My Year on GLP-1s

This year flew by. I guess that can happen when you are busy living life and not thinking about weight loss for the first time in your adult life. 

I have always been open about my decision to use GLP-1s. I never tried to hide it or pretend like my weight loss was from anything other than what it was. I wasn’t ashamed to be on them. I knew there would be comments and opinions and I was okay with that.  I recently heard a weight loss Dr talk about how your decision to admit to using GLP-1s was a personal one and it was ok to not share that with people - trust me there were times I wish I hadn’t. But she said to consider what that would mean for the woman or women who would inevitably ask you how you lost the weight? If you told her you just started eating better and working out, she would walk away feeling like she was the problem. Like she lacked willpower, why couldn’t she just do that? Or worse, she already was doing that and still wasn’t losing weight. She would feel defeated. I wasn’t going to do that, especially not as someone marketing herself on Instagram as a woman’s health nutritionist. Imagine how many women would have potentially hired me thinking I did this with nutrition and lifestyle alone. Trust me, I made all the changes I recommend to my clients, and just like some of them, wasn’t seeing the weight come off. 

Let’s get into why I made this decision.

I had been pre-diabetic since I was in my 20’s, always struggled with high cholesterol, and have a bum ankle that, through the years, has made it increasingly difficult to move my body in the ways that I used to. Having chronic pain is no fun and carrying excess weight on a little joint that constantly hurts was impacting my quality of life. 

I also have a family history of cardiovascular disease that robbed me of two very special people. I had a cardiovascular risk panel done last year prior to starting, because metabolic syndrome and excess belly fat are two very real risk factors for cardiovascular disease (and your girl had 'em both). I wanted to see if I was in a high-risk category. My labs came back pretty dismal, my cardiovascular risk factors were all in the highest/most severe category. 

It all kind of came to a head for me. I had gained weight again, my labs were a dumpster fire, I was told I needed a total ankle replacement, and I was in a lot of pain. 

So, when people would talk about this being a quick fix for weight loss, or cheating, I would wince on the inside. Try living in someone else’s body before jumping to conclusions about their health choices. But I digress….

I had a few things going against me - blood sugar dysregulation makes weight gain real easy and it makes weight loss real hard. Unless you can get a handle on the blood sugar imbalances, and all the hormone and metabolic implications that come with it, you are going to feel stuck in this cycle. The others were perimenopause and stress. I was still in the thick of grief over losing my brother and was trying to grow a business online...I was super stressed. 

If you saw my Stories on Instagram last week you know that I had done “all the things” at different times in my life. I tracked every ounce of food that entered my mouth and worked out diligently. I was able to get to my ideal goal weight or at least lose enough to help my self-esteem several times in my life - and that never improved my cholesterol or blood sugar markers. When I learned I could potentially improve my metabolic health, improve my cardiovascular health, potentially ease some pain while buying myself more time for an ankle replacement, and lose weight at the same time, I was fully in. 

I asked my PCP if I would qualify for Ozempic with my higher than optimal BMI and pre-diabetic status, but she said my BMI wasn’t high enough and told me to try to get it on my own. So, although my PCP couldn’t get it for me, she told me it was worth giving a try - I’d just need to get it on my own. 

So, I did. 

The first couple months were rough. I was sick to my stomach a lot, was constipated, wasn’t losing weight as fast as others (which I am grateful for now!), and was so food averse that eating was super challenging. Not an ideal place to be. Especially as a nutritionist who believes in nourishing food and gentle approaches to reaching health goals. I remember being at a gathering and watching people snack while socializing and it literally made me go white as a ghost and I had to leave the room. It wasn’t just difficult to eat, it was difficult to watch others eat as well. I decided to change from semaglutide (Ozempic) to tirzepatide (Wegovy/Monjauro) to see if I could get some relief from these side effects. It helped a TON! I felt better, was able to eat more and really felt like myself again, minus the food noise. 

Let’s talk about food noise. 

I didn’t realize why I mentally felt so good on these injections. Maybe it was impacting neurotransmitter levels in some way? Maybe this form of “fasting” was beneficial to my energy and mood? Then, a woman I met who was also on GLP-1s, asked me how it was now that I didn’t have the food noise, and a lightbulb went off! THAT WAS IT! That was what I was experiencing. Food was just fuel to me now. It wasn’t something I was constantly thinking about. For me, it wasn’t just that I love to eat and constantly think about my next meal, it was more this constant judgement of what I was eating, why I was eating, when I was eating. 

Food had morality attached to it, and I seemed to always be viewing it in the context of bad.

Any time I went off whatever new track I had placed myself on with food, I instantly felt guilt and shame. I snacked way too often because I would feel paralyzed at what to eat anytime I tried to restrict myself. I would end up under-nourishing myself and wrecking my metabolism even more. I would go to extremes, lose weight, start to judge food again and how bad I was around it, and gain all the weight back. 

So unbelievably exhausting. And for what purpose? I was never any closer to understanding how to best nourish my body without constantly tying food to weight loss. And judging myself for not being able to fix this and keep weight off. 

I wasn’t looking for a quick fix. I needed a break. A moment to breathe. 

 This year gave that to me. Have I done this perfectly? Nope. Have I learned new habits and skills, new tools to support my body in a better way, 100%. Do I feel 100% confident that I can come off these fully and maintain my weight loss and health benefits, yes and no. I feel like anytime you have gained and lost the same 40-50 pounds over and over again, you carry this sense of fear. I have said, “never again” several times in my life. So, a very deep part of me fears gaining weight again. And that is something I am really working on as I taper down and start to micro-dose. I need to be in a place of trust with my body. 

