September 27, 2024 • 53 mins
Curious about GLP-1s, the effects, and how your approach to eating may need to change on the medication? This episode is for you! Stronger U Registered Dietitians Katie Leahy and Gianna Masi dive deep into how GLP-1 medications work and their impact on nutrition habits. Coach Katie, a Certified Diabetes Care and Education Specialist, shares her insights on:
Together, she and Gianna explore the importance of lifestyle changes, like exercise and meal planning, to maximize the effectiveness of taking a GLP-1. They also discuss how to transition off these medications for sustainable long-term health.
Tune in here for the full episode and then head to the Stronger U Community to share your takeaways.
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- Adjusting and tracking your calorie intake and portion sizes
- Prioritizing protein and balanced meals
- Managing side effects like nausea and GI issues
Together, she and Gianna explore the importance of lifestyle changes, like exercise and meal planning, to maximize the effectiveness of taking a GLP-1. They also discuss how to transition off these medications for sustainable long-term health.
Tune in here for the full episode and then head to the Stronger U Community to share your takeaways.
Subscribe to Stronger U Radio
Follow us on Instagram
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome back to another episode of Stronger You Radio. This
is Gianna Massey. I'm a registered dietitian and I help
manage nutrition education at Stronger You. I'm so excited to
have another Stronger You RD joining me on the podcast today.
Who is Katie Lady? Katie is not only an RD,
(00:22):
but a board certified diabetes educator with a background in
exercise science and personal fitness. She has a passion for
women's health and she has three daughters under seven that
keep her on her toes. Welcome to the Stronger You Radio.
Stronger You Radio brings insightful conversations with top nutrition, health
(00:45):
and fitness experts, hosted by Stronger You dietitians and nationally
certified coaches skilled at simplifying nutrition science into actionable advice.
Get inspired with evidence based practice tips to optimize your
potential and crush your body composition, health and performance goals.
(01:07):
This is your time to level up and become a
stronger You. So today we're talking about all of Katie's
expertise and working with Stronger You members on GLP one
medications and transitioning them off, and how our approach to
eating needs to change on these medications. Katie shares a
lot of tips and tools that you'll want to listen to,
(01:30):
whether you're on one of these medications or just interested
in understanding them a bit more. There's something for you
on today's episode, Katie. Welcome to the Stronger You Radio.
I am so excited to be sitting down with a
Stronger You registered dietitian. Who is Katie Lahy. She is
(01:50):
an awesome dietitian and she has a lot of specialty
credentials herself, and one of them is being credentialed in
diabetes care and education. And so Katie, I would love
for you to describe what is that credential and that certificate,
all of that, what goes into it? Yes, well, thanks
for having me, Jana.
Speaker 2 (02:09):
So, the Certified Diabetes Care and Education Specialist credential is
basically a specialty within diabetes management from type one so
type two diabetes, pre diabetes, gestational diabetes, an array of
you know, everything that's under that umbrella, and you have
to kind of put in additional hours with people with
(02:30):
diabetes and counseling, you have to sit for a national
exam and so basically it just gives you a more
specialized view on diabetes management and how and you don't
have to be a registered dietician to do that. A
lot of cdceess are registered nurses or physicians, and so
(02:51):
it's basically you have additional experience, additional skill set that
particularly pertains to you know, people diabetes, from medications to
side effects to you know, long term management and care.
Speaker 1 (03:04):
And yeah, yeah, that's amazing. No, and that's not just
like you go online and get a quick sirt. This
is a lot of hours and experience and it's like
any other board certification for segments. So I think that's
impressive to share, especially with this topic today which we
are talking about GLP one medication so some anglue ties, trzepetides,
(03:27):
all the things that go into that hub. So this
is exciting to hear from you. And also I think
one thing that we didn't cover you is pre diabetes.
And if somebody is trying to prevent diabetes, that's also
you know, a skill set that you have. Would you say, oh, absolutely?
Speaker 2 (03:44):
And I think being proactive with our health and wellness
is key. So understanding your risk for diabetes is very important.
So yeah, pre diabetes, family history of diabetes, if you've
ever been diagnosed with gestational diabetes in the past or
PCOS poly cystic ovarian syndrome, you are at greater risk
for possibly developing type two diabetes.
Speaker 1 (04:04):
Later in life.
Speaker 2 (04:05):
So basically, when you have pre diabetes, this is the
time to be like, okay, lifestyle factors from nutrition to
movement to you know, sleep, stress management, this is the
time to really kind of build up your lifestyle factors
to prevent you know, further progression into type two.
Speaker 1 (04:22):
Basically, it's saying, hey, your body's not.
Speaker 2 (04:24):
Doing what it's supposed to do with glucose or you know,
insulin production red flag.
Speaker 1 (04:28):
What are you going to do about it?
Speaker 2 (04:29):
So it's kind of like that phase where you know
you have an opportunity to make some significant changes within
your lifestyle to really see if that has a beneficial effect.
We're reducing your risk of developing into type two.
Speaker 1 (04:43):
Yeah, that's so important, and I think that's it's really
helpful for people listening who are worried about that. So
there is a way forward, and there's definitely things that
you can do. That's what we help people at Stronger
You do, and especially like coach Katie here and then
I want to take a step back to for the
listener who they may be listening being like, yep, I
got it, I know what golp ones are. But just
(05:05):
to level set everyone, what are GLP one medications and
how do they work? And you can it's a high level,
like you can just give us a little description, that
would be really helpful. Yeah.
Speaker 2 (05:15):
So, basically, the GLP one hormone or gluca gun like
peptide one is actually already made in our body, So
these medications are exogynous or an additional version of that,
and so when they're injected, they basically are released after eating.
So after eating, these medications kind of work to signal
our body to make more insulin, which helps stabilize blood sugar.
Speaker 1 (05:38):
These medications also.
Speaker 2 (05:40):
They are typically you know, in the gut, so they
help to delay gastric emptying. Aka they're slowing down digestion,
which means, you know, food is broken down more slowly,
which kind of keeps us full for longer. So they
do a lot of different things within the body that
you know, really can help with the way we manage
blood glue, coost control portions, you know, food and take overall.
Speaker 1 (06:03):
Got it? Yeah, And what would you say to someone
that they asked you, oh, do these speed up my metabolism?
How would you answer that? That's a really good question.
Speaker 2 (06:13):
No, I think at the end of the day, no,
and I would love your take on it as well.
But they're not setting up your metabolism. They're making you
feel really full. They're reducing cravings. They are again slowing
down digestion, so like, not only do you feel full quickly,
but for longer. Therefore, you don't want to eat more,
Like you're in taking a lot less calories on these
(06:35):
medications because they're they're kind of discouraging your interest in food.
They're kind of just again reducing those hunger cues, so
you're less likely to just grab a snack just because
it's there, or you know, overeat different things like that.
Speaker 1 (06:48):
So they're not really speeding up your metabolism per se.
Speaker 2 (06:52):
They're just signaling making signals in your body that don't
make you want to eat as much, which creates more
of a calorie deficit.
Speaker 1 (06:59):
I completely agree. It's an interesting question because I was
seeing some people ask this on the internet and talking
about this, and I'm like, yeah, you know, I think
we have this notion that oh, to lose weight. I
need a faster metabolism, but really it is about reducing
our dietary intake, upping our movement and all of those
things that are really those basics. So I just want
(07:20):
people to hear that too, Like it's not like this
drug is doing something magical in terms of your metabolism,
But what's magical about it is really like what's happening
on that brain, Like you were saying, like less likely
to go have a snack, or like it's that food noise,
which is also a term a lot of people on
these medications are using to describe, like, oh my food
(07:42):
noise is minimize I'm not thinking about food as often,
so any thoughts on that, Oh my gosh.
Speaker 2 (07:48):
Yeah. So another piece to that, Gianna is that these
medications kind of pause that food noise, which we'll talk
about in a minute, so that you can build behaviors
and that foundation of balanced meals, portion control. It gives
you that pause of all the different variables and allows
(08:10):
you just to focus on building up that foundation, which
again varies based on the person, but for instance, you know,
these weight loss medications can create significant amount of weight
loss in a short period of time. All of a sudden,
you're lighter, maybe you can walk longer, or you know,
maybe have more endurance to do different things.
Speaker 1 (08:27):
And for instance, a woman that I.
Speaker 2 (08:29):
Worked with so quick kind of run down this Stronger
You remember prior to Stronger You had lost one hundred
pounds on her own. Wow diet an exercise, her dad
had a help thing that kind of jump started her
to make some big lifestyle changes. Then she kind of
found Stronger You to refine food, learn more about what
nutrition can do to maintain you know, her fat loss.
(08:52):
But at the end of the day, when you lose
a significant amount of weight, although your body has changed,
it takes a while for your mind to.
Speaker 1 (08:59):
Catch up up right. And so she recently, due.
Speaker 2 (09:02):
To perimenopause and some other things, felt like she needed
a little added jump start.
Speaker 1 (09:06):
So after you know, she toyed with the idea. She
felt like there's a.
Speaker 2 (09:09):
Stigma attached, like she didn't want the easy way out.
She started a GLP one recently and she said to me, Katie,
in the first time in forty four years, I have
zero food noise. I have no feelings of food fomo
or fear of missing out. She has, you know, a
husband and some boys and they eat a lot and
she goes, I am finally satisfied, you know, mentally, physically,
(09:30):
emotion with the portion that works for me, even though there,
you know, their portions are a lot bigger.
Speaker 1 (09:36):
It's allowing her to enjoy food on a new level.
Speaker 2 (09:39):
It's allowing her to you know, reduce decision fatigue, to
you know, put more emphasis on movement.
Speaker 1 (09:46):
And part of that too, was she was having.
Speaker 2 (09:47):
Some joint issues and things like that, and she felt
like if a little added fat loss, which she was
having a really hard time doing the stage of her life,
would help alleviate that pain. And so like just that
first thing in forty four years, I have no food
noise like that was that gave me chills?
Speaker 1 (10:02):
Like that that says a lot. It's incredible. Yeah, it's amazing.
And I think there are some people who who are
listening to that are like, oh, I don't relate to that.
It's like some people can eat something and feel satisfied
and move on with their day, and then there are
a lot of other people who just do not have
that mechanism built in, where it's like it's either gotten
(10:23):
blunted maybe they never had it. I think there's so
many factors there, too many to go into. But yes,
I hope people have a new awareness of this food
noise topic that we're talking about, because it is an
important one and it is why this medication does work.
And when I think about this medication, like, obviously you're
coming from this diabetes background and all this expertise. So
(10:47):
these medications started out for diabetes care. Can you talk
a little bit about who they were prescribed for maybe
five ten years ago and now who are they prescribed
for as well in the weight loss space?
Speaker 2 (11:02):
Absolutely, So they were initially prescribed for people with type
two diabetes and that might not have done well on
the oral medications and they needed a little extra to
help improve blood sugar management. So again, these medications kind
of make have the body make some more insulin so
that our body you know, digest gluecoss gets out of
(11:23):
our bloodstream. You know, it's used how it should be.
So it was initially for people to type two diabetes
who needed bloo gluecose management. And what they found was
individuals on these medications not only were improving their blood
glue coose management, but they were having fat loss as well.
They were seeing weight loss involuntarily, like they were feeling
full quicker. They were able to control portions better, which
(11:45):
also helped with improving blood glucose management. So they saw
that these medications, yes, on their own, without someone making changes,
blood glucose was improved, but also it helped these individuals
decrease portions, which also helped improve blood sugar as well.
Speaker 1 (12:01):
So then you know, they kind of saw that as, oh, well.
Speaker 2 (12:04):
If this can improve you know, if this can create
weight loss with these individuals, why can't it you know,
work with individuals that maybe don't have diabetes, but but
you know, our obese or need to target fat loss.
And so that's kind of how it evolved. It was,
you know, just to prove for people diabetes, and then
(12:25):
you know, some of the mecations became approved for people
without diabetes but met certain criteria with body mass indecks,
you know, obesity, and then it kind of keeps going
further and further where you.
Speaker 1 (12:36):
Know, almost anyone can get it, depending upon you know
where the sources right and if you have the resources
to go purchase it, right. That's a big component.
Speaker 2 (12:46):
Right, And like insurance has a lot of parameters. If
you want insurance to pay for it. You have to
you know, qualify X, Y and Z, body mass, indecks,
co morbidities, things like that. And like, for instance, the
woman I had mentioned, he pays a three hundred dollars
monthly copay. Her insurance covers the majority of the medicine,
which is like fifteen hundred dollars. So a lot of
(13:07):
people are not able to afford it out of pocket sustainably.
