Episode 130 | May 15, 2025

The Truth About Hormones and Weight Loss, With Ashley Fillmore

Why do so many women do all the “right” things and still struggle to lose weight—especially in midlife? This week on Health Coach Talk, Dr. Sandi sits down with metabolic health expert Ashley Fillmore to unpack why traditional dieting fails and what it really takes to achieve sustainable, long-term results. With nearly two decades of experience, Ashley helps women heal their hormones, repair their metabolism, and break free from the chronic diet cycle for good.

“I started to very quickly piece together that the eat less, work out more approach—even with strength training multiple times a week—just wasn’t helping women reach their goals. They were struggling and experiencing all kinds of symptoms. Once we started teaching lifestyle habits and how to eat for optimal hormonal health, that’s when the transformations really began.”

Ashley Fillmore

Ashley didn’t always focus on hormonal health. Early in her career, she worked full-time as a personal trainer, following the common “eat less, exercise more” approach. But when she noticed that strategy wasn’t helping many of her midlife clients, she began exploring the deeper relationship between hormones, metabolism, and lasting results. Her own story—and her clients’—led her to create the Metabolic Fix Method, which now helps thousands of women achieve sustainable change.

In this conversation, Ashley and Dr. Sandi discuss the traps of overexercising, underfueling, and focusing solely on the scale. Ashley outlines the three transformation phases she uses in her program—Repair, Rebuild, and Results—and how most people mistakenly try to jump ahead before their bodies are ready. From understanding cortisol and thyroid imbalances to recognizing the signs of chronic stress, Ashley breaks down what true hormonal balance looks like and how it changes across the stages of life.

Health coaches will find Ashley’s emphasis on lifestyle foundations refreshing—and familiar. She highlights how small, low-cost behavior changes like sleep hygiene, stress reduction, and strength training can shift hormonal patterns and promote healing. The episode also explores the role of coaches in helping clients personalize their wellness journey, educate themselves, and stay consistent over time. For those supporting women in midlife, Ashley’s insights are especially relevant.

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Transcript

Dr. Sandi: Achieving sustainable weight loss. That’s a goal that so many have in mind when they seek the services of a health coach, particularly women. Well, how do you help them achieve that goal? This is what I talk about with my guest on “Health Coach Talk.” Her name is Ashley Fillmore.

Let me tell you about Ashley. She is a leading expert in sustainable weight loss, helping women heal their metabolism, balance their hormones, and achieve body composition changes that last a lifetime. She has a BSc in exercise and nutrition and is a certified personal trainer, professional nutrition coach, and health educator with nearly 20 years of experience. Ashley is the host of “Cheers to Your Success!” podcast and the founder and president of Metabolic Fix, a premium online coaching company that has helped thousands of women finally break free from chronic dieting and achieve long-term sustainable results using the Metabolic Fix method. She’s deeply committed to helping women better their lives and strives to inspire others to embrace the life of health, happiness, and self-love that they deserve. Here is my discussion with Ashley.

Hi, Ashley. Welcome to “Health Coach Talk.”

Ashley: Hi, and thank you so much for having me on your show today. I’m so excited to be here and to connect with your audience.

Dr. Sandi: You specialize in hormonal health, but you didn’t always do that. You had a career in fitness. Can you share your personal journey? How did you transition to now hormonal health as a specialty and your Metabolic Fix approach?

Ashley: Yeah, really great question. So, my undergraduate degree is in exercise and nutrition, and yes, I did learn a ton about exercise psychology and the proper way to exercise and how different forms of exercise will impact our bodies very differently on metabolic levels. And I learned a lot about nutrition. But after graduating college and working as a full-time personal trainer and nutrition coach, I very quickly learned that there was a lot more to the picture besides eat less and exercise more, and specifically even strength train more.

