Advertise on podcast: High on Life

In this episode, I’m joined by Dr. Ariel Dalfen, a psychiatrist and women’s mental health specialist, to explore the intersection of reproductive hormones, mental health, body image, eating disorders, and metabolic health.We talk about why reproductive transitions—from the menstrual cycle to pregnancy, postpartum, perimenopause and menopause—can be particularly vulnerable times for mental health, and how clinicians can distinguish expected changes from symptoms that warrant treatment.We also discuss:- PMDD: what it is, how it differs from PMS, and why tracking symptoms across the menstrual cycle can be so helpful - Mental health during perimenopause and menopause, including anxiety, depression, sleep disruption and emotional dysregulation - How a history of PMDD, postpartum mental health concerns, or other psychiatric illness may influence risk during the menopause transition - When menopause hormone therapy, psychiatric medication, or a combination may be appropriate - How we should consider weight gain and metabolic health when choosing psychiatric medications -The significant impact of menopause on body image and the risk of eating disorder relapse - The growing pressure around food, exercise, protein, and body composition—and when healthy behaviours can become obsessive - What we know, and what we still don't know, about the relationship between GLP-1 medications and mental health - Why individualized, multidisciplinary care matters so much in women's mental health Most importantly, we talk about the importance of listening to women, taking their symptoms seriously, and looking at the whole person rather than reducing complex experiences to either "just hormones" or a psychiatric diagnosis. Dr. Dalfen is the CEO and co-founder of BRIA, a virtual women's mental health and hormone clinic. She is also an Assistant Professor of Psychiatry at the University of Toronto and previously led the perinatal mental health program at Mount Sinai Hospital in Toronto. Learn more about BRIA at betterbria.com and BRIA Academy at briaacademy.com.Follow BRIA on instagram: @bria.health

Why does staying on track with weight loss often feel so much easier during the week, only to become more challenging once Friday afternoon rolls around?In this episode, Tedi Glik, RD will break down what the “weekend effect” is, and how the way we approach food from Friday through Sunday can influence overall weight-loss progress. With more social events, meals out, brunches, alcohol, and time with family and friends, the weekend naturally looks different—but that doesn’t mean it needs to become a completely different eating pattern.We will talk about planning for indulgences rather than thinking in terms of “cheat meals.” The goal isn’t to eliminate the foods you enjoy, but to be more intentional about which foods and experiences are actually worth it to you. Whether that’s a favorite dessert, a croissant, or a glass of wine with friends, there’s a way to incorporate enjoyable foods while still building meals that are satisfying and supportive of your goals.We will also explore some of the thoughts that can drive weekend eating, including “I’ve been good all week, so I deserve to enjoy myself,” “I don’t want to think about food on the weekend,” and “I’ll just start again on Monday.” Sometimes the biggest shift isn’t changing what we eat, but changing the way we think about the weekend. Planning doesn’t have to mean restriction—it can actually create more freedom by reducing the number of food decisions you have to make.Ultimately, you don’t need to choose between losing weight and enjoying your life. The goal is to learn how to do both, and make your weekend part of the plan!MEDICAL PROGRAM FOR OBESITYO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Health & Consistency Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guideFOLLOW SASHAInstagramhttps://www.instagram.com/sashahighmd/

What happens after you’ve lost the weight you wanted to lose?In this episode, I’m looking at what we actually know about maintaining weight loss with GLP-1–based medications. The evidence so far suggests that for most people, continuing treatment at the dose that produced their weight loss provides the best chance of maintaining that weight loss and its associated health benefits.But what if staying on the same dose isn’t possible because of side effects, cost, access, or personal preference?I break down what we’re learning from SURMOUNT-MAINTAIN and ATTAIN-MAINTAIN, including evidence that reducing tirzepatide to a lower dose or switching from injectable semaglutide or tirzepatide to oral orforglipron can preserve substantially more of the weight loss achieved than stopping treatment altogether.We still have important questions about tapering, extending dosing intervals, and whether some people can eventually come off treatment successfully. But for now, the evidence suggests that if we need to reduce treatment intensity, maintaining some active treatment may be a much better strategy than simply stopping and waiting to see what happens.Ultimately, maintenance is about finding the level of treatment that allows an individual to maintain the health benefits they’ve achieved—while recognizing that for many people with chronic obesity, ongoing treatment at their effective dose will be necessary.MEDICAL PROGRAM FOR OBESITYO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Health & Consistency Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey.https://www.sashahighmd.com/podcast-guideFOLLOW SASHAInstagram - https://www.instagram.com/sashahighmd/

