Friday Q&A: sleep tracking; full body MRIs; Ozempic and the relationship with food; & eating smart during midlife
Keep the questions coming!
ICYMI 👉
🙋🏻♀️ Next Tuesday 7/15 at 11 am ET, I’ll be talking with Shannon Watts on her NYT bestseller Fired Up: How to Turn Your Spark into Flame & Come Alive at Any Age. Join us here!
In this week’s reader-submitted Q&A, we’re tackling these questions:
Do sleep tracking apps help or harm your rest?
Are full-body MRIs worth it for cancer screening?
How do you handle losing food joy on Ozempic?
Why am I always snacking but never satisfied?
📣 Send me your questions for future Q&As! Click here to write me. ✍️
The following subscriber questions have been lightly edited for length and clarity.
QUESTION #1: SLEEP TRACKING
What’s your take on sleep tracking apps? Are they helping or harming my rest?
-Sleepy
Hey there Sleepy,
In my opinion, sleep tracking apps occupy a funny gray area between helpful tool and digital saboteur. They can be both, often for the same person, depending on how you approach them and your underlying relationship with sleep.
These apps excel at revealing patterns you might not otherwise notice—perhaps you sleep better on nights when you exercise, or your sleep quality correlates with alcohol consumption or late-night screen time. This baseline awareness can be genuinely useful for making informed adjustments to your routine. Some people find the data motivating, finally understanding why they feel terrible after certain nights or discovering that their perceived "bad sleep" isn't actually as disruptive as they thought.
But here's the thing: many people develop what sleep specialists call "orthosomnia"—an obsession with perfect sleep data that paradoxically worsens sleep quality. I've seen patients who lie awake anxiously checking their sleep scores, creating a feedback loop where worry about sleep metrics prevents actual sleep. One patient described checking her app multiple times nightly, then spending the next day analyzing why her deep sleep percentage was only 18% instead of the recommended 20%.
The fundamental issue is that these apps often lack accuracy for the metrics they claim to measure. They can detect movement and heart rate changes, but they're not precisely measuring sleep stages the way a clinical sleep study would. Yet the specific numbers—your REM percentage, sleep efficiency score, or deep sleep duration—are presented with scientific precision that can make them feel more meaningful than they actually are.
Sleep quality is deeply personal and can't be fully captured by any device. You might have a "perfect" sleep score but wake up feeling unrested, or have terrible metrics after a night that felt restorative. Your subjective experience matters more than any algorithm's assessment.
My recommendation is to use sleep tracking apps as rough guides rather than authoritative judges. If you notice helpful patterns, great. But if you find yourself feeling anxious about your scores or making decisions based on imperfect data, it's time to step back and trust your body's own wisdom about rest.
QUESTION #2: FULL BODY MRIs
Are full-body MRIs something you recommend for your patients? Or is it true that they lead to unnecessary follow-ups, etc?
-Brian
Hello Brian,
Full-body MRIs may sound appealing—comprehensive cancer screening in a single test—but they often create more problems than they solve. While these scans are excellent diagnostic tools when used for specific medical concerns, using them as screening tools for healthy people isn't evidence-based.
The main issue is that full-body MRIs routinely detect abnormalities that look alarming but are clinically meaningless. These incidental findings can launch patients into months of anxiety, additional testing, and sometimes unnecessary procedures for discoveries that would never have caused harm.
These scans can also provide false reassurance. It is important to recognize that they provide snapshots of structure only, not function, taken at a single moment without clinical context. It's like trying to understand a complex family's relationships by looking at one group photo. You get information, but you're missing the crucial dynamics that actually matter.
The American College of Radiology doesn't recommend routine full-body MRIs for healthy individuals because the risks outweigh the benefits. Compare this to evidence-based cancer screening like mammograms, colonoscopies, and Pap smears, which have decades of research proving they save lives in specific populations. Full-body MRIs lack this supporting evidence.
The most effective approach to early detection remains something that is tragically not readily accessible to everyone in this country: working with a physician who can recommend personalized, targeted screening based on your age, family history, and individual risk factors. This comprehensive, contextualized approach is far more likely to catch meaningful problems early while avoiding the cascade of unnecessary worry that full-body imaging often triggers.
