As someone who has struggled with weight my entire life, I know the frustrations and fears that come with the journey to a healthier you. I’ve been there—elated by the scale’s downward trend thanks to medications like Ozempic, Wagovy, Mounjaro, and Rybelsus, yet haunted by the thought of regaining the weight once the medication stops. I found great success with Ozempic but faced the harsh reality of its cost once I reached my goal weight. Armed with deep clinical knowledge and even more personal experience, I have a few insights to help you maintain your weight loss. These life-changing medications are efficient and effective tools, but if you’re not planning to take them for life, you’re going to need a solid strategy to keep the weight off.
The Medications: A Comprehensive History
Not everyone has done extensive research and every year more of these medications are making their way on the scene. Understanding the GLP-1 agonist and semaglutide medications, how and why they work helps illustrate why they are game changers in the diabetes and weight loss arenas. It can also empower you to make informed decisions. Let’s take a look at each one:
Ozempic
History: Ozempic, also known as semaglutide, was initially approved for managing blood sugar levels in adults with type 2 diabetes. It gained popularity in the weight loss community due to its significant impact on appetite and weight reduction.
Mechanism of Action: Ozempic mimics the action of the hormone called GLP-1, which is released into the bloodstream from the intestines after a meal. This hormone sends a signal to the pancreas to release insulin, helping to lower blood sugar. Additionally, it slows down gastric emptying and reduces appetite, which is why it’s effective for weight loss.
Wagovy
History: Wagovy is another GLP-1 agonist that was developed for type 2 diabetes management but has also shown promise in aiding weight loss.
Mechanism of Action: Like Ozempic, Wagovy works by enhancing insulin secretion from the pancreas and slowing down the rate at which the stomach empties after eating. This dual action helps control blood sugar levels and reduces the feeling of hunger, aiding in weight loss.
Mounjaro
History: Mounjaro is a newer player in the field, designed for blood sugar management in type 2 diabetes. Its weight loss benefits have made it a popular choice for those looking to lose weight outside of the setting of diabetes.
Mechanism of Action: Mounjaro also mimics the GLP-1 hormone, reducing appetite and slowing gastric emptying. These actions help improve blood sugar control and contribute to weight loss by making you feel fuller for more extended periods.
Semaglutides
History: Semaglutides are a class of medications, including Ozempic and Rybelsus, initially developed for type 2 diabetes management. They have been repurposed for weight loss due to their appetite-suppressing effects. Believe it or not, so many people are starting these medications that there have been shortages over the past year.
Mechanism of Action: Semaglutides work by enhancing the body’s natural insulin response, helping to regulate blood sugar levels. They also slow down the rate at which the stomach empties, reducing your appetite and efficiently leading to weight loss.
Rybelsus
History: Rybelsus is unique because it’s an oral form of semaglutide, making it more convenient than injectable forms. Unlike the other injectables in this class, Rybelsus needs to be taken daily, while the others are once a week. It’s used for managing type 2 diabetes and has also been adopted for weight loss.
Mechanism of Action: Rybelsus works in the same way as other GLP-1 agonists by enhancing insulin secretion and slowing gastric emptying. The convenience of being an oral medication makes it a popular choice for those who are needle-averse.
Each of these medications offers a dual benefit: they help manage blood sugar levels, especially in type 2 diabetes and aid in weight loss, even for the most weight loss resistant. Their mechanisms of action are based on mimicking or enhancing the functions of the naturally occurring GLP-1 hormone, which plays a crucial role in both insulin secretion and appetite regulation.
By understanding how these medications work, you can better appreciate their role in your weight loss journey and make informed decisions about what you want to take now and in the future.
