If the study of metabolism was on a list of things people enjoy, I imagine it’d land right between leaving your camera on during a zoom and actually reading the f***ing manual. Unsexy as it is to most people, metabolism is my jam. In that one word we're referring to ‘all the chemical reactions that occur to maintain life’. Cool huh? Some of these reactions are anabolic, meaning they build something, while others are catabolic, meaning they break things down. I love that in a topic where we know so much, there is still so much we don’t know. Real scientist’s will never give absolutes. There’s something hot about the humbleness of an expert who's spent there whole career researching one part of something greater, openly admitting ‘there’s still so much I don’t know yet’. That’s rare these days. Particularly when it comes to the pathogenesis of metabolic disorder. In a system of thousands of metabolic pathways, there are possibly countless ways disorder can occur. When, how or if metabolic disorder occurs is different for all of us, based on genetics, environment and common behaviors. In one individual it could be abnormal liver enzymes in their 40s, in another high blood pressure in their 50s or high fasting blood glucose in their 60s. There’s no one size fits all.

For me, metabolic disorder red flags appeared as little skin tags around the base of my neck. That was mid 2020. But in truth, the signs were there years before. I just ignored them. In 2016, we moved our family from Sydney to San Francisco. Running on pure adrenaline and mid 30s optimism, my husband and I packed up all of our worldly belongings into a cargo container and swapped the Harbour Bridge for the Golden Gate, toddler and 5 month old in tow. We shoved the full emotional impact of the move out of the way and hit the ground running, settling into our new life like champs, far away from family and friends. In a tale as old as time, my husband got to work earning a living while I focused all (and I mean ALL) of my attention on getting us and the kids set up in our new home. In hindsight, we were both barely managing to keep our heads above water. Quietly drowning in our new life but also not wanting to burden the other. The subconscious stress ans anxiety I felt on the daily was visceral. To avoid it, I funneled all of the unused energy into becoming the ‘perfect mother’, an oxymoron if ever there was one. Cue the set up for complete failure.

As a kid, I’d used food as a distraction from boredom and a tool to ‘cope’ with stressful situations. My brain automatically found that prewired system again. And it worked! Well, for the moment in time I was actually eating the food it worked. Highly palatable foods created a great distraction and a hearty dose of dopamine to get me through the moment. Obviously, the food couldn’t really move my emotional needle. It wasn’t magic food. It was just an easy and safe detachment tool in the short term, which is why so many of us choose it as our tool of choice. Unlike more immediately problematic numbing tools, I could still parent appropriately on excess food, I wasn’t under the influence of anything, it’s cheaper than compulsive online shopping and by crikey is it easy to access in America. When I left Australia, apart from really big chains like McDonald’s and KFC, getting fast food was a process. Find a parking spot, get the kids out, walk to the store, order, wait for the coffee/food to be made, walk back to the car and get the kids back in. Yeah, pass. In America, car culture meant I didn’t even need to get out of the car to scratch the itch. Kids napping? Starbucks drive through. 12pm and I haven’t eaten today? In-n-Out drive through. Kids screaming, nerves like fingernails on a chalk board? Just find a window that food comes out of. The accessibility and sizes were on a level I’d never experienced before. I took full advantage.

While I still managed to get the kids to all of their health appointments, I rarely visited a doctor myself. Sometime in 2018, it occurred to me that my doctor’s check-ups had become aggravatingly focused on my increasing waist measurement, and I don’t mind saying, it was pissing me right off. This isn’t a criticism of my doctor’s knowledge or bedside manner, rather a result of the mindset I was in. I was emotionally strung out. Her warnings felt like criticism. My brain was already maxed out on the criticism I was giving myself for not having my shit together the way everyone around me seemed to. I disassociated during my doctor’s health lectures, internally eye rolling. ‘I’m a bloody dietitian! I already know this stuff’ my inner monologue said. ‘Then why aren't you doing it?’ my inner critic responded. I never actually told my doctor I was a dietitian, which is pretty significant in hindsight. None of my doctor’s advice landed because a) I already knew it and b) I didn’t want to hear it. I was still in my 30s (albeit late) and I thought ‘I’m young, there’s time to correct this later. For now, I’ve got enough on my plate’ (pun intended). So I participated in the conversation just enough for her to be able to acknowledge she’d covered ‘weight loss’ with me in my records and I got outta there asap. Back to my comfy anxiety driven tasks like caretaking everyone else, making sure the house was spotless and building resentments for later. Then, the pandemic arrived.

