The Power in Motion Podcast

Understanding Insulin Resistance in Perimenopause with Kate Williams Stone

• Kim Hagle • Episode 130

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 Insulin resistance in perimenopause is a term that's been buzzing in health circles lately. 

On this episode we welcome back Kate Williams Stone, a health and life coach for women in perimenopause to teach us about this phenomenon which she calls “metabolic inflexibility”.

While often blamed on weight, the truth is insulin resistance affects people of all sizes, and there’s lots that can be done to support good blood sugar and insulin balance with simple health supporting habits.

Tune in while Kate breaks down what insulin resistance means, the potential causes, and shares some actionable strategies  for better health management.

About Our Guest

Kate Williams Stone (she/her)  is a non diet health and life coach who helps women in perimenopause build confidence around food and feel good in your body so that they can feel amazing without the diet culture BS.

She uses the principles of Intuitive Eating coupled with hormone honoring health habits as a powerful way to support women through the challenges of perimenopause. Her signature framework includes: Mindful Eating, cyclical living, normalizing body changes with feminist non diet mindset coaching. 

Originally trained at the Health Coach Institute,  she completed additional Intuitive Eating training with Evelyn Tribole (co-creator of Intuitive Eating) and Stephanie Dodier (Going Beyond the Food Method). She is also a graduate of Carnegie Mellon University from the prestigious Drama program (B.F.A). 

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Grab Kate’s Free Guide to Perimenopause

About the Host

Kim Hagle (she/her)  is a Size Inclusive Fitness Specialist,  Non-Diet Nutritionist,  and certified Health and Life Coach specializing in body image.   

She is passionate about helping women develop a trusting and respectful relationship with their body so they can feel healthy, happy and confident while leaving  food rules, torturous exercise and body dissatisfaction behind and confidently create their best life - right now!

Offering cognitive behavioural coaching and weight neutral personal training, Kim supports her clients to feel their very best, both IN and ABOUT their body.

Want to learn how to support your body without obsessing over the scale?  Register for our FREE mini course. Learn simple, sustainable habits and mindset shifts so you can feel healthy, energetic and confident without rules, deprivation or willpower

Ready to take the next step? Visit our website to learn about how we can work together  

Let’s stay in touch! Kim is on Instagram, Facebook, TikTok, YouTube and LinkedIn @radiantvitalitywellness.  

Disclaimer.  The information contained in this podcast is for informational purposes only and is not a substitute for medical advice.  Always consult a health care professional about your unique needs.

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Hey, and welcome back to the Power in Motion podcast. If you've been following the podcast for the last few months, you'll know that I've been really digging into this theme of health at every size. I've had so many wonderful, knowledgeable experts on the show with a wide variety of expertise who've all in their own way detailed how weight and health are not the same thing. And in fact, how focusing on weight alone actually prevents people from achieving their health goals in the long term and how weight stigma prevents people from accessing the health support they need. Now, you'll also know the reason why I brought this theme forward and sought out all these experts was because I had an experience at the end of last year where my health problems were dismissed and my weight gain was focused on as the cause of all my problems when really it was a symptom of the illness I had. And that experience was so embarrassing, shameful, and, uh, Honestly, it just pissed me off so much, especially when the advice I received was just blatantly wrong. My weight was not to blame for my health problems, and I was able to resolve the issue by focusing on health supporting habits without losing a single pound. Which is great, and I'm so happy about that, and it just solidified what I already know. That we're really barking up the wrong tree with making things all about weight all the time. Which is not to say that I'm against weight loss. I mean bodies change all the time. Sometimes they get bigger, sometimes smaller, sometimes they stay the same. And it's true that sometimes when we implement health supporting habits, Weight is lost, and that's fine. What I'm against is this whole paradigm that everything begins and ends with weight. And that people are given different treatment plans based on their BMI. And that people feel afraid to seek medical care because they know their issues will just be blamed on their size. I never want anyone to feel the way that I did at that doctor's visit. And everyone deserves to know the truth, that there is so much that we can do to support our health through our habits, and that those things really do make a difference, even if the number on the scale doesn't change. Back a guest who's been on the show before, my good friend and colleague Kate Stone, who's a health and life coach for women in perimenopause. And, ironically, she's also experienced weight stigma at the doctor's office, which she'll share about in the interview. I invited Kate on to talk specifically about the topic of insulin resistance, which is the condition that I had, although I don't think I actually had it, which I'll explain in this interview, but that was the condition that was blamed on my weight. It's something that a lot of women experience during midlife, as our hormones and bodies change, and Kate has a really great perspective on this. She has a wonderful and compassionate way of explaining it, and also how we can support our blood sugar and insulin balance with simple health supporting habits. It's such an important episode to listen to if you're at this stage of life, and really a breath of fresh air compared to all of the cut carbs to lose your minnow belly BS that you read everywhere else. You're actually gonna walk away from this episode with some tangible tips that you can use. So, a little bit about Kate. Kate Williams Stone is a non diet health and life coach who helps women in perimenopause build confidence around food and feel good in their body so that they can feel amazing without the diet culture BS. She uses the principles of intuitive eating coupled with hormone honouring health habits as a powerful way to support women through the challenges of perimenopause. Her signature framework includes mindful eating, cyclical living, normalizing body changes with feminist non diet mindset coaching. Now I got so excited interviewing Kate that I forgot to have her tell us where you can find her, so I'll do that now. She's on Instagram at Kate W Stone and she shares great content over there. Her reels are so clever, so go give her a follow. And she also has a free guide to perimenopause that you can grab on her website at www. KateWilliamsStone. com slash guide. And all of that is in the show notes as well. All right, let's jump in.