Benefits and Side Effects: A Medication-Specific Overview
Understanding the benefits and the potential side effects can help you make informed choices about if you’re open to taking them, which is best for you and how long you want to stay on it. Here’s a quick breakdown:
Ozempic
Benefits:
- Rapid weight loss
- Improved insulin sensitivity
- Better blood sugar control
Side Effects:
- Minor: Nausea, vomiting, diarrhea, constipation, headache, dizziness, fatigue, and abdominal pain
- Major: Pancreatitis, gallbladder problems, and kidney issues
Wagovy
Benefits:
- Effective weight loss
- Enhanced insulin secretion
- Improved blood sugar levels
Side Effects:
- Minor: Nausea, vomiting, and abdominal pain
- Major: Risk of thyroid tumors, pancreatitis, and kidney problems
Mounjaro
Benefits:
- Significant weight loss
- Better blood sugar control
- Reduced appetite
Side Effects:
- Minor: Nausea, diarrhea, and constipation
- Major: Pancreatitis, gallbladder issues, and risk of thyroid tumors
Semaglutides (Including Ozempic and Rybelsus)
Benefits:
- Appetite suppression
- Weight loss
- Improved blood sugar levels
Side Effects:
- Minor: Nausea, vomiting, and abdominal pain
- Major: Risk of thyroid tumors, pancreatitis, and kidney issues
Rybelsus
Benefits:
- Convenient oral administration
- Weight loss
- Improved insulin sensitivity
Side Effects:
- Minor: Nausea, vomiting, diarrhea, and abdominal pain
- Major: Risk of thyroid tumors and pancreatitis
Again, each of these medications offers significant benefits; however, they all come with their own set of side effects, ranging from minor gastrointestinal issues to more severe conditions like gastroparesis, pancreatitis and thyroid tumors.
The Difference Between Losing Fat and Losing Muscle: A Critical Distinction
Add Powerful Image: A side-by-side comparison of 5-10 pounds of muscle and 5-10 pounds of fat, illustrating that muscle is denser and takes up less space than fat.
Understanding the difference between losing fat and losing muscle is crucial for anyone wanting to lose weight, but even more so for those on medications like Ozempic, Wagovy, Mounjaro, and Rybelsus. According to research, muscle is denser than fat and takes up less space in your body. This distinction is vital because while you may be elated watching the scale drop, you may not realize the type of weight you’re losing—fat or muscle.
Why Does This Matter?
Losing muscle mass can have long-term consequences. Muscle is metabolically active, meaning it burns calories even at rest. When you lose muscle, you’re essentially slowing down your metabolism, making it easier to regain weight. On the other hand, losing fat while maintaining or gaining muscle is the ideal scenario for sustainable weight loss and long-term health.
Take Action
If you’re curious about your body composition, I recommend using the free app MeThreeSixty to check your current body fat percentage. I was shocked at my results when I was at my scale low point, and you might be too. Knowing your body fat percentage can help you measure the effectiveness of your weight loss strategy and help you devise a more effective maintenance goal.
By understanding this critical difference, you can make more informed choices in your weight loss journey, ensuring that the pounds you’re losing are the ones you actually want to lose.
The Dilemma: What to Do Once You Reach Your Goal Weight
I remember the day I reached my goal weight like it was yesterday. The scale finally displayed that elusive number I’d been chasing for years. I was ecstatic, but also, I felt a tidal wave of anxiety wash over me.
What now?
As a member of numerous Semaglutides and Ozempic groups, I knew I wasn’t alone in this conundrum. I talk to people every day who are standing at this metaphorical cliff, and let me tell you, the struggle is real.
For me, the decision to go off the medication wasn’t taken lightly. I had to consider the financial burden, as the cost of these medications can be astronomical, especially without insurance and a diabetes diagnosis. I also thought about the long-term health implications and side effects. But most importantly, I wanted to prove to myself that I could maintain this new, healthier me without the aid of medication. I wanted to be free from the extra weight and the need for a pill or injection to keep me in this newfound body, finally at ease with my appearance.
So, what do you do when you’ve reached that coveted number on the scale? Well, you’ve got a few options, each with its own set of quirks.
Option 1: Stay on the Medications
The “Golden Handcuffs” Scenario: Ah, the comfort of staying on the meds that got you here. It’s like lounging in a luxurious hotel that you can’t afford long-term. Sure, you’re living the dream, but the bill will come due. For most people, the long-term cost of these medications is unrealistic, especially without insurance coverage. I’ve been there, weighing the pros and cons, and let me tell you, those golden handcuffs may look shiny, but they can weigh you down.
