GLP-1 Medications are a Tool, Not a Solution
GLP-1 medications, sold under the brand names Ozempic and Wegovy, are extremely effective tools for weight loss, with patients losing up to 14% of their body weight on average. Because they are still new to the market, the long-term effects are largely still unknown. As is true for any diet regimen, there is a risk for weight rebound when patients stop taking their medication.
So what is the plan, post-medication?
This is a valid question. It is not appealing for most people to consider a lifetime medication to control their weight. At the end of the day, while these medications are powerful tools to help people regain their health, it’s worth discussing how to use this tool to build a sustainable lifestyle patients can maintain when they come off of the drug.
The problem is, obesity is a consequence of the unhealthy modern food culture we live in. When the medications go away, the environment remains, making it all the more important to build healthy habits that last.
Obesity is an illness of environment
Obesity and weight related chronic illness has risen steeply in the past 20-30 years from less than 15% of the population to almost half today. People did not change biologically in this time, but our food environment has changed significantly.
Not only has the quality of our food gone down with the invention of highly palatable and addicting processed foods, but our general wellbeing has also declined, creating an overworked and overstressed population. It’s no wonder people have turned to easy outs like convenience foods and too much screen time to ease our troubled minds.
The problem is, taking these outs is like putting a bandaid on a broken leg. While we avoid the hard feelings in the moment, we actually compound our problems over time leading to depression, illness, and yes, obesity.
In GLP-1 medications, people are beginning to find a way to overcome food addiction and take back their health, but it doesn’t solve this problem of environment. There is a risk in giving people medications without the tools to continue the hard work of managing their health when they move on from weekly injections.
It’s clear that medication alone cannot solve this problem. That’s why we like to help our patients to learn to use their medication not as a one stop solution to weight loss, but as a tool to build a healthy lifestyle they can maintain for the rest of their life, medicated or not.
How GLP-1 medications work
Glucagon-like peptide-1, or GLP-1 medications, are an analog for a hormone that is naturally secreted by your body during digestion. They are called tirzepatide or semaglutide and were originally prescribed to help people manage their type 2 diabetes.
When doctors realized that a side effect of these medications was weight loss, it sparked new research and medical providers began to prescribe the drugs off-label to help people lose weight.
GLP-1 medications work by cueing your body to release satiety hormones, making you feel fuller. They also regulate blood sugar and slow stomach emptying, making the patient feel fuller for longer. Other than weight loss and diabetes care, the medications have been found to help lower blood pressure and cholesterol.
Some side effects of the weekly injectable medication include nausea, diarrhea, and constipation that can be managed through diet and lifestyle and usually gets better within a couple of weeks of use.
Medication as a tool
The past few years, GLP-1 medications have sparked heated discussion, with many people expressing strong opinions on both sides. Some people feel that these drugs are a miracle and will help people overcome obesity and chronic illness. Others think they are a cop-out and that people should take more personal responsibility for their health sans medication.
We think, like most things, the truth falls somewhere in the middle ground.
The truth is, the reason that many people seek help in the form of medication at all is because they’ve tried everything else. It can be extremely difficult for people to overcome bad habits when they are trying to cope with all of the other stressors of modern life. It is equally hard to just muscle your way out of food addiction and a sedentary lifestyle with willpower alone.
For example, when someone gets sick with a bacterial infection, they are prescribed antibiotics. They might also be instructed to get more rest, stay hydrated, eat healthy, and stop drinking alcohol while they are on the medications. In this way, medications are used as a tool in conjunction with other healthy habits that will work together to solve a problem.
Medication can be a saving grace for people who are facing health issues and yet have no idea where to begin when it comes to taking back control. Rather than shame people for using a highly effective resource, we feel that it’s more productive to discuss how we can best harness this tool to empower people reach a point of independence.
How to build a healthy lifestyle with GLP-1 medications
The key to harnessing GLP-1 medications not as a catch-all, but as a tool to help you take back your health, is by letting the medication remove the variable of willpower. This allows you to focus on the harder to achieve, long term functions of a healthy lifestyle.
Many of our patients say that when they start these medications, they are shocked by how effortless it is to stick to a calorie count and how they no longer desire the same indulgences that used to drive them crazy with craving.
