In conversation with clinical nutritionist Elly McLean
There is a particular kind of silence that surrounds women’s health.
Not the absence of information, but the presence of too much of it, and the ensuing confusion. Conflicting advice. Contradictory narratives. A growing sense that something is changing in the body, without a clear language to describe it.
For many women, this begins somewhere in their mid-thirties. Energy shifts. Moods swing. Sleep becomes fragmented. Weight changes—often suddenly, often inexplicably. Appetite feels different. What once worked, no longer does.
We call it perimenopause. But more often than not, it goes unnamed.
“There’s a gap,” says clinical nutritionist Elly McLean. “Most of the women I see are 35 and over, and they’re coming in with symptoms they don’t fully understand—and haven’t been properly supported through.”
What sits beneath these symptoms, she explains, is something far more foundational: metabolic health.
Metabolic Health: The System Beneath the Symptoms
Metabolic health is not a trend. It’s not a protocol. It’s the underlying system that governs how our body uses, stores, and produces energy.
“When someone is metabolically healthy,” Elly explains, “many of the symptoms we associate with perimenopause—weight gain, poor energy, appetite dysregulation—begin to improve.”
And yet, most women don’t arrive at her clinic asking about metabolism. They come in describing what they can feel:
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Weight gain, particularly around the midsection
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Changes in hunger and satiety
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Fatigue tied to food or blood sugar fluctuations
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Brain fog, poor sleep, reduced resilience
These are not isolated issues. They are signals.
Through blood testing—looking at markers like fasting glucose, insulin, HBA1C, inflammatory markers, alongside thyroid and reproductive hormones—Elly builds a picture of what’s happening beneath the surface.
In her experience, the vast majority of women show signs of compromised metabolic health. Not because they’ve done anything wrong—but because the system has shifted, and no one has shown them how to adapt.
Why Women Are Undersupported
Part of the problem is historical. For nearly two decades, following the early 2000s Women’s Health Initiative, hormone therapy was widely discouraged. As a result, an entire generation of clinicians were not trained in the nuances of perimenopause and menopause care.
Only recently has this begun to change.
But for many women currently moving through this stage, the support simply isn’t there yet.
Instead, they’re left to self-diagnose. To trial and error. To “eat less, move more.”
“I often hear women say they waited six to twelve months before seeking help,” Elly says. “They thought they should be able to fix it on their own.”
And when those efforts don’t work, the next wave of solutions appears.
GLP-1s: Tools, Not Solutions
Few topics in wellness are more charged right now than GLP-1 medications.
Originally developed for type 2 diabetes and obesity, drugs like Ozempic, Wegovy, and Mounjaro are now widely used for weight loss—often framed as a breakthrough, a shortcut, or even a cure.
But the reality is more complex.
“GLP-1s can be incredibly useful,” Elly says. “But they are one tool. Not the solution.”
In her practice, only a small percentage of clients are currently using them. For those who do, it’s typically within a very specific context—where inflammation and metabolic dysfunction have created a cycle that is difficult to break through lifestyle interventions alone.
Even then, the work doesn’t stop. It begins.
Because while GLP-1s suppress appetite, they do not inherently improve metabolic health. And without the right support, they can create new problems.
The Muscle Loss Problem
One of the most significant risks associated with GLP-1 use is unintended muscle loss.
When appetite is suppressed, calorie intake often drops—sometimes dramatically. And without sufficient protein intake and resistance training, the body begins to lose lean muscle mass.
This matters because muscle is metabolically active tissue.
It plays a critical role in maintaining metabolic rate. In regulating blood sugar. In supporting long-term health.
“When clients lose weight without protecting muscle,” Elly explains, “their metabolic rate drops. And then they have to keep eating less and less to maintain that weight.”
It becomes a downward spiral.
To counter this, she works closely with clients to:
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Prioritise resistance training
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Monitor body composition (not just weight)
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Maintain adequate protein intake
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Track changes in fat vs lean tissue
The goal is not just weight loss—but metabolic resilience.
The Role of Supplements: Support, Not Substitution
In a landscape driven by quick fixes, supplements are often positioned as solutions. But as Elly makes clear, they are not.
“People want a pill for everything,” she says. “But supplements are there to support the foundation—not replace it.”
That foundation is built through:
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Nutrition
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Movement
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Sleep
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Nervous system regulation
Only then do supplements become effective.
In her work with perimenopausal women, a few foundational supports often emerge:
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Magnesium blends (with glycine and taurine) for sleep, recovery, and resilience
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Creatine for cognitive function and muscle support
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Soy isoflavones, which act as selective estrogen receptor modulators and have strong evidence for reducing hot flushes and supporting bone and cardiovascular health
Beyond this, protocols become highly individualised—based on blood work, symptoms, and personal history.
There is no universal stack. Only the right support, at the right time.
Moving Beyond Extremes
The modern wellness industry often swings between two poles.
At one end: “just eat well and move your body.”
At the other: hyper-optimisation, biohacking, expensive testing, endless protocols.
Elly sits somewhere in the middle.
“Yes, simple changes alone aren’t always enough,” she says. “But you also don’t need the most extreme or expensive interventions to see meaningful results.”
In many cases, relatively accessible testing—combined with targeted nutrition, lifestyle adjustments, and appropriate supplementation—is enough to shift the trajectory.
The work is not about doing everything. It’s about doing what matters.
A New Framework
If there is one message Elly hopes more women understand, it is this:
Metabolic health is not separate from hormonal health. It is foundational to it.
Without it, the likelihood of experiencing more severe perimenopausal symptoms—and longer-term health issues such as cardiovascular disease or certain cancers—increases significantly.
And yet, this conversation is still not mainstream.
Which is why it matters.
Because when women understand what’s happening in their bodies—not just at a surface level, but systemically—they can make different decisions.
More informed ones. More supportive ones. More sustainable ones.
Perimenopause is not a problem to be fixed. It is a transition to be supported.
GLP-1s are not the enemy. Nor are they the answer.
Supplements are not shortcuts. They are tools.
And metabolic health is not optional. It is the foundation.
This is a space we are continually interested in exploring—not just what works, but why. Not just the product, but the system it supports.
Elly works with women around the world to analyse their symptoms and pathology, and craft a plan to heal their metabolism and address peri-menopausal, menopausal and post-menopausal symptoms.
Free Masterclass: Weight Loss in the GLP-1 Era
How to protect your muscle, preserve your metabolism, and keep the weight off
March 31st, 12.30pm AEDT
Register: https://www.nutritionelly.com/event-details/test-weight-loss-in-the-glp-1-era/form