Option 2: Stop and Hope for the Best
The “Leap of Faith” Scenario: This path is akin to jumping off a cliff and hoping you’ll sprout wings on the way down. If you haven’t made any lifestyle changes, your appetite will return, and so will the weight. It’s like breaking up but keeping your ex’s stuff; they’ll probably come back for it. I’ve seen this happen to too many people, and it’s a gamble I wasn’t willing to take.
Option 3: Continue Dieting Without Medication
The “Tightrope Walk” Scenario: You’re off the meds but still trying to diet. This strategy is like walking a tightrope without a safety net. Your body might go into fat storage mode to protect itself, and eating the same amount as when you were on meds can actually contribute to rebound weight gain. It’s like quitting your job but still showing up for work; it doesn’t make sense, and you won’t get paid. I’ve tried this route before, and it’s a balancing act that’s hard to maintain.
Option 4: Find a Strategy
The “Master Plan” Scenario: This approach is where you need a solid game plan. Programs like ours focus on resetting your metabolism through lean mass and eliminating the chance of weight regain. It’s like having a GPS for your weight loss journey; you might still hit some traffic, but at least you won’t get lost. This wasn’t my initial choice (I tried Option 3 initially), but it eventually became my chosen route, and it’s been a game-changer for me.
Each of these options comes with its own set of challenges and benefits. The key is to choose the one that aligns with your long-term goals and current lifestyle. And if you’re standing at that cliff, remember, you don’t have to jump alone. There are strategies and support systems, like our program, designed to help you make the best choice for your health journey.
Case Studies: The Risks of Stopping Without a Plan
Case Study 1: Emily, 42
Before Medication: Emily had tried everything from keto to intermittent fasting with little to no success. She felt stuck and hopeless, convinced that her body was just “not made for weight loss.”
On Ozempic: Within weeks, Emily started losing weight. She experienced minor nausea but was thrilled with the scale’s downward trend. Psychologically, she went from feeling defeated to empowered.
Reason for Discontinuing: The cost became too much to bear. She was paying cash and couldn’t afford the $799/month indefinitely.
Transition Off: Emily was terrified of regaining the weight. She had nightmares about her old clothes not fitting and dreaded stepping on the scale.
Results: Physiologically, Emily regained some weight and felt sluggish. Psychologically, her self-esteem plummeted, and she started avoiding social events and avoiding running into people she saw when she was at her most comfortable weight.
Case Study 2: Mark, 51
Before Medication: Mark had tried gym memberships and personal trainers but saw no lasting results. He felt like he was throwing money down the drain.
On Semaglutides: Mark and his wife both lost weight. He experienced some abdominal pain but was otherwise ecstatic. His self-confidence soared, and he felt like a new man.
Reason for Discontinuing: Mark wanted to get back to working out and prepare for ski season without relying on medication.
Transition Off: Mark was cautiously optimistic but also worried about losing his newfound physique.
Results: Mark regained some weight and felt a decline in energy. His self-esteem took a hit, and he started questioning his decision to go off the medication.
Case Study 3: Sarah, 37
Before Medication: Sarah had tried Weight Watchers and even prescription diet pills. She felt like she was at war with her body.
On Mounjaro: Sarah lost 27 pounds and experienced minor headaches. She felt like she was finally winning the battle against her weight.
Reason for Discontinuing: The $25 coupon she initially had was no longer available, making the medication unaffordable.
Transition Off: Sarah was conflicted. She was so close to her goal and terrified of regaining the weight.
Results: Sarah regained some weight and felt defeated. Her anxiety levels spiked, and she became overly conscious of her eating habits.
Case Study 4: Lisa, 33
Before Medication: Lisa had tried vegetarianism, veganism, pescetarianism and even juice cleanses. She felt desperate and was willing to try anything.
On Wagovy: Lisa lost 15 pounds but experienced fatigue. She felt like she had found the magic bullet for her weight issues.
Reason for Discontinuing: She was changing jobs and couldn’t afford the medication.
Transition Off: Lisa was unprepared and anxious. She had no backup plan.
Results: Lisa regained all the weight she had lost and then some. Her insulin levels spiked, exacerbating her PCOS. She felt like she was back to square one, both physically and emotionally.
Case Study 5: The Author (That’s Me!)
Before Medication: Like many of you, I had tried it all—fad diets, exercise regimens, you name it. I felt like I was stuck in a never-ending cycle of weight loss and gain.
