GLP-1 & Weight Regain: Why We Blame Ourselves

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GLP-1 & Weight Regain: Why We Blame Ourselves

When weight regain happens, most people ask, "What am I doing wrong?" Weight regain can happen during GLP-1 treatment, after bariatric surgery, or years into an obesity journey. For many, the first response is self-blame.

Licensed therapist, obesity advocate, and person living with the disease of obesity, Nanette Adams, shares her personal journey while exploring why obesity is a chronic disease, how treatment often evolves over time, and the emotional toll of stalls, plateaus, and weight regain. We discuss therapy, shame, self-compassion, and why long-term support matters.

About Our Guest
Nanette Adams, LPC, LMHC is a licensed therapist, obesity advocate, and person living with the disease of obesity. Through her platform, Weighted Wisdoms, she combines professional expertise with lived experience to help people better understand obesity, weight stigma, and the emotional side of long-term treatment.

Connect with Nanette
Website
https://weightedwisdoms.com

Substack
https://weightedwisdoms.substack.com

Instagram
https://www.instagram.com/nanetteadamslpc/

TikTok
https://www.tiktok.com/@weightedwisdoms

Facebook
http://www.facebook.com/weightedwisdoms


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Transcript

SPEAKER_01 0:01

Hey Plus Science community. Before we jump into the podcast, do me a favor, like, subscribe, and share if you haven't already. This helps us get referred up in the algorithm so we can find more people that need our help and guidance from our doctors. Thanks so much for supporting the show. Let's jump in. Are you interested in understanding GOP1 medications like Cosympic, Logolfi, or Manjaro? Then join us on the Plus Sides Cracking the Obesity Code, the groundbreaking podcast helping people change their lives one episode at a time.

SPEAKER_00 0:30

The Plus Sides podcast is Destructor.

SPEAKER_01 0:32

We're breaking down barriers, smashing stereotypes, and sharing inspiring stories that'll leave you feeling enforced and empowered. Join us every week to learn from doctors who are specialists around GLP1 medications like OSIPOMANGAROS. We'll provide you with science and facts to validate these incredible stories. But that's not all. We'll also bring you the voices of the GLP1 manjaro sticks, a community, real people who face the challenges of obesity related diseases and disorders, and discover the incredible plus sides of GLP1 medications. Our episodes are filled with heartwarming stories, laughter, and moments of triumph. You'll connect with our amazing community members who are reclaiming their health and experiencing their fullest lives. Are you ready to embark on a journey of discovery and empowerment? Tune in to the plus sides cracking the obesity code, and together we'll change the narrative around obesity and in the stigma. Subscribe now on YouTube or your favorite podcast platform and join our incredible community. Let's celebrate the plus sides of life together because every story deserves to be heard. Every life deserves to shine, and everyone deserves access to expert knowledge and medication. The Plus Sides Podcast. You're not alone. It's not your fault. Friends, the GLP1 math is just not mathing. When I look and see 104 million people in America are struggling with a disease of obesity, and about 11,500 obesity specialists, that breaks down to like one obesity specialist per 9,000 patients. I saw the stat that said 72% of GLP1 users say that they want more support on their journey. Because I think we all realize you start on these medicines and you think, oh, it's just going to be like better and me or anything else ever taken in the past. This ain't like that, bro. Like it's just not. It's different, you know? And I provide a lot of that here by interviewing doctors and things like that. But I've had people been asking me, emailing me for years, asking me to do one-on-one consults, which I do do, but they're expensive, right? So I decided to make a group where 10 people at a time would come in with myself and with Kat. We could talk about recipes, we could talk about exercise, we can talk about side effect management. Um, we could talk about, you know, ideas on breaking stalls or things that we've tried. None of it's medical advice, but it is community support. It costs $50. If you're interested in that, there's a link in my bio. You just fill out that form. If you're not and you just want to go this route, that's okay too. I love you. You're not alone, it's not your fault. And hopefully you'll sign up to hang out with us. All right. Now back to the show. Welcome, welcome to the Plus Sides Podcast. Hi, everybody. So um, again, our sweet cat is and funny cat and uh joy of the life cat and party um is taking a little break, just like she took care of some things for me while I had to take a break with my family and stuff. So today it is me and also my friend Nanette, who is going to be three things today. She is gonna be our uh co-host, uh extraordinaire, our community story, as well as our expert. So it should be a good episode and a little different than what you're listening to usually, but we're gonna cover a lot of different things. So hang with us. Um, make sure that you know that there may be some discussions around disordered eating and some more sensitive topics around addiction and mental health. So if you don't feel like you're in a good space for that, listen to this later, or maybe there's little ears in the room, or maybe when you're in a place to receive, come back to this episode. But I just want to make sure you know that before we get started. Lots of important stuff here. Um, so if you're new here to this podcast, uh, I'm gonna kind of tell you who we are and what we do. If you're a loyal listener, you listen every week and you sick and me tent, then go ahead and fast forward. You don't have to hear it. Our podcast is an education advocacy podcast all about uh basically metabolic disease and everything that encompasses that because it is incredibly complicated. Um, we talk a lot about GLP ones, but we also talk about surgery, mental health. Um, we interview dietitians, scientists, researchers. Uh, so we can really understand this to the best of our ability because this scientific space, we do know a lot, but there's a whole lot we don't know too. And ultimately, as you guys know, or if you maybe don't know yet, um, obesity is a chronic progressive disease. So we're gonna have this forever until there's a cure. And while these are amazing treatments, these aren't cures. And so we're always gonna need each other. So we really try to focus on bringing you everything that you need to know so that you can advocate for yourself and so that you can be the healthiest you you can be, right? As opposed to maybe some bullshit that somebody else says that you need to be. So um um, if again, I didn't say finding games, Kim. My name's Kim. Uh, and this is the Plus Sides podcast. And our podcast is where we interview experts about this. And um, also it is multi-award winning and it is very reputable and known in the space. So just know you're getting your information from a sound source. Um, I try to bring on the uh most educated people in this field, okay? So we're so glad to have you. I'm gonna now move over to uh my co-host, uh guest, and uh extra guest and friendette, and ask her who she is and how she helps people, and then we'll just get going.