I was working in a studio, a boutique studio, and so we only worked with clients one-on-one, and I had a full roster from day one, 40-plus hours a week working with clients. And so some of the women I was coaching, they were coming in anywhere from two to three to even four times per week. They were in midlife. At this point in my life, I was not in midlife. I was a young college graduate. My internship became my full-time job, so true transition right out of college into working full-time. But I started to very quickly piece together that the eat less, the workout more, even if you were strength training multiple times a week, it just wasn’t helping women reach their goals. My clients were coming in complaining. They were struggling. They had a lot of other symptoms.

And at that point, my boss, which I’ll be forever grateful for him, he had a certification that specialized a bit more in hormonal health and metabolic health. And so I thought, “Why not really immerse myself into this?” Because all of what he was saying was making perfect sense to me. I was starting to really listen to him more closely as he was talking. And before I was just coming into this with my undergraduate degree and my certification as a personal trainer, which again, there’s a lot of education in that, but not to the level of his education and understanding hormones and how your hormones impact weight loss and your ability to build muscle mass and cravings and your metabolic health.

And so I said, “You know what? Why not? This is my opportunity. I had no children. My life looked very different.” So, I went all in and worked myself through advanced certifications in hormonal health. And I will say, once I completed that certification, or to be honest, as I was even going through it, I started to connect how your thyroid can impact your ability to lose weight, how cortisol can impact fat storage. Even if you are in a caloric deficit and strength training, if your cortisol is elevated, if you’re going through perimenopause simultaneously and you have this cascade of hormonal chaos going on, how much those things can truly impact not just your weight but your overall health and well-being.

And so I started to pull all of that together. And once we started to transition and teach clients about lifestyle habits and eating better for optimal hormonal health and requesting at that time through the studio I worked at, maybe them having some more advanced labs ran, and we started to pull everything together. That’s when the clients started to transform. So, yes, strength training and eating well was a part of it, but there was more to the story. So, my education and certifications really allowed for me to bring that full circle and truly help women that were in their 40s or 45, 50 truly see lasting results. And some of my clients I met then were in their 50s and now in their 70s as they’ve transitioned through different phases of their life. And so even post-menopausal women were truly starting to see more progress when we really went about it in a more holistic way, incorporating hormones and more than just eat less, move more.

Dr. Sandi: It is critical that we pay attention to hormones. For many people, I know we have a lot of health coaches, prospective health coaches, practitioners who might be listening, and that phrase hormonal health might be misunderstood. People may know what hormones do, they may not. So, can you describe, let’s say you have a client and they say, well, what the hell is hormonal health?

Ashley: Yeah, I think that’s a really great question. I will say when I first started talking about hormones, it wasn’t trendy. Perimenopause wasn’t even a term that was used. And nowadays when we log online, we hear about hormonal imbalances, hormonal chaos, and really what does it mean, right? That’s a great question for someone that maybe didn’t go to school for this or have a practitioner degree or anything, depending on what they do for a living in the health field. We sometimes understand this language, but to the consumer, it is really confusing.

And I will say from my personal experience as a professional in this field for almost 20 years now, it’s very much so individualized for every single client. So, for example, I have had clients in their 40s going through perimenopause. Technically, they’re right there, 45 years old, their periods are getting a little irregular. But to them, it’s not so bad, really even causing any discomfort or symptoms. They’re sleeping well. But when I go to ask questions, “Oh, yeah, sometimes my cycles are stretching out a bit. Sometimes things are shifting a little bit, but I don’t really feel like it’s a big deal because I feel okay.” But then when we look at the stress in their life, they’re stressed to the max. They’re about to break at any second in their own words. One little thing happens in their day and they’re in tears and they’re unable to cope. And it’s almost like that feeling like if one more thing happens, I’m not going to be able to hang on. I’m just going to have a breakdown. And I used to hear women say that.

And so when it comes to hormonal health for that individual that’s really stressed out, optimizing her hormones would look like decreasing stress, implementing healthier lifestyle habits, potentially doing some testing to truly see what’s going on with her cortisol. At that point, potentially suggesting some form of herbal supplement, adaptogens to help support her and making sure she’s sleeping, because a lot of times with that really stressed out individual, especially in that phase of life, maybe sleep is decreasing too. Whereas someone else that’s experiencing full-on perimenopause comes into my community and says, “Hey, here are my labs. My estrogen is low, my testosterone is low, all of my hormones, my progesterone is low. I’m struggling with weight gain. I have night sweats. My periods aren’t even coming anymore,” hormonal balance for them is going to look a lot different. And sometimes it may even include things outside of my scope of practice.