When most people talk about their experience staying home for a year, their eyes take on a kibnda haunted look as the flashbacks start. They’ll mutter something about ‘loosing my mind’ but I can only relate to the online learning part, most of my experience of lock down was positive. Since the move I’d felt an acute loneliness that I wasn’t consciously aware of because I was ‘busy’. Any stay-at-home-parent will tell you how mentally unstimulating it can be looking after mini versions of yourself who’ve not only been genetically blessed with your attitude, but also think an appropriate expression of disapproval is a full body slam to grocery store floor while screaming bloody murder. As a young mom in Australia, I’d had friends or relatives in the same life stage to hang out with nearly every day of the work week. Regular companionship made the days feel easier and gave me a sense of ‘we’re in this together’. In America, I knew no one and the loneliness was palpable. Even going to a workplace where I could have meaningless conversations with other adults in the kitchenette would’ve been something. Looking back it was the most mentally brutal time I can remember, and I’ve had a few! As the kids got older and went to school, I started to meet people but it was still fleeting moments at drop-off or pick-up because they were busy too. We were all juggling multiple kids on different schedules. When lock down kicked off, boom. Overnight I had my husband home 24/7. Permanent adult company and instantly another person to share the parental responsibilities. That was the start of crawling out from the depression I’d unknowingly experienced for almost 4 years (what I now think of as my lock down) and starting to find some semblance of who I used to be. Unfortunately, in the interim, I’d found spoons of Nutella straight from the jar.

*Anyone else remember the baked feta and tomato pasta dish?*

And baking. Air frying. Viral recipes. And going grocery shopping just to escape the house for an hour. 2020 was all cooking and eating to curb boredom and stress at our place. As I mentioned earlier, I noticed the first skin tags pop up mid 2020. At first tiny but they grew remarkably fast. Because of my nutrition training, I knew they were a potential indication that my blood sugar might be high. Skin tags in areas where the skin creases, like around the neck, are a potential outward indication of high blood glucose levels over an extended period of time. But I wasn’t about to clog up my doctor’s schedule in the middle of a pandemic for her to tell me what I already knew, what she had tried to tell me before. I wasn’t doing ok, I’d pushed my body too far. I already knew I had too much visceral fat, now I likely had insulin resistance too.

insulin 101

I’m going to enthrall you now with a very basic explanation of healthy blood glucose metabolism and what happens when things go wrong. When we eat carbohydrate containing foods in a healthy metabolic system, our body breaks the complex carbohydrates down into their simplest form glucose, which gets released into our blood from our small intestine. This increases our blood glucose above our ‘baseline’ level prompting our pancreatic beta-cells to release insulin. Insulin gets to work picking up glucose molecules in the blood and shuttling them to our subcutaneous fat and muscle tissue. The cells in these tissues (should) open channels to allow glucose molecules into the cell. In this working system the cells get energy, our blood glucose starts to return to baseline and it’s happy days. When the system isn’t working as it should, insulin resistance is the result. Insulin resistance is a state in which our fat and muscle cells become unresponsive to the messaging of insulin. This primarily occurs when the cells are already storing the maximum amount of energy they can hold. If insulin comes knocking on the door of a fat cell or a muscle cell which already has enough glycogen (the energy storage in muscle cells), the cell will just say ‘no room here’ and shut the door, in order to protect itself. With nowhere to go, glucose hangs around longer than it should in the blood. The pancreas continues to detect these higher than baseline blood glucose levels and responds in kind by releasing more insulin. This can lead to a state called hyperinsulinemia. So now we have a situation in which blood glucose is too high, insulin levels are off the charts and our subcutaneous fat and muscle cells are still refusing to take on more glucose. Ladies and gentlemen, we’ve reached metabolic disorder. Our body has a set point for the amount of glucose it want’s in our blood at all times and levels over or under this amount can cause poor health outcomes. So insulin has to find other locations for it’s glucose luggage to be stored. At this juncture, our genetics determines whether we can simply produce new subcutaneous fat cells to compensate for extra energy storage, or if the body instead stores the excess in visceral fat and ectopic fat deposits. My body (surprise, surprise) does the latter. The skin tags told me it was very possible I was already pre-diabetic. When I finally got my butt into a doctor’s office in 2022, it was confirmed. My liver was showing signs of stress which meant I’d likely had fatty liver for a while and my HbA1c was in the pre-diabetic range. I was genuinely scared.