Kim:

Kate, welcome back to the Power in Motion podcast. It's so nice to have you here again. Thanks Kim. I'm excited to be here. I am too. And I'm really eager to get into this conversation about insulin resistance because I think that it's a buzzword these days. It's something we're hearing a lot about and particularly women of our age group, you know, who are also experiencing perimenopause. This is something that's quite common. And I know when I was, when I was told I was insulin resistant, there was a lot of confusion, a lot I didn't know about it, that I had to go looking for. So I'm really glad to have this conversation with you and to help shed some light on this topic for our listeners who might be just as confused as I was.

Kate:

Sounds good.

Kim:

Yeah. Okay. So I know you've been on the show in the past, but can you just give our listeners a quick little rundown about who you are and what you do and how you came to be doing the work that you do?

Kate:

Sure. So my name's Kate Williams Stone. I'm a certified health and life coach who focuses in perimenopause. So what I help women do is calm that mental chatter around the symptoms of perimenopause. So you can, like, stop wondering what the heck is going on with my body and start feeling energized and calm. There's so much, um, lack of support, lack of information around this time of life. And so I want to be an advocate and a support for my fellow women who are going through perimenopause, that it doesn't have to be scary. You shouldn't be wondering, is this normal? Is this not normal? Is something wrong with me? Do I have a brain disease? Right? Like, we should know what's going on with our bodies and our emotions during this time. And, I came to do this work because I experienced my own weight stigma in the medical system related to my own health challenges. So I first experienced, uh, perimenopause symptoms of heavy bleeding and periods and cramps. and extreme fatigue. And I went to my doctor asking, like, could this be perimenopause? And she's like, no, you're 42. You're too young. And dismissed me. But what she did bring up was that I had gained 10 pounds during COVID lockdown.

Kim:

So

Kate:

I got, uh, you know, a hyper focus on this weight gain, no blood drawn. And what she missed was I did have uterine fibroids and iron deficiency going on that was causing those extreme symptoms. And so, uh, I navigated my way through the healthcare system to find a solution that worked for me, but no woman should have to go through that feeling of being dismissed or, Oh, you're so silly for bringing this up so early. You're too young. Why should you know what's going on with your body? You know?

Kim:

Mm hmm. And then the shame of your body has changed and it's all your fault, right? I have experienced this. I'm sure so many of our listeners have too. We've have lots of episodes, if you go through my directory, about weight stigma and how it's just such a default for our problems to be blamed on our weight. And we're not about that. I'm on a mission to Educate so people know that it's not what's at the root of these things most of the time, right?

Kate:

Yeah,

Kim:

so let's talk about insulin resistance and the reason I invited you on the podcast. Can I share a personal story for a moment was because back in December when I had my experience with getting diagnosed with fibromyalgia, I had all my blood work drawn, right, because fibromyalgia is a, is a diagnosis of omission. They check everything and rule everything out, and once there's nothing else they can find, they say it's fibromyalgia. So that was the case for me, except that there was one little marker in my blood work, which was my A1c, which for those who don't know what that number is, it's the average of your blood sugar over the last three months. So it was a little bit elevated. I was told I had pre diabetes and that I was insulin resistant. And I said, well, why? Because, like, I think I eat relatively healthy. I move my body. Like, why on earth could this be happening to me? And he said, well, you've gained a lot of weight since I saw you last. Which, the last recorded weight he had for me was when I was at the height of my disordered eating and exercise days. So yeah, I had gained a lot. Um, and he said, you know, the fat cells on your body are no longer able to take up the insulin and, you know, if you don't do something about this, if you don't lose weight, you're going to get diabetes. And I left that office so ashamed, first of all, and, and really, like, scared, because I don't want to get type 2 diabetes. And starting to wonder if, like, oh my god, have I been misinforming people? Like, is this health at every size stuff actually true? Like, I started to question everything that I knew. So, I, I did some of my research, my own research, and I looked into this and realized there are some other things that can be affecting our blood glucose and our insulin levels, and I wanted to talk to another Health at Every Size professional about this to set the record straight. So, all of that to say, can you tell us what insulin resistance is, first of all, and, and then we'll get into the different causes and things like that.

