Since I am an old lady who has made this health gain and weight loss trip so many times, I feel qualified to share my knowledge and experience with others who are new to the GLP-1 system or are confused how the rules are utilized with or against them.
Remember, I am not your care provider, so check with yours before starting, changing,
modifying, or quitting any of your prescribed medications.
If you watch YouTube videos about GLP-1s like I do, you’ll know the common missteps made by the marjority of newbies on GLP-1s. I took some of the more common concerns and complaints and try to answer them here.
“I’m on a plateau!”
I hear this when folks have usually been on the meds for less than three months. People, people, people, you are still titrating up on the GLP-1s and it can take 8-10 weeks to get an even dose going in your body.
If we quit every time we didn’t lose weight one week, we would quit many times! And never lose anything if we quit taking the medications. Doesn’t that sound like a diet mindset?
Even when we are not losing weight on the scale, we are probably losing inches. And we are definitely getting healthier on the inside of our bodies. I know this first-hand because I have diabetes. Even when I am not losing, I know that my kidneys are working better, my liver is regenerating, my pancreas appreciates the help, my heart is doing better… and so many other inside parts we rarely think about are getting healthier so we can live longer.
If you can see this as you continue doing your program… your walking, your weekly shots, your lifting light or heavy weights… you will be a much happier person instead of staring at the scale waiting for the numbers to move the way you want them to.
All you can do is your part. The scale will do what it wants to do. It does not happen overnight or in a week or sometimes not even in a month. These actions we are taking to lose weight are things we need to do forever. So go for it!
“When do I move up in dose?”
Moving up in doses is usually a care provider’s decision. But when might you ask for help from your provider? What are the signs that you might be ready to move up?
When we are starting and are taking the lowest dose, we might not have the complete shut off valve functioning yet for our old habits or how our body is misfiring the cues to eat, eat, and eat more. Keep in touch with your body… journaling your experiences each day is a great way to do that. That way, when you talk to your provider, you will be able to describe what you are experiencing. That is a great help for them so they can figure out if it is time to go up or stay on the same dose.
If you’ve been on one dose for a month or two and you do not have constant hunger pangs, food noise, and you are still not snacking and grabbing random foods without thinking, you are doing great on the dosage you are on. However, if you’re having the opposite and you do have those hunger pangs and food noise as well as finding yourself craving those chips, cookies, or fast food, it might be time to talk about moving up a dose.
“Why Am I Losing Weight So Slowly?”
This is such a common question and deserves a few minutes to answer.
First, the closer you get to your goal, the slower the weight loss. That means, if your goal is only 20 or 40 lbs. away, you will not lose as fast as I did when I was 405 lbs. As I have gotten lower, my weight loss slows incrementally. I do not have a goal weight, but know I am almost done losing any more because I am having 8-10 week “stalls.” I will go up and down one pound for those 8-10 weeks. Then, for some unknown reason, I will begin to lose again.
I do not do the “eat more so your body doesn’t think it’s starving” thing like so many people do. I just eat like I always do and move my body with walking, weights, and bands. Sure, I change up the routines with body movement (exercise), but generally, I don’t change things up too much. Especially with what I eat. More on that in a moment.
If you are far from the weight you are wanting to be and are still losing slowly, there can be a few reasons:
- About 15% of people on a GLP-1 do not lose weight on the medication they are taking. This is called being a Non-responder. Slow/Hypo-responders do lose weight, but at a very slow pace compared to the study statistics. Perhaps they are on Wegovy (semaglutide), it would be good to change to Zepbound (tirzepatide) and see if that works better with your body. Or, if you are on Saxenda (liraglutide) and not losing, moving over to Wegovy, if you can, might do the trick. Of course, all of that switching around depends on your insurance, I understand that. If none of the changes help with the issue, you might have to wait until the next generation of weight loss medications come out. Retatrutide, Orforglipron, Survodutide, Bimagrumab, Mazdutide, and more are in the works. I am a Super/Hyper/High-responder because I have lost so much weight on the GLP-1s Trulicity and Mounjaro. We don’t know yet if it is genetics or some other reason for the differences in responders. It, most likely, is not your fault.
