Episode Transcript
Dr. Lindsey Henderson:
When we talk about weight, it’s not about the number. I honestly hate the BMI scale. I really wish we could get rid of it. It is not an accurate judgment.
Courtney Collen (announcer):
Welcome to “Her Kind of Healthy,” an informative and unfiltered podcast series by Sanford Health. We want to start new and honest conversations about age-old topics, from fertility to postpartum, and so much more with our Sanford Health experts.
In this episode, we’ll hear from Dr. Lindsey Henderson who specializes in family medicine and weight loss management at Sanford Health in Bismarck, North Dakota. We recorded her speaking during a Sanford Women’s event on Oct. 23, 2025 in Bismarck. It was called the Women’s Social where Dr. Henderson joined other Sanford Health providers on stage to discuss popular women’s health topics.
Here’s Dr. Henderson on weight loss medications.
Dr. Lindsey Henderson:
I think it’s fair to say if we all really thought about it, the majority of us have thought about our weight, probably judged ourself, weighed ourself, or thought about how our clothes fit, at least in the last week, if not in the last day. Weight has a significant impact on us and a lot of times all through our lives. When I talk with patients, I’ll have people tell me, like, “My mom put me on a diet when I was seven.” And those are things that really affect us long-term that we always think about.
So it’s been nice that there’s been more investigation and study into weight, and we now know it’s a chronic medical condition. It’s not a personal failure. Weight is something that we can’t necessarily help. There’s so many factors that influence our weight, our genetics, our metabolism, our hormones, our behavior, our environment.
So, when we think about treating it, it’s important that we look at all those things and not just tell somebody, “Hey, you should eat less and you should exercise more” because that’s not what it is. When we think about weight, I think it’s important to know goals should also be realistic. We are not how we were 20 years ago or 30 years ago or 40 or who we are now. And so meeting ourselves where we maybe could be now and not where we were when we were 22 because we’re not the same.
Our hormones have changed. We’ve had babies. We age. Age is the biggest factor with weight and we tend to get that deposition, the mid abdomen and that’s not something that somebody did. It’s just the way our bodies age. So it’s really important we look at all the different parts. We kind of look at four different pillars is what we call them when we talk about weight and when we’re trying to treat it.
So, behavior and mood is a big, big factor. You know, are we emotional eating? Is our mood controlled? Because that can really affect how we feel. Another one is diet, activity, and then medications are there and they’re great to use when they’re appropriate. But it’s important that we combine all of those things together.
BMI is an inaccurate measurement for many people
The other thing is when we talk about weight, it’s not about the number. I honestly hate the BMI scale. I really wish we could get rid of it. It is not an accurate judgment, and we don’t all fit the same mold. Our bodies are very, very different and it’s OK that they’re different. So somebody may lose five pounds but you know, maybe they’re moving easier and their clothes fit better and their mood is better and their cholesterol came down. That’s a win. It doesn’t matter if you lost 20 or you lost five or you lost a hundred.
Like it’s about how we make ourselves feel and how we feel in general. So I think it’s really important to have those realistic goals when we talk about weight and realize where we are. Medication, I absolutely will talk about medication. Obviously they’re all over right now. I could probably tell you if I got a dollar for every time I saw a TikTok picture, I would be rich because people bring them to me all the time and be like, I want to try this.
So those injection medications have gotten a lot of press because honestly they tend to work pretty well, but they’re not the only thing in our arsenal that we do have to use. Honestly, phentermine, one of the most commonly used medications still has been around since 1959 is still probably the most widely used medication that’s there. So there are oral medications as well as those injections medications that really are appropriate to use.
Photo by Sanford Health
But it’s important to talk to your provider to make sure they are fits for you because not everyone is OK for every medication. Just to kind of delve into the injections a little bit more because they have gotten so much press, so there’s three on the market right now.
Weight loss involves four pillars: medication is one
The first one that came out actually came out quite a while ago and we really don’t tend to use it. It’s called Saxenda. It was a daily medication and while it can work, it doesn’t work nearly as well as the kind of newer ones that have come out.
Wegovy and then Zepbound are the two main medications that are kind of all over, and they’re good medications. It is incredible to have somebody come back and tell me how they feel on them because it really helps with appetite and fullness. But I think the number one thing people like is it helps with that food noise, that kind of constant, “oh, what am I going to eat next? Where’s my next snack? You know, maybe I should grab this.” It really helps quiet that down.
But as much as these medications are good, I do have a little bit of a love-hate relationship with them. They’re not perfect. They also really need to be used appropriately. And that’s one thing is with weight in general and even as we age, we lose a lot of muscle mass and especially with these medications, we can lose a ton of muscle mass. So it’s really important that when you’re losing weight, whether with an injection or anything else that we’re working to do it in a good way that’s healthy for our bodies.
The other thing with these medications is they aren’t a short-term fix. Studies have come out that really show they are more indicated for long-term. If you stop them quickly, your weight will come back. The longer you’re on them, the better chance you have. But really it is a commitment. So it’s not just a short-term fix with these medications and making sure we use them appropriately is really one of the keys.
And of course cost. I mean we can’t forget the cost. The cost of them is atrocious. Hopefully over time that will eventually improve. But really for right now, the cost is probably one of our biggest factors with using these medications.
Behavior, diet, activity support long-term weight loss
But outside of medication, we do have to look at diet. And I know diet is like a bad term, right? It’s like eat less, starvation. But really the best diet is one you can sustain. Really working on like whole foods, lean meats, I think we talked about lots of vegetables, high fiber, and it really can help maintain our fullness and also help with maintaining our muscle mass as we’re working on a healthy lifestyle in general.
Looking at what we drink each day, you know, our water intake, do we drink a lot of other things? How often do we go out to eat? No one is perfect and no one should be perfect. We all have to have our good days, right? And that’s OK, but we always have to look at a broader picture of that and make sure that we still enjoy life. What we eat should not be something that is the center of our day all the time. It should just be part of what we do each day, but not the center of it.
Activity is usually kind of a dirty word, but really activity is one of the most important things, especially because of that muscle mass. But I think the most important thing is that we need to start with where you’re at, not where you think you should be.
Long-term goals are around 150 minutes a week of an organized activity that includes cardio as well as weight. But that doesn’t mean we need to get there tomorrow. If we are more of a sedentary person, it is OK if two times a week for five minutes. If you do an online video, fantastic, cause at least we’re getting it into our habits and we’re building those and we can progress from there. If you’re more of a cardio person, you know what? Pull out the weights. Maybe we can start with five minutes of weights twice a week.
Weight is considered a chronic medical condition
But it’s those small changes that are really important because then when we build those habits, we can continue those habits. They’re the hardest thing to do. It takes the time and that’s why activity’s usually the hardest because we’re exhausted. Our mental load is huge, but it is worth it to do it for yourself.
And I think that’s one thing is we probably aren’t good at taking time for ourselves, but that doesn’t mean we shouldn’t, and it doesn’t mean we can’t. It’s just trying to learn to do that as we go. So I probably have taken more time than I should, but I think it’s really important to remember that the goals of weight are different for everyone and our successes are different for everyone. But I think it’s important to also support each other in that because it’s not easy and it’s definitely work and it’s always a constant thing and that’s why we treat it as a chronic medical condition – because it is one.
Courtney Collen:
This was part of the “Her Kind of Healthy” podcast series by Sanford Health. For more by Sanford Health, visit Apple, Spotify and news.sanfordhealth.org.
Get more episodes in this series
…
Posted In Bismarck, Healthy Living, Nutrition, Weight Loss, Women's
