Hey ,
My next two emails will talk about weight loss and GLP-1 medications like Ozempic from my perspective working with clients/patients as part of an integrated care team. I wanted to give you a head's up, just in case you're in a space where talking about weight loss wouldn't be helpful for you. I can promise you that I'm coming from an informational and empathetic place as I try my best to do with all of my writing. But if today's not the day, please skip this one. ♥️
When GLP-1's first hit the market as weight loss solutions, I'll admit that I was definitely part of the "collective eye-roll" group. "Here we go again." I thought. "Another season where thin trends for those who can afford the drugs." I was worried about the messages we send about thin being better - at whatever cost - especially when Hollywood is leading the charge.
I also worried about the lack of transparency surrounding the support systems that were not being talked about with these medications. I tend to eschew anything that elevates itself to the level of "mass miracle cure" without offering up a lot of detail about the process." As I often say to my clients:
Quick fixes are often missing details about what's actually involved in the process, or they are meant to provide quick solutions, not for the long-term.
But since the early days of watching someone emerge onto a red carpet 50 lbs lighter after simply "watching what they eat," I've gathered quite a bit of experience working with people using GLP-1 medications, both for weight loss and health purposes. And I'm ready to share what I think are some interesting observations for your consideration.
The following is anecdotal based on my own experience as a board certified health coach working in tandem with medical professionals and is not meant to be taken as medical advice. If you have questions about whether a GLP 1 is right for you, or any medication for that matter, consulting with your health care provider to find the right course of action is always recommended.
A Plan Is Imperative
GLP-1s work mainly to mimic a natural hormone in your body that increases the amount of insulin that you produce, decreases the glucagon you release and slows down your stomach emptying. This trifecta reduces hunger and can promote feelings of fullness, leading to better blood sugar management for people with Type 2 diabetes and weight loss for people overall.
With more insulin to manage blood sugar, a lower appetite, and feelings of fullness when you do eat a meal, many of the people I've worked with quickly find themselves, well, not eating much at all. Or only eating once a day. The main challenge is the energy needs that are still there as a result of life. At some point, you're body will DEFINITELY remind you of this, through fatigue, mood changes, or body composition changes (muscle wasting.)
I could write 3 more emails about the perils of starting a GLP-1 without a plan or a registered dietician - I can't wrap my head around why this isn't a given for all. But here's the point: The people who I've seen succeed without an abundance of challenge start with a plan for smaller, consistent meals throughout the day.
Essentially, they begin the plan that they will continue with when/if they taper off of the GLP-1. Due to the lack of appetite, they often have to use willpower TO eat, which is a new challenge. However, with the right support (ahem - coach 😀) they can build a really strong set of dietary habits that helps them sustain their lifestyle changes beyond the initial phase of taking the medications.
The other positive (in my mind) is because their cravings are lessened, they have the brain space to choose foods that are higher in nutrient density and lower in palatability. This means that instead of reaching for the high fat/high flavor/craving-busting food, they have the ability to consider a meal that will actually satisfy their nutritional needs of fiber, protein, and low starch carbohydrates.
This comprehensive planning is important for everyone, regardless of budget or income level. In fact, many of the people I work with are on a fixed income and we do have Dollar Tree shopping lists that we work from as well as those from the grocery store.
Some People Don't Do Well On GLP-1s
It's heartbreaking. A client is tee'd up to start their medication, hope is high, the plan is ready, insurance approved and they take their first injection only to find out that the medication makes them sick as a dog.
The side-effects can be real. Between nausea, vomiting, and diarrhea, finding out that you aren't compatible with a GLP-1 can be as harsh as being introduced to motion sickness on your first fancy boat ride...
There are some things I've seen help people: a different dosage, a slower titrating of dosage, anti-nausea medication. But sometimes, it's come down to the medication simply not being a good fit for the person. In this case, we've turned back to the plan. Yes, it's harder. Yes, it takes more effort. But with support, great things are possible.
Navigating through disappointment is challenging, and that's one of the aspects that I'm there to help my clients with. Working through the grief of what they hoped they would receive. Moving forward to a new and more appropriate goal for them. Finding a different route with less suffering. It is hard, but worth it. And I'm there each step of the way.
In my next email, I'll share about the unexpected moments I've encountered when clients are ready to stop their GLP-1 medications. They are tired of not having an appetite, feel like they've lost enough weight, have their blood sugar under control, and want their life back. We'll look at the best practices we've used with their care team to keep their progress going. I'll also talk about the plans we develop for those who can't tolerate or afford the medication but still want to make a change.
If you are curious about GLP-1s the first place I recommend going is to your PCP for an annual check up and an A1C test. This test is often part of an annual work up for those of us in midlife and will give you a 3 month average of your blood sugar levels and where you sit on the spectrum of blood sugar management.
Finally, while this information is for sharing purposes, I want to hear from you. What is the single biggest question you have about GLP-1s? Or the long-term changes needed to sustain progress when it comes to shifting your diet and lifestyle?
Hit reply and let me know. I'm happy to share where I can and will definitely source out the answers from a trusted medical professional if I don't have them myself.
Living Well With You, Not At You,
Coach JZ (Jenna)
P.S. - this email was written with my fingers and not AI. I've been using dashes since before AI was a thing - it's how I talk in real life.
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