- You have not begun to move your body (aka exercise). You have heard it 100,000,000 times. The medication is half the battle to correcting your diabetes, metabolic syndrome, or helping with your having clinical obesity or overweight. Walking is often the first movement most of us do. When I started at 405 lbs., the furthest I could walk was to the bathroom and back. I was exhausted, but vowed to not use the walker as I had been for years because I was incredibly motivated to get my ass in gear. Gradually, I got to the edge of the living room, then to the kitchen. When I walked down the stairs, I had to get back up them. The day I made it to the mailbox, about 1/8 of a mile away, was a banner day for me. Granted, I had to stop and breathe twice to get there and four times to get back and up the stairs, but I did it! I kept going. Now I can walk 3+ miles a day and it makes me so proud. I also started lifting soup cans (see below in the “I Can’t” section) and finally 2, then 3. then 5 pound weights. I watch YouTube and follow the videos for beginning seniors, even now, two years in. Some days are harder than others, but I keep going. You can, too! Just start. Somewhere. And move your radius outward into the world If you are lucky enough to not weigh 400 lbs. to start, get going! If you do weigh 400 lbs. or more, you can get going, too. Do what you can. And then, do more. The medications, I feel, do half the work. Sure, you can sit on your ass and lose weight and muscle and that will show up on the scale, but how fit will you be? How will you live your new lifestyle if you can’t get off the couch? As Nike says, “Just Do It!”
- Eat the amount of protein your care provider, nutritionist, dietician, or wherever you can find a protein advisor says to eat. Note that online, you will find a lot of conflicting information about how much protein a body should have. That’s why it’s best to look at people that weigh about the same and have about the same amount of activity as you want to have. Don’t be looking at body builders or marathon runners unless you are doing those things. If you want to run a 5k, a 10k, or a marathon, each needs a different amount of protein in their diets. I encourage eating protein first so you get that in. Everything else can build on top of that in your stomach.
- Drink your water! You have heard this a million times, too. This also has a formula you can research, but I am easily drinking 120 ounces a day. (I was actually drinking 240 ounces and my health advisors were horrified! So were my kidneys. That’s why I dropped it down to a more manageable number of ounces.) 80-120 ounces a day is pretty standard. Getting a 40 oz. bottle makes it easier to count the ounces than a glass. I also track my water now to make sure I am not drinking too much.
The gist of all of that is to do what you know to do already. It is crucial to get into these habits from the beginning so you are able to sustain them throughout the rest of your life, whether you will be taking GLP-1s forever like I will, or want to maintain your weight after stopping them. (That is a whole post in itself. I will post that soon.)
“What Do You Eat?”
I eat mostly protein and Lean Cuisines or Healthy Choice meals.
I am really into the Jimmy Dean egg and chicken or turkey sausage dealios.
I get up about 5:00 am, sometimes earlier (without an alarm) and go for a walk at dawn, before the sun comes up. First, it is hot as Hades in Florida right now and second, I have had malignant melanoma three times and have been commanded to stay out of the sun.
After my walk, I drink a protein drink to get at least 30 g of protein in because I won’t eat anything else until 2:00 pm or so.
Before bed, I will have another high protein snack like yogurt or cottage cheese.
Now, I love cottage cheese so when I saw this one, I was so excited! 19 grams of protein!
Too bad it tasted like caca and I had to toss it. And seriously, I really love cottage cheese. This was just gross.
“I’m Not Losing Any More Weight & I Am Not At Goal Yet.”
The reality is your goal weight might not be your body’s goal weight. Every body has it’s own needs and wants and when it reaches them, it will fight you to stay there. Sure, you can up your body movement or lower your calories, but your body might rebel with fatigue, getting ill, making you hungrier and hungrier, despite the medication.
