GLP-1 agonists such as Semaglutide and Terzepatide are very effective for losing weight and have a good safety record. Millions of patients worldwide are taking GLP-1s not only for weight loss but for diabetes as well. Losing weight with GLP-1 agonists is the easy part. Maintaining that weight loss is the hard part and takes much more effort. In short, the “shot” is not the answer. It is an aid. Maintaining weight loss involves a COMPLETE lifestyle make-over. If you want to lose weight AND keep it off, in addition to the “shot” you MUST address the following areas and make PERMANENT changes:
1.Diet
You need to assess your eating behaviors and identify problem areas. The biggest problem areas are portion size, overeating, poor food choices, snacking and stress eating. You will need to limit refined sugars and processed foods. (Examples of refined sugars include white sugar, brown sugar, coconut sugar, palm sugar, and high-fructose corn syrup. Processed foods are treated and packaged so they have a longer shelf life.) Fast foods should be consumed on a rare occasion. Get rid of sugar drinks and diet drinks. Limit candy, chocolate, ice cream, baked goods, chips and crackers. Limit white flour and white rice as well.
2. Sleep
Sleep is critically important for your body and mind to rest and repair. Lack of sleep or poor sleep increases stress levels and leads to weight gain. You need at least 7 hours of good, sound sleep. Eight hours of sleep would be even better.
3. Exercise
Both aerobic exercise and weight training are important. However, weight training is even more important. You MUST become a religious exerciser. No excuses. The number one determinant of your metabolism is your muscle mass. The more you have, the more calories you will burn.
4. Stress
Stress needs to be managed. Identify your stressors. Everyone has them. It is a fact of life. We do need a certain amount of stress to move forward. However, too much stress– either mental, emotional, spiritual or physical– can induce stress hormones leading to weight gain. If your mental or spiritual well-being is suffering, your physical health will suffer as well. If you suffer from depression or anxiety it needs to be adequately and maybe professionally addressed.
5. Hormones
As we age our hormone levels decline. Hormone deficiency is a recognized health problem leading to decreased quality of life and chronic disease. Testosterone deficiency will result in loss of muscle mass and decreased ability to build muscle, the number one determinant of metabolism. Thyroid hormones tend to decline as well leading to fatigue and decreased energy. Chronic diseases associated with low hormone levels include diabetes, cardiovascular disease, osteoporosis, cancer and dementia. In order to increase muscle mass and improve metabolism, you will need to make sure your hormone levels are optimized.
6. Nutrition
Good nutrition is always important for proper cellular function and metabolism. Three of the most common nutritional deficiencies are Vitamin D, Magnesium and Iodine. Without adequate levels it is hard to feel good and hard to optimize health. These nutrients are critically important for optimal hormone metabolism. While on a GLP-1 agonist, the risk of nutritional deficiency is increased even more due to decreased food intake. A good, high quality comprehensive multivitamin will be important.