Dr Elly Michelle Lieppman is a naturopathic doctor and her areas of expertise are women's hormones, GI health and recovery from disordered eating.
Find more about doctor Elly here:
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Simple Strength For Women: A Bodyweight Strength Training Program for Women After Hypothalamic Amenorrhea Recovery: https://kersten-kimura.teachable.com/p/simple-strength-for-women
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With Dr Elly Michelle Lieppman
Dr Elly is a naturopathic doctor and her areas of expertise are women's hormones, GI health, recovery from disordered eating and more.
Dr Elly, please tell us little bit more about yourself.
First, let's talk about who naturopathic doctors are and what they do. Naturopathic doctors are licensed doctors whose philosophy is to get to the root cause of our health issues, which sets us apart from most medically trained doctors who are treating the symptoms by prescribing pharmaceuticals. Naturopathic doctors figure out the root causes of issues, creating longer, more sustainable results.
The other distinguishing factor is that our treatments are different. We focus on lifestyle changes, herbs, supplements, so we take a much more holistic approach to helping people solve their health problems.
I had an eating disorder, anorexia, which I developed 14-15 years old. That was my gateway into the world of healing and alternative medicine. I had gone through the conventional system and their approach always felt so wrong. Why did they want me to go on birth control or anti depression medication, instead of asking how I'm dealing with my issues?
After I had solved my eating disorder and started college, I became fascinated with a human body. I also realized how important movement was in my recovery, because yoga and dance had helped me to get out of my head and into my body. I also realized that if I wanted to move my body, I had to fuel it properly.
Once I learned about naturopathic medicine, I knew exactly that this is what I'm called to do. I didn't know in the beginning that my specialty is going to be hormones and eating disorders, but I knew that natural medicine is the right thing for me.
This is how we often find our calling, through personal experience.
Yes. And I didn't know too many NDs who were specialized in eating disorders. I wanted to fill this gap. I find that eating disorders, or any kind of restrictive eating, are the root cause of so many hormonal issues. I find that so many women have either major PMS symptoms or other hormonal issues, and they have body struggles too. I don't think this is a coincidence.
Nicole Jardim said in one of her programs that so many women who have been prescribed depression medication, may actually simply have hormonal imbalances which could be corrected with lifestyle changes.
Yes, and here's where we have to talk about birth control too. Very often people have more depression and anxiety when they're on the birth control. There's not enough data on how birth control pills affect our mental health, hormones and more.
What kind of problems do you see the most with those of your patients who have eating disorders or disordered eating behaviors?
Mostly Hypothalamic Amenorrhea. I see that a lot.
Some women have a lot of PMS symptoms, and those women too have restricted their foods a lot.
Another one is digestive concerns. Sometimes it's a chicken or the egg thing: did the disordered eating trigger the disordered eating, or vice versa? Many women have a lot of bloating, cramping or mood symptoms around their periods. They're getting their cycles but they have a lot food and body obsession.
These problems don't always look the same, but the more clinical experience I get, the more I see that it comes from the body not feeling safe. If we're becoming too obsessive with food and body, the hormones are going to respond.
In one of your recent Instagram Stories, you were talking about how us feeling unsafe will show up in our hormonal health. Can you tell us a bit more about that?
When the body is under a lot of stress, the body doesn't feel safe. This is where Hypothalamic Amenorrhea happens. It all comes down to cortisol.
We often think that stress comes from work, overtraining, financial concerns… But we're not thinking about our internal environment. If we're constantly beating ourselves up which causes stress too. Think about a child who grows up in an environment where the parents are constantly mean to her. This is a big stressor for her. And we are creating the similar stress to ourselves!
So many people have the people pleasing complex. That means we're under a lot of pressure all the time.
How do you get started when working with a new client? Where do you even start?
It really depends on the person.
There's a lot of art and intuition on what I do. Some people just need to focus on food. If they're not eating enough, they're not available for the emotional work. Food and emotions are so intertwined. But with most women, I have to tell them first: You have to eat more. For some people, it's a relief. They ‘re happy to hear that it's okay because everyone else tells them they have to eat less.
I get most of my women to eat more protein. Most women are under eating protein.
Most women I work with have been on a very low carb diet. Do you see that too?