So if you do meet the criteria, insurance will cover
it to some degree.
Speaker 1 (13:13):
Otherwise it's out of pocket. Not three hundred dollars. At
least from my people I've worked with, that seems actually
cheaper than some of the other people I've heard who
are paying like five hundred and so, So even with
a cope, three hundred dollars and I have seen some
people get it totally covered, which is amazing, Like that
makes me so happy. Do you think, just your personal opinion,
(13:34):
do you think that that will continue to improve? I do?
I do.
Speaker 2 (13:38):
I feel like the research the results that are you know,
better being shown are unbelievable, Like this is changing people's
quality of life, it's reducing their risk of disease complications
or even reducing the risk of you know, diseases in general.
I do think this will become more accessible in many ways.
Speaker 1 (13:59):
Yes, yeah, do you think? I mean this is also
just I'm curious your opinions. And you know, you and
I are both dieticians and we want to help as
many people as possible and eliminate as much biased as possible.
So clearly listening to this so far, I mean, people
know that we are not anti these medications. What would
you say to someone if they were like, oh, like
(14:21):
you said before, like that is taking the easy way out,
or that is you know, oh, that's like not the
way I want to do it, because I'll be judged.
And you know, we hear all of these different things,
and so I'm just curious, like if we could discuss
that a little bit more.
Speaker 2 (14:35):
Oh yeah, and you know, most of the research out
there circulating promotes to get maximum efficiency of fat loss
on these medications, they should be used alongside to lifestyle changes,
especially nutrition. So these even the drug companies that are
you know, making a lot of money on these, they
(14:55):
are still saying, hey, these medications are great, but they
need to be used in conjunction with lifestyle factors nutrition, exercise,
for the maximum capacity of you know, of efficiency. So
I think that alone speaks volumes. Also, you know, there's
always a lot of stigma attached. However, you know, we
all know ourselves best and what we need. You know,
(15:17):
no matter what you know, body composition, you are, we
all have things we're working on behaviorally, physically, mentally, emotionally,
and a lot of these medications are helping beyond the scale,
you know, beyond bo glucose management.
Speaker 1 (15:31):
But again, I think they.
Speaker 2 (15:32):
Allow the pause for individuals to work on, you know,
building up their foundation of lifestyle factors that will overall
help their health and wellness long term, you know, whether
they're on their medications or not.
Speaker 1 (15:44):
So I know there's always a stigma attached.
Speaker 2 (15:47):
And I know there's a lot of judging out there,
but you have to look at you know, the pros
and the cons and you know, determine if this is
something that would you know, benefit you in the long
run health wise and beyond.
Speaker 1 (15:58):
Yeah, definitely, And I think that people listening if you
have a bias or kind of a knee jerk reaction
when you hear these medications or when it's talked about,
or maybe a friend just started and you're kind of judging,
you know, maybe not directly to them hopefully, but in
your own processing. I would get curious about where that's
coming from, because that's one thing that really can help
open up a little bit more. I mean, we can
(16:21):
have a whole segment on like fat bias in this
country and beyond, and that definitely exists. So I just
I would feel remiss if I didn't mention that here
today because it is such a big topic and it's
important that people know that stronger you supports you with
whether you want to take a medication or you don't,
we will help you do it in whatever way makes
(16:42):
sense for you right now. And you're always allowed to
change your mind, which I think is really important.
Speaker 2 (16:47):
Absolutely, And as a nutrition professional, you know we are neutral.
We are here to support your choices, you know the
direction you are in, so that you know whatever results
that you achieve there there sustainable. We're here to support
you know, whatever your choices are, we are neutral and
whatever is going to help you most, that's what you
know we want you to lead the way with.
Speaker 1 (17:09):
Yeah. Absolutely, And so if we're talking a little bit
more about coaching now, more of our jam, our bread
and butter, and so I'm wondering how my calorie needs
change when you're on a GLP one medication.
Speaker 2 (17:22):
Yeah, you're let me preface, So these medications are here
to stay. They're very effective in blood glucose, you know,
significant fat loss and a short period of time. The
thing is these medications are only going to get stronger
and more effective, which means they're creating more drastic weight
loss and shorter period of times. To emphasize this, you know,
like ozembic offers a really nice twelve percent average fat loss,
(17:44):
which is great, it's very significant, and it's progressive, whereas
the most recent released approved GLP ones are averaging twenty
to twenty five percent.
Speaker 1 (17:54):
Weight loss average weight loss and that same period of time.
So this is.
Speaker 2 (17:57):
Driving home you know even more or that you know,
and those those medications were coined the King Kong and
Godzilla of weight loss medication, So it's a whole new level.
They're almost doubling the percentage of weight loss within the
same window of time.
Speaker 1 (18:11):
And so why is that kind of challenging.
Speaker 2 (18:14):
Or potentially a negative thing, because you know, very aggressive
weight loss in a short period of time can create
an abundance of side effects, muscle wasting, nutrient deficiencies, disordered eating,
and more so, having that solid, you know, team of
professionals while you're on these medications and navigating on and
off of them increase dosing can be super beneficial. Ductor therapist,
(18:36):
registered dietitian, nutrition coach, even friends and family like having
them on board, and specifically, you know, nutrition coaching. We're
able to get to know you very well, so we're
able to address challenges, individualized needs. We're able to make
sure that you're maintaining the enjoyment of eating, your understanding
(18:58):
you know, how food is affect you now, but also
long term, we're able to provide practical and relevant tools
so that.
Speaker 1 (19:05):
You can you know, use in the long term.
Speaker 2 (19:07):
So basically, to get back to your initial question, calorie
intake is significantly reduced. What happens again, you're feeling full
quickly for longer, so you just you are not going
to You're you're not going to have the same caloric
needs or even want to eat as much as you
were prior to these medications. And so, you know, having
(19:27):
a dietician nutrition coach really allows you to transition from
going to eating you know, hunger cues eating more than
usual to all of a sudden eating less, but with
the focus of nutrition quality, so quality of food, types
of food, and we're able to kind of work with
you to kind of break it down and so that
(19:48):
despite significant less needs, you are able to get adequate nutrients,
so that again, muscle wasting is you know, minimal, you know,
nutrition deficiencies don't happen.
Speaker 1 (20:00):
Yeah, Yeah, we can kind of dig into more of
the nutrition side of things. Yeah, And I want to
pick on the muscle wasting a little bit more so
for someone who's listening, like, can you describe that a
little bit more and why that's so important because we
know that we will lose muscle when we're losing weight,
whether from a GLP one or from just diet an exercise,
(20:20):
And I want to make that really clear. I think
some people are like, oh, these medications are XYZ negative
because it has you lose more muscle. And it's because
of the speed of weight loss. So even if you're
losing weight quickly from just eating less, we can have
that same muscle loss as well. So it's important no
(20:41):
matter how you're losing weight. And I just want to
remind m.
Speaker 2 (20:45):
Yeah, literally when you're in a calorie deficit, your body
doesn't discriminate. You know where it's pulling from. It's going
to pull from muscle, it's going to pull from sat.
Speaker 1 (20:52):
We want to minimize that muscle loss, whether.
Speaker 2 (20:54):
On the medications or not, by prioritizing protein, doing weight
bearing activity, walking and shrink training so that although muscle
wasting will still happen, we slow it down as much
as possible. And so you know, when you need less calories,
you need to make the most of the calories that
you are eating, and.
Speaker 1 (21:14):
That will help me preserve more muscle. Right.
Speaker 2 (21:16):
Absolutely, when we're prioritizing protein, we're looking at other lifestyle
factors like weight bearing activity. Those are really really important
to helping to preserve that muscle mass and slow down
a little bit more. But also, you know, when individuals
start medications, if they don't have any idea of you know,
nutrition or a concept of hey, I actually need to
(21:39):
think about what I'm eating. Like for instance, some members
that I'm working with that are on you know, GLP ones,
They're like, oh, I could just have a slice of
pizza all day and be fine. Well, we know, you know,
a slice of pizza is a couple hundred calories, but
we have to be a little bit more intentional about
meal timing and composition so that you know, we're giving
back to our bodies. Still though it's not telling us
(22:01):
it's hungry, we still need to make sure that we're
getting adequate calories and nutrients in for overall health and wellness,
for our bone mass density.
Speaker 1 (22:09):
Long term, you know, we want to reduce the risk.
Speaker 2 (22:11):
Of osteoporosis, osteopenia, you know, for cognitive health if we're
eating too little. You know, beyond muscle wasting, there's there's other,
you know, challenges that we could come across.
Speaker 1 (22:22):
Yeah. Absolutely, And I think i'd be curious to know
how do you work with someone, let's say, who just
started on a GLP one. Maybe they're feeling a little
bit of nausea maybe, or like you're saying, the drug
is just very effective. They don't need to eat as
much or not need Sorry, they don't feel like they
need to eat as much. How do you start them off?
(22:43):
Are you doing smaller meals? Like what are some of
the strategies that you'll you'll try with people? Absolutely?
Speaker 2 (22:50):
And the cool part is there's endless strategies as a
nutrition coach, when I'm working one on one with someone,
we're trialing and airing. So what works, what doesn't, And
it's going to be so different for everyone. You know,
someone could get full on a glass of water, whereas
someone you know could actually eat an apple and peanut
butter and be fine. It just really depends on the individuals.
So basically, you know, when we're when I'm working with someone,
(23:13):
I'm trying to find you know, foods that are higher
in protein and smaller amounts so low volume, high nutrient density.
You know, foods again that are high in fiber lower
and fat lower, lower and volume higher and nutrient density.
And so what I like to start out with doing
is having them track their intake. Tracking your food is
one of the best things you can do because we
(23:35):
don't know what we don't know, and so we you know,
by seeing an individual's meal timing, meal composition, you'll frequency.
We're then able to determine, you know, some ways to
improve intake. So a couple things that have been working
really well with individuals on these medications are like liquid
(23:57):
so nutrient dense calery liquids like smoothie protein shake, even
like soups. They're able to get a lot of nutrients
in the liquids are oftentimes easier to digest in terms
of you know, less symptoms. Again, able to get more
nutrient density without feeling too stuffed or over satiated. So
(24:20):
liquids have been playing a big role. I think this
is a great time to introduce protein supplement.
Speaker 1 (24:27):
Again.
Speaker 2 (24:27):
We need a lot of nutrient bang for our buck
in a small amount, and so something like that can
offer that to someone.
Speaker 1 (24:36):
Another approach that I've.
Speaker 2 (24:37):
Been doing a lot with individuals is almost like Bento
box like meals, but it's pre planned, it's intentional. So
taking like a hard boiled egg, a third of a
cup of cottage cheese, and then pairing it with you know,
a piece of fruit like a mandarin orange, a couple carrots,
ten crackers.
Speaker 1 (24:55):
So we're getting each of the food groups you.
Speaker 2 (24:57):
Know, protein, carb, fat, but we're combined them together, so
almost like the snacky meals don't keep us full for longer,
but they're still giving us that nutrient like impact.
Speaker 1 (25:07):
If that makes sense, Yeah, definitely. And we all love
an adult lunchables, so I love it. I love the
Beta bus.
Speaker 2 (25:14):
It's mix and match especially for teachers or people in
the healthcare industry when they kind of have to grab
things and go.
Speaker 1 (25:19):
It's so easy and accessible. Yeah, I love that idea.
That's great. So yeah, and I heard you say low
food volumes, So you want to have smaller food volume
when you're on one of these medications. And then I've
heard you say before like the opposite, if you're not
on one of these medications, that's when we want food
volume to be a little bit higher, so that way
(25:40):
we can feel like we're eating a little bit more
if we're in a deficit. I mean, other thoughts on
that subject.
Speaker 2 (25:47):
Yeah, absolutely, so I think we have to be very versatile. Hey,
this is a good strategy for when I'm on these medications.
This is a great strategy for if and when I'm
not on these medications. And so that transition for fat loss.
Not on medications, you're thinking high volume, low calorie, what's
going to keep me full for longer?
Speaker 1 (26:05):
And when you're on.
Speaker 2 (26:06):
These medications, you already feel full, So you have to
reduce the volume.
Speaker 1 (26:10):
And increase the nutrient density. Absolutely, And I think.
Speaker 2 (26:13):
Another part of that is, you know a lot of
times when I work with individuals that are not on
weight loss medications. I'm like, Okay, let's aim for three
larger meals per day. Let's you know, avoid the snacks
or you know, plug a few intentional ones in there. Again,
when you're on these weight loss medications, you know, smaller
meals more frequently throughout.