Kate:

Yeah, sure. So this term insulin resistance, what it means is that it's a condition where the cells are not as responsive to insulin as they used to be. And so that increases your insulin levels in the body. And just to refresh everyone, insulin is the hormone from the pancreas that helps bring glucose. from the bloodstream into the cells that provides our body with energy, right? So we need that energy. and so under normal circumstances, you know, you eat food, which is, which Is glucose or sugar, which is your body's main source of energy. The glucose enters the bloodstream, which signals to your pancreas to release that insulin. And then the insulin helps glucose in your blood, enter your muscle, your fat, your liver cells. So they can use it for energy or store it for later use. So what happens is that, um, you know, our insulin becomes less responsive, right? This is this insulin resistance term, which actually like, to me, when I hear insulin resistance is like nails on a chalkboard to me, I hate that term. Um, so I like to use the term metabolically inflexible. I know it's just a language thing, but you also know how powerful language is. Do I ever. Right? And that's not a term I created. I borrowed it from somebody, but when I heard it, I was like, ah, I'd so much be in, rather be inflexible than resistant.

Kim:

Yeah. Yeah. Right. I agree with you. Cause the resistant makes it sound like Your body's broken, right? It's almost sounds like you're rejecting like when I resist a theory, it's like I'm rejecting that. I don't want it. So it's like my cells are saying, I don't want the insulin anymore. Go away. Right? Like,

Kate:

yeah, which is not what's happening. It's that the insulin is just not as responsive as it once was. And so when you look at all of the aging processes. that go on in the body, like there's a lot of things that start slowing down as we age. And so this is just another one that starts slowing down. So it's just not as responsive as maybe your insulin levels were 10, 20 years ago. But it's not that your body is rejecting insulin or it's broken in some way.

Kim:

Yeah. Yeah. Or that you have, like I was told, you have too much fat on your body that can't, uh, can't absorb the insulin.

Kate:

Yeah. And I think that's a great time to, a good time to make this point that this insulin resistance or metabolic inflexibility, um, there's lots of different causes and it happens in different body shapes and sizes. So it's not related to. body

Kim:

size. Hmm. So someone who's in a thin body can become insulin resistant too. Absolutely.

Kate:

Absolutely. And I see this in perimenopause because insulin is a hunger hormone. And we tend to think of our hormones working in silos, like sex hormones and hunger hormones and stress hormones. And like, they're all separate, but they all interact. In the body together, so as we see our sex hormones like estrogen and progesterone and testosterone, those levels fluctuate that also has an impact on our insulin levels.

Kim:

So what I hear you saying is that insulin resistance or metabolic inflexibility. Happens to all people. It happens to people of all sizes and shapes and it tends to be more common for women in this age group because our hormones are doing all kinds of wild and wacky things. So with that said, like, what can we do to help support our body? And besides Losing weight because that's the only advice that I was offered at my doctor's office was lose weight and I was like, well, how would you like me to do that? Exactly. Without Retriggering my, my disordered eating and exercise habits like, and that was the whole Ozempic conversation. That's another podcast. But how can we support these fluctuating hormones and to help our body be more efficient, more receptive to insulin without just focusing on the number on the scale?

Kate:

Yeah. So it's a great question. I think this is where we lean into health promoting behaviors, right? Focusing on what we can control rather than an outcome, like a number on the scale. And so I like to talk about Hormone honoring habits, right? Those are those health promoting habits that support hormone health and stability. And so there are things like, eating at regular time intervals, right? Is really important. And if you're familiar with gentle nutrition, these things are that I'm going to list will be like, Oh yeah, I know how to do that with gentle nutrition. So just taking extra care and focus around some of these hormone honoring habits. So eating at regular timed intervals so that our blood sugar levels aren't on a big roller coaster going up and down and up and down, not skipping meals. Yes. Right? That can be a setup for another kind of rollercoaster, right? That binge restrict cycle, which also has a huge impact on your blood sugar levels. And then when you are eating, I think bringing some extra focus to food combining for stable blood sugar levels. And this is a really. Like easy and practical way to support your blood sugar. So say you're going to have some crackers, like a handful of crackers. Well, instead of just having that handful of crackers alone, how can you add some protein and fat to that carbohydrate for blood sugar balance? So like adding some cheese. to the crackers would be a great example. Or, um, if you're having some cereal, instead of just having cereal, could you add some, um, Greek yogurt, which is high in protein to it, right? So really thinking about how can I food combine a carbohydrate with some fat or protein to give it some staying power with my blood sugar levels, right? Which is. really gentle nutrition.