SPEAKER_02 5:42

Sure. I'm glad to introduce myself. Um I am Nina Adams. I'm a licensed professional counselor, licensed mental health counselor. Uh I have a couple of designations because I'm licensed in 13 states, um, but I'm also a bariatric patient and I am someone who's passionate about obesity care advocacy. I've been with the Obesity Action Coalition for 13 years, maybe longer than that, attending the conferences. It was my 10th conference this past uh July. Um, I have attended many conferences in both the professional and patient space, uh, the uh International Federation Federation of Obesity Surgery, uh, the ASMBS conference, uh, the Obesby Society Conference. I've been to a number of all of those over the last, well, since 2013, so 13 years. Um, and my own bariatric patient story is complicated. I like to call it the hurricane uh of bariatric stories. Um I had LAP ban after graduating with my master's degree in mental health counseling uh after Hurricane Katrina in New Orleans, and uh the reason for that was a lot of internal internalized bias. Uh I had this perception that my patients would judge me. And I, you know, decided to have the Lap Band because I really wanted to get through obesity. I was done with being overweight. I'd been overweight since I was four. My parents tried to help in many ways. I went to Weight Watchers at eight years old. I went to a children's hospital weight management program. My weight seemed like it was my identity. Um, I got my undergraduate degree at LSU in human ecology, textiles design, and uh apparel design and merchandising, and uh minor in psychology. I was really passionate about psychology, but I just wanted to get through college. I gave fashion one last try and took a job in New York with Liz Claiborne and went up there for a summer, got offered a full-time job. But the devil wears Prada is real. And a woman in a larger body, I was stigmatized and ridiculed uh quietly in the hallways. I had a wonderful office on the seventh floor of the building at the top of um you know Times Square, getting to do uh design specs for China. And for two months I got to do this work and it was wonderful. I loved the work, but the cruelty of the environment was just mean, girl. So I left there. I had a pending internship with Disney, and I said, I'm gonna go to Disney World and I'm gonna interview to be an Imagineer. And if I don't get that, I'm gonna turn around and go back to New Orleans, get my master's in mental health counseling and be a therapist. And here we are. So you need to become an Imagineer, huh? I did not become an Imagineer. I was not selected, I was very upset about that, but I was studying for the GRE. I had a backup plan that I was passionate about, moved back to New Orleans, embraced life and culture in New Orleans, got really involved in Mardi Gras, but decided to go the path of getting a lap band because it seemed the least invasive. And at the time I was blaming myself. I thought it was my fault. I don't even know what that what year? Yeah, 2009. So January of 2009, I took 2007.

SPEAKER_01 9:03

So it was before they were saying obesity is a disease. Yep, right? Yeah, yeah, yeah.

SPEAKER_02 9:09

So the I had the lap band, I turned 30 on January 3rd, and on January 19th, I got a lap band. Um, and I had it for three and a half years, and in that process developed an eating disorder. Uh, you know, I had never in my life been bulimic, um, but it seemed like every time I ate, or at least several times a week, I could not keep food down. It was uncomfortable, uh, developed food anxieties, had issues, you know, variable issues. The band would uh or the they would fill my port, unfill my port, completely open it. And then one weekend, I thought I had the flu and I couldn't keep water down and I felt awful. I was pale. There's a picture of me on this. I put it on my Substack recently because I went hunting for it. But I was in the ER. They tried to stick me 26 times to get an IV. It was very traumatizing. And um didn't have insurance at the time as well, so that's an aside. But cash pay for the ban, cash pay for the removal, which was uh put a hurting on me. Um, and then they sent me home before taking the band out. It was a Sunday evening, I was dehydrated, they pumped me with fluid so I could at least function, and told me to come back the next day to see my surgeon. And I woke up the next morning, checked the weather. There was a hurricane coming toward New Orleans. It was uh Hurricane Isaac, got back to the hospital, like called them at eight o'clock in the morning. They're like, you need to be here now. And I'm like, uh, okay, well, they shouldn't have sent me home. And got back to the to the hospital around 8:30. And by 10, they were removing the band. The band was mangled, uh, it had slipped. Um, ended up in the hospital for five days, went from 167 pounds to 196 pounds from dehydration, and then proceeded to regain five pounds a month for 14 months. Um did not have coverage once I did have insurance in that period, and chose to go to Mexico for my sleeve. Uh wonderful group down there. Um, Dr. Elias Ortiz is my surgeon and a dear friend now. Uh, he was like, We're revising you to sleeve. We're gonna, this was not an appropriate procedure for you. I spent the next almost year and a half struggling to get the weight off, even with the sleeve. I ended up with acid reflux, which we determined was from um the scar tissue and had insomnia, uh, was only able to lose about 40 pounds, even with like very consistent exercising daily, uh, really restricting calories. It was a very frustrating process. Yeah. So revised to uh ruin why that was May of 2015. What's the difference between that and sleeve?