QUESTION #3: OZEMPIC & THE RELATIONSHIP WITH FOOD
I’ve been on Ozempic for a few months and while I’m eating less, I’m also less interested in food in general—even the social parts I used to love like going out to dinner with friends. Is this common? How do people navigate that shift without feeling disconnected from joy?
-Katherine
Great question, Katherine. What you're experiencing is incredibly common with GLP-1 medications. These drugs don't just reduce appetite—they can fundamentally change your relationship with food, including the social and cultural aspects that bring joy and connection.
And food isn't just fuel—it's how we celebrate, connect, and express care. When medication significantly reduces your interest in food, you can feel like you're missing out on meaningful social experiences. Some of my patients have described feeling like they're watching social eating occasions “through glass,”—i.e., present but not fully engaged.
Assuming you want to continue the GLP-1 med, it’s important to find a dose that balances the benefits and downsides appropriately—that is, attuned to your specific health and lifestyle goals.
Alternatively, you might seek new ways to maintain connection while honoring your body's changed relationship with food—for example, focusing more on conversation and company rather than the meal itself, or trying smaller portions of foods you previously enjoyed, savoring them mindfully rather than expecting the same enthusiasm. Being open with friends and family about this change can help. Explaining that you're experiencing decreased food interest due to medication helps others understand and adapt social plans accordingly.
This adjustment takes time, and it's completely valid to grieve the loss of that particular kind of food-centered pleasure while appreciating the benefits the medication provides. The goal isn't to force pleasure where none exists, but to preserve the connection and meaning that shared experiences represent, even if they look different now.
QUESTION #4: EATING SMART DURING MID-LIFE
I feel like I spend my whole day eating “healthy” snacks—almonds, protein bars, fruit—but I’m still tired and never really full. I’m in my mid-40s and wondering if this is a hormone thing or just poor planning. How do you help patients figure out how to fuel their bodies in midlife?
-Sandy
Hi Sandy,
Your pattern sounds incredibly familiar—you may be experiencing the classic "grazing trap" that leaves many people feeling simultaneously overfed and undernourished. In this case, the issue isn't what you're eating, but how you're eating it.
Those healthy snacks you're choosing are fine individually, but they're not designed to create lasting satiety. Almonds provide healthy fats but limited protein. Most protein bars are highly processed and digest quickly. Fruit offers vitamins but can cause blood sugar spikes when eaten alone. You're essentially running your body on nutritional appetizers all day, never giving it the substantial fuel it needs.
Your body needs adequate protein, fiber, and healthy fats together to trigger proper satiety signals. A mid-morning snack of almonds simply can't compete with a breakfast that includes 25-30 grams of protein, complex carbohydrates, and fiber.
In midlife, this balance becomes even more important. Hormonal changes during perimenopause and menopause can affect how our bodies regulate hunger and blood sugar. Declining estrogen impacts insulin sensitivity, making it harder to feel satisfied after eating and easier to experience energy crashes.
The fix isn't complicated: focus on three substantial, balanced meals rather than constant snacking. Include protein at every meal—eggs, Greek yogurt, or lean meats. Add fiber through whole grains, beans, or vegetables. Include healthy fats like avocado or nuts as part of meals, not standalone snacks.
This shift from grazing to structured eating can transform energy levels and satiety within days. Your body will finally get the consistent fuel it needs rather than the nutritional confusion of constant small inputs. Give it a whirl!
Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.
ICYMI, check out my recent Q&As on:
Re: the loss of food enjoyment. Me and my husband began eating a whole food Keto diet last year for a multitude of health-related reasons. We lost weight, have better lab numbers, and feel great. But eating out, especially with friends, or visiting family who eat a lot of ultra-processed foods, brings dread now! We attended a family function and the only thing on our plates was the pork that was smoked by the host. Every other side dish served was total carbs. Nobody batted an eye, at least not in front of us. We have learned how to adjust, most of the time. Checking out the appetizer and side dish lists on the restaurant menu can be helpful, as is subbing out the rice or potatoes for broccoli or side salad.
Thanks for the review. I appreciate your balanced, reasonable approach. The social, community, recreational aspect of eating is important, no small consideration.