In this episode, I sit down with Dr. Tasneem Sajwani, Medical Director of the Edmonton Weight Management Centre, for a behind-the-scenes look at the world of obesity medicine. We discuss how she found her passion for this field, the challenges and rewards of building a successful obesity medicine clinic, and the key elements that drive long-term patient success.We also explore the critical role of allied health professionals, lessons learned from years in practice, and practical clinical pearls that patients can apply to their own health journeys. Whether you're a healthcare professional or someone interested in understanding obesity treatment more deeply, this conversation offers valuable insights into the science, systems, and support that make effective obesity care possible.Find Dr. Tasneem Sajwani’s practice in Edmonton, Alberta, here: https://www.ewmc.info/Find Dr. Sasha High’s practice in Ontario here: www.highmetabolicclinic.com

Significant weight loss can be life-changing for your health—but it can also lead to changes in facial volume, skin laxity, and the way we see ourselves in the mirror. In this episode, I’m joined by dermatologist Dr. Kucy Pon to unpack what happens to the face after significant weight loss, including weight loss associated with GLP-1 medications. We discuss why these changes are a result of weight loss itself—not a toxicity of the medication—and why age, genetics, skin quality, and the speed and amount of weight loss can all play a role. We also explore what can be done to support skin quality and facial volume, including skincare, nutrition and resistance training, as well as aesthetic options such as hyaluronic acid fillers and biostimulators like Sculptra® and Restylane®. As part of today’s episode, we also discuss Sculpt and Lift by Sculptra® and Restylane®, and how these treatments may be used as complementary approaches to address different aspects of facial volume loss and skin quality. Most importantly, we talk about the importance of individualized assessment, realistic expectations, choosing an experienced, medically trained injector, and remembering that aesthetic treatment is entirely optional. My biggest takeaway: improving your health and wanting to feel good about how you look are not competing priorities. We pursue obesity treatment for health and longevity, but it’s completely okay to want your outward appearance to reflect how vibrant and healthy you feel inside. Please speak with your trusted injector to discuss Sculptra and Restylane’s safety profiles. Learn more at galdermaaesthetics.com/ca or @aestheticsbygalderma.ca Sculptra® Canadian Instructions for Use July 2022. Restylane® LyftTM Canadian Instructions for Use February 2024 Thank you to Galderma for sponsoring this episode.

Feeling like your metabolism is “broken” can be frustrating, especially when you’re eating well and exercising but not seeing the results you expect. In this episode, Tedi Glik, RD, MPH, breaks down three common factors that can make sustainable weight loss more challenging—and what you can do about them.In This Episode We Will Explore: - How fad diets are working against you: Aggressive calorie restriction can increase hunger and cravings and make long-term weight management more difficult.- Why sleep is essential: Poor sleep can affect hunger, cravings, movement, recovery, and your ability to stick with healthy habits.- How to protect your muscle: The importance of focusing on preserving as much lean muscle as possible.- Looking beyond the scale: How body composition can provide a more meaningful picture of your progress than body weight alone. WORK WITH USOntario-Wide Virtual Obesity Management ClinicJoin my Weight Loss Coaching Program for women, Best WeightRecover Strong for Binge EatingTaking the first step toward weight loss can feel overwhelming—but you don’t have to do it alone. I’ve created a curated list of podcast episodes to gently guide you as you begin your journey. Explore the Podcast GuideFOLLOW SASHAInstagram

Summer can make healthy eating feel more challenging, but you don’t need to be perfect to stay on track. In this episode, Tedi Glik, RD, MPH, shares practical strategies for navigating unexpected meals, social pressure, cravings, and all-or-nothing thinking.In This Episode- Have a Plan B: Keep easy protein-rich snacks on hand to prevent getting overly hungry when your schedule changes.- Practice the pivot: When plans change, ask, “What’s the next best decision I can make from here?”- Build balanced meals: Think vegetables + protein + carbohydrate rather than trying to eliminate certain foods.- Handle cravings: You can want more of a highly palatable food without automatically having more. Pause and check in with your hunger and fullness.- Navigate food pushers: You can appreciate someone’s food without accepting another serving. - - Let go of judgment: Make food choices based on what you actually want—not what you think others expect you to eat.- Avoid all-or-nothing thinking: There’s a middle ground between eating perfectly and giving up. Your Summer TakeawayYou don’t need to be perfect. Plan when you can, pivot when you can’t, and don’t turn one meal into a reason to give up.You can enjoy your summer and continue working toward your goals.WORK WITH USO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guideFOLLOW SASHAInstagram - https://www.instagram.com/sashahighmd/