So, for that individual, it could be lifestyle changes, changing their diet, ensuring they’re eating enough protein, ensuring that they’re eating enough calories, incorporating strength training. But it could also mean that certain supplements aren’t going to be sufficient and they may need to go on to HRT or consider different therapies. So, I think hormonal balance really looks different for all of us. But on a base level, I think really thinking about how can you truly focus in on eating well, moving your body correctly, and I’m happy to go into more details on both of those, focusing in on your lifestyle habits outside of the cost of food and potentially the cost to invest in dumbbells at home or gym membership. Everything is free. And those are the things I would suggest you start out with before you add in a million different supplements, cocktails of things that may not even be optimal for your body, and just truly start there because that is where we should all start, even if we needed to tear on other things to ensure that we have optimal hormonal health.

Dr. Sandi: Yeah, and I love how you’re emphasizing the basics. It doesn’t have to be a complicated protocol. And what you’ve described are things that are clearly within the scope of practice of health coaches who are not licensed to diagnose, to order tests, to prescribe. And when you start with eating whole, real food, moving throughout the day, and also focusing on not moving too much in terms of over-exercising, a lot of women who are in perimenopause, menopause are over-exercising. They’re going to Orangetheory and they are just exhausted. And they don’t have those recovery or they’re not doing the right type of exercise. And being out in nature and getting sufficient sleep. And you work with those and then the hormones then tend to balance out.

But sometimes what I have seen frequently, and I want to get your opinion as well, is that the medical community might be not really the best people to… The traditional community. You go to your OB-GYN, your primary care doctor, and they might do a TSH test just for your thyroid and that’s it. They don’t look at cortisol, they don’t look at a hormone panel. In my experience, when I was 36, I went to a primary care internist and he looked at their lab results, “Oh, your TSH is high. We’ll put you on Synthroid.” And that, in retrospect, started me down a path that at that point I was eating a poor diet, I was stressed. There were so many things that were contributing, and I might have still needed that replacement. But if I had a coach, if I had a guide at that time to look at the whole picture, then my health trajectory would have been much different. What is your experience? Because I think especially women go to their doctor, they’re frustrated. They get this basic blood panel and many times it is incomplete or it’s leading them down the wrong path in terms of what they truly need.

Ashley: Yeah, I couldn’t agree more and I have clients every week reaching out, truly, multiple times a week reaching out to me. They have labs. They go to the doctor. They have symptoms that they’re very concerned about, many different things from their energy to their digestion, their cycles and the doctors run just standard labs and they’ll come back and say 99% of the time everything’s okay. And at times even things are in abnormal ranges or not optimal ranges and as you probably know better than I do, with functional nutrition and medicine, optimal looks very different than necessarily what we see as standard in our normal doctor’s office. And so there’s a lot of confusion and people feel very overwhelmed. And I know for myself, there’s even been times when my doctor has looked at me, if my cholesterol came back a little high and would say, “Oh, you just need to eat well and don’t have fried foods and exercise more.”

Well, if you get to know me, you’re going to understand really quickly that I eat incredibly well, and I also definitely shouldn’t be exercising anymore because I would teeter on the side of over exercising at that point. And so even for myself, I too get very discouraged and think, “No, there’s something else going on.” And I personally know, okay, this elevated cholesterol could mean a lot of different things, but for someone else, they may not know that. And so I agree. And I think that is why it’s so important to have a team of people that are there to support you. So, this could be a very knowledgeable and experienced health coach and personal trainer that can truly guide you and understands hormones and metabolic health. In addition to that, it’s great to have a functional nutritionist or doctor that’s there, that can also guide you and run labs if necessary. And if it’s an MD, obviously diagnose and even treat you at that point.

