Confused About Weight, Hormones, PCOS and Nutrition? Here’s How to Actually Navigate Care
By Coven Women’s Health, featuring Dr. Michelle Jacobson OBGYN & Nishta Saxena RD
If you’ve ever stared at your algorithm and thought, “Okay… but what am I supposed to do?” — you’re not alone.
Women are being bombarded with advice right now: Cut carbs. Go keto. Fast in a tiny window. Take this probiotic. Wear a weighted vest 14 hours a day. “Just eat more protein.” Start a GLP-1. Don’t start a GLP-1. Take supplements. Don’t take supplements. Do it all, perfectly, forever.
And if you’re in perimenopause, menopause, or living with PCOS or insulin resistance, it can feel like your body changed the rules… and nobody gave you the updated playbook.
At Coven, we built our care model around one simple truth:
Women don’t need more noise. They need a map.
This post is that map. A way to navigate weight changes, hormones, PCOS, nutrition, and medications (including GLP-1s) without shame, hype, or guesswork.
Why This Feels So Hard Right Now (It’s Not You)
Here’s what we see every day: women aren’t failing. They’re being asked to navigate a system that wasn’t designed for them.
As Dr. Michelle Jacobson put it in our conversation with Registered Dietitian Nish:
In perimenopause and menopause, women often feel like “a forgotten person” — like healthcare and science have moved on without them.
Add the modern food environment (North America is… not France), the pressure to do it all while caring for everyone else, and a steady stream of “quick fixes,” and it’s no wonder women feel overwhelmed.
The desperation makes sense. It’s not weakness. It’s unmet needs.
The Coven POV: There’s No Unicorn Solution — There’s a Toolbox
In the episode, Nish describes GLP-1s as “a tool in the toolbox.” We apply that philosophy to everything:
nutrition
strength training
habit change
mindset support
medical care
medication when appropriate
No single tool works for every woman. And no tool works well in isolation.
Just like menopause hormone therapy isn’t a “magic solve” for every symptom, GLP-1s aren’t a magical unicorn drug either. They can help some women — when the risks are mitigated and the plan is built around the whole person.
That’s why Coven Women’s Health is multidisciplinary by design.
The Big Myth: “Just Do This One Thing”
Let’s bust the most common trap: believing there’s one rule that will finally make everything click.
Myth: “Cut carbs and you’ll fix it.”
Nish sees this constantly: Women eating “fat, vegetables, and protein” while serving their families pasta — and white-knuckling their way through meals.
Her point is simple and very Coven:
The pattern has to be livable. You are living your life in perimenopause. You’re not doing a six-week diet to become a 21-year-old version of yourself and then snapping back.
Myth: “Supplements will solve it.”
The supplement industry is loud right now. The promise is always the same: take this, and everything changes.
But real change doesn’t come from adding a powder to a life that’s already stretched thin.
Myth: “You need to do more.”
Often, women don’t need more tactics. They need better sequencing:
what matters first
what matters second
what actually fits your life
That’s navigation.
What Women Actually Want (And It Makes Sense)
Women come to Coven Women’s Health saying:
“I’m doing the same thing I’ve always done — and it’s not working anymore.”
“I don’t recognize my body.”
“I miss myself.”
“My doctor told me, ‘this is just it.’”
And yes — weight changes are often part of it. But the deeper goal is usually: I want to feel like me again.
With energy. Strength. Confidence. A brain that works. A body that doesn’t feel out of control.
That’s why our care doesn’t fixate on a number. We focus on outcomes that matter long-term:
metabolic health
lean muscle and bone strength
cardiovascular risk reduction
brain health
sustainable habits
food freedom (if that’s your goal)
Nish said it bluntly (and we agree):
”Women should worry more about heart disease than almost anything else — and lifestyle changes can protect your heart and your brain while also helping you feel better in your body.”
Why Multidisciplinary Care Matters (Especially Now)
This is the part most women haven’t been offered:
Your symptoms might look like “weight gain,” but the drivers can include:
insulin resistance
hormonal transition
sleep disruption
stress physiology
under-fueling or inconsistent fueling
loss of lean muscle over time
a food environment working against you
So at Coven, we don’t treat “weight” like a character flaw or a one-provider problem.
We built one-stop, collaborative care so women can access:
Registered Dietitian support (real science + real-life meal planning)
Health coaching (habit + boundaries + accountability)
Nurse practitioner / physician care (medical assessment and options)
Mental health support when needed (because food + body image are never just food)
Or as Nish put it: “It’s much more than apples and oranges.”
It’s mindset, boundaries, habits, and putting yourself first — without turning your life into a full-time optimization project.
Considering GLP-1s? Here’s the Coven Lens
GLP-1s can be a helpful tool for some women — but they come with:
nutritional risk
potential psychological risk
the reality that some weight loss will include lean tissue unless you actively protect muscle
So the Coven approach is:
Don’t get it out of a vending machine.
Don’t get it from “Joe.”
Don’t get it as a standalone plan.
If GLP-1s are part of your care, they should be paired with:
adequate protein and fueling strategy
strength training guidance
symptom + tolerance support
long-term transition planning
And for many women, the best first step isn’t a prescription — it’s understanding your baseline and building the foundation.
How to Start at Coven (A Simple Map)
You don’t need to know the “right” appointment. You just need a starting point.
If you’re considering GLP-1s (or already on one)
Start with nutrition strategy + risk mitigation so you protect muscle, energy, and long-term health.
Start here: Book a consult with Nish (Registered Dietitian) →
If weight changes are your main concern (especially midlife belly / metabolic shifts)
Start with metabolic + lifestyle assessment and a plan that’s sustainable.
Start here: Feel Powerful Weight Management
If PCOS or insulin resistance is part of your story
Start with nutrition + clinical context (PCOS is not “just hormones” and not “just food”).
Start here: Feel Powerful PCOS
If you feel overwhelmed, stuck, or unsure
Start with care navigation — because you shouldn’t have to self-diagnose to get help.
Start here: Expert Health Care Navigation
We Don’t Do Diets at Coven
We’re going to say this clearly, because it’s core to our voice:
We don’t diet at Coven.
There’s no temporary plan you suffer through to reach a destination and then abandon.
We build patterns you can live with — patterns that support:
your body now
your brain and heart long-term
your goals (whatever they are)
Some women want to be shredded. Some want food freedom. Some want stability and energy. Many want all of the above.
There’s a spectrum — and your care should reflect your goal, not someone else’s.
The Bottom Line: You Deserve a Map (Not More Noise)
If you’ve felt dismissed, confused, or like you’re “too old” to feel better — we want you to hear this:
It is your birthright to feel good.
And you don’t have to figure it out alone.
If nutrition, weight changes, PCOS, or GLP-1 questions are on your mind, a consult with Nish is one of the easiest, lowest-friction places to start — and from there, we’ll help you navigate what’s next.
→ Book a consult with Nish
and let’s build your plan with clarity, not chaos.
