Fitness life

Follow Up + Thank You!

July 20, 2023

Seriously, THANK YOU for your support (and commiseration and ideas/experiences/expertise shared) in yesterday’s post. I was nervous when I hit “post”, I will be honest. But it’s been on my mind and I wanted to share. I don’t have any grand conclusions, but I appreciate the great resources shared — from Stacey Sims to Meghann Featherstun and way beyond.

Before I try changing anything specific (including the OCP – thank you for the notes related to that!), I do think I will try some (imperfect) quantitative nutrition tracking to better understand what is going on. You all know I am a huge believer in tracking things in general when I’m trying to work on them, so there’s no reason this needs to be different. Like time tracking, it’s not something I want to commit to long term, but getting some info seems reasonable.

(My biggest qualm about nutrition tracking is that it is SO HARD to accurately measure things like non-chain restaurant meals or things that are made at home – especially when often I’m not the one doing the cooking! But estimating/eyeballing and accepting that some values are just an approximation is probably better than throwing my hands up entirely because obtaining perfect data is impossible.)

One thing I know I have to work on is not letting the feelings of not being at my bodily ‘ideal’ take up more mental space than they need to. I have made some progress in this realm over the years, but still. I have sooooo much I am looking forward to over the next few months, from trips to kid milestones to professional things. Just like with things that feel like something to work on, but also morally neutral — like the clutter in my house — I want this to be something I’m paying attention to/working on WITHOUT letting it dominate.

Because I definitely do think there are many more important things to spend mental energy on.


  • connecting with family + friends
  • savoring the ‘golden years’ of having kids 5-11
  • having fun running and being grateful that I can still do it — and even see some improvement — in my 40s, and hopefully much longer
  • enjoying travel and nature
  • supporting my kids in big transitions this year (all 3, really, in one way or another!)
  • having fun with art the world has to offer, from a juicy novel to a great movie or concert
  • making plans (personal fave . . . ) and pursuing dreams personal + professional

NONE OF THE ABOVE are impacted by anything I wrote yesterday. Can’t lose sight of any of that.


  • Reply omdg July 20, 2023 at 8:53 am

    For calorie tracking, I usually have the same thing for breakfast each morning, and the total comes to between 400-500 calories. For lunch I’ve been eating Hello Fresh which has a calorie estimate, or I make something, in which case I can add calories myself. It’s usually between 700-900 calories. By then I am at about 1400-1600 calories for the day. If it’s 1600, no more food. If it’s 1400 I have a snack. No advice if you’re not cooking for yourself — I usually assume that if I feel “full” I’ve eaten 1000 calories or more, so having one serving only or stopping eating when you feel anything in your stomach has helped me in the past. I no longer have that level of self control however. Sigh. You can probably eat a little more since you’re exercising more than I can.

    I do wish people would stop referring to ages 5-11 as “the golden years.” So many people hate teenagers (yes, hate), and it makes me so sad. 11 is my favorite age yet because my daughter is capable of so much, so articulate, and it’s so fun to watch her grow up and become more independent. I’m sure someone will say, “Oh just you wait until she hits middle school,” and while I’m sure there will be difficult times ahead, I’m also sure there will be good times too. And also buzz off and stop being so negative.

    • Reply Sarah Hart-Unger July 20, 2023 at 9:13 am

      That’s helpful. And you’re right- “just you wait” is my least favorite parenting trope ever. I think I just used golden years bc I’ve heard that before, but there is no reason to think the teen years will be any less great! Of course there are challenges – I’m not naive to that – but generally I enjoy teens and I think there will be a lot to enjoy within that stage.

      I prefer 13 to 3 any day 🙂

    • Reply Erin July 20, 2023 at 10:04 am

      I only have one teen so far (13, 11, 8) but she’s amazing and every year so far has been better especially in terms of her attitude. I do think that the tougher part about teens is they are just starting to be actually physically not available for as much family stuff – work, extracurriculars, friend stuff etc. So maybe that is also where the “golden years” trope comes from, just because during those years the parent has a lot more control over their schedule………. being generous with that interpretation probably 😛 I find it annoying too!

    • Reply gwinne July 20, 2023 at 10:16 am

      I have definitely used “golden years” descriptor! That’s not to say that it’s all bad before and after–and obviously it depends on the kid (11 has been SUPER challenging here)–but at least with my 19-year-old there was something really special about elementary school / pre-puberty. 18+ has been pretty great, too. 12-14 was crushing. May it be easier for you!

    • Reply Jessica July 20, 2023 at 3:59 pm

      I don’t think saying “golden years” is necessarily being negative about other years. My oldest 3 are currently teens and I love them and am so proud of the people they are. I have absolutely not one bad word to say. However, it is just different- they have jobs, and homework (so much!) and friends and extracurriculars. They have commitments on school breaks. We pulled up to the house today and my youngest just about jumped out of the car because he saw the 16yr old in the window and was so excited to see him- because the 16yr old is gone most of the time (at good things). I certainly don’t say “just you wait” but I personally find the 5-11yrs pretty magical.