I see so many people depressed because they do not lose any more no matter what they do. It doesn’t matter if they need to lose 20 or 200… they think they have control over the numbers on the scale. The sooner folks can let go of the control about something they have no control over, the better. Until then, do what you know you need to do… for the rest of your life. Not just to reach a number on a piece of metal that holds you up and spins numbers. The scale is nothing more than an invention of people. Sure, I like watching the numbers go down just as much as everyone else. However, it can be disheartening if you don’t see the magical numbers you want to see on it. Our ancestors had no scales. They ate what they needed and went on with their days.
There were people in our history who had obesity and overweight, but they were usually the wealthy and didn’t have to forage for their own food. Our bodies were meant to migrate the earth and eat what we could find. Hunter-gatherer cultures, even today, eat about 2000-3000 calories a day and burn an average of 2650 calories a day. In those cultures, men typically walk about seven miles a day while also working hard in the sun. Women walk about three and a half miles a day, but they also stoop, forage, and cook while doing all of that. They never give a thought about their weight. Dieting is not a part of their lives.
It is crucial to understand, this is not a trip to a goal weight and then your life becomes amazing. This is your life. Forever. For-ever. Focusing on the scale is just going to drive you crazy. Focus on your life and live it. Find a hobby. Do something for someone else. Just live. If you do the medication and the movement you need for your body (exercise), things will settle into place.
“I Can’t… Walk Outside/Afford the Gym/Afford weights/
Walk very far/Walk outside because I am embarrassed/
<Fill in the excuse of your choice here>
- Weather Part 1: I am in Florida and it is roasting here. So I walk at dawn. I am up before the sun and walk watching the sun rise. I am home before it comes up over the houses and gets suffocatingly hot. If you aren’t an early bird like me, walk as the sun is setting.
- Weather Part 2: If it’s freezing where you are, then dress for the weather and work up a sweat walking in the snow. I always have to remind myself people around the world live in every climate that exists… from deserts to the icy tundra. If they can do it, so can we.
- No Money for Gym: I have zero extra money or time to go to a gym. I need to stay home and do my “workouts” when I have a few minutes here and there. One does not need to go to the gym to move their body enough to save their muscles. As I got more and more fit, I began watching beginner-senior workouts on YouTube, sometimes just sitting workouts when I was still pretty heavy.
- No Money for Home Gym Gear: This is one of my faves to offer ideas for. I didn’t have weights for a year and a half. Even the ones I have now are just 2, 3, and 5 pound ones. What I did before was use soup cans as my weights. I was so unable to lift anything because I was carrying around 400+ pounds, but as I started getting healthier and losing weight, I was more able to lift something besides my body.
I didn’t even start with regular Campbell’s Soup cans, I started with those half-size vegetable cans. It was all I could do. Then I got the full-size cans, then the Campbell’s Chunky cans… and I kept moving up and into small liquid laundry soap bottles then the next size up. If you’re stronger than I am, keep going up until you are using Costco brand size!
When I started walking, I moved down to the smaller cans again and walked with them, using them as weights. When I felt they were too easy, I gradually moved up in size.
If you don’t have cans, put beans in a plastic grocery bag. Or rice. Or sand. Or dirt. Or kitty litter (clean!).
Carry tangerines, then oranges, then navel oranges, then grapefruit.
Bring cantaloupes with you on your walk.
Grab some apples.
Be creative!
One can do isometric exercises with a rolled up towel or a long rope… or just your own arms.
Exercise/Physical Therapy/Resistance Bands are relatively inexpensive. I got these from Amazon for $14. There are classes on YouTube for beginners and those who need to do the workouts while sitting.
Borrow anything you can. People always have extra gym equipment holding their clothes in their bedroom. I borrowed the bands at first until I could buy my own.
Find workarounds with obstacles. There is always another way.
Now Get Out There!
All of this is to say:
Keep going!
Quitting is what you do on a diet. You never quit on life.
Stay strong and be brave!
