Think You're a GLP-1 Non-Responder? Address These Key Issues First

Are you frustrated because your GLP-1 medication isn’t delivering the rapid results other people seem to achieve? It’s common to feel disappointed when your progress falls short of expectations. I know all too well the desire for that “magic” solution where all the challenges of obesity disappear overnight and you can achieve your goals effortlessly. Unfortunately, that’s not the reality for most people.

In this episode, I’ll dive into why some people experience slower results than others and clarify why terms like "non-responders" or "hypo-responders" might not be helpful if you haven't first addressed key lifestyle factors like hydration, protein intake, and sleep. Join me as I break down the numbers for successful weight loss with GLP-1 medications, share real-life insights into medication effectiveness, and offer practical advice on how to make the most out of your GLP-1 medication.

References

The Top 5 Mistakes That People Make When Starting a GLP-1

Ep. 69 - BMI: Proof it Falls Short as a Measure of Health

My Doctor Started Me on a GLP-1: Now What? Spotify Playlist

Audio Stamps

01:44 - Patients often feel frustrated with slow responses to anti-obesity medications because they aren't given clear expectations at the start.

04:00 - When starting GLP-1 medications, aiming for a 5% weight loss in 12 weeks ensures continued insurance coverage and effective results.

08:28 - Dr. Rentea shares the maximum percentage of total body weight to lose per week when starting GLP-1 medications like Wegovy or Ozempic.

10:45 - If you're not losing at least 5% of your body weight in the first 12 weeks on GLP-1 medications, Dr. Rentea advises you to evaluate key areas of your lifestyle and habits to improve results.

14:13 - Dr. Rentea shares an example of how convenient options can help maintain nutritional goals.

Quotes

“A lot of people think that they're going to start and it's just like fireworks and everything's going to be amazing.” - Matthea Rentea MD

“From a weight loss standpoint, on average we're going to look for at least 5 percent total body weight reduction within the first 12 weeks.” - Matthea Rentea MD

“The max percentage that we want you to lose total body weight per week wou

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Premium Season 1 of The Obesity Guide: Behind the Curtain -Dive into real clinical scenarios, from my personal medication journey to tackling weight loss plateaus, understanding insulin resistance, and overcoming challenges with GLP-1s. Plus, get a 40+ page guide packed with protein charts, weight loss formulas, and more.

April 30/30 registration.