      Also, for me, the experience of parenting teens has been harder (and not because of my kids). Everything just seems more high stakes and they have more heartbreaks that I am powerless to fix. When my kids get cut from a team, a dance date canceled, a friend group implodes, etc I find it hard in a way I didn’t find disappointments hard when they were in elementary.

  • Reply Liz July 20, 2023 at 9:23 am

    Sarah, thanks for sharing so honestly–your post yesterday resonated with me very much. If you decide to track nutrition on MyFitnessPal, just a few quick tips I learned that have made it easier:
    When you add food, it allows you to add a recipe. When you go to add the recipe, you can scan the text with the Camera app on your phone, the same way you would a QR code and it shows a little icon with lines which copies the text. I take that, clean it up and paste it into MyFitnessPal to create a new recipe (adjusting any tweaks I’ve made and making better matches for the ingredients) and it is such a game changer. I used to hate adding recipes line by line, but this speeds it up so much. It also means you can go back and add that same recipe again in the future.
    If you pay for the premium version, you can have it show the percentage of macros by meal. Beyond looking at total calories and portions, this has been helpful just to give me a better sense of which meals that overall are “healthy” and “balanced” but maybe lack the protein and fat that I need to feel full. I’ve found it to be less pressure than calories but still gives me a finger on the pulse of my eating.

  • Reply jenny July 20, 2023 at 9:27 am

    I commented yesterday and I really appreciate your follow up today. Everything you said is so true.

    I have tracked my calories in MFP on and off since 2012. I’ve been committed to doing it the last month or so and am trying to take the judgement out of it and look at it more from a place of curiosity. I used to have the mentality of well I’m going over my goal so I’m done tracking. Like if I don’t track it it doesn’t count somehow. Tracking everything has helped me to see what I can eat and still feel satisfied and train well and also the calorie range in which I start to gain weight. You can also see the total week view / average which is helpful for me because I tend to eat more on the weekends so its interesting to see my average for the week.

    Meghann Featherstone had a comment about tracking that really hit home for me. She talked about how people don’t like to see the number of calories they “have left” for the day getting smaller so they will eat less in the morning/afternoon and save the calories for the evening, which is not ideal for fueling. I definitely have done that and I’m working on it.

  • Reply Sarah M July 20, 2023 at 11:19 am

    I feel like tracking every single calorie and every food item in order to maintain a very thin body ideal is not worth it and will take a lot of the pleasure out of eating. It also borders on disordered eating. Even if it is common among a small subset of well-heeled middle aged women hoping to meet this body ideal, that does not make it healthy or worthwhile. I would advise against. For what it’s worth, I’m a runner too. I see my weight go up and down depending on how much I’m running. It does go up when I run more. It’s ok.

    • Reply Sarah Hart-Unger July 20, 2023 at 11:40 am

      Just to be clear, I have no desire to track long term – just wanted to do it to get an idea. I am not willing/interested in doing it indefinitely. Just was thinking to try for a week (sort of like how I time track – a week or 2 every few months) to get some exploratory data. But I do get your point!

    • Reply Omdg July 20, 2023 at 12:18 pm

      Lady, I’m just trying not to gain another ten lbs next year. And yeah, I’m not obese or even overweight (yet). Does this qualify as an eating disorder in your opinion? Get a grip. Fully aware some people find this triggering, but your “free eating” strategy where we should all just follow our “natural body cues” doesn’t work for a lot of people. The thing is, It is really easy to lose track of how much you are eating unless you occasionally measure it because 2000 calories is not that much food, and yet it is still too much. And lastly, if you’re not in your mid-40s yet maybe you should consider not opining on this again until you get there. ✌🏻

      • Reply Amy July 20, 2023 at 2:57 pm

        👏🏻👏🏻👏🏻 Thanks for saying this.

    • Reply Liz July 20, 2023 at 1:39 pm

      I agree with you here, Sarah M and I’m also as a runner in my 40s. After having gone through a number of years in my 20s trying to fit a body ideal by not eating quite enough (I was never underweight), I don’t feel it’s worth it. While running a lot of mileage, I really try to focus on eating more protein and eating enough to helping me feel strong and energized. I’ve gained ~15 lbs in the past year or two and can definitely empathize with not feeling great about how I look but my running is going better than it has in years so I’m focusing on that.

    • Reply Heather July 20, 2023 at 2:04 pm

      Just here to say that it is perfectly healthy to track the food that you eat in order to fuel your body for your athletic endeavors. Yes, it can become disordered if you allow it to control your social life and everything you do, but there are plenty of athletes out there who track their food in a healthy way.

      • Reply Grateful Kae July 20, 2023 at 3:51 pm

        Yeah, I take some issue with the idea that tracking food/macros automatically = disordered. I personally don’t track my food (long term; I have tracked in the past though occasionally), mostly because I just have sucky discipline and never stick to the numbers anyway. But I can TOTALLY see the benefits to it in certain situations. I guess I personally liken it to someone who struggles with saving money deciding to carefully track their expenses. No part of me would call that disordered; I’d find it responsible I think! I would assume that many people track their finances closely, and no one thinks it’s disordered for someone to track their expenses or balance a checkbook…. but I do also see Sarah M’s point about food being pleasurable, too. And the whole social aspect, role modeling for kids, etc. So I guess I see both sides of this argument.