Let’s take a look at four ways to build healthy habits into your lifestyle while on GLP-1 medications.
Count your calories
One issue we see regularly brought up online is the potential for GLP-1 medications to induce or exacerbate an existing eating disorder. While there is potential for this to be true, these medications are prescribed under medical supervision. Ideally, medical professionals will be able to identify disordered behaviors and counsel a patient to overcome them or stop the medication entirely.
Under-eating while on GLP-1’s could pose a risk to the patient when they eventually stop using the medications. Not only will their weight bounce back, but their metabolism could also be negatively impacted, making weight loss harder to achieve or maintain in the future.
This medication is not an excuse to under-eat, but presents an opportunity to build a diet you can stick to. This may mean monitoring your calories to stay within a deficit but also ensure that you are eating enough. Calorie counting can help you to stay accountable and relearn what a balanced day of eating looks like. This is an important reality check for a person who has been overeating for years.
We don’t recommend food logging long term, but doing so for weeks or months at a time is a powerful lesson in portion size that you can carry into your everyday life.
Cut out highly processed foods
Many patients report feeling less cravings for highly palatable, highly processed foods that lead to weight gain. These foods are often also addicting because they have been developed in labs to keep you wanting more. GLP-1 medications can help quiet the mental noise of craving and desire and help you to ditch those foods that trigger you to binge or which you have a hard time controlling yourself around.
When you stop eating highly processed foods regularly, they start to lose the addictive qualities that keep you wanting, and you begin to desire them less.
Use the medications as an opportunity to shift your diet in the right direction. Incorporate more fresh, whole foods into your diet, focusing on lean meats, poultry, and fish, whole grains, fresh produce, and healthy fats.
Not only will building a healthy diet help you when you come off of the medications, it will actually help you to manage adverse side effects which are made worse by eating greasy, high fat, processed foods.
Build an exercise routine
Making major lifestyle changes takes a lot of mental and emotional energy. It can be really hard to change your diet and introduce exercise all at once. The medication’s power to clear mental noise around food can make it much easier to stick to your diet which in turn frees up energy to start building routines in other areas of your life.
Adding exercise into your daily routine will help you sustain your weight loss long after you come off of medications. Exercise can help you to maintain muscle mass as you lose weight. It will also help you to lose weight faster, stabilize your mood, give you more energy, and give you stronger muscles and bones. All of these benefits help you to age more gracefully.
Everyone’s relationship to exercise is different, and it should be positive and fulfilling rather than feel like a punishment. Choose a form of exercise that you actually enjoy, whether it’s walking, yoga, running, weightlifting, zumba, kickboxing, or swimming. Choosing something you actually enjoy will only make it easier to continue doing it after you finish with the medication.
Address your stress
Stress makes everything harder, and is one of the leading factors that has caused our population to become disproportionately obese and chronically ill. Traditional dieting only adds another stressor to your already full plate.
Just like the medications can help you to build new routines like exercise, making weight loss easier can help you to have more time and energy to spend on addressing the other stressful parts of your life. Eating healthy and exercising is part of that stress management, but so is connecting with your community, having hobbies you enjoy, and getting adequate rest.
Take the time while on medications to create a lifestyle that minimizes stress and is holistically healthy. This can look like exploring tools which help you to cope with everyday frustrations such as meditation, journaling, or therapy.
Some of the fittest people in the world are the most depressed and anxious. Health should encompass both mental and physical wellness, and it’s important to address both or risk burning out and ending up back at square one.
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Conclusion
Hopefully this post has given you a better idea about how you can use GLP-1 medications not as a crutch but as a very powerful tool to help you to change your life —and health— for the better.
When you are ready to slow down or stop taking GLP-1 medications, hopefully you will not have spent that time eating fast food, skipping workouts, and neglecting your mental health. Instead, you will have have built a lifestyle you can sustain all on your own.
Some people reach their goal weight and come off of their medication completely. Others go down to a monthly maintenance dose or use the medications only when they feel they need extra support.
Whatever you choose, make sure that you are using these medications as the amazing tool they are and not as a way to avoid the personal responsibility you have toward your health. You deserve to be healthy and happy, and it’s up to you to get there.