Speaker 1 (26:33):
The day are more ideal.
Speaker 2 (26:34):
Your body cannot digest a lot of food at once
on these medications, right, and so we want to break
it down and kind of spread it throughout the day.
You know, four to six smaller meals. Yeah, that's time consuming,
it's it's kind of a commitment, but it's what your
body will like the most. And so we have to
definitely transition our strategies and our thinking when we're on
these medications versus when we're not on these medications.
Speaker 1 (26:57):
Yeah, and I'm curious too, Like I heard you mentioned,
like in the Vento box, you had some fruits, you
had some veggies, so you're obviously getting some fiber. Should
people be concerned about the nutrient absorption and like the
digestion differences there when they're on these medications.
Speaker 2 (27:15):
I mean, so with digestion being slowed down already, absorption
is also slowed down. It kind of goes hand in hand. However,
you know, I think at the end of the day,
if we're getting in balanced meals, we're going to eventually
get all the things that we need, you know, vitamins, minerals,
you know, all those things. It's just keeping a variety
(27:35):
of you know, balanced meals going throughout the day. So
you know, any anyone in general, I always recommend obviously
checking with your physician first, but I always recommend a
multi vitamin just for nutritional insurance. Now, when you're on
these medications and you're having very aggressive, you know, weight
loss quickly, you are at risk for other deficiencies that
(27:58):
you can chat with your physician about, you know, if
you need additional supplementation based on bloodwork or whatever. But
I think at the end of the day, when you're
eating balance meals throughout the day, you're going to get
what you need eventually.
Speaker 1 (28:12):
Yeah, definitely. Okay, that's super helpful for people to hear.
Thank you. And then if I am on one of
these how can I ensure I'm getting enough protein, fiber
and all of those nutrients while potentially eating less And
you answer this a little bit, but any other methods
that you think would be helpful to share.
Speaker 2 (28:31):
Yeah, so obviously tracking we don't know what we don't know.
I think tracking is helpful. I think sometimes you know
in a more specific way, if someone's losing, you know,
more than two pounds per week of weight loss, I
feel like that is a sign that you know, calories
might be too low.
Speaker 1 (28:46):
That's very aggressive. Not to say it's bad, but it's
very very aggressive.
Speaker 2 (28:49):
And you know a lot of research backs Hey, one
pound per week weight loss is sustainable weight loss over time.
Speaker 1 (28:55):
And I think that's a piece of these weight.
Speaker 2 (28:57):
Loss medications is yes, they target loss, but we also
have to be thinking of the endgame. The goal is
fat loss, but what happens when you hit the fat loss?
What happens when you reach your goals? And so as
we are, you know, on this fat loss journey, on
these medications, we want to make sure that we're you know,
again finding balanced meals that we can plug in. So
(29:18):
the three three three method is something that you know,
stronger you promote. It's basically saying, at every meal, where's
your protein, where's your car where's your fat source? I
like the veggies in there, you know, thrown in there
as well, And so I think that's a great way
to check your work as well, even if you're not tracking. Okay,
if I know every meal, I'm getting a nice lean protein,
a high fiber carbohydrate, you know, think fruits, veggies, grains,
(29:40):
beans and lagoons.
Speaker 1 (29:41):
Even milk and dairy is a.
Speaker 2 (29:43):
Nice carbohydrate with some nutrients and a heart healthy fat.
You know, that really does help to set the stage
for Okay, am.
Speaker 1 (29:50):
I getting what I need? Am I getting a variety
of things? Yeah? But I think tracking your food is
helpful so you can kind.
Speaker 2 (29:56):
Of see where you're at, and it gives you feedback Okay,
more protein or wow, that was a lot of fat grams,
or you know, oh I felt really good today, I
didn't feel sick, I didn't feel too full.
Speaker 1 (30:07):
What did I eat?
Speaker 2 (30:07):
So it also allows you to reflect back so you
can repeat things that work. Well.
Speaker 1 (30:12):
Yeah, no, that's super helpful, Thank you. And I think
one thing that's just coming to my mind now is
like if somebody isn't already resistance training or doing any
sort of weights, I think now like, as you said,
like some people who are in bigger bodies who are
having a hard time to exercise and move their body
Hopefully as they progress on these medications, they'll be more
(30:34):
open to that maybe that's a little bit easier to them.
So I think now is a really good time to
prioritize that even if like you work with a trainer
once or twice to understand like some basic movements, if
you follow a program on an app in the comfort
of your own home, doing some sort of resistance training
is so important. And I think that that needs to
(30:55):
be like a must alongside this nutrition and lifestyle here
that we're talking about. That I could not agree more.
Speaker 2 (31:02):
And the reuseer's out there backs that resistance training or
weight bearing activity is actually more important after the fat loss,
and it is initially, so we know exercise isn't really
going to move the scale. It's the nutrition piece, it's
calories and versus calories out, but it's a lot more
complicated than that. The exercise is an added bonus that's
(31:24):
going to again build muscle, help with balance, range of
motion for now. But also when we're like ninety, you know,
and so we are at the end of the day,
we still need to have that big picture in mind.
So when we're thinking of what we can do now
to help us later not only you know, strength endurance wise,
but also maintaining the fat loss. Exercise resistance training is
(31:47):
a big piece of that. Now, I will say, you know,
some members have very low energy, They feel very fatigued
on these medications because they are in taking such a
very low calorie intake. And so you know, a nutrition
culture dietician can really help to see where we can
plug in, you know, some added energy to ensure they
can get some movement in. But it doesn't have to
be sixty minutes a day. It's you know, let's start somewhere.
(32:10):
Can I walk five minutes out, five minutes back? Can
I do somebody squats, you know, wheat squats, you know,
something like that. So we don't have to go zero
to crazy. We're just trying to figure out, yes, this
is I think this is the perfect time to implement movement,
not only really not for the fat loss aspect, but
for you know, bone health, you know again strength and
endurance as well as maintenance down the road.
Speaker 1 (32:31):
Yeah, definitely, And I think you know, we've had a
lot of successful members doing things like Orange Theory and
you know, getting to a point where they're able to
go to these classes that incorporate a mix like you said,
of endurance and strength training, and so I love that.
I think that is something to work towards and to
help with maintenance as well as that initial and so
(32:51):
I think it's really important that you said, yes, it's
even more important after this fat last phase to then
keep that muscle tissue going. So thank you, Okatie, that's
super helpful to hear. Is it time for you to
level up? Get matched with a Stronger You coach who's
dedicated to your success and accountability. Work one on one
(33:12):
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(33:34):
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That's SU Radio fifty. This is where a Stronger You
(33:55):
begins let's do this. I'm curious we didn't really talk
about the most common side effects. You know, I'm sure
there's a lot of outliers as well with these medications,
but what are some of the most common GI side
effects that you're seeing when you work with people.
Speaker 2 (34:11):
Oh? Yes, the most common GI side effects are nausea, vomiting, diarrhea, constipation,
and digestion like burping.
Speaker 1 (34:20):
And so this is a lot of what I work.
Speaker 2 (34:23):
With numbers on tackling, right, and there's a lot of
tips and tricks. So, for instance, if someone's having constipation,
you know, small frequent meals are very helpful to that, right,
we're not overloading our digestive track. The trifecta and my
eyes of good digestion, whether you're on these medications or not.
Speaker 1 (34:40):
Adequate fiber, adequate hydration.
Speaker 2 (34:43):
And movement, you know, movement definitely keeps things going on
the inside. Incorporating higher fiber foods daily like your fruits,
your veggies, your whole grains super super important. And again
back to that adequate hydration. You know, again, if we're
if we're not being cued up that we're hungry, we're
probably not being cued up that we're thirsty either, so
we really have to incorporate making sure that we're drinking
(35:05):
enough you know, hydration and really any liquids do count.
Speaker 1 (35:08):
However, Yeah, that's fantastic. I think we overlook the hydration
piece also being impacted on these medications. So thank you
for that point. That's really helpful.
Speaker 2 (35:19):
And then on the other side of that diarrhea, you know,
we definitely want to stay hydrated with that, making sure
that we don't get dehydrated due see the excess loss
of fluids. You know, a lower fiber diet during a
phase of diarrhea is very helpful. I think like the
easy digest added hydration foods that you tell right well,
like I think of like eggs, fish, rice pudding, banana toast,
(35:39):
canned fruit cream, a wheat apple sauce, noodles like you know,
a nighttime sick I'll just have like noodles because it's
very easy on the gut. They're kind of bland, so
they're not going to like flare up anything. So when
you have diarrhea, making sure that you're proactively countering it,
you know, eating per tolerance things like that.
Speaker 1 (35:56):
And then why you'd want to work with someone like
you on, because if I have diarrhea, this person's constipate.
Those are very different things. We don't want to just
follow like the same type of plan.
Speaker 2 (36:07):
Absolutely, and again it's so individualized. Again, some people have
allergies or intolerances, so then we're working with okay, what
foods can they tolerate, but also that they can digest
or you know eat without any issues as well. So
the nutrition coach, the dietitian aspect, we really take a
deep dive into someone's nutrition, you know, especially when there
are side effects again nausea and vomiting. So this is
(36:30):
another very very common side effect and a lot of
the research is saying, okay, to help reduce nausea and vomiting,
have your biggest meal before injection, and the next couple
of days after that follow with a very low fat diet,
small or more frequent meals. Obviously is definitely the theme
of the things, including those to reduce side effects, and
(36:53):
same thing with nausea and vomiting, you know, almost like
sick day protocol, you want to eat very soft, blended
or liquid meals like brath you know, to make sure
that you're still getting nutrients, but you're doing it very lightly.
Speaker 1 (37:06):
So having your biggest meal before injection is healthy. And
then lower fat.
Speaker 2 (37:12):
You know, lower fat can exacerbate GI symptoms as higher
fat can exacerbate nausea vomiting GI symptoms as well. So
again working with a dietician, Hey, what what are fat sources?
Speaker 1 (37:23):
You know, what's a lot for me or you know,
working through that.
Speaker 2 (37:26):
I can't tell you how many times I'll look into
someone's food logs and they don't even realize you know,
where their fat sources are coming from.
Speaker 1 (37:32):
So it's a really good teaching moment. You know how much?
Speaker 2 (37:35):
How often? How can you know? We make this work
to reduce symptoms? And then you know again with any
nausea vomiting that adequate hydration can play a role. Now,
sometimes I'm finding with individuals on these medications, caffeine and
carbonated drinks can exacerbate nausea and vomiting. I would be
in big trouble because I love my flavored waters, I
love my coffee. But it's very again individualized. It might bother,
(37:57):
you know, one individual, but completely unphased another one. So
those are some other things that you could trial and
error if you're having nausea and vomiting.
Speaker 1 (38:05):
Maybe drink coffee a little more conservatively in the beginning
to see how you tolerate that.
Speaker 2 (38:10):
That's water in between your coffee. No, and then and
then lower fat intake again. You know, fat sources take
them in it to digest in our body without medications.
So now that our digestion is slowed further, you know,
higher fat foods are going to cause a little bit
of trouble.
Speaker 1 (38:26):
It's just going to be harder to digest.
Speaker 2 (38:28):
So if you are having nausea, vomiting, or any gi issues,
you know, lower fat, lower added sugar intake can really
help symptoms stay at bay.
Speaker 1 (38:37):
And how does alcohol come into play in all of this?
Speaker 2 (38:42):
Yeah, No, this is a really good topic that I
feel like needs a lot more research devoted towards it.
Speaker 1 (38:48):
But again, at.
Speaker 2 (38:49):
The end of the day, your digestion is slowed, and
so even alcohol, you know, as it breaks down in
the body, it's going to be slowed.
Speaker 1 (38:58):
And I cannot tell you how many.
Speaker 2 (38:59):
Members have said to me, oh my gosh, I had
my first drink since being on these medications. I have
felt drunk for two days. Like, not to scare anybody,
but it's going to linger in your system a heck
of a lot longer on these medications. So sip slowly, savor,
you know, trial and error a little bit. And you know,
again with these medications, you don't want to have a
(39:21):
lot of added sugar, so making sure that the alcoholic
drinks you have, you know, don't have a lot of
added sugar in them.
Speaker 1 (39:27):
But yeah, I think it's been very interesting to hear
feedback from individuals if.
Speaker 2 (39:31):
And when they do have alcohol on how it affects them.
You know, it's a lot more potent.
