CASE STUDY: Anna's Path Through Perimenopause, Weight and Energy Management With GLP-1

The Challenge: The "Invisible" Weight Gain

At 45, Anna felt like her body had become a stranger. Despite maintaining the same diet and exercise routine that had worked for a decade, she had gained 9kg over the last three years, primarily around her midsection.

Like many perimenopausal women, Anna experienced a combination of overlapping factors:

• Hormonal shifts: fluctuating oestrogen levels linked to insulin resistance and a slower metabolism.
• The GLP-1 gap: while her GLP-1 prescription successfully suppressed her appetite, she felt "skinny-fat," losing weight but also feeling weaker, more fatigued, and noticing a visible loss of muscle tone.
• Confidence crisis: the physical changes were affecting her self-esteem and daily energy levels.

IN SHORT
This illustrative case shows how testing-informed nutrition, alongside GLP-1 treatment, can help protect muscle mass and support energy during perimenopause-related weight changes.

The vivaBALANCE Approach: Precision Over Guesswork

Anna didn't need another generic calorie-controlled diet. She needed to understand her own biochemistry. Through vivaBIOME and vivaMETABOLITE testing, specific markers holding her back were identified:

1. Metabolic markers: testing revealed that while the GLP-1 was managing her glucose, her protein intake was low, putting her at higher risk for sarcopenia (age-related muscle loss).
2. Micronutrient status: low levels of vitamin D and magnesium were linked to her afternoon energy crashes and poor sleep quality.
3. Hormonal context: identifying her stage of perimenopausal transition informed a more targeted approach to supporting her broader hormonal picture.

The Plan: Structured, Simple Support

Alongside her GLP-1 treatment, Anna followed a structured nutrient plan designed to protect her lean mass and support her mood.

• Muscle-sparing nutrition: a higher-protein framework (around 1.6g per kg of body weight, a range commonly supported in sports nutrition literature) to help ensure the weight lost was more fat than muscle.
• Targeted supplementation:
  • Whey or plant protein isolate, for easy, high-bioavailability protein.
  • Magnesium glycinate, linked to improved sleep and muscle recovery.
  • Omega-3 fatty acids, linked to reduced low-grade inflammation, common during perimenopause.
• Resistance training: a shift in focus from cardio toward strength, with two 30-minute resistance sessions per week.

The Illustrative Outcome

After 12 weeks following this approach, the scenario illustrates change beyond the scale alone:

Swipe table to view more info.

Marker	Before	After
Weight	+9kg (baseline)	-7kg (gradual loss)
Body composition	Higher body fat %	Increased muscle definition
Energy levels	Afternoon slump	More consistent through the day
Confidence	Avoided mirrors	Felt stronger, more at ease

"For the first time in years, I don't just feel smaller. I feel stronger. The GLP-1 started the process, but the testing gave me a clearer picture of what my body actually needed to feel like myself again."

— Anna (illustrative scenario)

Conclusion

This scenario illustrates a broader point: GLP-1 medications are powerful tools, and they may be more effective when paired with testing-informed nutrition insights. Addressing the specific needs of the perimenopausal body is one way to support against muscle loss during weight loss, alongside working closely with a healthcare provider.

Understand what your own biology needs
A vivaINSIGHT test combines vivaBIOME and vivaMETABOLITE to show your own metabolic and nutrient markers. vivaBALANCE 360 retests at 4 and 9 months to track change over time.

vivaLAB's services are designed to support health optimisation and are not a substitute for medical advice. Consult a qualified health practitioner for individual health decisions, including any changes to medication or supplementation.