So, I think it really does depend on your individual needs. And this is why I’m such a big believer of customization. I believe that when you are in midlife, your body, your hormones, metabolic health, and your lifestyle is shifting so much that you need individual attention and customization because your life is unique and your body is as well. And you should be treated that way and looked at as an individual. And what you’re doing today may not even be optimal for you in six months. And so things should constantly be evolving with your program.

Dr. Sandi: Amen to that. It is all about personalization, and that’s one of the things that I think as your work and what I’ve seen in health coaches can help somebody to personalize, but it’s that individual who is personalizing the plan. They’re saying, “This is going to work. This is not so much.” And they know themselves well and can be their own advocates in this medical system. And do you find that there are people who are pretty stuck in this old theory of weight loss and that you have to really educate them in terms of the importance of hormonal balance and that it’s not just a matter of eating less, exercising more, counting calories?

Ashley: Exactly. Yes. There’s nothing wrong with having a weight loss goal or aesthetic goals. I have them as well. But a bigger concern I have as someone that’s been doing this for almost 20 years now with my clients is the overall health of my clients and helping them truly improve their overall health, because here’s what I do know is you may have a weight loss goal, but really your weight, the number on the scale is just one little component of your health. And we also know that the number on the scale does not tell you how much muscle mass you have, how much body fat you have, how strong your bones are. And if you are in midlife and I specialize in helping women in midlife, you need to focus more on other things. Sure. You could say, “I hear you, but I need to lose 10 to 20 pounds.” I get it. And we can work that into your plan.

But the beauty in the work that I do is oftentimes when we focus on this from a holistic health perspective, a side effect is weight loss, improved body composition, better aesthetic appeal, meaning when you look in the mirror, maybe you want to have muscle striations and you want to, as my clients say, look like I work out. I work out so hard and all my life I’ve never felt like I look that way, meaning I don’t have muscle mass. I don’t feel like my body’s firm. And so when we focus on this first, your health coming first, and then weight loss coming second, that is when everything really pulls together and you will lose inches and you potentially will lose pounds if you need to. And you will build muscle and transform your health and get in smaller pant sizes if that’s something that you want. But really I think focusing in on health more than exclusively weight loss.

Dr. Sandi: For sure. Another population that is often overlooked because they think they’re healthy and their doctors may think they’re healthy as well. It was skinny fat. It was SOFI, skinny on the outside, fat on the inside. That was me for many years. I was slender, but I had a higher percentage of body fat. So, it didn’t matter what the scale said and how I could fit into my clothes. I was wearing a zero and people would be envious of that. But when I started to measure my body fat, they said, “Wait, this is not good.” And that’s why I got into strength training and focusing on measuring my mean muscle mass, skeletal mass, and not focusing on the exact number on the scale in terms of pounds. But I see so many women, many of my contemporaries, I’m in my 70s. And this woman I saw on the treadmill that she was about my age, my height, my size, and she was just going at it for an hour. And she wasn’t even smiling. She just had to get through it. And that’s kind of this mentality that, “I’m going to exercise more, eat less,” and they’re wasting away and not realizing it.

Ashley: Yeah, I couldn’t agree more. So, actually, it’s very similar to you. I definitely checked the skinny fat box when I was younger. When I was finishing college, as I was going through my certifications, I very much so got caught up in, well, if I’m going to have this new job title, I need to look the part. And at that time, I had magazines to look to and I would see these beautiful trainers and nutritionists and they had beautiful muscles. And I just thought, “Well, I’m going to have to be an outlier and go outside of the norm to accomplish that desired look.”

So, I cut my calories really low. I added in a bunch of cardio. I was stressing my body also with weight training but not doing it in the correct way. I remember, at my lowest weight, I was so incredibly unhealthy, mentally and physically, to be honest with you. And it was just such a bad place for me to be in, but I was technically skinny. When you looked at the number on the scale, I was skinny. And maybe to some people’s standards, it’s like, “Oh, you’re healthy.” But I was so far from healthy.

