The Menopause Reset

The Menopause Reset argues that the weight gain, fatigue and brain fog many women experience in their 40s and 50s are metabolic rather than inevitable, driven by insulin resistance and near-continuous eating, and that the fix is to restore the body's ability to switch between burning glucose and burning fat.

The mechanism Pelz builds on is metabolic switching: alternating periods of eating and fasting so that insulin falls far enough, often enough, for fat oxidation and ketone production to occur. In practice that means time-restricted eating extended over time, varied fasting lengths, and a pattern of lower-carbohydrate days alternating with deliberately higher-carbohydrate days, which she ties to the hormonal rhythm in women still cycling. The book is short, practical and prescriptive.

It is written for women who have found that what previously controlled their weight has stopped working, and who want a concrete pattern to follow rather than a physiology lecture.

On evidence, the general and the specific diverge. Time-restricted eating and intermittent fasting have a real and growing trial literature for weight and some metabolic markers, and the fair reading of it is that results are broadly comparable to continuous calorie restriction rather than clearly superior — the benefit largely tracks eating less, more consistently. Extended fasts, and fasting patterns tailored specifically to perimenopausal and postmenopausal women, have not been tested in controlled trials at all; that part of the book is extrapolation. Fasting also is not appropriate for everyone: it warrants caution with a history of disordered eating, with insulin or sulfonylureas, and in several other clinical situations. And metabolic strategies do not address the vasomotor, bone and genitourinary aspects of menopause, which have their own evidence base and their own treatment discussion to have with a physician.