Should you be on a GLP1? I get this question all the time. In fact, I have wondered this myself multiple times. And, if not a GLP1, should you be on some sort of weight management prescription drug, supplement, protocol, diet plan, or sign up with a health coach? It is maddening! I can’t even open up Instagram without getting targeted ads for online GLP1 companies and supplement companies targeted to support GLP1 use.
Big deep breath, and big step back. Weight loss is complicated. If it were as simple as many make it seem, it wouldn’t be a trillion dollar industry. Let’s start with the basics. Weight is complicated – It is not just diet and exercise although those are big and important parts. We’ve identified over 400 genes responsible for metabolism and weight and 40 hormones responsible for metabolism. Poor sleep and stress are also huge factors contributing to weight loss/weight gain/inability to do either of those things. That’s typically where I start the conversation with patients when they are inquiring about weight. Other factors include your gut microbiome and gut inflammation – WHOA another area of market opportunity to target women with tests, protocols, supplements, and the next latest and greatest. Smoking and alcohol surely do not help matters. Stress and poor sleep can complicate this picture even more!
So how do you know you are a good candidate for weight loss medication? If you are willing to use it alongside an intentionally focused diet, exercise, prioritizing sleep and stress management, and having goals for weight loss. Goals for weight loss can include a “number” whether it’s a scale number, a body fat percentage number, a clothing size number, but that shouldn’t be the only goal you have. Goals should also include non-scale victories such as blood pressure reduction or reducing the amount of blood pressure medication you are on, reduction in LDL or triglycerides, being able to keep up playing with your kids or grand kids, reduced weight leading to reduced back or knee pain so you can remain physically active, and others.
What kind of diet should you be on? One that works for you, long term. I am not a diet girlie. I rarely recommend intermittent fasting, keto diet, or gluten-free (unless indicated) to my patients. Instead I counsel on the need for a wide range fruits, vegetables, whole grains, non-animal proteins, hydration and limiting sugary beverages. Shopping the perimeter of the store and eating all the colors of the rainbow is good general nutrition guidance. I don’t like restrictions, and I don’t like eating a certain way that is not sustainable for the long haul. Am I 100% against convenience foods or processed foods? Absolutely not! I am a mom and a business owner myself, and some days if it weren’t for these foods, I wouldn’t eat. I do advise (myself and) my patients to limit these to the best of their ability, but if it’s between eating no food and eating something processed, I’d rather you eat something processed. Be reflective and intentional on meal planning and meal prepping, making it a family effort, and we can limit when those “crunch” times happen. When individuals start a GLP1 they may have appetite suppression, but that is not the goal of the GLP1. It is important to eat small, frequent meals. You may have to avoid big salads or raw foods that require a lot of digestion as this may worsen the side effects when you initially start.
For exercise, it’s important to get cardio, weight training, and stretching/mobility training. What ratio that is for you, that depends on a lot of factors and it’s important you work with a healthcare provider. If you are on a GLP1 it is very important that you include strength training as part of your regimen, because GLP1’s don’t just make you loose fat, they make you loose muscle!
So, if you are incorporating all the lifestyle measures, or at least some with the plan to incorporate them as you get going, and you have clearly defined goals for yourself, then yes a GLP1 might be right for you. It is my advisement that individuals get these from a qualified healthcare provider who knows them, knows their medical history, and can have frequent contact with for monitoring, adjustments, side effect amelioration, and titrating as needed to meet goals. I would strongly encourage individuals to avoid getting these products online from third party telehealth companies. Just my 2 cents!