Summer brings travel, restaurants, BBQs, cottage weekends, and more social eating—which can make weight loss feel impossible.In This EpisodeWe cover practical strategies to:- Plan ahead: Map out your week and anticipate social meals.- Stay consistent: Keep your usual protein-rich meals and snacks on non-social days.- Navigate restaurants: Check menus ahead of time and have a few go-to balanced options.- Move beyond "cheat meals": Enjoy pizza, dessert, or other foods without the "I've blown it" mentality.- Aim for B+ work: Focus on consistency rather than nutritional perfection.- Be intentional with alcohol: Plan when and how much you want to drink.- Limit everyday culprits: Pay attention to added sugars and highly processed foods that may not keep you satisfied.The Mindset ShiftInstead of: "How do I stay on my diet this summer?"Ask: "How can I make choices that support my health while still enjoying my summer?"You don't need to choose between making progress and living your life. You can travel, eat out, enjoy dessert, and spend time with family and friends—all while building sustainable habits.WORK USO​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guideFOLLOW SASHAInstagramhttps://www.instagram.com/sashahighmd/RESOURCESNames for sugar on your food label:https://www.healthline.com/nutrition/56-different-names-for-sugarEpisode 139. Reconsidering Alcohol:https://www.sashahighmd.com/podcasts/the-obesity-doctor-podcast/episodes/214898613

Do GLP-1 medications affect bone health?GLP-1 medications have transformed obesity treatment, but they've also sparked important questions about bone health, bone density, and fracture risk.In this episode, I’m joined by obesity medicine specialist Dr. Sandra Cortina to unpack what the current evidence actually shows about bone health during GLP-1 therapy. We separate evidence from headlines and explore how clinicians and patients can make informed decisions while balancing the substantial benefits of GLP-1 therapy with potential risks. This is a nuanced, evidence-based conversation for anyone interested in the science of obesity treatment.Find Dr. Cortina:Instagram @cortinaweightmedicineWebsitewww.cortinaweightmedicine.ca in British Columbia, CanadaHome Exercises Referenced by Dr. Cortina:https://www.youtube.com/@silversneakers

You're eating healthy, exercising, and doing everything you think you should, but the scale isn't moving. So what's going on?In this episode, we explore the five most common reasons weight loss stalls, including hidden calorie intake, chronic under-fueling, metabolic adaptation, and lifestyle factors like sleep, stress, and movement. You'll learn why your body isn't broken and how building consistent, sustainable habits is the key to long-term success.In This Episode- Why healthy eating doesn't always lead to weight loss- The difference between overeating and under-fueling- How chronic dieting can affect your metabolism- The importance of protein, balanced meals, and consistency- Why sleep, stress, strength training, and patience matterMentioned in This Episode- Episode 170: Why Eating 1,200 Calories Is Working Against You: https://www.sashahighmd.com/podcasts/the-obesity-doctor-podcast/episodes/2149162617 - Resting Metabolic Rate (RMR) Calculator:https://www.calculator.net/bmr-calculator.htmlWork With Us:O​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

Menopause is something every woman will experience, yet many still feel confused, dismissed, or overwhelmed when symptoms begin. In this conversation, I’m joined by Dr. Sheila Wijayasinghe to unpack the realities of perimenopause, menopause, and hormone therapy in a practical, evidence-based way.We talk about what the menopause transition actually looks like, why symptoms can begin years before periods stop, and why so many women are told their labs are “normal” even when they don’t feel normal. We also break down some of the biggest misconceptions around hormone therapy, including safety concerns, breast cancer risk, cardiovascular risk, and whether bloodwork is actually useful in making a diagnosis.In this conversation, we cover:- The difference between perimenopause and menopause- Early symptoms women may notice in their 40s- Whether hormone testing is necessary- What menopausal hormone therapy (MHT) is and who may benefit- The difference between regulated bioidentical hormones and compounded products- How hormone therapy may impact sleep, mood, bone health, urogenital symptoms, and brain fog - Non-hormonal approaches to symptom management- How women can advocate for themselves if they feel dismissed in healthcare settingsMy hope is that this episode helps bring clarity to a stage of life that still carries so much confusion and misinformation, and that women walk away feeling more informed and empowered to make decisions about their health.Links & ResourcesYou can follow Dr. Sheila Wijayasinghe on Instagram at @drsheilaw and check out the Doc Talk Podcast for more evidence-based health conversations.Menopause Management Resource from the Centre for Effective Practicehttps://cep.health/clinical-products/menopause-management/Menopause Symptom Trackerhttps://menopausefoundationcanada.ca/resources/menopause-symptoms/

I’m joined by Dr. Lauren Colenso-Semple to unpack the rapidly growing world of wellness peptides — from BPC-157 and CJC-1295 to Ipamorelin, Tesamorelin, NAD, and the so-called “fat-burning” and “healing” peptides taking over social media. We discuss what peptides actually are, why they’ve become so popular, and how legitimate medical therapies have blurred into a largely unregulated wellness industry.We also break down the claims being made about popular peptides marketed for fat loss, recovery, anti-aging, and performance enhancement, while taking a closer look at what evidence truly exists (and what doesn’t). Dr. Lauren shares important insight into the safety concerns, marketing tactics, and cultural obsession with optimization that are fueling this trend online.If you’ve been curious about peptides or wondering whether the internet hype matches the science, this episode will help you think more critically before jumping on the trend.Check out Dr. Lauren Colenso-Semple’s work here: https://www.drlaurencs.com/