Transcript

0:28

Welcome back to another episode of the podcast. How is everybody doing? I am recording this episode today because I got such amazing feedback on a previous episode of mine where I went over how the body mass index is not accurate to your health and I really went over some very specific body composition numbers and what I'm really realizing is the crowd that is on this podcast and that's you if you're listening for listening. You like to nerd out like me. You like to actually hear the behind the scenes, what actually matters. You don't want kind of the little generic soundbites anymore. You are smart, intellectual people that are listening and you want to learn all the details and you want to be able to navigate this stuff better. So today it occurred to me that something that has been occurring in a lot of my visits is that sometimes people do not respond to the medication at the same rate as others, and they get very frustrated by this. Okay. And part of what is going on is that. A lot of people have not been educated as far as what to expect in the beginning on the medicine. And so I literally had a patient tell me today, you know, I'm disappointed because it wasn't magic when I started the med and I really had to really share a moment with this patient of completely understanding completely. And I, I really get it. I really get it daily having a struggle with obesity, you know, despite being on meds and all the things that. I really understand just wanting there to be something where you take it and all the struggles go away and all the challenges go away and you achieve 100 percent what you want to and all the things, but that's not most people's story. And I, I always really like to normalize this to you, that I feel that. The two things we hear about are people that are getting horrendous side effects, where it seems not a doctor in the land is overseeing them, and I don't know where they're going and what they're doing, or we hear about the person that every month is having the most tremendous results of their life, and I'm just sitting there thinking, you know, Who is this person? Because I've never encountered them. So, I mean, the most I can say, I can think of on one hand, maybe four or five patients in the past year where, where they're just, you know, it's leaps and bounds every month and I keep thinking, when's the, when's the plateau going to hit? When's the hard time going to occur? And they maybe doesn't happen. But all the rest of them, the other 97 percent of people, They're not having that story, and so this one's for you, if you're calling yourself a non responder or a hypo responder, meaning a low responder, if you are putting yourself in that category, I want to talk today numbers, what I actually consider this. I don't think that there's good consensus in the literature or the research to say, yeah, this is considered a hyporesponder and that's not. But here are my thoughts that I think are pretty well clinically established. And so let's talk numbers. And then I want to talk what you can do about it because I, I don't agree with the numbers, how it, how it's listed in the research. So let's talk through this. So first of all, if you are started newly on a GLP 1 medication, a GLP 1 agonist. So something like Wegovy, which is the same thing as Ozempic. Remember Wagovi. I say these names and all these things again, because we have people coming at different times. So Wagovi, FDA approved for weight management, Ozempic, FDA approved for type two diabetes, same medication, semi glutaric acid. Tide or semaglutide, depending on how you say it. And then the other one that's used the most common right now, which is by far more popular right now than Wigovi, which would be a terzepatide, which if it's FDA approved for weight management would be zep bound. And if it's FDA approved for type two diabetes, Menjaro, again, semaglutide. So if you're started on that, a lot of people think that they're going to start and it's just like fireworks and everything's going to be amazing. Now a lot of the time this does occur, that they start to notice my hunger is lower, my urges and cravings are down, that food noise, meaning that constant track of like, what am I going to eat and what am I going to eat and, and it's never silenced by the way. So those of you that have never experienced food noise in your life, it's not like, all right, you have a great meal. And then. You're good. You get some relief for a few hours until the next one. No, it's just constantly firing. I remember just really growing up, honestly, my whole life. I remember I could be stuffed and think, man, but I wish I had something sweet or something salty or like there was just always another thing that that could be eaten. When you start these medications, the thing I am looking for as far as yeah. If I'm purely looking at the numbers from a weight loss standpoint, on average, we're going to look for at least 5 percent total body weight reduction within the first 12 weeks, which is 3 months. If you look at a 3 month period, regardless of if you stayed on the same dose or kept titrating up the doses, hopefully you were managed appropriately during that time. So meaning if you didn't lose anything the first month, hopefully the dose was increased the second month, right? But three months in, where are we at weight loss wise? And if we're not at 5%, number one, that's not clinically significant weight loss, but number two, it's a really good predictor that you might be struggling in the future with this. Now it doesn't mean. that you can't turn that around, that adjustments can't be made, but how it's been going, we're going to have to change things for the future to look different. So a lot of insurance companies, if by six months you're not achieving at least 5 percent weight loss, they straight up will not allow you to continue on the medication. So there is a sense of urgency here because if your medication is covered by insurance, we have to get you over the 5 percent line. Otherwise, even even if you're experiencing all these other benefits, there's so many people, even if they're not reaching these big weight loss numbers, they're just feeling so much better. But none of that matters because insurance, again, They're not your physician and they're not clinical, but yet they're going to be making all these clinical decisions, right? I mean, that's, that's a whole nother matter that I just don't want to, don't want to go off on this podcast today. But so to me, it's very critical that we're getting you to that 5%, not just from a weight loss perspective, but because I don't want this medication to get taken away from you if it's helpful to you. And so we will look, By 12 weeks, are we at 5 percent and the way you're always going to calculate a total body weight loss percentage. Again, I have whole episodes focused on this, but let's just recap in case you're newer to me. You're going to put your current weight and it's going to be divided by your starting weight and that's going to give you a percentage. So let's use numbers here. If you started at 200 pounds and let's say three months later, You are 180 pounds. We're going to put 180 pounds divided by 200. That is 0. 