This Is All Too Familiar: GLP-1s vs. RNY

Sept. 13, 2023

I started at 405 pounds, BMI 74.1 on April 22, 2022. Quit Uber Eats and Salt: Down 40 pounds in 4 months With Trulicity: Down 86 pounds in 12 months / Today is Mounjaro Day 6: Down 7 pounds Total lost is 133 pounds. Today I weigh 272 pounds with BMI 49.7.

As I continue reading and learning about the GLP-1 and my GLP-1/GIP diabetes and weight loss medications, I am really surprised at how similar taking these meds is to when I had the Roux en Y Gastric Bypass in 2001.

Protein First

Before my RNY in 2001, it was drilled into us to eat protein first. That is the same admonition I hear with providers so we can make sure we get enough protein along with the fat loss. Muscle loss happens (hence Ozempic Face and Ozempic Butt) and protein first supposedly can help keep muscle mass instead of losing it, too.

I do want to say that exercise/weight training would do way more than just eating protein for maintaining/growing your muscle mass. Most docs say that, but I don’t hear people repeating that admonition so not sure if everyone’s listening.

Baggy Skin

Of course the Ozempic Face and Butt does not just happen on that one semaglutide medication, but can happen with all people who have rapid weight loss.

For me, I would rather have baggy skin than being so fat I have to buy medical gowns for people up to 600 pounds… which I did. Go ahead, make my face look like an old hag! I’m 62 and have very little modesty or vanity anymore, so that might make a difference. For most every baggy area, there is a way to take care of it and hold it from jiggling. Girdles/Spanx/Leggings/Long-Sleeves can all hide the gooshy parts if you feel you need to do that.

Around my 100-pound weight loss, I asked the girls if I should stop wearing sleeveless clothes and wear a sweater over my arms. Without hesitation, they told me to be proud of my jiggling skin. They said it quite enthusiastically, too. I was pretty surprised, but glad because it’s just too damn hot for long sleeves and sweaters. Amusingly, I got into wearing sleeveless because my arms were/are so big, I couldn’t find shirts or dresses that have arms big enough for me. It was just easier to wear sleeveless.

Sweet side story: My 4-year old granddaughter loves the soft and gooshy dripping skin from my upper arm. Initially, she called it “Huckabuck” which is a bread she makes at her Waldorf School. She said it felt like the dough. I thought that was so sweet! Then I taught her they were called batwings and now that’s what she calls them as she massages my smooshy skin. It’s endearing and my smiles show her that having a different body is a good thing.

Hair Loss

People are going on about hair loss. With Weight Loss Surgery (WLS), hair loss is common. When the body’s caloric intake plummets, unnecessary body functions go by the wayside. Hair growth or pumping heart? The body chooses the heart and says, “Screw the hair growth!” (Sadly, it doesn’t seem to stop growing on our legs or underarms! Only our heads.)

The hair loss is not forever, I promise. It can last a year or so, but usually less. I’ve never seen anyone go bald. Well, I am bald because I shave my head, so this is a zero issue for me, but I wouldn’t care if I did have hair.

Hair grows back.

Gall Bladder Issues

So many people had post-op gallbladder issues after WLS, doctors began taking it out during the initial surgery. Mine was not taken out with my RNY and I had no problems during my 190 pound in 1 year weight loss in 2001. Having rapid weight loss can send the gallbladder into distress. Thank heavens mine was removed 10 years ago!

Nausea & Vomiting

This happens with WLS, too. I have not had any on either the Trulicity or the Mounjaro, thank goodness. I learned that eating too much brought on a lot of nausea and vomiting. From what I can see with these meds, I am not sure yet if eating too much or noshing on greasy or cheesy foods causes folks to have more nausea than if they were eating cleaner. I’d love to hear from vegetarians and vegans about their nausea levels.

No Water During Eating

The one thing we did with WLS was we were told not to drink anything while eating because that flushes the food through the pouch and makes you hungry sooner. Of course, these medications operate differently, but I wonder if not drinking with meals might help mitigate nausea and vomiting as well and keep someone feeling full longer.

The Hoopla

Back in the olden days, the admonitions were the same:

• We don’t know enough about them.
• They were rushed through the testing process.
• We don’t know what they are going to do in the long term.
• Big Medicine & Big Parma are only in it for the money and don’t care about the patient.
• People are just going to re-gain weight. (And I did after my RNY, but it took 19 years to get to where I started before the surgery.)
• Folks have to take a dozen supplements to make up for the lack of food.
• The side effects aren’t worth it.

What is different from 22 years ago is there was no social media so the clarion call wasn’t nearly as loud as it is now. This is part of why I want to share that these admonitions have been around for decades now.

You are not alone!

photo by Barb Herrera