great, Now what?

So now we’re in 2025, what’s happened since then? I’ll be honest, I didn’t change much over night. I was scared, sure. I had a pretty informed view of what sort of future might await me if I didn’t do what I could to turn it around. I knew what changes I wanted to make. But looking at all the changes together was like being at the bottom of a mountain I had zero interest climbing. The habits I’d created in my ‘time of need’ felt very sticky and I was exhausted. I wanted my body to heal, just without me having to actually do anything. Is that too much to ask? I liked my habits. They’d made me feel temporary happiness at a time when little else did. But they were also making me sick, and the period of my life I’d needed them for had passed. Like everyone else who embarks on lifestyle change, I had to take it one step at a time.

The quote ‘All things worth doing, take time’ hasn’t seemed to have entered the lexicon when it comes to habit change. Everyone wants change to happen fast, preferrebly yesterday. Every diet book title includes a time in which results are ‘guaranteed’. It’s all nonsense. What’s the point in making temporary lifestyle changes. If it isn’t something you want to do weekly or daily, why are you adopting the change at all? It’s also the reason fad diets can never work long term. Fad diets aren’t sustainable for a number of reasons but mainly its because they completely disregard the main crusade your body is on; to keep you alive in a famine. Your body’s only goal is survival. It’s ability to do that is magnitudes more powerful than the measly amount of ‘willpower’ we try and bring to the equation. Let’s put it this way, presenting a diet that is highly restrictive to your brain, is like bringing a knife to a drone fight. If you intentionally engage in ‘famine behavior’, especially in an environment where food is plentiful, your 400,000yr old DNA is going to override your ‘willpower’. It might take a week or 6 months, but it will happen and the ricochet won’t be subtle. Your appetite for the foods you’ve deprived yourself will be on fire. Fad diets aim to give you ‘results’ as quickly as possible. Many of them start with huge depletions in carbohydrates. Trust me, you will lose body mass after a week of zero carbohydrates, but it’s glycogen and water you’re losing, not stored fat. The creators of these diets know this. They also know that your brain will perceive this initial loss as ‘success’. In your mind the diet ‘works’, if only you could stick to it. But it was never ‘working’ to begin with. There needs to be a cultural shift in our beliefs around change and timeframes. These diets were born from the belief that results should happen quickly. Why? Do you get a medal if you fix your health in 6 weeks? Life isn’t ‘The Biggest Loser’. And thank goodness because we all know how that story ended!

So, what behaviors did I actually change? Well I’ll tell you but remember this is not a prescription for what you should do, just an example of what sustainable habit change looked like for me. One person’s story is only an anecdote not a solution, this is no different. By some accident of genius, we’d purchased a treadmill which arrived just before lockdown. When those first skin tags popped up and reality dawned, I started walking each day to try and improve my insulin sensitivity. Make some room in my fat and muscle cells by using some of that stored energy. For me this was an unemotional change. I didn’t resent having to do it. I didn’t change anything. After getting used to a 30 minute walk every day, I gradually started increasing the incline on the treadmill to make it more of a hike. After a few weeks of that, I decided my next goal would be to remove drive-through foods. Drive-throughs had played a very emotional role for me so this was a more difficult change to make. Drive through foods are generally ultra processed and designed to be highly palatable, read ‘instant dopamine hit’. The trickiest part was managing my self-talk when I did find myself in a drive-through line. Shame is such an unproductive emotion. Change is hard enough. Change with a side of self loathing is impossible. Over time, driving straight past my old temptations became easier as the emotional attachment started to wane and I started to prefer the money saving alternatives (coffee brought from home, packed snacks etc).