Speaker 1 (39:36):
Yeah, No, that's that's very important. It's a very cautionary
disclaimer too that I think we need to consider. And
I think that also I've heard people aren't less interested
in alcohol, which makes sense, Like we were talking about
that food noise, there's a little bit less interest in
these like dopamine seeking behaviors of like alcohol, cigarettes and
(39:57):
all of the things that we can overdo.
Speaker 2 (40:01):
Yes, and that's another thing, right, So these medications start
out to help blo glucose management. Then they started you know,
expanding on that to fat loss or weight loss for
you know OBC.
Speaker 1 (40:12):
Now they're showing you know, some.
Speaker 2 (40:14):
Promise in reducing those addictive behaviors or you know, alcohol,
things like that. So it's wild how these medications are
affecting our systems in so many different ways.
Speaker 1 (40:26):
Yeah, and I think when I'm thinking about all the
different strategies for chloric deficits and body composition, obviously there's
things like eating low car some people follow intermittent fasting
or maybe different dietary patterns if someone is on a
GLP one, are there maybe some pros or cons to
(40:47):
following some of those different strategies.
Speaker 2 (40:49):
Yeah, So in my opinion, you know, weight loss strategies
all have the same thing in common.
Speaker 1 (40:53):
They create a calorie deficit end of the day.
Speaker 2 (40:56):
So intermittent fasting, if it's done right, you know it's
closing your.
Speaker 1 (40:59):
Window of eating.
Speaker 2 (41:00):
So ideally, you know you're eating less calories consumed throughout
the day as a whole low carb Again, you're decreasing
your carbohydrate intake while keeping you know, protein and fats
around the same, So again you're eating less calories in
terms of you know, I think they all are okay
on their own, but I don't really in my opinion,
I don't believe if you're on a GLP one you
(41:20):
need to do interminute fasting or low carb. You're kind
of already inadvertently doing lower carb whether you mean to
or not, just because you're not able to eat as
much period carbs included. But you know, with intermittent fasting again,
you're you're really significantly closing your window of eating.
Speaker 1 (41:37):
I would rather have someone have smaller, you know, more.
Speaker 2 (41:40):
Frequent meal spread throughout the day versus you know, plugged
into this tiny window where you're probably going to be
over stuff. Now, these medications do a lot of things,
including you know, if you were to push past the
point of fullness when you're eating, that can exacerbate GI
symptoms as well. So I personally feel that GLP ones
(42:01):
do not need the added assistance of intermittent fasting or
low carb in general.
Speaker 1 (42:06):
Yeah, I agree, and especially for the internet and fasting.
Like sure, if someone's eating lower carb anyways, okay, I can.
I can get with that a little bit more. But
the intermittent fasting, like you said, I think you run
out of eating opportunities to get the amount of protein
and nutrition that we need, like you just highlighted so
wonderfully of like we need all this for the muscle
(42:28):
nutrients and also to prevent nausea, because if someone was
intermittent fasting before these medications, they likely were eating larger
meals in these smaller windows of time, and that strategy
I just don't see that lasting as much. So I
don't mean to yuck anyone's yum. If you're listening and
you love intermittent fasting or you love different types of fasting,
(42:49):
just reconsider it a little bit if you are on
these medications.
Speaker 2 (42:53):
But also to add on to that point, so intermittent fasting,
like you said, essentially is giving you large your meals
in a shorter period of time, which is the opposite
of what we want to do on GLP ones. We
need smaller meals spread throughout the day because our body's full, right,
And so you know, intermittent fasting could be really helpful
if you're not on a weight loss medication but want
(43:15):
to target fat loss. It gives you that added structure.
But right now, we're not looking for high volume meals
on these medications. We're looking for very low volume because
that's what our body can handle, all right.
Speaker 1 (43:26):
So I'm curious, how could I enhance the effectiveness of
GLP one medications if I'm already on it. I'm doing well,
but I really want to make sure I'm maximizing this
time with this medication. Are there things that I could do,
whether nutrition or practical strategies.
Speaker 2 (43:46):
Obviously lifestyle is number one. What is your you know, lifestyle,
your systems in place supporting you know, health and wellness overall,
you know, from movement.
Speaker 1 (43:55):
And activity to quality of food. That is huge.
Speaker 2 (43:59):
Working with a red Diitisian nutrition coach so that we
can take a deeper dive into what you're doing to
support you know, long term health. I think adequate sleep,
stress management, those are all things that are not going
to go away. Like we need those while we're on
these medications.
Speaker 1 (44:14):
We need those to be good when.
Speaker 2 (44:15):
We're off these medications, and they are supporting overall health
and wellness. So definitely working on you know those aspects
as well. If we're not getting adequate sleep, then you
know we're not going to be as sharp or have
as much energy, and we might be making different food
choices than we should be.
Speaker 1 (44:32):
Same with stress.
Speaker 2 (44:33):
Management, and so yeah, I think there are a lot
of Again, diet seems so simple, but it's so you know,
deep rooted, and there's a lot that we could do
to maximize you know, those effects.
Speaker 1 (44:44):
Yeah, And I don't even think diet is simple, right,
It's so complex, but we try to simplify it for
everybody else as much as we can.
Speaker 2 (44:51):
And it's and it's not cookie cutter, like everyone needs
different things from hydration to protein, like like there's no
there's the same thing doesn't apply to everyone. And so
that's the fun about nutrition for me is everyone I
work with needs so many different things, right, and so
that I'm we're able to customize it as a team
together to like maximize again health, wellness, performance, body composition
(45:14):
in the long haul.
Speaker 1 (45:15):
All right, So I have a couple questions that we
received about you know, the more long term perspective, and
one of those is what are the potential nutritional risks
of being on a GLP one for a long period
of time and maybe how can I mitigate them?
Speaker 2 (45:33):
Yes, yeah, so I think again working with a team
is very helpful. So like your physician can keep blood
work going to make sure that there's no nutrient deficiencies
that you know, all the big picture help things are
looking good. You have regular follow ups, you know, people
monitoring your health and wellness, you know from an outside
(45:55):
perspective looking in and you know, being on weight loss
medications without normally understanding or having a direction with food again,
like we said, can create some challenges like nutritional deficiencies,
you know, loss of bone mass, you know, issues with
gut health, cognitive health. So I mentioned before there are
some common deficiencies with rapid weight loss, including on these
(46:18):
medications from iron to celcium B twelve, vitamin D, and
so we need to make sure that we're proactive in
the big picture help so getting follow ups, getting blood
work done, and making sure you know, someone other than
yourself is monitoring this on a on a deeper level,
like we know our body best. However, you know, we're
an expert in ourselves, but maybe not nutrition or you know,
(46:41):
medication or things like that. And so we you know,
having a like an expert view is definitely helpful and
it allows us to you know, continue to support our
health and wellness a lot like long term and more confidently, right,
we have more tools in our kit to you know,
strategize based on what we need it any given time.
Speaker 1 (47:01):
Definitely, And so I'm thinking about that's if someone's on
a long term path, I'm curious if someone is transitioning
off of GLP ones. And I know you've helped many
people transition off of these GLP ones. What are you
doing there, like, what considerations come up? Could you talk
us through that a little bit?
Speaker 2 (47:20):
Yeah, absolutely, So this is a big hot topic that
I'm seeing frequently. So anyone on these medications should always
be prepared for them to stop, whether it's involuntary or voluntary.
I've had so many Stronger YOU members all of a
sudden not have these weight loss medications due to changes
of insurance coverage due to shortages. But also a lot
(47:41):
of individuals are looking to take these medications short term
to kickstart, you know, fat loss, to give them a
chance to feel better, lighter, you know, And so for
a lot of individuals, this is a short term scenario.
Speaker 1 (47:55):
And so yeah, we want to make.
Speaker 2 (47:57):
Sure that you're not only able to navigate health and wellness, nutrition,
you know, lifestyle on these medications, but you know exactly
what it takes to transition off of them. So ideally,
best case scenario, you're able to work with your doctor
to wean off these medications over time so your body
can adjust to lower doses and you know, slowly work
(48:20):
on you know, addressing hunger, you know, queues that are
starting to come back, cravings that are starting to come back. However, again,
like I've experienced, some members all of a sudden just
can't get it and it's unexpected. And so we are
diving in and kind of amplifying what we've already been
doing on these medications. So we're still prioritizing protein, but now,
(48:41):
you know, if we're weaning off these medications, are no
longer on them, we're increasing the amount of.
Speaker 1 (48:45):
Protein that we were having.
Speaker 2 (48:47):
So let's say you could only tolerate one or two
ounces of protein, now we're doing three or four. So
we're slightly increasing the portions of the foods we're already eating.
Speaker 1 (48:56):
Again, you know, we want to amp up hydration.
Speaker 2 (48:59):
We need to trial and error ways to make sure
hydration is prioritized.
Speaker 1 (49:02):
On these medications as well as off of them.
Speaker 2 (49:04):
Whether we're pre filling water bottles using a straw that
always gets me more hydration.
Speaker 1 (49:08):
I don't know why.
Speaker 2 (49:09):
Being aware of you know, what fluids are tolerated. And again,
when you're transitioning off of these medications, those small or
more frequent meals that once worked may need to start
to get bigger, right, So instead of for to six
small meals per day, maybe we're doing three to four
slightly larger meals per day. You know, when you're transitioning
(49:29):
off of these medications, your digestion is going to evolve,
those hunger cues, energy is going to change, and so
we need to be prepared to, you know, slowly, which
is easier said than done, increase the volume of food
that we're eating very intentionally.
Speaker 1 (49:45):
Yeah, And would you say also, I mean something I
would want to hit is increasing exercise or at least
maintaining the exercise we've been doing as we transition off.
Speaker 2 (49:55):
Absolutely, Yeah, maintaining exercise. Having a good exercise routine is
one of the key factors for maintaining weight loss over time. Again,
I think is if not important, more important having an
exercise routine as you're weaning off of these medications or
off of them than it was when you started.
Speaker 1 (50:17):
I mean, it's even more important as you transition off
of these medications to have an exercise routine. I mean,
of course we always want an exercise routine, but it's
even more important because that calorie deficit that you were
in that window is going to get a little bit smaller,
and so we want our activity to go up, so
(50:38):
that way we are expending more energy that way.
Speaker 2 (50:41):
Yeah, exercise is going to be a paramount piece of
weaning off of those medications, are no longer being on
those medications, having again, And we don't want to think
of it as all or nothing.
Speaker 1 (50:51):
You know, it's not exercise or bus.
Speaker 2 (50:53):
It's you know, how can I incorporate activity more frequently
throughout my week with things that I enjoy that I
like doing. That like going up to what we like doing.
You know, activity wise five years ago looks very different.
I know you're a collegiate gymnast. I played soccer briefly
in college, right, Like, that kind of training and intensity
is way different than.
Speaker 1 (51:11):
What I like to do now. I like walking, I
like going.
Speaker 2 (51:14):
To kickboxing classes. I used to teach them, but now
I like taking them. Right, And so we have to
find and start to work on, you know, what kind
of exercise we enjoy.
Speaker 1 (51:23):
Where do we like to do it? You know, working
from home, I've been needing to get out of the house.
Speaker 2 (51:28):
A little bit more so now I'm leaving the house
to get exercise. It's nice because there's a little out
of accountability at the gym.
Speaker 1 (51:34):
They're looking for me, you know.
Speaker 2 (51:36):
So, yes, we want to establish exercise activity one that
we enjoy, two.
Speaker 1 (51:42):
That you know feels good, and three that you know
we can incorporate you know, frequently throughout the week. Yeah. Absolutely, So, Katie,
thank you so much for your time and walking us
through all of these different strategies and the ways that
you work with people. So if someone is like, Okay,
I'm on a medication or I know I'm going on one,
(52:04):
I want to work with a dietitian. Can someone come
to stronger you and do that with us? Oh?
Speaker 2 (52:11):
Absolutely, and we welcome you with open arms. It is
one of the best things to have a coach and
dietitian in your pocket. It offers endless guidance, you know,
opportunity to kind of collaborate to understand, Hey, what's going
to work best for me right now?
Speaker 1 (52:26):
How can I max out you know.
Speaker 2 (52:27):
Nutrition in a very realistic and relevant, long term kind
of way. And yeah, we would love for y'all to
join us and see what kind of collaboration that looks like.
Speaker 1 (52:38):
Man, And if you're listening to this podcast, if you
email us, we'll give you a special discount for being
a podcast listener, so you can email us to sign up.
And also wanted to say that Katie who's on the
show today, she has a blog coming out for Stronger
You about transitioning off of GLP one, so some tips
and tricks. If you want more reading on that, you
(53:01):
can just google Stronger You. I think we'll just call
it's probably transitioning off of GLB one, so it'll come up.