In Part 2 of this series, we're diving into the practical nutrition strategies that can help you feel your best while taking medications like Ozempic, Mounjaro, and Zepbound.From constipation and digestive changes to hitting your protein goals with a low appetite, this episode focuses on the habits that support long-term success and help you maintain your results. We'll cover:• Why constipation is so common on GLP-1 medications and how to prevent it• How to reach your protein goals when you get full quickly• What to do when protein foods don't sound appealing• How GLP-1 medications change hunger and fullness cues• What to expect if you need to temporarily stop your medicationGLP-1 medications can be powerful tools, but they work best when paired with the right nutrition and lifestyle habits. Learning how to fuel your body, support digestion, and adapt to your changing appetite is key to protecting your health while achieving sustainable weight loss.WORK WITH US:O​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

In this episode, Dr. Neil Naik and I unpack a foundational question—is obesity actually linked to cancer, and what’s really driving that connection? We explore the underlying biology, from chronic inflammation and insulin resistance to the hormonal activity of adipose tissue, and why visceral fat may matter more than we think.We then move beyond risk and into what happens after a diagnosis—how obesity can influence treatment response, toxicity, dosing, and outcomes across chemotherapy, surgery, and radiation. The conversation also highlights the often-overlooked phase of survivorship, including the role of metabolic health in recurrence risk and long-term prognosis.We close by discussing where emerging therapies like GLP-1 medications fit, how clinicians can move beyond BMI toward more individualized care, and how to talk about the obesity–cancer connection in a way that informs without adding shame.My Guest Dr. Neil NaikDr. Neil Naik, a family physician, educator, and innovator based in Waterloo, Ontario. Trained at the Royal College of Surgeons in Ireland, he completed residencies in Newfoundland and Nunavut and holds an Executive MBA from Ivey, where he focused on technology-driven healthcare innovation. He runs a Family Practice and an obesity medicine clinic in Waterloo, along with an AI-enabled skin cancer screening program, while teaching medical students at both McMaster University and the University of Waterloo.Dr. Naik advises startups, leads regional primary care and cancer prevention initiatives, and champions universal healthcare, leveraging AI to make safe, high-quality care accessible to everyone, everywhere.LinkedIn: https://www.linkedin.com/in/neil-naik/

GLP-1 medications like Ozempic, Mounjaro, and Zepbound are changing the conversation around obesity and weight loss — but there’s one major problem: most people are starting these medications with little to no guidance on how to properly nourish their body while taking them.And that matters.Because while GLP-1s can be incredibly effective tools for weight loss, they can also lead to muscle loss, under-eating, fatigue, nausea, hair loss, and long-term metabolic issues when nutrition is neglected.In today’s episode, I’m breaking down the biggest nutrition mistakes people make on GLP-1 medications — and exactly how to protect your metabolism, preserve muscle, maintain energy, and build sustainable habits while losing weight.We’ll cover:- Why protein becomes non-negotiable on GLP-1 medications- How much protein you actually need- The hidden dangers of under-eating- Why rapid weight loss can harm your metabolism- How to preserve muscle while losing fat- The critical role of strength training- What to do if you have no appetite- Tips for nausea and food aversions- How to create sustainable eating habits while on GLP-1s- Rebuilding a healthier relationship with foodThis episode is especially important if you’ve ever thought:“I’m barely eating… so why do I feel exhausted?”“Why am I losing muscle instead of just fat?”“How do I hit my protein goals when I’m never hungry?”GLP-1 medications are not magic — but when combined with proper nutrition and lifestyle support, they can become powerful tools for long-term health.If you’re currently taking a GLP-1 medication, considering one, or supporting someone who is, this episode is a must-listen.And if you’re looking for support along your journey, Dr. Sasha High and I would love to welcome you into our women’s coaching program, Best Weight, where we openly discuss treatment options like GLP-1 medications and help women build sustainable, healthy weight loss habits together. WORK WITH US:O​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedTaking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guideFOLLOW SASHAInstagramhttps://www.instagram.com/sashahighmd/ADDITIONAL RESOURCES:BMI CalculatorBasal Metabolic Rate Calculator(BMR) REFERENCES:Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. https://doi.org/10.3390/nu11051136 McCarthy, D., & Berg, A. (2021). Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients, 13(7), 2473. https://doi.org/10.3390/nu13072473 Scott Butsch, W., Sulo, S., Chang, A. T., Kim, J. A., Kerr, K. W., Williams, D. R., Hegazi, R., Panchalingam, T., Goates, S., & Heymsfield, S. B. (2025). Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study. Obesity pillars, 15, 100186. https://doi.org/10.1016/j.obpill.2025.100186