Far beyond the mirror: what sustains a healthy life

The pursuit of a healthy life often starts with appearance, the desire to lose weight, or the goal of improving physical fitness. But taking care of one's health involves much more than what is reflected in the mirror. Nutrition, physical activity, sleep quality, mental health, self-esteem, and hormonal balance are all part of a set of factors that influence well-being throughout life.

This broader perspective becomes especially important among women juggling work, family, personal responsibilities, and the effort to maintain a self-care routine. For those who already exercise, the challenge may be finding balance and consistency. For those looking to start, the difficulty often lies in turning good intentions into sustainable habits.

Physician Dr. Marília Zaneti, a specialist in clinical nutrition who focuses on hormonal health, menopause, and female longevity—especially for women aged 35 and older—highlights that knowledge about nutrition and lifestyle has broadened the possibilities for care. According to her, combining accurate information with actionable changes in daily routines can foster a healthier life.

“All this knowledge we have today about nutrition, lifestyle, and what we can actually apply day-to-day—along with medical cannabis and emerging peptides like tirzepatide—has added immense value and promoted longevity for anyone willing to put it into practice,” she says.

The physician notes that the convenience of modern life has also transformed people's relationship with food. “If we look back at the last century, there was a boom in ultra-processed foods that made modern life easier with frozen meals and quick fixes, but on the other hand, we forgot how to eat naturally and organically. Little by little, we have been relearning how to put this into practice to live a healthier life.”

Health is not defined by the scale

Engaging in regular physical activity and eating a balanced diet are key pillars of health, but they are not always easy to incorporate into everyday life. Busy schedules, fatigue, and emotional states can hinder the adoption and maintenance of these habits.

Marília emphasizes that one's emotional state directly affects the drive to take care of the body. “I need the patient to be in a good place mentally and physically so they can handle the basics, and we know that the basics—physical activity and proper nutrition—are not so simple to fit into everyday routines to actually work. When a patient is very anxious or depressed, it disrupts sleep, leaving them with no energy to work out.”

Psychiatrist Dr. Marina Zaneti also points to the connection between emotions and food. In clinical practice, she observes that emotional eating is a frequent issue and should not be automatically conflated with binge eating disorder.

“What we see most in clinical practice is not so much binge eating, but rather emotional eating. Emotional eating means using food to cope with emotions. Generally, these are negative feelings—frustration, exhaustion—leading the person to seek out comfort foods with high emotional value and high palatability, something that brings emotional solace and harkens back to childhood, like the brigadeiro their mother used to make. Having this happen once in a while is part of being human, but physical hunger needs to be far more prevalent in daily life,” Marina explains.

Binge eating disorder, on the other hand, involves recurrent episodes of eating large amounts of food in a short period, accompanied by a sense of loss of control and marked distress. The psychiatrist explains that, for a diagnosis of binge eating disorder, these episodes must occur at least once a week for three months.

Drawing this distinction is crucial because different eating behaviors require distinct assessments and therapeutic approaches. Rather than viewing every dietary struggle as a lack of willpower, it is necessary to examine the underlying emotional and clinical factors.

Sleep is an essential part of self-care

Getting quality sleep is another fundamental component of health. More than merely counting hours spent in bed, it is vital to consider sleep quality and schedule consistency.

Marília explains that sleep is closely tied to the circadian rhythm, the biological mechanism that regulates bodily functions throughout the day and night. “The ideal is to get a minimum number of hours of sleep; around six hours is the bare minimum. However, the number of hours alone is often not enough to ensure quality.”

The physician also highlights the role of light exposure and the cycle of cortisol, a hormone that fluctuates throughout the day. “The circadian rhythm needs to follow the wave created by cortisol, which peaks in the morning and steadily declines over the course of the day alongside light levels. The appropriate time to sleep is at night.”

She also warns that sedative medications and alcoholic beverages can disrupt sleep architecture. “Sleep induced by medications (such as benzodiazepines—clonazepam or alprazolam) results in very shallow, non-restorative sleep, as the drug interferes with the brainwave patterns and overall architecture of sleep. Alcohol does the exact same thing: it severely disrupts sleep architecture, compromising the quality of rest.”

Guidance regarding medications must always be individualized. Prescribed treatments should never be discontinued or altered without the supervision of the attending healthcare professional.

Weight loss: protecting health also matters

The search for quick results has gained momentum with the widespread popularity of weight-loss injections. However, a lower number on the scale does not, in itself, guarantee a proportional improvement in health.

Marina notes that expecting immediate transformations can lead to frustration and an unsustainable relationship with one's body. “We live in an intensely fast-paced society where everything happens quickly, and people expect their bodies to respond at the same speed, thinking they will lose ten kilograms a month with a weight-loss pen. It doesn't work that way: our body requires deeper care and genuine lifestyle changes for consistent, long-term transformation to take place. It’s one small step at a time, just like running a marathon.”