We'll link in the show notes here as well. And Katie,
thank you so much for your time today. We will
chat with you again soon, I'm sure. Thank you for
having me. Thank you for listening to Stronger You Radio.
(53:22):
For more information about how you can get started with
a Stronger You coach, visit stronger you dot com or
click the link in the episode description. As a special
thank you for listening, we have a Stronger You discount
code just for our listeners. Use the code radio fifty
at checkout for fifty percent off your first month of
(53:42):
coaching with Stronger You. Tune in next time for more
health and nutrition conversations
Welcome back to another episode of Stronger You Radio. This
is Gianna Massey. I'm a registered dietitian and I help
manage nutrition education at Stronger You. I'm so excited to
have another Stronger You RD joining me on the podcast today.
Who is Katie Lady? Katie is not only an RD,
(00:22):
but a board certified diabetes educator with a background in
exercise science and personal fitness. She has a passion for
women's health and she has three daughters under seven that
keep her on her toes. Welcome to the Stronger You Radio.
Stronger You Radio brings insightful conversations with top nutrition, health
(00:45):
and fitness experts, hosted by Stronger You dietitians and nationally
certified coaches skilled at simplifying nutrition science into actionable advice.
Get inspired with evidence based practice tips to optimize your
potential and crush your body composition, health and performance goals.
(01:07):
This is your time to level up and become a
stronger You. So today we're talking about all of Katie's
expertise and working with Stronger You members on GLP one
medications and transitioning them off, and how our approach to
eating needs to change on these medications. Katie shares a
lot of tips and tools that you'll want to listen to,
(01:30):
whether you're on one of these medications or just interested
in understanding them a bit more. There's something for you
on today's episode, Katie. Welcome to the Stronger You Radio.
I am so excited to be sitting down with a
Stronger You registered dietitian. Who is Katie Lahy. She is
(01:50):
an awesome dietitian and she has a lot of specialty
credentials herself, and one of them is being credentialed in
diabetes care and education. And so Katie, I would love
for you to describe what is that credential and that certificate,
all of that, what goes into it? Yes, well, thanks
for having me, Jana.
Speaker 2 (02:09):
So, the Certified Diabetes Care and Education Specialist credential is
basically a specialty within diabetes management from type one so
type two diabetes, pre diabetes, gestational diabetes, an array of
you know, everything that's under that umbrella, and you have
to kind of put in additional hours with people with
(02:30):
diabetes and counseling, you have to sit for a national
exam and so basically it just gives you a more
specialized view on diabetes management and how and you don't
have to be a registered dietician to do that. A
lot of cdceess are registered nurses or physicians, and so
(02:51):
it's basically you have additional experience, additional skill set that
particularly pertains to you know, people diabetes, from medications to
side effects to you know, long term management and care.
Speaker 1 (03:04):
And yeah, yeah, that's amazing. No, and that's not just
like you go online and get a quick sirt. This
is a lot of hours and experience and it's like
any other board certification for segments. So I think that's
impressive to share, especially with this topic today which we
are talking about GLP one medication so some anglue ties, trzepetides,
(03:27):
all the things that go into that hub. So this
is exciting to hear from you. And also I think
one thing that we didn't cover you is pre diabetes.
And if somebody is trying to prevent diabetes, that's also
you know, a skill set that you have. Would you say, oh, absolutely?
Speaker 2 (03:44):
And I think being proactive with our health and wellness
is key. So understanding your risk for diabetes is very important.
So yeah, pre diabetes, family history of diabetes, if you've
ever been diagnosed with gestational diabetes in the past or
PCOS poly cystic ovarian syndrome, you are at greater risk
for possibly developing type two diabetes.
Speaker 1 (04:04):
Later in life.
Speaker 2 (04:05):
So basically, when you have pre diabetes, this is the
time to be like, okay, lifestyle factors from nutrition to
movement to you know, sleep, stress management, this is the
time to really kind of build up your lifestyle factors
to prevent you know, further progression into type two.
Speaker 1 (04:22):
Basically, it's saying, hey, your body's not.
Speaker 2 (04:24):
Doing what it's supposed to do with glucose or you know,
insulin production red flag.
Speaker 1 (04:28):
What are you going to do about it?
Speaker 2 (04:29):
So it's kind of like that phase where you know
you have an opportunity to make some significant changes within
your lifestyle to really see if that has a beneficial effect.
We're reducing your risk of developing into type two.
Speaker 1 (04:43):
Yeah, that's so important, and I think that's it's really
helpful for people listening who are worried about that. So
there is a way forward, and there's definitely things that
you can do. That's what we help people at Stronger
You do, and especially like coach Katie here and then
I want to take a step back to for the
listener who they may be listening being like, yep, I
got it, I know what golp ones are. But just
(05:05):
to level set everyone, what are GLP one medications and
how do they work? And you can it's a high level,
like you can just give us a little description, that
would be really helpful. Yeah.
Speaker 2 (05:15):
So, basically, the GLP one hormone or gluca gun like
peptide one is actually already made in our body, So
these medications are exogynous or an additional version of that,
and so when they're injected, they basically are released after eating.
So after eating, these medications kind of work to signal
our body to make more insulin, which helps stabilize blood sugar.
Speaker 1 (05:38):
These medications also.
Speaker 2 (05:40):
They are typically you know, in the gut, so they
help to delay gastric emptying. Aka they're slowing down digestion,
which means, you know, food is broken down more slowly,
which kind of keeps us full for longer. So they
do a lot of different things within the body that
you know, really can help with the way we manage
blood glue, coost control portions, you know, food and take overall.
Speaker 1 (06:03):
Got it? Yeah, And what would you say to someone
that they asked you, oh, do these speed up my metabolism?
How would you answer that? That's a really good question.
Speaker 2 (06:13):
No, I think at the end of the day, no,
and I would love your take on it as well.
But they're not setting up your metabolism. They're making you
feel really full. They're reducing cravings. They are again slowing
down digestion, so like, not only do you feel full quickly,
but for longer. Therefore, you don't want to eat more,
Like you're in taking a lot less calories on these
(06:35):
medications because they're they're kind of discouraging your interest in food.
They're kind of just again reducing those hunger cues, so
you're less likely to just grab a snack just because
it's there, or you know, overeat different things like that.
Speaker 1 (06:48):
So they're not really speeding up your metabolism per se.
Speaker 2 (06:52):
They're just signaling making signals in your body that don't
make you want to eat as much, which creates more
of a calorie deficit.
Speaker 1 (06:59):
I completely agree. It's an interesting question because I was
seeing some people ask this on the internet and talking
about this, and I'm like, yeah, you know, I think
we have this notion that oh, to lose weight. I
need a faster metabolism, but really it is about reducing
our dietary intake, upping our movement and all of those
things that are really those basics. So I just want
(07:20):
people to hear that too, Like it's not like this
drug is doing something magical in terms of your metabolism,
But what's magical about it is really like what's happening
on that brain, Like you were saying, like less likely
to go have a snack, or like it's that food noise,
which is also a term a lot of people on
these medications are using to describe, like, oh my food
(07:42):
noise is minimize I'm not thinking about food as often,
so any thoughts on that, Oh my gosh.
Speaker 2 (07:48):
Yeah. So another piece to that, Gianna is that these
medications kind of pause that food noise, which we'll talk
about in a minute, so that you can build behaviors
and that foundation of balanced meals, portion control. It gives
you that pause of all the different variables and allows
(08:10):
you just to focus on building up that foundation, which
again varies based on the person, but for instance, you know,
these weight loss medications can create significant amount of weight
loss in a short period of time. All of a sudden,
you're lighter, maybe you can walk longer, or you know,
maybe have more endurance to do different things.
Speaker 1 (08:27):
And for instance, a woman that I.
Speaker 2 (08:29):
Worked with so quick kind of run down this Stronger
You remember prior to Stronger You had lost one hundred
pounds on her own. Wow diet an exercise, her dad
had a help thing that kind of jump started her
to make some big lifestyle changes. Then she kind of
found Stronger You to refine food, learn more about what
nutrition can do to maintain you know, her fat loss.
(08:52):
But at the end of the day, when you lose
a significant amount of weight, although your body has changed,
it takes a while for your mind to.
Speaker 1 (08:59):
Catch up up right. And so she recently, due.
Speaker 2 (09:02):
To perimenopause and some other things, felt like she needed
a little added jump start.
Speaker 1 (09:06):
So after you know, she toyed with the idea. She
felt like there's a.
Speaker 2 (09:09):
Stigma attached, like she didn't want the easy way out.
She started a GLP one recently and she said to me, Katie,
in the first time in forty four years, I have
zero food noise. I have no feelings of food fomo
or fear of missing out. She has, you know, a
husband and some boys and they eat a lot and
she goes, I am finally satisfied, you know, mentally, physically,
(09:30):
emotion with the portion that works for me, even though there,
you know, their portions are a lot bigger.
Speaker 1 (09:36):
It's allowing her to enjoy food on a new level.
Speaker 2 (09:39):
It's allowing her to you know, reduce decision fatigue, to
you know, put more emphasis on movement.
Speaker 1 (09:46):
And part of that too, was she was having.
Speaker 2 (09:47):
Some joint issues and things like that, and she felt
like if a little added fat loss, which she was
having a really hard time doing the stage of her life,
would help alleviate that pain. And so like just that
first thing in forty four years, I have no food
noise like that was that gave me chills?
Speaker 1 (10:02):
Like that that says a lot. It's incredible. Yeah, it's amazing.
And I think there are some people who who are
listening to that are like, oh, I don't relate to that.
It's like some people can eat something and feel satisfied
and move on with their day, and then there are
a lot of other people who just do not have
that mechanism built in, where it's like it's either gotten
(10:23):
blunted maybe they never had it. I think there's so
many factors there, too many to go into. But yes,
I hope people have a new awareness of this food
noise topic that we're talking about, because it is an
important one and it is why this medication does work.
And when I think about this medication, like, obviously you're
coming from this diabetes background and all this expertise. So
(10:47):
these medications started out for diabetes care. Can you talk
a little bit about who they were prescribed for maybe
five ten years ago and now who are they prescribed
for as well in the weight loss space?
Speaker 2 (11:02):
Absolutely, So they were initially prescribed for people with type
two diabetes and that might not have done well on
the oral medications and they needed a little extra to
help improve blood sugar management. So again, these medications kind
of make have the body make some more insulin so
that our body you know, digest gluecoss gets out of
(11:23):
our bloodstream. You know, it's used how it should be.
So it was initially for people to type two diabetes
who needed bloo gluecose management. And what they found was
individuals on these medications not only were improving their blood
glue coose management, but they were having fat loss as well.
They were seeing weight loss involuntarily, like they were feeling
full quicker. They were able to control portions better, which
(11:45):
also helped with improving blood glucose management. So they saw
that these medications, yes, on their own, without someone making changes,
blood glucose was improved, but also it helped these individuals
decrease portions, which also helped improve blood sugar as well.
Speaker 1 (12:01):
So then you know, they kind of saw that as, oh, well.
Speaker 2 (12:04):
If this can improve you know, if this can create
weight loss with these individuals, why can't it you know,
work with individuals that maybe don't have diabetes, but but
you know, our obese or need to target fat loss.
And so that's kind of how it evolved. It was,
you know, just to prove for people diabetes, and then
(12:25):
you know, some of the mecations became approved for people
without diabetes but met certain criteria with body mass indecks,
you know, obesity, and then it kind of keeps going
further and further where you.
Speaker 1 (12:36):
Know, almost anyone can get it, depending upon you know
where the sources right and if you have the resources
to go purchase it, right. That's a big component.
Speaker 2 (12:46):
Right, And like insurance has a lot of parameters. If
you want insurance to pay for it. You have to
you know, qualify X, Y and Z, body mass, indecks,
co morbidities, things like that. And like, for instance, the
woman I had mentioned, he pays a three hundred dollars
monthly copay. Her insurance covers the majority of the medicine,
which is like fifteen hundred dollars. So a lot of
(13:07):
people are not able to afford it out of pocket sustainably.
So if you do meet the criteria, insurance will cover
it to some degree.
Speaker 1 (13:13):
Otherwise it's out of pocket. Not three hundred dollars. At
least from my people I've worked with, that seems actually
cheaper than some of the other people I've heard who
are paying like five hundred and so, So even with
a cope, three hundred dollars and I have seen some
people get it totally covered, which is amazing, Like that
makes me so happy. Do you think, just your personal opinion,
(13:34):
do you think that that will continue to improve? I do?
