#172: How Under-Eating Impacts Our Hormones and Long-Term Health with Dr. Nicola Sykes
What happens when a body goes quiet in its own defense? What systems shut down when we’re under-eating? (yes, even when we’re under-eating by “just a little bit”)
Maybe you’ve experienced a missing period yourself. Maybe you’re deep in the perimenopause transition. Maybe you’re worried that your past dieting and intense exercise habits are showing up in ways you’re only now beginning to understand. Or maybe you simply want to better understand how our bodies speak to us through absence.
Today, we’re talking about the impact of an energy deficit on our hormonal health — from hypothalamic amenorrhea (a condition often misunderstood, oversimplified, or reduced to a fertility concern), to digestive function, to long-term bone health, and everything in-between.
But like most things in the body, this story is layered. It’s about hunger and rest, yes — but also about control, identity, grief, and the impossible standards so many of us have been taught to meet at the expense of our own health.
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My guest today is Dr. Nicola Sykes (formerly Nicola Rinaldi), who quite literally wrote the book on how restriction and over-exercise impact our body’s endocrine system. Together, we look beyond the surface — past the “just eat more and rest more” advice — into the deeper questions of how we heal when we’ve been praised for our restriction, and what it means to rebuild trust with a body that had to shut down in order to survive.
I personally went through this myself a long time ago. I was told for so long that it was normal as an athlete, but that misinformation led to a serious health complications for me down the road.
Looking into the future, especially with increased use of GLP-1s for weight-loss, I really want us to be talking about what happens to the body in a state of malnutrition and malnourishment. And I believe this conversation is an important starting point.
Behind the paywall, we get into:
Why Nicola changed her mind about the connection between weight and health
What under-eating does to our digestive system
How to navigate misinformation about hormone health
Understanding extreme hunger in recovery
What the stress of over-exercise does to our body
How to re-nourish yourself after a prolonged period of restrictive eating
Overcoming the cycle of restriction and bingeing
How under-fueling plays a role in fertility
Eating enough in pregnancy and postpartum
Longer term implications of under-eating on our health
How to trust your body through the process of eating more
How to infuse our healing with more self-compassion and understanding
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I truly hope you find support and compassion in this episode. It’s infused with depth, science, and hope — and I know we all need more of that right now.
When you give it a listen, I’d love to hear what you think.
More About Nicola:
Dr. Nicola Sykes (formerly Rinaldi) is a leading expert in hypothalamic amenorrhea (HA) and the author of the book No Period. Now What? She holds a Ph.D. in computational biology from MIT and has dedicated her career to understanding and addressing the complexities of menstrual health, particularly in relation to energy balance, stress, and hormonal function.
After her own experience with HA, during which she faced infertility and a lack of information about the condition, Dr. Sykes immersed herself in research to find a path to recovery. Her personal journey led her to write a comprehensive guide that combines scientific insights with practical advice for those experiencing missing periods. Her book has been translated into multiple languages and is widely used by dietitians and medical professionals to support individuals in regaining their menstrual cycles and improving fertility.
Find her at @noperiodnowwhat on instagram, noperiod.info/book for the book, noperiod.info/blog for research, and noperiod.info/reveal for a hypothalamic amenorrhea registry study.
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