Dear Eric: Like many women in perimenopause, when my hormones started getting out of whack, I gained about 25 pounds due to a sudden and uncontrollable hunger (estrogen helps moderate ghrelin, the hunger hormone). When I finally started hormone replacement therapy, I got the constant hunger and other issues back under control and worked hard to return to my normal weight.
People who see me now will often ask if I am “on medication” to lose weight. I know what they mean is GLP-1s, so I don’t want to say “yes,” but I also wouldn’t have been able to stop my weight from ballooning without hormonal therapy, so the answer isn’t really “no.”
I also had to be diligent about diet and exercise to get my weight back down once the uncontrollable hunger went away, and I don’t want to dismiss the hard work I had to do.
What’s a good way to answer this question without going into personal details with acquaintances?
– Perimenopause Questions
Dear Questions: A good place to start is by asking them in return, “why do you ask?” This can help divert people who are just being nosy and clarify the intention of others. Some may be seeking your advice about GLP-1s and so you can let them know that you don’t have the expertise they’re assuming. Others might be looking for diet and exercise advice.
You’re under no obligation to say anything about your own medical care or your body. So, while I understand the distinction you’re making about hormone replacement therapy being a helpful medical intervention, its primary purpose is not weight loss.
So, if someone is asking you about weight loss drugs, it’s fair to simply say “no.” If you feel compelled to elaborate, you can say, “there are a lot of factors that contributed to my weight gain and weight loss.” But, again, only if you want to. There’s no shame in any of this, but no one is required to go into detail about their own body.
Dear Eric: In the letter from “Feeling Guilty” I could hear the voices of all of my families. I’m a home hospice nurse, and anyone who has had to place a family member in a setting other than home feels this exact same way.
One option that I would recommend for FG to explore would be group homes in their area. A group home is a private home that is set up for people like the letter writer’s mother to live, where caregivers are there 24/7 to manage medications, cook, clean, assist with personal care, et cetera. The cost is usually a little less than an assisted-living facility, and they are bound by the same licensure and care standards as any ALF.
FG can find a list of these places from the local aging services division or services like A Place For Mom. The homes work with all outside care providers like home health or hospice.
The most important part of choosing a home is going and touring them; the vibe is very individual and very important. Mom definitely needs to be in on the tours so that she can get the feel of them.
Be aware that most group homes have a significant population of seniors with dementia; it helps to know that going in, because it can explain the behaviors that you will see there. They also do not have the same roster of activities for the residents; this may be a factor for FG and their mom.
– Hospice Nurse
Dear Nurse: Thank you for this very comprehensive recommendation.
Dear Eric: “Feeling Guilty” was suffering with her mother’s unhappiness in assisted living. Your advice to work with mom’s care team and primary care doctor was totally correct. But I’d also spend some time at the facility getting to know the other residents to verify whether they are generally feeling happy and safe. Getting to know the care team is also truly helpful. You may learn that mom is putting on a show for the family and is fine with everyone else. Perhaps relocating mom to another facility would be prudent if she’s truly miserable.
I’d also suggest that reframing her thoughts might be healthy for Guilty.
Making the hard decisions is, unfortunately, a part of the role of a caregiver. Guilt kind of goes with the territory. She should give herself a hug, remind herself that she’s doing what’s best for mom and learn to turn off the voices making her second guess everything.
– Caregiver Sympathy
Dear Sympathy: The suggestion of getting to know the facility is a good one. While the mother is grieving a loss of autonomy, it’s important for the caregiving daughter to make sure that the care she’s receiving is of the quality she expects.
(Send questions to R. Eric Thomas at eric@askingeric.com or P.O. Box 22474, Philadelphia, PA 19110. Follow him on Instagram and sign up for his weekly newsletter at rericthomas.com.)