I do.
Speaker 2 (13:38):
I feel like the research the results that are you know,
better being shown are unbelievable, Like this is changing people's
quality of life, it's reducing their risk of disease complications
or even reducing the risk of you know, diseases in general.
I do think this will become more accessible in many ways.
Speaker 1 (13:59):
Yes, yeah, do you think? I mean this is also
just I'm curious your opinions. And you know, you and
I are both dieticians and we want to help as
many people as possible and eliminate as much biased as possible.
So clearly listening to this so far, I mean, people
know that we are not anti these medications. What would
you say to someone if they were like, oh, like
(14:21):
you said before, like that is taking the easy way out,
or that is you know, oh, that's like not the
way I want to do it, because I'll be judged.
And you know, we hear all of these different things,
and so I'm just curious, like if we could discuss
that a little bit more.
Speaker 2 (14:35):
Oh yeah, and you know, most of the research out
there circulating promotes to get maximum efficiency of fat loss
on these medications, they should be used alongside to lifestyle changes,
especially nutrition. So these even the drug companies that are
you know, making a lot of money on these, they
(14:55):
are still saying, hey, these medications are great, but they
need to be used in conjunction with lifestyle factors nutrition, exercise,
for the maximum capacity of you know, of efficiency. So
I think that alone speaks volumes. Also, you know, there's
always a lot of stigma attached. However, you know, we
all know ourselves best and what we need. You know,
(15:17):
no matter what you know, body composition, you are, we
all have things we're working on behaviorally, physically, mentally, emotionally,
and a lot of these medications are helping beyond the scale,
you know, beyond bo glucose management.
Speaker 1 (15:31):
But again, I think they.
Speaker 2 (15:32):
Allow the pause for individuals to work on, you know,
building up their foundation of lifestyle factors that will overall
help their health and wellness long term, you know, whether
they're on their medications or not.
Speaker 1 (15:44):
So I know there's always a stigma attached.
Speaker 2 (15:47):
And I know there's a lot of judging out there,
but you have to look at you know, the pros
and the cons and you know, determine if this is
something that would you know, benefit you in the long
run health wise and beyond.
Speaker 1 (15:58):
Yeah, definitely, And I think that people listening if you
have a bias or kind of a knee jerk reaction
when you hear these medications or when it's talked about,
or maybe a friend just started and you're kind of judging,
you know, maybe not directly to them hopefully, but in
your own processing. I would get curious about where that's
coming from, because that's one thing that really can help
open up a little bit more. I mean, we can
(16:21):
have a whole segment on like fat bias in this
country and beyond, and that definitely exists. So I just
I would feel remiss if I didn't mention that here
today because it is such a big topic and it's
important that people know that stronger you supports you with
whether you want to take a medication or you don't,
we will help you do it in whatever way makes
(16:42):
sense for you right now. And you're always allowed to
change your mind, which I think is really important.
Speaker 2 (16:47):
Absolutely, And as a nutrition professional, you know we are neutral.
We are here to support your choices, you know the
direction you are in, so that you know whatever results
that you achieve there there sustainable. We're here to support
you know, whatever your choices are, we are neutral and
whatever is going to help you most, that's what you
know we want you to lead the way with.
Speaker 1 (17:09):
Yeah. Absolutely, And so if we're talking a little bit
more about coaching now, more of our jam, our bread
and butter, and so I'm wondering how my calorie needs
change when you're on a GLP one medication.
Speaker 2 (17:22):
Yeah, you're let me preface, So these medications are here
to stay. They're very effective in blood glucose, you know,
significant fat loss and a short period of time. The
thing is these medications are only going to get stronger
and more effective, which means they're creating more drastic weight
loss and shorter period of times. To emphasize this, you know,
like ozembic offers a really nice twelve percent average fat loss,
(17:44):
which is great, it's very significant, and it's progressive, whereas
the most recent released approved GLP ones are averaging twenty
to twenty five percent.
Speaker 1 (17:54):
Weight loss average weight loss and that same period of time.
So this is.
Speaker 2 (17:57):
Driving home you know even more or that you know,
and those those medications were coined the King Kong and
Godzilla of weight loss medication, So it's a whole new level.
They're almost doubling the percentage of weight loss within the
same window of time.
Speaker 1 (18:11):
And so why is that kind of challenging.
Speaker 2 (18:14):
Or potentially a negative thing, because you know, very aggressive
weight loss in a short period of time can create
an abundance of side effects, muscle wasting, nutrient deficiencies, disordered eating,
and more so, having that solid, you know, team of
professionals while you're on these medications and navigating on and
off of them increase dosing can be super beneficial. Ductor therapist,
(18:36):
registered dietitian, nutrition coach, even friends and family like having
them on board, and specifically, you know, nutrition coaching. We're
able to get to know you very well, so we're
able to address challenges, individualized needs. We're able to make
sure that you're maintaining the enjoyment of eating, your understanding
(18:58):
you know, how food is affect you now, but also
long term, we're able to provide practical and relevant tools
so that.
Speaker 1 (19:05):
You can you know, use in the long term.
Speaker 2 (19:07):
So basically, to get back to your initial question, calorie
intake is significantly reduced. What happens again, you're feeling full
quickly for longer, so you just you are not going
to You're you're not going to have the same caloric
needs or even want to eat as much as you
were prior to these medications. And so, you know, having
(19:27):
a dietician nutrition coach really allows you to transition from
going to eating you know, hunger cues eating more than
usual to all of a sudden eating less, but with
the focus of nutrition quality, so quality of food, types
of food, and we're able to kind of work with
you to kind of break it down and so that
(19:48):
despite significant less needs, you are able to get adequate nutrients,
so that again, muscle wasting is you know, minimal, you know,
nutrition deficiencies don't happen.
Speaker 1 (20:00):
Yeah, Yeah, we can kind of dig into more of
the nutrition side of things. Yeah, And I want to
pick on the muscle wasting a little bit more so
for someone who's listening, like, can you describe that a
little bit more and why that's so important because we
know that we will lose muscle when we're losing weight,
whether from a GLP one or from just diet an exercise,
(20:20):
And I want to make that really clear. I think
some people are like, oh, these medications are XYZ negative
because it has you lose more muscle. And it's because
of the speed of weight loss. So even if you're
losing weight quickly from just eating less, we can have
that same muscle loss as well. So it's important no
(20:41):
matter how you're losing weight. And I just want to
remind m.
Speaker 2 (20:45):
Yeah, literally when you're in a calorie deficit, your body
doesn't discriminate. You know where it's pulling from. It's going
to pull from muscle, it's going to pull from sat.
Speaker 1 (20:52):
We want to minimize that muscle loss, whether.
Speaker 2 (20:54):
On the medications or not, by prioritizing protein, doing weight
bearing activity, walking and shrink training so that although muscle
wasting will still happen, we slow it down as much
as possible. And so you know, when you need less calories,
you need to make the most of the calories that
you are eating, and.
Speaker 1 (21:14):
That will help me preserve more muscle. Right.
Speaker 2 (21:16):
Absolutely, when we're prioritizing protein, we're looking at other lifestyle
factors like weight bearing activity. Those are really really important
to helping to preserve that muscle mass and slow down
a little bit more. But also, you know, when individuals
start medications, if they don't have any idea of you know,
nutrition or a concept of hey, I actually need to
(21:39):
think about what I'm eating. Like for instance, some members
that I'm working with that are on you know, GLP ones,
They're like, oh, I could just have a slice of
pizza all day and be fine. Well, we know, you know,
a slice of pizza is a couple hundred calories, but
we have to be a little bit more intentional about
meal timing and composition so that you know, we're giving
back to our bodies. Still though it's not telling us
(22:01):
it's hungry, we still need to make sure that we're
getting adequate calories and nutrients in for overall health and wellness,
for our bone mass density.
Speaker 1 (22:09):
Long term, you know, we want to reduce the risk.
Speaker 2 (22:11):
Of osteoporosis, osteopenia, you know, for cognitive health if we're
eating too little. You know, beyond muscle wasting, there's there's other,
you know, challenges that we could come across.
Speaker 1 (22:22):
Yeah. Absolutely, And I think i'd be curious to know
how do you work with someone, let's say, who just
started on a GLP one. Maybe they're feeling a little
bit of nausea maybe, or like you're saying, the drug
is just very effective. They don't need to eat as
much or not need Sorry, they don't feel like they
need to eat as much. How do you start them off?
(22:43):
Are you doing smaller meals? Like what are some of
the strategies that you'll you'll try with people? Absolutely?
Speaker 2 (22:50):
And the cool part is there's endless strategies as a
nutrition coach, when I'm working one on one with someone,
we're trialing and airing. So what works, what doesn't, And
it's going to be so different for everyone. You know,
someone could get full on a glass of water, whereas
someone you know could actually eat an apple and peanut
butter and be fine. It just really depends on the individuals.
So basically, you know, when we're when I'm working with someone,
(23:13):
I'm trying to find you know, foods that are higher
in protein and smaller amounts so low volume, high nutrient density.
You know, foods again that are high in fiber lower
and fat lower, lower and volume higher and nutrient density.
And so what I like to start out with doing
is having them track their intake. Tracking your food is
one of the best things you can do because we
(23:35):
don't know what we don't know, and so we you know,
by seeing an individual's meal timing, meal composition, you'll frequency.
We're then able to determine, you know, some ways to
improve intake. So a couple things that have been working
really well with individuals on these medications are like liquid
(23:57):
so nutrient dense calery liquids like smoothie protein shake, even
like soups. They're able to get a lot of nutrients
in the liquids are oftentimes easier to digest in terms
of you know, less symptoms. Again, able to get more
nutrient density without feeling too stuffed or over satiated. So
(24:20):
liquids have been playing a big role. I think this
is a great time to introduce protein supplement.
Speaker 1 (24:27):
Again.
Speaker 2 (24:27):
We need a lot of nutrient bang for our buck
in a small amount, and so something like that can
offer that to someone.
Speaker 1 (24:36):
Another approach that I've.
Speaker 2 (24:37):
Been doing a lot with individuals is almost like Bento
box like meals, but it's pre planned, it's intentional. So
taking like a hard boiled egg, a third of a
cup of cottage cheese, and then pairing it with you know,
a piece of fruit like a mandarin orange, a couple carrots,
ten crackers.
Speaker 1 (24:55):
So we're getting each of the food groups you.
Speaker 2 (24:57):
Know, protein, carb, fat, but we're combined them together, so
almost like the snacky meals don't keep us full for longer,
but they're still giving us that nutrient like impact.
Speaker 1 (25:07):
If that makes sense, Yeah, definitely. And we all love
an adult lunchables, so I love it. I love the
Beta bus.
Speaker 2 (25:14):
It's mix and match especially for teachers or people in
the healthcare industry when they kind of have to grab
things and go.
Speaker 1 (25:19):
It's so easy and accessible. Yeah, I love that idea.
That's great. So yeah, and I heard you say low
food volumes, So you want to have smaller food volume
when you're on one of these medications. And then I've
heard you say before like the opposite, if you're not
on one of these medications, that's when we want food
volume to be a little bit higher, so that way
(25:40):
we can feel like we're eating a little bit more
if we're in a deficit. I mean, other thoughts on
that subject.
Speaker 2 (25:47):
Yeah, absolutely, so I think we have to be very versatile. Hey,
this is a good strategy for when I'm on these medications.
This is a great strategy for if and when I'm
not on these medications. And so that transition for fat loss.
Not on medications, you're thinking high volume, low calorie, what's
going to keep me full for longer?
Speaker 1 (26:05):
And when you're on.
Speaker 2 (26:06):
These medications, you already feel full, So you have to
reduce the volume.
Speaker 1 (26:10):
And increase the nutrient density. Absolutely, And I think.
Speaker 2 (26:13):
Another part of that is, you know a lot of
times when I work with individuals that are not on
weight loss medications. I'm like, Okay, let's aim for three
larger meals per day. Let's you know, avoid the snacks
or you know, plug a few intentional ones in there. Again,
when you're on these weight loss medications, you know, smaller
meals more frequently throughout.
Speaker 1 (26:33):
The day are more ideal.
Speaker 2 (26:34):
Your body cannot digest a lot of food at once
on these medications, right, and so we want to break
it down and kind of spread it throughout the day.
You know, four to six smaller meals. Yeah, that's time consuming,
it's it's kind of a commitment, but it's what your
body will like the most. And so we have to
definitely transition our strategies and our thinking when we're on
these medications versus when we're not on these medications.