9. So that's 90%. So you have lost 10 percent of your total body weight. That's the way in which I think about things. So we could say, okay, however, months in. 10 percent of the body weight down. I would encourage you to always think in body weight percentages. Someone just said to me earlier today, Oh, I've, I've only lost seven pounds in whatever amount of time that was. And I had to convert it into a percentage to understand, okay, that equals 3%. The seven pounds meant absolutely nothing to me, but the three percent by four to five months in, that I could understand we're not making progress, this is not going in the direction that's helpful, and I can't even justify at this point all the, all of what's happening for that. So, it lets you know kind of clinically where you're at. So, always think in percentages. Your current weight over your starting weight, that's going to let you know your total body weight loss. And then you can even do month to month, I think it's a good idea to figure out what you're losing. So for example, pretty well accepted is that the max percentage that we want you to lose total body weight per week would be 1%. That's the upper limit of what we're wanting. So even if you're losing half a percent or less than that per week, you're still great. So per month, then let's assume that that month has four weeks in it. We don't want you to exceed 4 percent total body weight loss. Now, again, the first month on these meds can be a little different. Some people that first week or two, they have so much decreased inflammation and they're changing so radically what they're eating that. their weight sometimes dramatically goes down right in the beginning, but it's because these, these big shifts are happening. But overall, long term, we don't per week want to go down more than 1 percent per week, 4 percent per month. And so you can do the math that if you're this hyper responder where you're just really clipping along, maybe By the, by the 12 week mark, maybe you've already achieved 12 plus percent weight loss. And I'll give you an example to kind of draw other numbers into this. When they were doing the original studies with Menjaro, when they were doing that study and they were looking at how much weight had someone lost by what week, they every month were going up on the dose, right? So it's a weekly medication, but every month they were increasing it. And so they would go from. Manjaro 2. 5 milligrams up to 10, right? They were just every single month going up. And by the 5 milligram dose, majority of people had lost 15 percent body weight, 1. 5. And so that tells you that they were even more rapidly exceeding what we would want. And that's why when you look at a lot of these studies, The muscle loss percentage, my answer here to explain why is it that I'm not seeing any of this muscle loss in my clinic, or a very small percent, and you hear these high numbers reported in studies, I think it's because they were really exceeding what is necessarily best for the body, because again, I'm just not seeing that happen in practice. So anyway, so back to the plot, I would really always look at Total weight loss percentage up to this point in time and then month to month, what percentage are you losing? Because again, also if you're tracking in that capacity, as time goes on, you might still be losing the same percentage, but the pound number looks less. Okay, but back to the plot at hand. So you look at, let's say that first three months, that 12 week period, and you realize you're less than 5%. So it could be. If you look at different studies, the majority of them will show somewhere around like five percent of people being hypo, or they'll call them like non responders. I don't see that clinically. I see it being a lot smaller, the numbers of who's not actually responding. So again, I don't, I don't want to go against the studies because typically these studies very closely emulate, you Real life, but the one thing I want you to really ask yourself and these are things that I would suggest in the beginning with getting on these meds that you really get on board with these kind of following these type of guidelines because not only are you going to hold on to your muscle, not only are you going to have less side effects, not only are you going to lose more weight, all the things, But you're actually going to get the results that you want. And, and I think that's the important thing. The meds not going to get taken away from you if insurance covers it. I mean, I could go on and on, but it's like there are reasons why we care about certain things. So I would look at, here is my list of, I think I have six things on here. Have you been getting all your water every day? You've just got to. I don't want you vomiting. Okay, don't take this to a crazy place. But are you getting your hydration in? Are you getting your fiber in? Are you getting all that protein? Are you getting movement in consistently? What's your sleep look like and what's your stress look like? I know that sounds a lot but I'm just here to tell you like from the beginning when I start someone on the meds there's a reason why I see people in my clinic so often that first month or two because I'm just like Okay, let's get the water habit in place. Let's set the protein goals for you based on height or goals or what their body composition looks like. There's so many different tools that we're using to kind of guide some of these things. We're following things over time. And we can tell, really, honestly, we can tell within the first three weeks how it's going for someone. So we don't need to wait for week 12 to know that