People with Hypothalamic Amenorrhea, yes. Most of them have been on low carb diet. Other women not too much. Right now I'm working with someone who had very restrictive eating habits, but was eating a lot of carbs and hardly any protein. So it depends.
Just recently, I interviewed two women who took a completely different approach to their Hypothalamic Amenorrhea recovery. One of them took the fast approach and ate everything she wanted, quickly, because she was so deprived and hungry, and because she wanted to get her period back fast (interview here). The other woman took the longer approach: Brought her calories up to a maintenance level, continued training, and overall used this very strategic approach to get her period back (interview here). It took her a year, whereas for the first woman, it took 6 weeks. Do you see that there are different approaches that work for different people?
Definitely. My approach as an ND is that everyone is individual. No two people are the same. No matter what, they're going to eat more but how much more and what that looks like, is really very unique. I haven't seen too many people who want to go all in quickly.
Many people have found me after they read the No Period, Now What book. Dr Rinaldi coined that term “all in”. Not a lot of people want to do it, and I didn't either when I went through this.
I give them guidelines: Three meals, a few snacks, and they should contain all the macronutrients and vegetables. The focus should be on the macronutrients for sure. Most people have no problem eating all the vegetables, but they don't get enough calories from them.
Having a framework is important. Many people are not very in tune with their hunger and fullness. They need some structure because they don't really know their bodies.
That's so true and I really like this structure. Three meals and some snacks. And trying to keep the meals roughly equal size, so that you don't eat 100 calories for breakfast and lunch and thousands for dinner. Your body wants to feel safe. Especially if you've done intermittent fasting and your body lacks all kinds of safety.
Your body wants to feel safe. It wants to know that nourishment is coming.
What about food quality versus food quantity in Hypothalamic Amenorrhea recovery?
Of course, in Hypothalamic Amenorrhea, quantity is very important, although quality is too. But many women who come to me, have cycles. I have them do labs and I can see from these results that they need to eat more.
Because I'm a doctor, I can run labs. That's a huge motivator for many people. When I run the labs and we can see that, for example, something is going on with the thyroid and as we know, thyroid governs the metabolism. When we're decreasing our food, our metabolism slows down and our thyroid tells a lot about it.
Also our cholesterol levels, blood sugar levels, sex hormone levels all tell me how well fueled we are. Our nutrient levels tell us that too – if your nutrient levels are low, you're under eating.
Food quality is very important too. As an ND I feel very strongly that lifestyle and nutrition create our health. That means having foods that are low in toxins and pesticides because that will also have a different kind of harmful effect on hormones. Women who do have healthy levels of hormones, may not be able to process those hormones well because it's a lot of work for our liver to process.
That's why eating organic is important. If we don't eat organic, we're more exposed to pesticides and herbicides which are extremely harmful for us.
I'm definitely a proponent of eating meat. We should eat animals that were pastured and were not given soy and corn. So I do think that food quality is very important for our overall health.
I agree with you. A lot of people would now say that this is another food obsession, an encourages becoming extremely preoccupied with food. But it's been shown so many times how poor quality food can be harmful for the hormones and in general, not make us feel great.
This is such a touchy topic. Yes, we do know about orthorexia which is another form of an eating disorder where we become so obsessed with foods that we can't go out and socialize, for example. So it can definitely be a problem. I think we all have to find that balance.
For me, when I'm at home, I do the best that I can, to eat well. I do spend a lot of money on organic and good quality meat. But if I'm out, I'm not going to not eat just because they didn't have the grass-fed meat. When I'm at home, I'm in full control, and when I'm out, I just make the best choice that I can.
In the past, where there was no organic or grass-fed meat, I would have not eaten or I would have been so stressed out and felt so much guilt. Now, I just make the best choice I can.
Watch the rest of the episode on my YouTube or listen to it on the Balanced Vibes podcast!
More topics covered in this episode:
What balanced eating looks like
The importance of eating red meat and organ meats, and why women shouldn't be afraid to eat them
Why maintaining muscle mass matters
The importance of strength training on your hormones, physiology and mental health
The importance of sleep on your hormones, brain function, inflammation levels
How to use blood sugar tracking and macro tracking in a healthy way that doesn't trigger past eating disorders