On Ozempic: I finally started to see the pounds melt away. Sure, I had some nausea, but who cares when you’re fitting into jeans you haven’t worn in years?
Reason for Discontinuing: The cost was just not sustainable for me, and I wanted to maintain my weight loss without taking medication for the rest of my life.
Transition Off: I won’t lie; I was scared. But I also knew that I had the knowledge and tools to make it work. Little did I know, I still had a lot to learn.
Results: After I figured it out (you’ll read more later in the blog), I managed to maintain my weight and even gained some muscle mass. Psychologically, I felt empowered, knowing that I had conquered my weight loss demons once and for all.
Each of these case studies highlights the emotional rollercoaster that comes with discontinuing these medications. The fear of regaining weight is real and can have both physiological and psychological impacts – even for someone like myself who has both the intellectual knowledge, a degree in human physiology, and a ton of personal experience. But remember, you’re not alone. There are strategies and support systems designed to help you maintain your hard-earned weight loss.
Tips While on Medication: Maximize Your Success
1. Don’t Skip Protein
Protein is essential for muscle repair and growth, especially when you’re losing weight. Skimping on protein can lead to muscle loss, which is the last thing you want. When I was on Ozempic, I made sure to include a source of lean protein in every meal, whether it was chicken, tofu, or a protein shake.
2. Eat Food-Based Fiber
Fiber helps with digestion, gives toxins something to bind to as you break them down, and will increase blood sugar stability and glycemic control. Too much fiber can get you too full too quickly, increasing indigestion and nausea or taking the place of the essential protein you should have had room for.
I always aimed for whole grains, fruits, and vegetables to meet my fiber needs. A simple strategy I used was adding a side of steamed vegetables to my dinners – it never made me too full, and I got my veggies in.
3. Eliminate High Glycemic Foods
High glycemic foods can cause rapid spikes and drops in blood sugar levels, leading to increased hunger and potential weight gain. I made it a point to swap out white bread for whole-grain options and opted for quinoa over white or brown rice.
4. Make Sure to Eat
It might sound counterintuitive when you’re trying to lose weight, but not eating can slow down your metabolism. I made sure to eat small, balanced meals throughout the day to keep my metabolism active.
5. Understand Calories vs. Nutrients
It’s not just about eating fewer calories; it’s about making those calories count. I focused on nutrient-dense foods that provide vitamins and minerals, not just energy. For example, I’d opt for a handful of almonds over a bag of chips, even if the calorie count was similar.
6. When You Can’t Eat Due to Nausea or Lack of Appetite: Drink Protein Shakes
There were days when the thought of eating solid food made me nauseous. On those days, I’d opt for a protein shake. It was easier on my stomach and still provided the nutrients I needed.
7. Don’t Skip Breakfast
Breakfast is the meal that kickstarts your metabolism for the day. Skipping it can lead to overeating later on. I always made sure to have a protein-rich breakfast, even if it was just a quick smoothie on the go.
8. Combine Intermittent Fasting
Intermittent fasting can be a useful tool when combined with these medications. It helped me create a more structured eating schedule and made me more mindful of my food choices. I followed a 16:8 fasting schedule, fasting for 16 hours and eating during an 8-hour window.
9. Make Sure You’re Staying Hydrated
Hydration is key for multiple reasons. It accelerates fat loss, reduces the likelihood of constipation, and sets you up for a good habit you’ll need later. I made it a point to drink at least 80 ounces of water a day, and I noticed a significant improvement in how I felt overall.
By incorporating these tips into your routine, you can maximize the benefits of your medication and set yourself up for long-term success. Remember, it’s not just about losing weight; it’s about creating a healthier, more sustainable lifestyle.
Escaping a Lifetime of Dieting: The Final Frontier
For as long as I can remember, I’ve been on a diet. Even when I wasn’t actively dieting, I was mentally on one. The baggage of a lifetime of dieting weighed me down, both emotionally and physically. I had never actually transitioned into a “maintenance mode” because, in my mind, I was always either gaining weight or trying to lose it.
