Weight Loss Success: With or Without GLP-1

In this powerful conversation, Emily Sadri shares how she’s transforming the way women approach health in midlife. Emily is a double-board certified Women’s Health Nurse Practitioner and Certified Nurse Midwife, trained at the University of Pennsylvania. After years in conventional medicine, she grew frustrated with rushed appointments and care that didn’t truly support women. So, she founded Aurelia Health—a practice built on long visits, strong relationships, and personalized care.

Emily believes women don’t need more willpower—they need better support. She’s also a mom of four, juggling life and work like so many of the women she serves. In this Q&A, she talks about why weight loss in midlife is so hard, how hormones and stress play a bigger role than we think, and why true health starts with feeling seen and cared for.

Leslie: What brought you from conventional medicine to founding an integrative women’s health practice?

Emily: Like many people, the pandemic was a catalyst. I had been practicing in traditional medicine for years as a midwife and women’s health nurse practitioner. In 2021, I decided to open my own integrative practice—not necessarily focused on menopause or weight loss, but that's where the need brought me. Practically every woman walking into my office was in perimenopause or menopause and struggling with weight. And I realized quickly: the functional medicine tools I’d learned weren’t enough. The usual elimination diets didn’t address the root metabolic and hormonal imbalances so many women in this phase experience.

Leslie: What’s different about your approach to weight management in midlife women?

Emily: Most women have a long history with dieting—restriction, calorie counting, and guilt. We're a generation raised on processed snacks and watching our mothers diet. But that legacy, combined with hormonal changes in midlife, creates what I call “metabolic inflexibility”—your body holds onto fat, resists muscle building, and stops responding to caloric restriction. It's not a willpower problem. It’s physiological. My approach is about restoring metabolic health by addressing nutrient deficiencies, inflammation, hormone levels, stress, and more. It’s not just “eat less, move more.” That advice is outdated and often harmful.

Leslie: You mentioned stress and the nervous system a few times. How does that play into weight resistance?

Emily: It’s huge. Chronic stress puts the body into “sympathetic overdrive”—constantly on alert. That raises cortisol, keeps blood sugar high, and sends the signal to store fat. Even if you’re fasting or eating clean, your liver may still be dripping glucose into your bloodstream because it thinks you’re preparing to outrun a bear. I’ve seen women who spike blood sugar from just eating Brussels sprouts. That’s not because of poor choices—it’s stress physiology. We have to address the nervous system as much as the food.

Leslie: You’re a fan of GLP-1s, which are hotly debated. When and how do you use them?

Emily: I’m cautious but optimistic. I never set out to prescribe medications—I often try to get people off them—but GLP-1s can be a game-changer, especially in metabolically stuck women. That said, I never prescribe them casually. Every patient gets six months of high-touch support from my team, including dietitians and coaches. We also use compounded, low-dose formulations instead of commercial high-dose options like Wegovy or Zepbound. This reduces side effects and lets us personalize treatment. But again, medication is just one tool. It only works well in the context of lifestyle, nutrition, and care.

Leslie: There’s a lot of fear around compounded medications. What’s your view?

Emily: Yes, you need to use a reputable compounder. But to suggest compounded medications are inherently unsafe is inaccurate. In fact, traditional medication errors in hospitals are one of the leading causes of death. Compounding allows us to dose more appropriately, make medications affordable, and customize care. Banning them under pressure from pharmaceutical interests does a disservice to patients.

Leslie: What’s your foundational advice for women around nutrition, especially when on GLP-1s or trying to lose weight?

Emily: Focus on two things: protein and fiber. That’s it. If a woman can hit her protein and fiber targets—typically 90–140g of protein and 30–35g of fiber per day—so much else falls into place. It supports satiety, blood sugar regulation, muscle synthesis, and gut health. I don’t ask people to count calories. I ask them to track these two macros. We’re also big on hydration and eating lots of colors from plants. After that, you can personalize—maybe remove inflammatory foods or seed oils. But starting simple works.

Leslie: What’s your take on vegetarian or vegan diets during midlife?

Emily: It’s harder, not impossible. To meet protein needs with plants, you often have to consume significantly more calories and carbs. That can be tough if you’re trying to lose weight or manage inflammation. Plus, some essential amino acids like leucine, which is key for muscle growth, are very hard to get from plants alone. So while I respect plant-forward diets, I encourage midlife women to consider at least some high-quality animal protein if they can tolerate it.

Leslie: How do Eastern traditions or integrative practices shape your approach to care?

Emily: I love this question. While we don’t practice traditional Chinese medicine, we absolutely honor its philosophy—especially the role of energy and nervous system regulation. I always ask: is this person cold all the time because of thyroid dysfunction, or are they depleted from stress? Are they digestively weak and need warm, cooked foods instead of raw? Eastern perspectives remind us to treat the whole person, not just the labs. Sometimes what we recommend isn’t just a food or a supplement, it’s a change in how energy is managed.

Leslie: So many women say, “I know what to do, I just don’t do it.” How do you address that?

Emily: We carry so much blame. We think we’re lazy or undisciplined. But most of the time, it’s not about willpower—it’s about a lack of support, clarity, and aligned care. Many women I see are incredibly high-achieving, but they’re stuck because no one has actually given them a plan that works for their biology. It’s my job to take the mental load off and create a roadmap that feels doable—not punishing. Women need care, not criticism. That’s what leads to transformation.

Leslie: What’s your vision for women’s health?

Emily: I want women to stop feeling like their body is broken. I want them to feel empowered and safe. We need to shift from transactional, one-size-fits-all care to relationship-based, personalized medicine. Whether through better food, smarter medications, nervous system support, or just being heard—we can give women the tools to live long, strong, and vibrant lives. We don’t need to be frail grandmothers. We can be energetic, joyful, and thriving well into the later decades of life.

Leslie: Where can people find you and learn more about your work?

Emily: You can follow me on Instagram @EmilySadri_NP or visit aureliahealth.com for clinical services. I also publish a weekly newsletter that dives deep into hormone health, midlife wellness, and actionable tips. My goal is to help women be the CEO of their own health.