Speaker 1 (26:57):
Yeah, and I'm curious too, Like I heard you mentioned,
like in the Vento box, you had some fruits, you
had some veggies, so you're obviously getting some fiber. Should
people be concerned about the nutrient absorption and like the
digestion differences there when they're on these medications.
Speaker 2 (27:15):
I mean, so with digestion being slowed down already, absorption
is also slowed down. It kind of goes hand in hand. However,
you know, I think at the end of the day,
if we're getting in balanced meals, we're going to eventually
get all the things that we need, you know, vitamins, minerals,
you know, all those things. It's just keeping a variety
(27:35):
of you know, balanced meals going throughout the day. So
you know, any anyone in general, I always recommend obviously
checking with your physician first, but I always recommend a
multi vitamin just for nutritional insurance. Now, when you're on
these medications and you're having very aggressive, you know, weight
loss quickly, you are at risk for other deficiencies that
(27:58):
you can chat with your physician about, you know, if
you need additional supplementation based on bloodwork or whatever. But
I think at the end of the day, when you're
eating balance meals throughout the day, you're going to get
what you need eventually.
Speaker 1 (28:12):
Yeah, definitely. Okay, that's super helpful for people to hear.
Thank you. And then if I am on one of
these how can I ensure I'm getting enough protein, fiber
and all of those nutrients while potentially eating less And
you answer this a little bit, but any other methods
that you think would be helpful to share.
Speaker 2 (28:31):
Yeah, so obviously tracking we don't know what we don't know.
I think tracking is helpful. I think sometimes you know
in a more specific way, if someone's losing, you know,
more than two pounds per week of weight loss, I
feel like that is a sign that you know, calories
might be too low.
Speaker 1 (28:46):
That's very aggressive. Not to say it's bad, but it's
very very aggressive.
Speaker 2 (28:49):
And you know a lot of research backs Hey, one
pound per week weight loss is sustainable weight loss over time.
Speaker 1 (28:55):
And I think that's a piece of these weight.
Speaker 2 (28:57):
Loss medications is yes, they target loss, but we also
have to be thinking of the endgame. The goal is
fat loss, but what happens when you hit the fat loss?
What happens when you reach your goals? And so as
we are, you know, on this fat loss journey, on
these medications, we want to make sure that we're you know,
again finding balanced meals that we can plug in. So
(29:18):
the three three three method is something that you know,
stronger you promote. It's basically saying, at every meal, where's
your protein, where's your car where's your fat source? I
like the veggies in there, you know, thrown in there
as well, And so I think that's a great way
to check your work as well, even if you're not tracking. Okay,
if I know every meal, I'm getting a nice lean protein,
a high fiber carbohydrate, you know, think fruits, veggies, grains,
(29:40):
beans and lagoons.
Speaker 1 (29:41):
Even milk and dairy is a.
Speaker 2 (29:43):
Nice carbohydrate with some nutrients and a heart healthy fat.
You know, that really does help to set the stage
for Okay, am.
Speaker 1 (29:50):
I getting what I need? Am I getting a variety
of things? Yeah? But I think tracking your food is
helpful so you can kind.
Speaker 2 (29:56):
Of see where you're at, and it gives you feedback Okay,
more protein or wow, that was a lot of fat grams,
or you know, oh I felt really good today, I
didn't feel sick, I didn't feel too full.
Speaker 1 (30:07):
What did I eat?
Speaker 2 (30:07):
So it also allows you to reflect back so you
can repeat things that work. Well.
Speaker 1 (30:12):
Yeah, no, that's super helpful, Thank you. And I think
one thing that's just coming to my mind now is
like if somebody isn't already resistance training or doing any
sort of weights, I think now like, as you said,
like some people who are in bigger bodies who are
having a hard time to exercise and move their body
Hopefully as they progress on these medications, they'll be more
(30:34):
open to that maybe that's a little bit easier to them.
So I think now is a really good time to
prioritize that even if like you work with a trainer
once or twice to understand like some basic movements, if
you follow a program on an app in the comfort
of your own home, doing some sort of resistance training
is so important. And I think that that needs to
(30:55):
be like a must alongside this nutrition and lifestyle here
that we're talking about. That I could not agree more.
Speaker 2 (31:02):
And the reuseer's out there backs that resistance training or
weight bearing activity is actually more important after the fat loss,
and it is initially, so we know exercise isn't really
going to move the scale. It's the nutrition piece, it's
calories and versus calories out, but it's a lot more
complicated than that. The exercise is an added bonus that's
(31:24):
going to again build muscle, help with balance, range of
motion for now. But also when we're like ninety, you know,
and so we are at the end of the day,
we still need to have that big picture in mind.
So when we're thinking of what we can do now
to help us later not only you know, strength endurance wise,
but also maintaining the fat loss. Exercise resistance training is
(31:47):
a big piece of that. Now, I will say, you know,
some members have very low energy, They feel very fatigued
on these medications because they are in taking such a
very low calorie intake. And so you know, a nutrition
culture dietician can really help to see where we can
plug in, you know, some added energy to ensure they
can get some movement in. But it doesn't have to
be sixty minutes a day. It's you know, let's start somewhere.
(32:10):
Can I walk five minutes out, five minutes back? Can
I do somebody squats, you know, wheat squats, you know,
something like that. So we don't have to go zero
to crazy. We're just trying to figure out, yes, this
is I think this is the perfect time to implement movement,
not only really not for the fat loss aspect, but
for you know, bone health, you know again strength and
endurance as well as maintenance down the road.
Speaker 1 (32:31):
Yeah, definitely, And I think you know, we've had a
lot of successful members doing things like Orange Theory and
you know, getting to a point where they're able to
go to these classes that incorporate a mix like you said,
of endurance and strength training, and so I love that.
I think that is something to work towards and to
help with maintenance as well as that initial and so
(32:51):
I think it's really important that you said, yes, it's
even more important after this fat last phase to then
keep that muscle tissue going. So thank you, Okatie, that's
super helpful to hear. Is it time for you to
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(33:12):
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(33:34):
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That's SU Radio fifty. This is where a Stronger You
(33:55):
begins let's do this. I'm curious we didn't really talk
about the most common side effects. You know, I'm sure
there's a lot of outliers as well with these medications,
but what are some of the most common GI side
effects that you're seeing when you work with people.
Speaker 2 (34:11):
Oh? Yes, the most common GI side effects are nausea, vomiting, diarrhea, constipation,
and digestion like burping.
Speaker 1 (34:20):
And so this is a lot of what I work.
Speaker 2 (34:23):
With numbers on tackling, right, and there's a lot of
tips and tricks. So, for instance, if someone's having constipation,
you know, small frequent meals are very helpful to that, right,
we're not overloading our digestive track. The trifecta and my
eyes of good digestion, whether you're on these medications or not.
Speaker 1 (34:40):
Adequate fiber, adequate hydration.
Speaker 2 (34:43):
And movement, you know, movement definitely keeps things going on
the inside. Incorporating higher fiber foods daily like your fruits,
your veggies, your whole grains super super important. And again
back to that adequate hydration. You know, again, if we're
if we're not being cued up that we're hungry, we're
probably not being cued up that we're thirsty either, so
we really have to incorporate making sure that we're drinking
(35:05):
enough you know, hydration and really any liquids do count.
Speaker 1 (35:08):
However, Yeah, that's fantastic. I think we overlook the hydration
piece also being impacted on these medications. So thank you
for that point. That's really helpful.
Speaker 2 (35:19):
And then on the other side of that diarrhea, you know,
we definitely want to stay hydrated with that, making sure
that we don't get dehydrated due see the excess loss
of fluids. You know, a lower fiber diet during a
phase of diarrhea is very helpful. I think like the
easy digest added hydration foods that you tell right well,
like I think of like eggs, fish, rice pudding, banana toast,
(35:39):
canned fruit cream, a wheat apple sauce, noodles like you know,
a nighttime sick I'll just have like noodles because it's
very easy on the gut. They're kind of bland, so
they're not going to like flare up anything. So when
you have diarrhea, making sure that you're proactively countering it,
you know, eating per tolerance things like that.
Speaker 1 (35:56):
And then why you'd want to work with someone like
you on, because if I have diarrhea, this person's constipate.
Those are very different things. We don't want to just
follow like the same type of plan.
Speaker 2 (36:07):
Absolutely, and again it's so individualized. Again, some people have
allergies or intolerances, so then we're working with okay, what
foods can they tolerate, but also that they can digest
or you know eat without any issues as well. So
the nutrition coach, the dietitian aspect, we really take a
deep dive into someone's nutrition, you know, especially when there
are side effects again nausea and vomiting. So this is
(36:30):
another very very common side effect and a lot of
the research is saying, okay, to help reduce nausea and vomiting,
have your biggest meal before injection, and the next couple
of days after that follow with a very low fat diet,
small or more frequent meals. Obviously is definitely the theme
of the things, including those to reduce side effects, and
(36:53):
same thing with nausea and vomiting, you know, almost like
sick day protocol, you want to eat very soft, blended
or liquid meals like brath you know, to make sure
that you're still getting nutrients, but you're doing it very lightly.
Speaker 1 (37:06):
So having your biggest meal before injection is healthy. And
then lower fat.
Speaker 2 (37:12):
You know, lower fat can exacerbate GI symptoms as higher
fat can exacerbate nausea vomiting GI symptoms as well. So
again working with a dietician, Hey, what what are fat sources?
Speaker 1 (37:23):
You know, what's a lot for me or you know,
working through that.
Speaker 2 (37:26):
I can't tell you how many times I'll look into
someone's food logs and they don't even realize you know,
where their fat sources are coming from.
Speaker 1 (37:32):
So it's a really good teaching moment. You know how much?
Speaker 2 (37:35):
How often? How can you know? We make this work
to reduce symptoms? And then you know again with any
nausea vomiting that adequate hydration can play a role. Now,
sometimes I'm finding with individuals on these medications, caffeine and
carbonated drinks can exacerbate nausea and vomiting. I would be
in big trouble because I love my flavored waters, I
love my coffee. But it's very again individualized. It might bother,
(37:57):
you know, one individual, but completely unphased another one. So
those are some other things that you could trial and
error if you're having nausea and vomiting.
Speaker 1 (38:05):
Maybe drink coffee a little more conservatively in the beginning
to see how you tolerate that.
Speaker 2 (38:10):
That's water in between your coffee. No, and then and
then lower fat intake again. You know, fat sources take
them in it to digest in our body without medications.
So now that our digestion is slowed further, you know,
higher fat foods are going to cause a little bit
of trouble.
Speaker 1 (38:26):
It's just going to be harder to digest.
Speaker 2 (38:28):
So if you are having nausea, vomiting, or any gi issues,
you know, lower fat, lower added sugar intake can really
help symptoms stay at bay.
Speaker 1 (38:37):
And how does alcohol come into play in all of this?
Speaker 2 (38:42):
Yeah, No, this is a really good topic that I
feel like needs a lot more research devoted towards it.
Speaker 1 (38:48):
But again, at.
Speaker 2 (38:49):
The end of the day, your digestion is slowed, and
so even alcohol, you know, as it breaks down in
the body, it's going to be slowed.
Speaker 1 (38:58):
And I cannot tell you how many.
Speaker 2 (38:59):
Members have said to me, oh my gosh, I had
my first drink since being on these medications. I have
felt drunk for two days. Like, not to scare anybody,
but it's going to linger in your system a heck
of a lot longer on these medications. So sip slowly, savor,
you know, trial and error a little bit. And you know,
again with these medications, you don't want to have a
(39:21):
lot of added sugar, so making sure that the alcoholic
drinks you have, you know, don't have a lot of
added sugar in them.
Speaker 1 (39:27):
But yeah, I think it's been very interesting to hear
feedback from individuals if.
Speaker 2 (39:31):
And when they do have alcohol on how it affects them.
You know, it's a lot more potent.
Speaker 1 (39:36):
Yeah, No, that's that's very important. It's a very cautionary
disclaimer too that I think we need to consider. And
I think that also I've heard people aren't less interested
in alcohol, which makes sense, Like we were talking about
that food noise, there's a little bit less interest in
these like dopamine seeking behaviors of like alcohol, cigarettes and
(39:57):
all of the things that we can overdo.
Speaker 2 (40:01):
Yes, and that's another thing, right, So these medications start
out to help blo glucose management. Then they started you know,
expanding on that to fat loss or weight loss for
you know OBC.
Speaker 1 (40:12):
Now they're showing you know, some.
Speaker 2 (40:14):
Promise in reducing those addictive behaviors or you know, alcohol,
things like that. So it's wild how these medications are
affecting our systems in so many different ways.