Kim:

Absolutely. Absolutely. And makes a big difference. And I love how your approach is about adding in, right? You get so much of what we read, especially in perimenopause is about cutting out. cutting out carbohydrates, cutting out sugar, reducing your portions, blah, blah, blah, blah, but no, you need, you still need carbohydrates. They're a great source of energy. They're really good for your brain, right? Which tends to be a little foggy at this time of life, right? So adding in some protein and fat and fiber to help those carbohydrates balance out your blood sugar is a really great habit.

Kate:

Yeah, and what I frequently see women in midlife doing is they're so busy and stressed and taking care of other people That they're frequently skipping meals or not eating on a regular meal schedule schedule. It's come as you can. I'll get a meal when I can, when there's a break. And sometimes they're waiting all day to eat and then they're overeating or binging. And so how can you really prioritize your own health in keeping things really, really stable? in your nutrition.

Kim:

Yes, absolutely. And I love how you also mentioned how we tend to be so busy and so stressed because those are also things that can affect our hormone levels and affect our blood sugar, right? So time there's lots we can do with our food and movement choices that affect our blood sugar. But what else lifestyle wise can help us like think outside of the food and exercise box to help keep our blood sugar stable.

Kate:

Yeah. So the other thing, stress management, right? What's in your toolbox that supports your mood and your stress, right? So for different people, it's different things, but for me, like a yoga practice and understanding cognitive behavioral coaching has just been like mind blowing, right? Understanding how my brain affects My mood and my thoughts and my habits has been a game changer along with a mindfulness practice. For me, it's yoga, but you know, it could be Tai Chi. It could be walking in the woods. It could be laying down and reading a book. Like, how do you calm down your mind, get into that, you know, parasympathetic, like nervous system response? How do you calm yourself down? And midlife is a great time to just. Fill your toolbox with some extra stress management tools.

Kim:

Absolutely. Absolutely, right? That rest and digest state of the parasympathetic nervous system is so, so important, right? Like, our body doesn't work well when we're in fight and flight. And that, you know, and especially at this age, right? So like being, being able to manage our stress and calm ourself down allows everything to work that much better. Sleep factors in too. Yeah. Let's talk about sleep. Cause sleep.

Kate:

So, I mean, first of all, just a moment of grace for all the women suffering from, um, night sweats, hot flashes. I know sleep can be hard to come by. So like you do the best you can, but this is a time to really prioritize your sleep because that is when our body has a time to rest and repair. And so it's so, so critical. It's also feeds into that stress management piece and also hunger cravings. Yeah. Like we all know when we are sleep deprived, we are more hungry. The cravings are more intense. The mood swings are bigger. So midlife is really a time to prioritize at least eight hours of sleep. It's okay to lean to like nine or 10. And I know there are sleep disturbances, right? Those 3 a. m. wake ups. It's waking up drenched in sweat, like, yes, those things happen, um, but just as much as you can make it a priority. It doesn't have to be perfect, but yeah, I've become a big fan

Kim:

of weekend napping and it's not something I've never been a napper in my life. But I'm really embracing the habit now because yeah, my weekday sleep. It's it's not great, right? I try my best. I really really do but there's not an opportunity during the week to kind of catch up But I make sure that I prioritize that on the weekend and I feel no shame about it. I love it. Love

Kate:

it Great. That's great. So yeah, all of those habits are gonna interact together to affect our insulin levels, right? So it's not just a food and exercise thing. It's also a stress management and a sleep thing. And there are simple things you can do to stabilize blood sugar levels.

Kim:

Yeah. And I can, back to my personal example, I can testify to that because I practice gentle nutrition. I eat a fairly well balanced diet and I'm. moving my body on a pretty consistent basis. What I was lacking was the stress management and actually like pain was the big factor for me, like, uh, unmanaged pain. I, in my research, I discovered can have an impact on our blood sugar and insulin levels. And once I received medication to address my pain and I became even that much more disciplined about my sleep and stress management, I set some firm boundaries. I got clear on my values and like, started saying no to things that didn't align. My A1c came right back in the normal range by the time that I visited my doctor three months later. I made no changes to my diet, no changes to my exercise, and my weight actually increased by two pounds when I saw him at my follow up. So, you know, it's just all these other things really do have an impact on our hormones. Some things we can control and some things we can't, right? Like, we can do everything right and not necessarily. Be able to control our hormones, but there is lots that we can do.