And for me, I did hit a rock bottom and realize, “This is not healthy. My hormones look as if I’m in perimenopause and I’m only 20, 21 years old.” And so I see that now happening with women that are in their 30s, in their 40s, that are doing those things that on the elliptical, doing Orangetheory every day, in addition to running and weight lifting and taking fitness classes. And it’s just like, “Whoa, this is not the way to reach your goals. This is a formula for muscle loss, adrenal burnout, and just truly crashing and burning,” which is not what you want to do at any phase of your life but definitely not when you’re in your 30s and 40s and raising your family and building your career. And people depend on you oftentimes.

Dr. Sandi: Yeah, and I know that contributed to ultimately my thyroid dysfunction in my mid-30s. And it was years of binging on sugar and then going on crash diets. But why? Just because I wanted to fit into a dress the following weekend. I’ll easily lose five pounds and not really looking at the impact as we can today and really help women. One of the ways you help is through your program, the Metabolic Fix. Can you explain what that is and those three phases to that transformation?

Ashley: Yes. So, the Metabolic Fix, the three phases of transformation, I will say as I was working with my clients in person, this is when really the beginning of everything in regards to the three phases of transformation started. I very quickly learned as I was working with clients that not everyone needed to start in the exact same place. And I realized that when we tried to group women in one category, everybody responded different. And to be honest, yes, there’s always a percentage that did great, but there were also large percentages of women that didn’t thrive and some even regressed. And the mistake that was being made was that everyone was starting in the exact same place with the exact same rules. And nowadays we can think of this as really any crash diet you see. You open up your app, you open up whatever diet app you have downloaded, whatever program you’ve bought, everyone’s doing the same workout, everyone’s doing the same amount of cardio, eating the same macro percentages and caloric targets. Maybe you’re on the 1,200 calorie plan or whatever it may be. The number one thing I realized then was that we have to make sure that we’re treating each individual client as an individual and personalizing their plan for them.

But really through my work, I realized there’s really three starting places for people. Although most people want to start in the results phase, very few people are ready, metabolically speaking, hormonally, and to be honest with their mindset, to go into a fat loss phase instantly, especially if they have a dieting history and they’ve tried diets off and on over the years, losing and gaining the same 10, 20 pounds. So, there’s the results phase. But first, we start usually with the repair phase. The repair phase is built for someone that has hormonal concerns, that has potentially metabolic adaptation. So, from chronically dieting, they say, “Hey, I’m very sure that I’m only eating 1,000 calories a day, 1,500 calories a day, and I’m gaining weight. I’m not sure what’s going on. I’ve been dieting for 10, 20 years now. I just feel like my body’s not responding.” So, they would start in that phase.

And then also anyone that really just has never built a foundation with clean eating, they’re coming from a dieting background or maybe not a dieting background at all, but they just know from self-educating that their diet’s probably not optimal. They don’t feel great. So, in that repair phase, we really do all of the foundational work, healing the metabolism, helping optimize hormonal health, building that foundation, educating our clients on proper nutrition and what that looks like. I have women coming to me that has tried and spent hundreds of dollars on diets, tried many diets. They don’t know what a whole protein is. They’re still counting their peanut butter as a protein. They’re still counting oatmeal as a protein in the morning. They’re having a sandwich with a slice of turkey or maybe two slices, and they’re counting that as enough protein. There is a huge disconnect between, even if you’ve done a diet, what proper nutrition and healthy eating truly looks like. So, we do that in that phase.

Once those goals are accomplished and the client has achieved those necessary milestones, the next phase is the rebuild phase. And many women actually start here. And this is where we focus in on ensuring that you’re eating enough but ensuring that you’re doing that consistently, because we all know that you can eat enough for one day or two days, but are you doing it day after day? You have that foundation built with strength training, and we do a ton of work on your mindset, preparing you for a sustainable fat loss or body transformation phase and the results phase and also prepping you for maintenance and starting to talk about when you hit your goal, because we know you’re going to hit your goal if you follow the protocol that’s customized to you. We know you’re going to hit your goal.

