real culprits: the hormonal disruptions, the sleep issues, the stress responses, and yes, sometimes the need for medical intervention.
The Four Pillars That Actually Work
A comprehensive approach to midlife health needs to address:
Mindset - Shifting from shame to understanding the science behind what's happening
Movement - Finding physical activity that works with our energy levels and joint health
Meals - Eating in a way that supports our changing metabolism
Medication - When appropriate, using tools that address the biological dysregulation
Hormone Therapy: Not a Magic Bullet, But a Foundation
Let me be clear: hormone therapy isn't a weight loss medication. But when it helps you sleep better, reduces hot flashes, and improves your energy, suddenly you have the foundation to make the lifestyle changes that actually work.
When you're not exhausted and fighting your body every step of the way, eating well and moving your body becomes possible again.
Redefining Success Beyond the Scale
Most of the time, that arbitrary number on the scale represents something deeper—wanting to feel confident in photos, having energy to keep up with family, or being able to do activities you love without feeling winded.
What if you weighed 10 pounds more than your "goal weight" but felt strong, energetic, and confident? Would that actually be a failure?
When you dig deeper into what you really want, it's rarely about the number itself. It's about feeling comfortable in your own skin, having the stamina to live fully, and not avoiding mirrors or photos. These goals are achievable regardless of what the scale says.
A Compassionate Path Forward
As women, we are so used to having our symptoms dismissed and being blamed for biological changes beyond our control. Too many of us have been told to "just eat less and move more" without any acknowledgment of the complex hormonal shifts happening in our bodies.
But you deserve better. You deserve to be heard, understood, and supported through this transition.
The path forward isn't about restriction, shame, or forcing your body into submission. It's about understanding what's actually happening, addressing the underlying biology, and approaching your health with compassion.
This might mean:
Working with healthcare providers who understand hormonal health
Prioritizing sleep and stress management alongside nutrition and exercise
Considering hormone therapy if you're a candidate
Focusing on how you feel rather than just what you weigh
Building sustainable habits instead of following extreme diets
Midlife isn't about fighting your body—it's about learning to work with it. Your body isn't betraying you; it's responding to significant biological changes that require a different approach than what worked in your twenties and thirties.
The sooner we stop blaming ourselves and start addressing the real culprits—hormonal disruption, sleep issues, stress, and metabolic changes—the sooner we can start feeling like ourselves again.
You're not broken. You're not lacking willpower. You're navigating one of the most significant biological transitions of your life, and you deserve support, understanding, and science-based solutions that actually work.
About Dr. Caissa Troutman
The insights I've shared come from my conversation with Dr. Caissa Troutman, a physician who truly understands this journey from both sides of the exam room. What makes her different isn't just her credentials—it's that she's walked this path herself.
Dr. Troutman is the Physician Founder of Midlife reMDy/WEIGHT reMDy in central Pennsylvania. As a quadruple board-certified physician specializing in both Obesity Medicine and Menopause, she offers her signature 4M Pillar Foundation Plan (mindset, movement, meals, and medication) with a refreshingly honest, "no-judgment, no-gaslighting" approach.
Understanding the journey firsthand as someone navigating perimenopause herself, she brings both professional expertise and personal empathy to helping women reclaim their health during midlife.
Ready to Work With Your Body, Not Against It?
If you're in central Pennsylvania and ready for compassionate, science-based care, learn more at weightremdy.com or find her on Facebook.