Speaker 1 (40:26):
Yeah, and I think when I'm thinking about all the
different strategies for chloric deficits and body composition, obviously there's
things like eating low car some people follow intermittent fasting
or maybe different dietary patterns if someone is on a
GLP one, are there maybe some pros or cons to
(40:47):
following some of those different strategies.
Speaker 2 (40:49):
Yeah, So in my opinion, you know, weight loss strategies
all have the same thing in common.
Speaker 1 (40:53):
They create a calorie deficit end of the day.
Speaker 2 (40:56):
So intermittent fasting, if it's done right, you know it's
closing your.
Speaker 1 (40:59):
Window of eating.
Speaker 2 (41:00):
So ideally, you know you're eating less calories consumed throughout
the day as a whole low carb Again, you're decreasing
your carbohydrate intake while keeping you know, protein and fats
around the same, So again you're eating less calories in
terms of you know, I think they all are okay
on their own, but I don't really in my opinion,
I don't believe if you're on a GLP one you
(41:20):
need to do interminute fasting or low carb. You're kind
of already inadvertently doing lower carb whether you mean to
or not, just because you're not able to eat as
much period carbs included. But you know, with intermittent fasting again,
you're you're really significantly closing your window of eating.
Speaker 1 (41:37):
I would rather have someone have smaller, you know, more.
Speaker 2 (41:40):
Frequent meal spread throughout the day versus you know, plugged
into this tiny window where you're probably going to be
over stuff. Now, these medications do a lot of things,
including you know, if you were to push past the
point of fullness when you're eating, that can exacerbate GI
symptoms as well. So I personally feel that GLP ones
(42:01):
do not need the added assistance of intermittent fasting or
low carb in general.
Speaker 1 (42:06):
Yeah, I agree, and especially for the internet and fasting.
Like sure, if someone's eating lower carb anyways, okay, I can.
I can get with that a little bit more. But
the intermittent fasting, like you said, I think you run
out of eating opportunities to get the amount of protein
and nutrition that we need, like you just highlighted so
wonderfully of like we need all this for the muscle
(42:28):
nutrients and also to prevent nausea, because if someone was
intermittent fasting before these medications, they likely were eating larger
meals in these smaller windows of time, and that strategy
I just don't see that lasting as much. So I
don't mean to yuck anyone's yum. If you're listening and
you love intermittent fasting or you love different types of fasting,
(42:49):
just reconsider it a little bit if you are on
these medications.
Speaker 2 (42:53):
But also to add on to that point, so intermittent fasting,
like you said, essentially is giving you large your meals
in a shorter period of time, which is the opposite
of what we want to do on GLP ones. We
need smaller meals spread throughout the day because our body's full, right,
And so you know, intermittent fasting could be really helpful
if you're not on a weight loss medication but want
(43:15):
to target fat loss. It gives you that added structure.
But right now, we're not looking for high volume meals
on these medications. We're looking for very low volume because
that's what our body can handle, all right.
Speaker 1 (43:26):
So I'm curious, how could I enhance the effectiveness of
GLP one medications if I'm already on it. I'm doing well,
but I really want to make sure I'm maximizing this
time with this medication. Are there things that I could do,
whether nutrition or practical strategies.
Speaker 2 (43:46):
Obviously lifestyle is number one. What is your you know, lifestyle,
your systems in place supporting you know, health and wellness overall,
you know, from movement.
Speaker 1 (43:55):
And activity to quality of food. That is huge.
Speaker 2 (43:59):
Working with a red Diitisian nutrition coach so that we
can take a deeper dive into what you're doing to
support you know, long term health. I think adequate sleep,
stress management, those are all things that are not going
to go away. Like we need those while we're on
these medications.
Speaker 1 (44:14):
We need those to be good when.
Speaker 2 (44:15):
We're off these medications, and they are supporting overall health
and wellness. So definitely working on you know those aspects
as well. If we're not getting adequate sleep, then you
know we're not going to be as sharp or have
as much energy, and we might be making different food
choices than we should be.
Speaker 1 (44:32):
Same with stress.
Speaker 2 (44:33):
Management, and so yeah, I think there are a lot
of Again, diet seems so simple, but it's so you know,
deep rooted, and there's a lot that we could do
to maximize you know, those effects.
Speaker 1 (44:44):
Yeah, And I don't even think diet is simple, right,
It's so complex, but we try to simplify it for
everybody else as much as we can.
Speaker 2 (44:51):
And it's and it's not cookie cutter, like everyone needs
different things from hydration to protein, like like there's no
there's the same thing doesn't apply to everyone. And so
that's the fun about nutrition for me is everyone I
work with needs so many different things, right, and so
that I'm we're able to customize it as a team
together to like maximize again health, wellness, performance, body composition
(45:14):
in the long haul.
Speaker 1 (45:15):
All right, So I have a couple questions that we
received about you know, the more long term perspective, and
one of those is what are the potential nutritional risks
of being on a GLP one for a long period
of time and maybe how can I mitigate them?
Speaker 2 (45:33):
Yes, yeah, so I think again working with a team
is very helpful. So like your physician can keep blood
work going to make sure that there's no nutrient deficiencies
that you know, all the big picture help things are
looking good. You have regular follow ups, you know, people
monitoring your health and wellness, you know from an outside
(45:55):
perspective looking in and you know, being on weight loss
medications without normally understanding or having a direction with food again,
like we said, can create some challenges like nutritional deficiencies,
you know, loss of bone mass, you know, issues with
gut health, cognitive health. So I mentioned before there are
some common deficiencies with rapid weight loss, including on these
(46:18):
medications from iron to celcium B twelve, vitamin D, and
so we need to make sure that we're proactive in
the big picture help so getting follow ups, getting blood
work done, and making sure you know, someone other than
yourself is monitoring this on a on a deeper level,
like we know our body best. However, you know, we're
an expert in ourselves, but maybe not nutrition or you know,
(46:41):
medication or things like that. And so we you know,
having a like an expert view is definitely helpful and
it allows us to you know, continue to support our
health and wellness a lot like long term and more confidently, right,
we have more tools in our kit to you know,
strategize based on what we need it any given time.
Speaker 1 (47:01):
Definitely, And so I'm thinking about that's if someone's on
a long term path, I'm curious if someone is transitioning
off of GLP ones. And I know you've helped many
people transition off of these GLP ones. What are you
doing there, like, what considerations come up? Could you talk
us through that a little bit?
Speaker 2 (47:20):
Yeah, absolutely, So this is a big hot topic that
I'm seeing frequently. So anyone on these medications should always
be prepared for them to stop, whether it's involuntary or voluntary.
I've had so many Stronger YOU members all of a
sudden not have these weight loss medications due to changes
of insurance coverage due to shortages. But also a lot
(47:41):
of individuals are looking to take these medications short term
to kickstart, you know, fat loss, to give them a
chance to feel better, lighter, you know, And so for
a lot of individuals, this is a short term scenario.
Speaker 1 (47:55):
And so yeah, we want to make.
Speaker 2 (47:57):
Sure that you're not only able to navigate health and wellness, nutrition,
you know, lifestyle on these medications, but you know exactly
what it takes to transition off of them. So ideally,
best case scenario, you're able to work with your doctor
to wean off these medications over time so your body
can adjust to lower doses and you know, slowly work
(48:20):
on you know, addressing hunger, you know, queues that are
starting to come back, cravings that are starting to come back. However, again,
like I've experienced, some members all of a sudden just
can't get it and it's unexpected. And so we are
diving in and kind of amplifying what we've already been
doing on these medications. So we're still prioritizing protein, but now,
(48:41):
you know, if we're weaning off these medications, are no
longer on them, we're increasing the amount of.
Speaker 1 (48:45):
Protein that we were having.
Speaker 2 (48:47):
So let's say you could only tolerate one or two
ounces of protein, now we're doing three or four. So
we're slightly increasing the portions of the foods we're already eating.
Speaker 1 (48:56):
Again, you know, we want to amp up hydration.
Speaker 2 (48:59):
We need to trial and error ways to make sure
hydration is prioritized.
Speaker 1 (49:02):
On these medications as well as off of them.
Speaker 2 (49:04):
Whether we're pre filling water bottles using a straw that
always gets me more hydration.
Speaker 1 (49:08):
I don't know why.
Speaker 2 (49:09):
Being aware of you know, what fluids are tolerated. And again,
when you're transitioning off of these medications, those small or
more frequent meals that once worked may need to start
to get bigger, right, So instead of for to six
small meals per day, maybe we're doing three to four
slightly larger meals per day. You know, when you're transitioning
(49:29):
off of these medications, your digestion is going to evolve,
those hunger cues, energy is going to change, and so
we need to be prepared to, you know, slowly, which
is easier said than done, increase the volume of food
that we're eating very intentionally.
Speaker 1 (49:45):
Yeah, And would you say also, I mean something I
would want to hit is increasing exercise or at least
maintaining the exercise we've been doing as we transition off.
Speaker 2 (49:55):
Absolutely, Yeah, maintaining exercise. Having a good exercise routine is
one of the key factors for maintaining weight loss over time. Again,
I think is if not important, more important having an
exercise routine as you're weaning off of these medications or
off of them than it was when you started.
Speaker 1 (50:17):
I mean, it's even more important as you transition off
of these medications to have an exercise routine. I mean,
of course we always want an exercise routine, but it's
even more important because that calorie deficit that you were
in that window is going to get a little bit smaller,
and so we want our activity to go up, so
(50:38):
that way we are expending more energy that way.
Speaker 2 (50:41):
Yeah, exercise is going to be a paramount piece of
weaning off of those medications, are no longer being on
those medications, having again, And we don't want to think
of it as all or nothing.
Speaker 1 (50:51):
You know, it's not exercise or bus.
Speaker 2 (50:53):
It's you know, how can I incorporate activity more frequently
throughout my week with things that I enjoy that I
like doing. That like going up to what we like doing.
You know, activity wise five years ago looks very different.
I know you're a collegiate gymnast. I played soccer briefly
in college, right, Like, that kind of training and intensity
is way different than.
Speaker 1 (51:11):
What I like to do now. I like walking, I
like going.
Speaker 2 (51:14):
To kickboxing classes. I used to teach them, but now
I like taking them. Right, And so we have to
find and start to work on, you know, what kind
of exercise we enjoy.
Speaker 1 (51:23):
Where do we like to do it? You know, working
from home, I've been needing to get out of the house.
Speaker 2 (51:28):
A little bit more so now I'm leaving the house
to get exercise. It's nice because there's a little out
of accountability at the gym.
Speaker 1 (51:34):
They're looking for me, you know.
Speaker 2 (51:36):
So, yes, we want to establish exercise activity one that
we enjoy, two.
Speaker 1 (51:42):
That you know feels good, and three that you know
we can incorporate you know, frequently throughout the week. Yeah. Absolutely, So, Katie,
thank you so much for your time and walking us
through all of these different strategies and the ways that
you work with people. So if someone is like, Okay,
I'm on a medication or I know I'm going on one,
(52:04):
I want to work with a dietitian. Can someone come
to stronger you and do that with us? Oh?
Speaker 2 (52:11):
Absolutely, and we welcome you with open arms. It is
one of the best things to have a coach and
dietitian in your pocket. It offers endless guidance, you know,
opportunity to kind of collaborate to understand, Hey, what's going
to work best for me right now?
Speaker 1 (52:26):
How can I max out you know.
Speaker 2 (52:27):
Nutrition in a very realistic and relevant, long term kind
of way. And yeah, we would love for y'all to
join us and see what kind of collaboration that looks like.
Speaker 1 (52:38):
Man, And if you're listening to this podcast, if you
email us, we'll give you a special discount for being
a podcast listener, so you can email us to sign up.
And also wanted to say that Katie who's on the
show today, she has a blog coming out for Stronger
You about transitioning off of GLP one, so some tips
and tricks. If you want more reading on that, you
(53:01):
can just google Stronger You. I think we'll just call
it's probably transitioning off of GLB one, so it'll come up.
We'll link in the show notes here as well. And Katie,
thank you so much for your time today. We will
chat with you again soon, I'm sure. Thank you for
having me. Thank you for listening to Stronger You Radio.
(53:22):
For more information about how you can get started with
a Stronger You coach, visit stronger you dot com or
click the link in the episode description. As a special
thank you for listening, we have a Stronger You discount
code just for our listeners. Use the code radio fifty
at checkout for fifty percent off your first month of
(53:42):
coaching with Stronger You. Tune in next time for more
health and nutrition conversations
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