Like a lot of families, ours had found ourselves in an expensive habit of ordering food on the apps during lockdown. A ritual which continued way after they ended. We decided to delete both the apps from our phones and make our meals at home unless we went out to eat. After about one week we reinstated ‘take-out Fridays’, but the apps remained deleted. Either we collected the take-out ourselves like in the ‘olden days’ or we went out to eat. This change was emotional but easier in that it was a collaboration with another person. We were both responsible for the habit, we were both on the same page in wanting to change it.

I added some resistance training to my routine using YouTube videos and light weights in my living room. But life intervened when an old back issue resurfaced. I took a few weeks off for physical therapy. Then I had all 4 wisdom teeth out and pretty much couldn’t eat solid foods for 3 weeks losing some of the muscle mass I’d built (zero stars do not recommend). Then I went on a trip back to Australia and ate as much as I could for 5 days (no regrets). All this to say, change isn’t linear and nor should it be in my opinion. There are often emotional changes to be made and life stresses in the way. You’re inevitably going to encounter some emotion-led behaviors that once existed to help you. Help you numb, help you disassociate, help you not feel lonely or bored, whatever the reason. And those behaviors don’t disappear over night because you woke up and decided they’re not helpful anymore. There will be some resistance and life will get in the way as you rewire new behaviors. Longterm change looks more like a straight line drawn by a kid bouncing on a trampoline, you’re still making progress forward, it’s just bumpy. To ease your way through it let yourself feel the success of one or two behavior changes before you attempt the next.

*“This is how I did it and how you can do it too!”*

If you made it this far into the article, firstly thanks for hanging in til the end. And please be mindful of what people are trying to sell. Excuse me while I mount my soap box. Ahem, aspiration porn is at chronic levels in our attention hungry economy and we’re all conditioned to have a heightened response to flashy images. Gone are the days when solid research was the norm. Now everyone can become a health guru by getting on social media and announcing themselves to be so. Fat loss aspiration posts in particular are the bane of social media, particularly since the rise in use of GLP-1 medications. Basic rule of thumb, if you see a before and after photo combined with a talking head telling you to buy ‘miracle weight loss product’ because it worked for them, just run! Immediate scroll. They’re a sales person, not a health professional and in the age of filters and AI, you can’t even be sure their pictures are real. Even if their outcomes are real, what relevance does their experience have to yours? They’re not living your life. They know nothing about your genetics, relationships, responsibilities, children, schedules, past trauma, neurodiversity, history or daily stress. How could they possibly have tailored advice without any of that background knowledge? The role of a coach is to present evidence based scientific research that can improve your health. Only yours. Then guide and support you as you begin to implement changes in your life. When you tell your coach what your goals are, they keep that image of you in their mind as they guide you, but you take ownership of the additions or swaps you’re willing to make and when you’re ready to make them.

I hope in sharing my own story, it demonstrate how easy it is to lose track of yourself. I’m a professional with five collective years studying the human body and nutrition. But when my own mental health fell off a cliff, none of my education mattered, I was just as vulnerable in this food environment as everyone else. I can relate to the mental gymnastics involved in knowing your health is suffering yet not wanting to upset the delicate echo system of your brain with lifestyle changes. I’ll go out on a limb here and suggest that you actually do know at least some of the changes you want to make. What you’re struggling with is how to implement them in your life, when habits die hard and life never gives you a break to focus on yourself. You’re not a lost cause because you find change difficult. You are capable of changing your behaviors. You have agency in what you do with your body. If you need support, get it. Take a breath. All things worth doing, take time.

Metabolic disorder: a personal history.

insulin 101

great, Now what?

HER TRU NORTH