there's an alarm going. That's why these clinics, where they're seeing you, and I'm, like, these primary care clinics are like, okay, see you back in three months or four months or whatever it is. It's too long. It's like, you've already missed it. You have half a chance to get it right, and then you have, like, no, no, no shot at turning this thing around. So the thing I really want to say is, before we're going to say that you're this non responder, or you're slow, or this or that, or all these other terms, I Are you truly doing all these other things? And yes, I'm here to tell you in the beginning, it's going to be a lot of work. I have so many patients that they're just so overwhelmed and exhausted and they're working all the time and they kind of wanted to take this med and for things to just get easier, which a lot of the time it does help, but it, it can't. Put protein in the fridge, it can't make a walk time occur. If you are overworking yourself to the point where you have no time for movement, I get it. I've been there, but there has to come this moment where you're like, this matters more that I'm going to get some strength training in that I'm going to get a little bit of walking time. And I know you have to carve it out. I am there. I can't even tell you. It's like, I've been through all of it as well. I get it. Here's the deal. You having this health is going to require an investment. It's going to require some time of you moving, it's going to require you managing your mind in some capacity, you getting the things in the house, you figuring out how can I eat in such a way where I like it. I want to give you a little example. I finally tried Legendary Protein Chips. Can I just say I love them a million times more than Quest? And by the way, I'm still going to eat them. I still love them. Still like Quest. Don't take my Quest chips away. I, the Quest nacho chips are just next level amazing flavor, but Legendary chips are much more, they're thicker, and they're almost more like a popcorn consistency, like I can't describe it. It's much more of an airy chip, and Quest is a little bit almost more chalky and fine. So a million percent worth doing a taste test. But I had a really busy day and this is going to sound like a not great option, but hear me out. So I had a really busy clinic day today. I had like, I think 15 minutes for lunch and I was really hungry. It wasn't enough time for me to bust out all my veggies and to do all these other things, so here's what I did. I opened a Quest chip thing, and then I had cottage cheese with some taco seasoning on it, and I literally put like a teaspoon of cottage cheese onto each of those chips, and I got 32 grams of protein in less than 10 minutes. And ironically, because I was overworked, I was overstressed, really enjoyed the crunch. It almost felt like I was having like a junk food, kind of just like super quick, tastes great. And, you know, in the morning I had food that was more supportive, at night I'll have more supportive stuff. But, but that worked for me, but it's like, but the moment had to occur earlier where I got those things in the house as a backup. Am I doing that every day? No! No, I'm always gonna say whole based foods and all the things, but there are times when I love something like that. And I'm realizing, honestly, they were so great. I know you've, you guys have heard me. Is it, is it pop chips? What are the other ones? The point is, every so often I'm gonna have a chip and I'm so glad that has 20 grams of protein and that I could fit it in the middle of a busy day. And so, the thing I just want to bring up, It's that we cannot say that you're a hyporesponder if you're having a bunch of processed food, if you're not hydrating, if you're not moving, if you're not taking your sleep seriously. These things matter. So if you want to dig into this more, I renamed my mini course because this is what we were doing. It used to be called. Optimizing body fat and maintaining muscle on a GLP 1. And now it's called the top five mistakes people make when starting a GLP 1. Because this is it. They end up being a hyporesponder if they're not getting their water, they're not doing the protein, they're not getting the fiber, they're not moving. These things matter. They don't need to take over your life, but they do need to happen in some capacity for you to be successful. So I hope that this episode was helpful today. I always think they're going to be like two minute episodes. And then by the time we talk, they're longer. I hope you love this. Please, please, please leave a review wherever you are listening. It really helps more people to find the podcast. The other super exciting thing I want to share with you is Let's say if you already found this podcast amazing, but some of you have friends that have just started on the meds and they are so confused and they are They are flipper in the wild. They don't know what they're doing. So what I want to recommend is that you, in the show notes, we have a link where you can give them, where they can sign up to get our custom curated Spotify playlist, where it's called my doctor started me on a GLP one and now what? And I literally have the top 10 episodes where if you're starting on this med, you can just quickly go from one episode to the next and I will walk you through how the meds work. They're all episodes that have aired before. How do the meds work? How can you avoid the different side effects? How can you track stuff in a way that makes sense so that you don't need to dig through years of my podcast? You can just kind of go and one after the other, go through this playlist. I've picked them out myself. We've made it super easy for you. Again, that playlist is my doctor started me on a GLP one and now what, and to get access to that, again, there's a link in the show notes and we will. When you sign up for that, we will right away give you the link to that so you can go listen. All right. I hope you all have a great rest of the week. And remember, do not throw these terms on yourself that you're a hypo responder or not responding if you have not truly done all of this other work. It doesn't serve you. It doesn't help you. And it's not going to ultimately get you the things that you want by you putting that label on yourself. And so if you need that list. Get the link in the show notes so that we can get this to you. And I hope you all have an amazing rest of the week.