Like many things in the health space, my views change over time. If you've been subscribing here for a while, you might recall this post I did a while back. As drugs like Ozempic were gaining in popularity, it seemed like we were living yet another version of fen-phen. But alas, not only has it stayed popular, but newer and more effective versions have come on the market. I have over 15% of my clientele taking some form of a glucagon-like peptide-1 receptor agonist (GLP-1RA)
Why, you might ask, would one of my health coaching clients still need a drug like this to lose weight if my advice is so good? Well, because they need that extra nudge. It's that simple. Human bodies are not designed to live in an abundance of calories 24 hours a day, 365 days a year. We are designed to go through periods of feast and famine. Days of plenty and days of want.
Our metabolisms just haven't adjusted yet to the fact that food is no longer scarce.
Over the last year or so, I have stopped discouraging clients from trying these new drugs and instead have embraced how to enhance their effects. Of course, we ensure they have done all the foundational things first to optimize their metabolism and body composition. This includes the four categories of health being dialed in: nourishing well, moving appropriately for their goals, exploring root causes of weight loss resistance, and maybe even sprinkling in strategic supplementation. Then, and only then, do I work on helping them get the best results at the lowest possible dosage of these GLP-1RAs for the shortest possible time.
Even with medical intervention, I help them OWN THEIR WELLNESS.
A recent health-tracking poll found that 1 in 8 Americans (12%) have taken a GLP-1RA drug at some point. Forty percent of those took the drugs for the sole purpose of weight loss, not to manage diseases like type-2 diabetes or obesity.(1) But how effective were these drugs at helping people reach their weight-loss goals? According to this retrospective cohort study, after 72 weeks on GLP-1RA, patients lost on average 5% of their bodyweight. Other studies have shown that at the highest doses, weight loss of 15% can seen by 68 weeks.(2) But all that is assuming you want to stay on it long enough to see results. Several studies have shown that the vast majority of people stop taking the drugs way before they see meaningful results.(3) Why?
Adverse symptoms of the injections, such as nausea, diarrhea, and constipation, might be at play here. Oh, and, of course, the issue of cost (these drugs are not covered by insurance unless you have type 2 diabetes) and supply-chain issues.(4) But no, it has been my experience that many people don't want to hang in there for over a year to finally get back into their skinny jeans. We are still a society hungry for quick fixes. And I'll be honest, I'm glad that these drugs aren't the overnight miracle people want them to be.
My clients with the best success with GLP-1RA drugs also do all the foundational work to optimize those results.
Here are the strategies I have been implementing with my clients seeking to break through their weight-loss plateaus with or without medical intervention.
Optimize protein in the diet and eliminate empty calories. I encourage my clients to consume at least 1 gram of protein per pound of body weight. This will help maximize MPS (muscle protein synthesis) and minimize MPB (muscle protein breakdown).(5) If you go one step further and eat all your protein first, followed by your veggies, you will naturally eat less starch and empty calories. Every bite of food should help you reach your goals.
Focus on heavy resistance training 3-4 times weekly, hitting all major muscle groups. When we lose weight, regardless of how, we will lose a fair amount of muscle.(6) This will only further slow your metabolism and compound your body composition issues if/when you gain weight back. So, build muscle!
Manage your blood sugar. Tracking blood glucose can be very illuminating. Even if you don't have diabetes, wild swings in blood sugar (from food, stress, and lack of sleep) can wreak havoc on your inflammation and waistline. Your goal should be to have a fasting blood sugar of 90 or less in the morning and a post-prandial reading back at baseline (premeal) within 1-2 hours.(7)
Supplement to optimize gut health and maintain muscle mass. Remember, glucagon-like peptide-1 is a natural hormone our bodies already make. So why not try to get the most out of our natural ability to tap into it? Plus, by strategically supplementing to maintain our hard-earned muscle, we will keep our metabolism fired up and look even better as the fat starts to melt away. I generally recommend the following supplement stack:
Pendulum's GLP-1 Probiotic Pro contains specific strains that naturally enhance the glucagon-like peptide pathways.
BodyHealth's Perfect Amino powder will help you maintain muscle by replenishing you with amino acids you cannot assimilate on your own.
Pure Encapsulation's RENUAL enhances mitochondrial renewal. It features MitopureTM Urolithin A to power muscle function, increase cellular energy, and promote healthy aging.
Metagenic's Creatine UP will promote lean muscle growth and muscle strength with exercise and enhance cognition and energy production.
I believe so much in this stack, that I have bundled them together for you in my online dispensary.
I'd love to hear from you. Whether you have been trying one of these new drugs, considering it, or just trying to avoid having to ever think about them, tell me what you're doing and what your struggles are. I'm always here to help you OWN YOUR WELLNESS.
Yours in health,
DD
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