Frequently Asked Questions
Everything you've been wondering about naturopathic care, hormonal health, and what working with Lisa actually looks like.
These are the questions Lisa hears most often from women in their 40s and 50s — women who are doing everything right and still not getting results. If your question isn't here, your free Health Clarity Call is the perfect place to ask it.
Why am I gaining weight in my 40s even though I'm eating less and exercising more?
Midlife weight gain is rarely about willpower. During perimenopause, fluctuating oestrogen influences how fat is stored, with research showing greater redistribution toward the abdominal area during the menopausal transition — even after accounting for ageing. The North American Menopause Society recognises central fat gain as a common feature of this stage.
Long-term dieting can also lower resting metabolic rate beyond what weight loss alone would predict — a well-documented phenomenon known as adaptive thermogenesis. Add chronic stress into the mix, and elevated cortisol is associated with increased visceral fat and insulin resistance.
"I've worked with many women in their 40s, and rarely is the issue that they're not doing enough. If anything, they're doing too much on too little. Midlife weight gain is usually your body sending signals — about stress, under-fuelling, or hormonal change. It's not a reflection of how hard you're trying." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
The key isn't more restriction — it's understanding which system needs support.
Is it worth seeing a naturopath if my GP says my tests are fine?
Standard medical testing is designed to detect diagnosable disease — and it does that very well. However, it may not always explain persistent symptoms such as fatigue, weight gain, brain fog, or sleep disruption.
Endocrine and metabolic guidelines recognise that "subclinical" patterns can exist, where laboratory markers sit within reference ranges but symptoms are present. For example, early thyroid dysfunction or insulin resistance can occur before diagnostic thresholds are reached. The Endocrine Society emphasises that laboratory findings should be interpreted alongside clinical symptoms, not in isolation.
"'My tests are normal' is one of the most common things women tell me when they first come to see me. But normal simply means there's no diagnosable disease. It doesn't mean everything is functioning at an optimal level. There's a lot of territory between 'fine' and 'thriving.'" — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
A naturopathic consultation focuses on identifying patterns across hormones, stress physiology, nutrition, and lifestyle — particularly during perimenopause — while continuing to work collaboratively with your GP when appropriate.
What does a naturopath do differently for weight loss?
Traditional weight loss advice often centres on calorie restriction and exercise. While energy balance matters, endocrine and menopause research recognises that hormonal changes, insulin sensitivity, stress physiology, sleep disruption, and muscle mass all influence how the body regulates weight — particularly during perimenopause.
Metabolic research also describes adaptive thermogenesis, where prolonged energy restriction can lower resting metabolic rate beyond what weight loss alone would predict. This helps explain why "eat less, move more" doesn't always produce sustainable results in midlife.
"When women come to see me about weight, we don't start with calories. We start with a different question: what is your body trying to tell you? Midlife weight gain is usually a signal — from your hormones, your stress system, your metabolism. It's not usually a maths problem." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
A naturopathic approach looks at each woman's individual drivers — hormones, stress, metabolism, nutrition — and builds a strategy around her physiology rather than against it.
Could perimenopause be causing my belly fat and fatigue?
Yes — and for many women in their 40s, it's one of the first signs that hormonal transition is underway.
Research across menopause and endocrine literature shows that during the menopausal transition, fat distribution often shifts toward the abdominal area. The North American Menopause Society recognises central fat gain as a common feature of this stage. Oestrogen plays a particularly significant role — fluctuations can affect insulin sensitivity, sleep regulation, and stress physiology. Sleep disruption alone has been associated with changes in appetite hormones and reduced insulin sensitivity.
"Belly fat and fatigue are two of the most common things women tell me they're experiencing in their 40s — and very often, it's not random. Perimenopause doesn't just affect your periods, it affects your metabolism. When oestrogen and progesterone fluctuate, it changes insulin sensitivity, sleep quality, and how your body stores fat. That's why these two symptoms so often show up together." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
Understanding which factors are driving the changes — whether hormones, sleep, stress physiology, or metabolism — is the first step toward supporting your body more effectively.
How do I know if my thyroid is underactive if my blood tests are "normal"?
Thyroid testing in conventional medicine is designed primarily to detect diagnosable thyroid disease. The most common screening test is TSH (thyroid-stimulating hormone), sometimes alongside free T4. These markers are highly reliable for detecting overt hypothyroidism or hyperthyroidism when interpreted within the full clinical context.
However, thyroid physiology is complex. Professional endocrine guidelines note that symptoms and laboratory values do not always align perfectly — particularly in early or subclinical stages of thyroid dysfunction.
"Many women come to see me saying their thyroid tests are normal, but they still feel exhausted, foggy, or stuck with weight gain. Normal doesn't always explain how you're feeling. Often only TSH, and sometimes T4, has been checked — and looking at a fuller thyroid panel can sometimes reveal patterns that help explain why symptoms are still present." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
In clinic, Lisa always runs a full thyroid panel to look at all the relationships between thyroid hormones together — giving a much clearer picture and allowing for more personalised support, while always collaborating with your GP or endocrinologist where medical treatment is needed.