The Wake-Up Call: Resting Metabolic Rate Testing
I had heard of Resting Metabolic Rate (RMR) testing before, but it wasn’t until I started working at BioIntelligent Wellness that I actually took the test. This was about three months after I had stopped taking Ozempic. My clothes were starting to feel snug, and the scale was inching upwards. Despite my professional knowledge and personal experience, I felt helpless and like I had to hide it.
I confided in a fellow nutritionist at the practice, who practically dragged me to take the RMR test. The test itself was simple and took only 20 minutes. I lay there, breathing into a machine that calculated my body’s caloric needs. The results were eye-opening. My RMR was 1847 calories, while I had been consuming between 1190 and 1400 calories daily.
The Reality Check: Calories in vs. Calories Out
I thought I was doing everything right. I was eating less than my body’s caloric requirement, but my body was still storing fat and breaking down muscle. It was a humbling realization that my unintentional dieting, combined with rapid weight loss from Ozempic, had put my body into fat-storage mode. I thought back to all the diets and workout regimes I had tried over the years. I had never consumed anything close to what my body actually needed, setting me up for a cycle of weight gain and loss that eventually led me to Ozempic.
The Dieter’s Lifecycle: A Trap
The dieter’s lifecycle is a vicious circle. You’re either on a diet, breaking your diet, or having an extended “last supper” as you gear up for yet another diet. This cycle keeps most people trapped in a never-ending loop of weight loss and gain. The second issue is the overwhelming amount of information and misinformation out there. Most people end up using trial and error to navigate through it all, often reverting to strategies that worked in the past but are less effective now.
The Way Forward: Living Off a Diet
The biggest challenge for those escaping a lifetime of dieting is learning to live off a diet. It’s about having the right tools in place for those moments when the scale starts to creep back up. Contrary to popular belief, the solution is usually not going back on a diet; it often just requires a little clean-up.
The weight loss industry thrives on repeat customers, but whoever taught people what their body actually needs? Whoever said that undereating, overexercising, or a combination of both could actually make you gain weight? Escaping a lifetime of dieting can be the most difficult part of the journey, but it’s crucial to understand the pitfalls and avoid repeating the cycle.
For those interested in taking the first step toward understanding their body’s needs, I highly recommend RMR testing. It’s a small investment that can provide invaluable insights into your body’s true caloric needs, helping you break free from the cycle of dieting once and for all.
By understanding your body’s needs and equipping yourself with the right tools and knowledge, you can finally escape the cycle of endless dieting and step into a new way of living. It’s not just about losing weight; it’s about sustaining your results and enjoying your life to the fullest.
The Road Ahead is Paved with Possibilities
If you’ve made it this far, you’re likely grappling with the same fears and questions that I once did. The fear of regaining weight after stopping medication is real and paralyzing. But let me assure you, there is a way forward that doesn’t involve going back to square one (or the highest weight you’ve seen on your scale).
My Journey Back on Track
After my eye-opening RMR test, my colleague put me on a quick GLP-1 transition program. Not only did I lose the weight I had regained, but I also stabilized my blood sugar levels and cravings. Most importantly, I learned to eat according to my metabolism, not according to some arbitrary diet plan.
The Importance of Timing
The best time to make lifestyle changes is while you’re still on medication. The more groundwork you can lay now, the easier your transition will be later. But even if you’re reading this after you’ve stopped your medication, know that it’s never too late to make a change.
The Power of Knowledge
Understanding your body’s needs, both physiological and psychological, is the key to long-term success. Whether it’s taking an RMR test to understand your metabolic needs or addressing the psychological aspects of weight loss, knowledge is your most powerful tool.
The Optimism of a Sustainable Future
The road ahead may seem daunting, but it’s paved with possibilities. With the right tools and information, you can transition off medication without the fear of regaining weight. It will take work, commitment, and perhaps a shift in mindset, but the end result is a sustainable, healthier you that is no longer consumed with fear or weight.
If you’re not already a member of the groups on Facebook, join as soon as possible. If you have questions or need guidance on your journey off GLP-1 agonists, reach out to us at 858-228-3644. Your future self is already thanking you for taking the time to read this blog and for taking this important step today. Remember, the end of your Ozempic, Wegovy, Mounjaro, Rybelsus or any Semaglutide medication doesn’t have to be the end of your progress.
Make it the beginning of a new, empowered chapter in your life.