So, when you hit your goal, we need to teach you how to sustain those results because very few people sustain the weight that they lose. And that’s a big concern, especially me wanting to have a sustainable transformation program, sustainable weight loss program. So, we start talking about that. And usually that’s when clients start having the aha moments like, “Oh, wow, maintenance? What does that even mean? Don’t I just eat the same way that I was to lose the weight? Shouldn’t I just do everything the same? I’ve never been able to maintain weight. I don’t even know what that looks like.” And so all of that happens in the results phase. But again, a lot of people think that they’re ready to start in their results phase. And many people do. They buy these extreme diets and start them. Their body’s not responding. They hit these big plateaus. They burn out. And truly the reason is because they just weren’t ready for that phase. And also the way that they’re going about it isn’t designed for their body. It’s a very cookie cutter, mass produced program.

Dr. Sandi: So, first of all, thanks for that great explanation. And it sounds like it’s been very successful. And it was very encouraging to hear you talk about the importance of maintenance, because I think that’s where the rubber hits the road. And that’s why weight loss programs fail, because they may have a great start, initially lose weight, but historically, that’s been the challenge. How do you keep it off and not go back to your old habits unless you are working with someone like you? So, can you share a success story?

Ashley: Yes. So, I have many success stories, but one lady comes to mind right now. And actually I have two, but I’ll focus in on just one. When she came into my world, she was very exhausted mentally and physically as many of the women I work with. This is it for me. I’m going to give this a go. And in that moment, they feel like if this doesn’t work out for me, I am not going to try anything else. But I know that this is going to work out for them. I’m very confident in that. And the reason I’m always so confident, and I remember this specific client asking me, she said, “You’re confident in your ability to help me reach my goal.” And she’s a doctor. And so she says to me, “You have a lot of confidence.” And I said, “The reason I’m so confident is it’s fail-proof. If you’re willing to commit to showing up and doing the work that we agree to as a team, and you continue to work through the phases, I know you’re going to reach your goal, because everything is personalized to you. There’s no way for it to fail if it’s personalized to you.”

And so over the course of… I’d say it actually took closer to nine months for her. And I noticed some women that may sound like a long time, but when you’re sustainably changing your habits and working on improving your nutrition and developing healthier habits, nine months isn’t that long actually. She lost 30 pounds, 100% sustainably. And the best part is she’s been able to maintain that. And then I have another client, very similar story, lots of dieting. She’s a nurse. She’s a mom of two. She’s been through so much. And not only did she lose 20 pounds and 30, 35 inches throughout my program, she’s now been able to maintain it for three years, 100% sustainably. So, I had her come back on my podcast, actually, and share her story through maintenance and what that looks like for her. And so many people reached out to me and said, “I didn’t realize that was possible. I always thought I had to track my food every day, or I had to keep my calories super low, and I couldn’t eat carbs anymore.” And I’m like, “No, that is misinformation.”

And so for me to see busy women with thriving careers and building families or even some that have older children or maybe the kids are out of the house and able to reach their goals in a safe and sustainable way, and then most importantly maintain it, that’s how I know things are working really well. It’s the maintaining it. As a coach, that’s our number one goal is to teach our clients how to sustain the results they accomplish with you on their own long-term.

Dr. Sandi: Oh, absolutely. Well, this has been a wonderful discussion on a very important topic. Ashley, where can people find you?

Ashley: So, I have a podcast, my show is named “Cheers to Your Success!” And I’m always releasing one to two episodes per week, actually recently had you on my show.

Dr. Sandi: We had a great conversation.

Ashley: That’s going to be an amazing conversation as well. Solo episodes, amazing experts like yourself come on to my show. You could also find me on Instagram. My Instagram handle is @ashley_fillmore1 and then my website metabolicfix.com. You can see my one-on-one coaching program and the different offers I have to support women.

Dr. Sandi: Check her out. She has a wonderful program. And thanks for being a guest today.

Ashley: Thank you so much.