One key concern during treatment is preserving muscle mass. Marília explains that significant appetite suppression can make adequate nutrient intake challenging and compromise the energy needed to exercise.

“The greatest concern patients must have with weight-loss pens is muscle mass. Since the primary effect is a substantial decrease in appetite, people tend to barely eat and have very low energy to train. Adequate protein intake and a baseline level of physical activity are essential to maintain lean mass,” she states.

The doctor also cautions against prioritizing the raw number of pounds lost above all else. “The illusion of losing ten kilos at any cost is harmful, because the likelihood of losing muscle along with fat is very high.”

Marina adds that losing muscle mass during weight loss can have lasting repercussions once the medication is stopped. “If a patient misuses the drug and loses significant muscle mass without proper monitoring, weight regain after stopping the medication will consist mostly of fat, since rebuilding muscle is extremely challenging.”

For this reason, professional oversight should account not only for weight reduction, but also for body composition, nutrition, physical activity, and each individual's overall health profile.

Hormonal health and changes in a woman's body

Starting around age 35, many women begin to notice changes in their energy levels, sleep patterns, body composition, and how their bodies respond to habits that previously seemed sufficient. These shifts can stem from various causes and should not be reflexively attributed solely to aging or hormones.

Hormonal health becomes even more critical during perimenopause and menopause, phases that can involve changes in libido, sleep, mood, and other bodily functions.

Marília emphasizes that hormonal evaluation can be crucial when a woman maintains healthy nutrition and exercise habits yet continues to experience symptoms that diminish her quality of life.

“In women over 40, if weight loss and physical activity are on track but libido does not improve, hormonal factors related to perimenopause and menopause must be considered. When there are no contraindications, estradiol replacement therapy yields remarkable results for libido, cognitive symptoms, and anxiety, helping far more than simply prescribing antidepressants,” she affirms.

However, hormone replacement therapy is not universally indicated for every woman. The decision depends on an individual evaluation of symptoms, clinical history, risks, and potential contraindications. Medical guidance is indispensable to determine whether therapy is appropriate and which approach best fits the case.

The physician also notes that self-esteem and sexual health can be closely tied to how a woman feels about her own body. “What most impairs libido in psychiatric treatment are certain older antidepressants. Conversely, taking care of one’s body and going through a weight-loss journey significantly improves self-image and self-esteem, which often translates into an increased libido.”

Medical cannabis as part of integrative care

The discussion surrounding comprehensive healthcare also includes medical cannabis. In the framework presented by Marília, cannabidiol (CBD) can be considered an adjunctive option in specific circumstances, particularly when residual symptoms related to anxiety or sleep persist during patient care.

“Today, we use medical cannabis as an adjunct. Typically, when a patient has an indication for anxiety or depression medication and lingering symptoms related to sleep or anxiety remain—and increasing the dose of that medication is not warranted—we add cannabidiol to enhance the drug's effect and address those remaining symptoms,” she explains.

The physician also links this topic to how the body responds to stress. She describes the sympathetic nervous system as part of the fight, flight, and survival response, whereas the parasympathetic system governs rest and digestive functions.

“Today, we deal with chronic stress dominated by the sympathetic system (our fight, flight, and survival mechanism). We live in a hyperconnected world with millions of things happening simultaneously. For the gut to function well and produce digestive enzymes, we need the parasympathetic system,” she states.

In her view, cannabidiol can play a role within this context. However, she stresses the necessity of evaluating each patient's clinical profile and treatment plan. The use of cannabis-based products must be discussed with qualified healthcare professionals, taking into account indications, formulation, dosage, potential interactions, and ongoing follow-up.

Marina also mentions tetrahydrocannabivarin (THCV), another phytocannabinoid, when discussing research and possibilities regarding metabolic health. She cites potential effects on parameters such as appetite, blood glucose, and insulin levels. These applications, however, should not be construed as established indications for weight loss or as substitutes for conventional treatments. Thorough evaluation of clinical evidence and safety remains essential before any clinical use.

Achievable changes, without comparisons

Amid a wealth of information about nutrition, exercise, medications, and emerging therapies, one of the greatest challenges is translating knowledge into sustainable choices. For Marília, care does not need to start with an exhaustive list of interventions or radical changes.

“Neither Marina nor I believe in overwhelming a patient with an endless list of fifteen supplements and prescriptions right at the first appointment. We prefer a measured approach: we identify the main goal, work together, and make month-by-month adjustments so the treatment makes genuine sense and fits sustainably into their routine,” she states.

Building healthy habits also does not require matching someone else's pace or standards. Every person's journey involves distinct circumstances, needs, and possibilities. What matters most is identifying changes that can be maintained over time, backed by professional guidance whenever needed.

“With all the resources and knowledge available today, I always tell patients never to give up. Whether someone is 80 years old and wants to change their lifestyle: it is always the right time. Any positive change brings immense benefits. We should never compare ourselves to others, because there is no greater asset than our health,” Marília concludes.