        I think if someone is dreadfully unhappy/ overweight/ unhealthy, tracking could be a great way to make actual progress which could turn that person into a happier, healthier person overall, even if that tracking is sort of a pain. Like OMDG points out, following “natural cues” can be very challenging and misleading sometimes. And I’d argue many people, myself included, drastically underestimate how many calories are in the foods they regularly consume. Tracking can help raise awareness. Not to mention the benefits of getting in increased protein! Without tracking ever most people probably don’t realize how little protein they actually consume. In SHU’s case, I think tracking could be useful to really dial in on the # of calories/ carbs that she needs to perform well, while limiting “excess”/ unnecessary calories that might just be leading to extra weight gain. NOT saying she should diet or be in a caloric deficit! Just that maybe sometimes all the running/revved up appetite might be causing a little more overindulging than realized, that’s all.

  • Reply Sarah July 20, 2023 at 12:58 pm

    Actually I’m 49 and I have PCOS.

    • Reply Omdg July 20, 2023 at 2:05 pm

      Still really tired of the “omg eating disorder” whenever the mention of limiting or counting calories is raised. How is that different from eating “clean” eating or “eating whole unprocessed foods.” Anything can become an obsession. If you don’t want to, or find it triggering then don’t count calories for goodness sake! I recently found it useful to note that my dinner was usually 700 calories, putting me over 2000 calories most days. So I stopped eating so much. 🤷🏼‍♀️

  • Reply K July 21, 2023 at 12:36 am

    Having T1D and a child with T1D, it’s hard reading your posts from yesterday and today, because you are a practicing pediatric endo. I find cooking at home is the easiest way to track nutritional information because we can use a scale and calculate the macros in the serving/meal. Maybe you can use your nutrition tracking to step into the shoes of what can be life-or-death matters for your patients. We don’t have the luxury to guess/eyeball for a few weeks and then stop.

    • Reply Sarah Hart-Unger July 21, 2023 at 5:48 am

      I dont in any way want to imply it’s easy for patients!!!! Very much the opposite – it’s really really hard and my heart goes out to those who have to manage T1 (in themselves or a child), it’s challenging and can be all consuming.

      At the same time, I wasn’t trying to imply it’s impossible, just that it would involve changes in practice would be challenging for me and it is not necessarily mean it’s something I want to do myself long term. I hope that makes sense.

  • Reply Laura Erdman August 1, 2023 at 10:19 am

    I’m late to post a reply but a few thoughts that I’ve relied on over the years (from really smart people whom I’ve heard speak at various Grand Rounds, etc):
    1. From a lipidologist who is also a NAMS (North American Menopause Society) expert – our metabolic pathways change drastically as our hormones change during peri/post menopause, and there is nothing we can do about that! All the OCs or HRT in the world will not restore the number of enzymes that are up-regulated by our own endogenous estrogen…. For those who have been ‘genetically lucky’ – not ever having to worry about overweight, this comes as a huge life change – having to really think about and track food. The best approach is to follow a truly Mediterranean diet – lots of veggies, a few fruits, lots of seafood, some lean meats, and a few non-simple carbs, no added sugar (this is hard for younger super athletic nutritionists to understand as they mostly deal with a population whose ‘good’ metabolic pathways are working really well so they can handle the carb loading that gets converted by these good biochemical pathways into immediately usable energy)
    2. From Patsy Sulak, MD (ob/gyn at Baylor Scott-White) – she is in her mid 70s. She was one of the main developers of Yaz! (both the DRSP and the scheduling of it) – she is absolutely brilliant. She now runs her own wellness consulting company (with her husband). She was the keynote speaker at an ACOG conf last October and jumped up on the stage and did 10 fast jumping jacks. She summed it all up by saying – exercise is for our health, it’s good for our bones (strength training) and for our hearts (cardio) and for our balance (yoga, etc). But to lose and maintain a healthy weight, we MUST change the way we eat – she’s also a big fan of limiting cabs and intermittent fasting (which again, a lot of young nutritionists do not subscribe to). She is all evidence based, has done a ton of research and is really a trustworthy source. And she focuses on those of us who are beyond our glorious 30’s decade!
    Good luck with all these changes – but the sooner in the mid 40s one adjusts, the easier it’ll be when full on menopause and the 50s hit!

    • Reply Sarah Hart-Unger August 1, 2023 at 6:59 pm

      thanks Laura! I honesty already feel a bit better after cleaning things up eating-wise the past couple weeks. Our bodies definitely seem FAR less forgiving as we get older, don’t they!?!? So funny about the jumping jack demo!

    Leave a Reply

    This site uses Akismet to reduce spam. Learn how your comment data is processed.