 I do know that I am wiser, I know what my triggers are. I know what stress does to me mentally and physically. I know my body better. I was able to do that because I knew I would lose weight without having to feel like I traded my sanity for it. I was able to focus on the root causes for me, to really figure out the mental aspect, and how to set myself up for long term success.  And I gave myself enough time to make these habits part of my new baseline. To teach my body that this is its normal weight, its new homeostasis. I knew I would be on these for 1 year. That was always my goal, as long as my body did well on them. I wanted to give myself enough time to get sustainable results. 

 As I have started coming down on dose over the last 5 months, my appetite has returned a little. I no longer have to make myself eat; I am ready to eat. I am intentionally eating more but making better choices. And my weight has held steady. I reached my goal weight 5 months ago and have maintained that. 

I recently celebrated my 45th birthday and had no desire for cake. It is a choice I made based on my goals and the fact that food is fuel to me now. Not because cake is bad, and I lack willpower and don’t care about my goals if I eat it. I might have cake next week and won’t assign morality to that decision either.  I am learning to trust my body. I wouldn’t have been able to feel this way without GLP-1s. My experience and my honesty with myself help that statement feel very true to me. For me, this was what I needed. 

Common things I was and was not worried about while taking GLP-1s:

Thyroid cancer: no family history and I checked in on my thyroid with blood labs before and 4 months in.

Losing my gallbladder: a little worried. I think I potentially had a gallbladder attack a few years ago, so I paid extra attention to pain in that upper right quadrant area. All good one-year in.

Losing muscle: newsflash, any time you lose weight this is likely going to happen, especially if you aren’t prioritizing strength training. But this isn’t a long-term thing unless you continue to restrict and not move your body. Movement isn’t an issue for me. Even though I am in pain daily, I still make it happen. I likely did lose some muscle early on, but I knew that would happen. I have always been on the more muscular side and still have a little bit of a booty. No Ozempic butt over here. 

I get asked a lot if I think someone should go on GLP-1s and my answer is always, maybe.  

Just because something was right for me (and worked for me) does NOT mean it is what’s right for you and will work for you.  My goal has always been to share my experience and to be a safe place where women could ask questions without fear of judgement. I am very honest about my belief that this will be another yo-yo dieting moment for you if you don’t set yourself up for success and learn new habits and skills related to your relationship with food. And there are other ways to lose weight besides GLP-1s. I don’t want anyone to think this is the only way. Finding the root cause and addressing your unique issues and imbalances plus having a plan and the right support can help as well. 

For me, so much of this was a mental game and I was tired. 

For myself, and for a lot of women I've been able to connect with, this has been about so much more than just “getting skinny” - it is improving metabolic health and lowering inflammation too. Will these benefits last once the GLP-1s are stopped? Only time will tell I guess. But again, GLP-1s aren’t the only way to see health benefits, they are simply a tool that allows you some breathing room to do the deeper work. You get to keep making the changes that support and nourish your body once you come off GLP-1s and I truly believe the health benefits will last as you continue to prioritize these changes and continue to stay tuned in to your body. 

Anytime we make health changes and see positive benefits, we have to be prepared to make some of the changes a lifelong habit. There are women who lose weight in a way that is “socially acceptable” and once the habits come back so do the old health challenges and weight. This is no different, and we have to decide to use GLP-1s in a healthy and responsible way in order to not get right back into the cycle that led us to try them in the first place. 

I also wanted to hit on what happens when you lose a lot of weight. 

Not all of it is positive. I have been told that I am too skinny and that I shouldn’t lose any more weight - not something I ever thought I’d hear! Here is what I think is happening; people get used to you being a certain weight. I am certainly not too skinny, but I’m also no longer overweight. No one who just met me would ever walk away and say I’m too skinny, that is FOR SURE. But people who know you best and are used to seeing you overweight, may feel that way. Let it go. Protect your energy. It is an odd feeling though and not a comfortable one, because it still makes you feel like your weight is a defining feature of who you are as a human. That people are still seeing your weight and making judgement calls about it. 

Honestly at one point I told my husband that I just wanted people to stop talking about my appearance. I just wanted to live my life and be me, without weight always being at the center of my existence - either for me or for others. 

The other issue was anytime someone asked how I lost weight and their first reaction to me saying GLP-1s was not a positive one. “Thank you, Deborah, yes, I am glad you think I am going to just gain it all back, thanks for the encouragement. That thought hadn't crossed my mind at all!”

I don’t sell GLP-1s. I am not here to monetize off of women taking them. I just wanted to be an honest voice based on my own personal experience for the women who had questions. Anytime something becomes popular, you will have voices on both sides vying for likes and views and follows and the more extreme the thoughts the more attention it gets. I never wanted to be a GLP-1 nutritionist - I still don’t. I literally have zero clients who come to me for support while on GLP-1s. I can just share my opinion and have conversations with women with no strings attached. 

I am grateful for this past year. 

I have learned a lot about myself and have been able to focus on life and joy and growth and my goals in a way that I couldn’t before. My weight and my self-esteem were a barrier to a lot of things in my life. As I get more in the thick of perimenopause, I have learned to do things my way and shut out the noise. To trust my decisions and to be curious about what I need to feel my absolute best. 

You deserve that too. No matter what health challenge you have or health goal you are longing to reach, you are capable of getting there. Be patient, be kind to yourself, be curious, be honest about what factors are getting in your way, be ready and prepared to dig in and do some work. Make the small steady changes that you need. Trust yourself.