Can stress and cortisol make weight loss much harder?
Chronic stress can make weight loss significantly more difficult — particularly during midlife. Cortisol is the body's primary stress hormone and plays an important role in regulating energy, blood sugar, and metabolism. When stress becomes prolonged, higher or more sustained cortisol exposure is linked in many studies with greater abdominal fat, changes in appetite regulation, and reduced insulin sensitivity.
Sleep disruption, which commonly accompanies chronic stress, can also influence hunger hormones such as leptin and ghrelin, further affecting appetite and energy regulation.
"Many women I see feel like they're doing everything right — eating well, exercising, trying to lose weight — but they're also exhausted and under constant pressure. When stress becomes chronic, your body's physiology tends to prioritise short-term survival and energy availability rather than fat loss, which can make losing weight much harder." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
Addressing stress physiology and its impact on sleep, appetite, and behaviour is often an important part of sustainable weight management.
Can naturopaths help with hormonal weight gain and fatigue?
Yes — many women experiencing hormonal weight gain and fatigue benefit from a more personalised, systems-based approach. During perimenopause, shifts in oestrogen and progesterone can influence insulin sensitivity, stress physiology, sleep quality, and fat distribution. The North American Menopause Society notes that hormonal changes around menopause contribute to shifts in body composition, including increased abdominal fat.
A naturopathic approach focuses on identifying the underlying drivers behind these symptoms — whether that relates to metabolic health, stress physiology, sleep disruption, thyroid function, or nutritional status — and supporting those systems alongside sustainable lifestyle strategies.
"Most of the women I work with aren't failing — their bodies are adapting. Hormonal weight gain and fatigue often improve when we stop treating weight as the problem and start looking at the systems underneath it. In my experience, women get the best results when we identify the main driver — whether that's insulin resistance, stress overload, perimenopause, thyroid function, or poor sleep — and then build the plan around that. Women often start feeling better before they even see the scales shift." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
When the underlying drivers are addressed, improvements in energy and wellbeing often appear before changes in body weight.
What actually happens in a naturopathy consultation for weight loss?
A naturopathy consultation for weight loss is about understanding the whole picture of your health — not just your diet or the number on the scales. Research shows that metabolism is shaped by multiple systems working together, and weight changes rarely have a single cause.
"When someone comes to see me about weight, the first thing I want to know is their story. We cover everything — hormones, stress, sleep, digestion, nutrition, health history — because weight changes rarely have a single cause. The plan we build comes from that picture, not from a generic template." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
From there, we may review or recommend relevant testing and develop a plan that includes targeted nutrition, lifestyle adjustments, and strategies tailored to your physiology and what your body actually needs right now.
How long does it take to see results with naturopathic treatment?
The timeline for results can vary depending on the underlying drivers behind your symptoms. Weight gain and fatigue during midlife are often influenced by several interconnected factors, including hormonal shifts, stress physiology, sleep quality, metabolic health, and nutritional status.
Research in lifestyle and metabolic medicine shows that improvements in areas such as sleep, blood sugar regulation, and energy levels can often begin to appear within weeks when supportive nutrition and lifestyle strategies are introduced. Body composition changes usually emerge over the following months.
"Results rarely happen overnight, but the body often responds faster than people expect once we start addressing the right drivers. Most women notice the early shifts in energy, sleep, or digestion first — and those early wins tell us we're on the right track. Sometimes though, this physiology has layers that need to be peeled away, and that can take a little more time. I always tell my clients — we sometimes need to play the long game to get lasting results." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
Health organisations such as the American College of Lifestyle Medicine recognise that sustainable metabolic improvements typically come through gradual, personalised lifestyle changes rather than rapid short-term interventions.
Will I have to take lots of supplements or change everything at once?
Not necessarily — and this is something Lisa is really mindful of in clinic. Starting with a few key priorities is almost always more effective than overhauling everything at once. Research in lifestyle and metabolic medicine backs this up, showing that gradual, targeted changes tend to produce better long-term results than trying to do too much too soon.
"One of the biggest things women worry about before coming to see me is that they'll walk out with a bag full of supplements and a complete life overhaul. In reality, my approach is quite the opposite. I always keep things simple, because overwhelm is only going to slow us down. We start by looking for the drivers behind your symptoms — because that's where the real work needs to begin. If supplements are recommended, I always explain exactly why and how they support what we're trying to address. A targeted supplement with a clear purpose is always going to be more valuable than a long list of things you're not sure you need." — Lisa Scarfo, BSc, Adv.Dip.Nat.Med
In practice, most plans evolve gradually — focusing on the changes that will make the biggest difference first.
The Best Next Step Is A Conversation.
Your Health Clarity Call is free, no-obligation, and the perfect place to ask anything that isn't covered here. Lisa will give you honest, personalised guidance — no pressure, just clarity.
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