Kate:

Yeah. My concern for women is that like another woman would be in the doctor's office with that experience that you had, Kim, with some elevated a one C's and a prescription to, to lose weight, but not a way to do it in a sustainable way. And. You know, what we were taught to lose weight is like high cardio, high impact for long periods of time and make those meals as small as possible. And what

Kim:

happens when we do that, Kate?

Kate:

So glad you

Kim:

brought this up.

Kate:

Well, I mean, it affects your mood. It affects your sleep. It affects your energy levels. And stress hormones,

Kim:

right?

Kate:

Stress to the max, to the max. And sure, you might lose weight. For a short period of time, but I know it's not sustainable. And I know, you know, it's not sustainable in the long term. And that's why I'm a non diet practitioner at this time of life, because I'm like, I know that's what we were taught. And it takes so much work to undo that thinking of like, more is better. Harder is better. Smaller meals are better, but there's actually for your hormone health. That is a recipe for disaster. Absolutely. That is the worst thing you can do. And for your sex hormones too. Um, it's the worst thing you can do instead. What for hormone health, it's actually about like more rest, more relaxation, more activation of the parasympathetic nervous system, a little bit more fat and protein in the diet, which, you know, if you were raised in the low fat craze, you're like, what do you mean? More fat. Yeah, that's a little bit scary, you know, so this is a time to like undo all of the diet culture programming that we were taught. It's not our fault, you know, like we're not wrong for thinking this, but it's also a chance to like approach health from a new perspective.

Kim:

Absolutely. Absolutely. And what worked, and I use work very cautiously, what worked in our 20s and 30s is not gonna work at this stage of life. Right? Like, especially like, as far as exercise goes, long periods of high intensity cardio, like, Anything you read about exercise during midlife will tell you that is not what you should be doing. Right? Yeah. Strength training, heavier loads, shorter bursts of gentle cardio. Like it's, it's about scaling back and prioritizing like what really matters, which is like keeping your, your bones strong and healthy.

Kate:

You brought up a great point, Kim, because I hear this phrase a lot of like, what used to work doesn't work anymore. What used to work in my twenties doesn't work in my forties. And I think that's actually a great example of this metabolic inflexibility. Uh huh, uh huh. As your insulin is less responsive, you can't quote unquote get away with what you used to be able to get away with, right? So it feels as if like, oh, those things worked, but it was actually that your body's system was just a little bit more efficient at that time. Mm

Kim:

hmm. Yep. So it's not that it, it's not that it ever really worked and it's not that it's not working now, right? It's just, our hormones don't let us get away with it.

Kate:

Yeah, right. It's because it you're less flexible, right? You can't get away with get away with as much, right? The physical body is not as forgiving or as pliable I see it as a call up to like, okay., how are you going to take care of yourself even more? How are you going to prioritize your health and well being in this time? And while it can feel really uncomfortable and unnerving, some of these body changes and like, Oh, I'm just not operating the same way I used to. Like it, it does a number to the mind for sure. But it is a call up to like, okay, so then how are you going to

Kim:

respond?

Kate:

Yeah. Yeah.

Kim:

Yeah. How am I going to work with this body instead of fighting against it? Yeah, I love that. It's been such a great conversation. Is there anything else that you feel is pertinent to add to this before we sign off for the day?

Kate:

I just want to remind people, it is a myth that insulin resistance is caused by weight or body size. I think that's really important to know. There are lots of causes, um, of this phenomenon. It's also very fixable. through habit change and lifestyle change, which we've talked about today. Um, there are other impacts to insulin resistance that can be genetic or medications, right? So we didn't get into that today, but there's other things to explore in your holistic health that could be

Kim:

impacting. Yeah, nothing exists in isolation, right? There's so many things that can affect another thing in our body. So there's lots of possible causes. There's lots of possible outcomes. And yes, there's lots that we can do to support our body. And like we said, sometimes it works great, and sometimes it doesn't. But that's what medication is for, right? Like, I guess what I would add to the conversation is, it's not your fault. It's not your body's fault. And There's lots that can be done, whether through lifestyle changes or medically, to get your body working most efficiently. Yeah. I love that. Well, Kate, this has been a really enlightening conversation. I always love having you on the podcast and Oh, I always love talking to you. Same, same. And I hope we'll have you back here again one day. Thanks so much for sharing your time and your expertise today. Thank you.

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