SPEAKER_01 12:01

Can we explain for our guest?

SPEAKER_02 12:03

So with the sleeve, it's we should tell lap band. So yeah, lap band. Sure. Yeah. So the lap band is like an adjustable gastric band with an inner tube in the middle that has a port where they inject saline to make the internal part of it smaller or wider, right? So you literally have a band with an inner tube that you can deflate or inflate inside to restrict the speed at which food passes through that hole, right? So had that cause scar tissue, especially with the slip. So I had scar tissue around my stomach, a full stomach. The stomach was not decreased in any size. So in a conversion, if they would have done it immediately, it would be considered conversion, but this was a revision to a sleeve. The sleeve makes it like a banana tunnel. So literally a tunnel in your stomach does not change your intestines, does not change the routing. It is literally just reducing the size of your stomach, which does have some hormonal impact. But as many people have noticed, you know, when they have this procedure, it doesn't always last. You don't always get that benefit. So the revision to ruin Y reroutes the intestines, and there's three place it placements of the intestine. So there's medial, distal, and proximal placements of where they might, and that varies from how much malabsorption you might get from that procedure. So that being said, I had a distal ruin wine gastric bypass, which is the longest deviation that they can. So I get the maximum calorie malabsorption. Wow. Even with that, there was a wall I hit. I couldn't get past, you know, that like 75% of my weight lost. My goal was always 200 pounds from my lowest weight. My highest weight was 250 or 353. I now hover right at like 150, 153. So I'm in a very tight, sweet spot now with GOP1. But um I could never, even with Ruin Y, get down to where I had always said my goal was. Like it was just a challenge. I could do everything right. And so that was very frustrating. Yeah. In this process, while I still had a ban, I realized there was a need for mental health counselors who understood obesity, right? Who were in the space, who could relate to it, who were non-judgmental, and who could be present. I even still had my own judgments at that time. The day I got out of the hospital from my ban removal, I received a phone call. No power in my house, still in the throes of a surgery. Got a phone call from the CEO of a company called Obesity Prevention Policy and Management. I had put in a resume with them and sent her a long letter about why I wanted to come to work for her. We had that conversation and she had had her ban out too. She had had complications, and she said, I don't have a job for you right now, but I'm bringing you on as soon as I can. You're going to be the sixth employee in the company, and I will hire you as soon as we can make that position. So I went on to work for them for the end of the year, that was 2012, and worked for them for three years while I was also getting my license in mental health counseling. I became an LPC in November of 2014, and was doing private practice with uh a local group, seeing people in person under supervision, as well as working for them, coordinating uh for multiple bariatric practice, the patient inflow, and doing educational seminars and uh um social media writing. So I got to read the research and summarize the research for multiple practices and put out newsletters. It was a lot of fun. So that developed the passion for the research for me. Um, I remember the day, I remember where it was when the AMA came out and said that obesity is a disease, and we were so excited because it's like this updates, everything we've been saying. We've been trying to help people understand that obesity is stigmatized and the weight bias that exists in our heads and in society is untrue and unfounded. And so that led me to passionate work with the Obesity Action Coalition, uh, being on uh Capitol Hill, lobbying for the Treat and Reduce Obesity Act, um, being a very active member, recruiting more members, developing an amazing community that it is so lovely to see so many people coming into this community when I've had so much passion for it for so long.

SPEAKER_01 16:41

Yeah, absolutely. So true. I think um there's a lot of things that go on, and you and I have kind of discussed this, um, where on social media specifically, kind of an issue seems to be at play where um what's getting pushed on the algorithm, if you will, is usually people in very big bodies going to very small bodies. And so, like comparison is the thief of joy, and many people, just like you said, right, with how you felt when you were doing all the quote right things, which the right things usually equal, friends, diet and exercise, right? Um, stress management, whatever. And that it was just still stopping. There's a lot of biological reasons for that, which you guys know if you've this is the first time you've seen this, we talk about that on the show. And you can go back and look at the the first episode of the season where we talk about that extensively with a preventative cardiologist. Okay. So um, but there's many, many reasons for that. But at the end of the day, it is incredibly complex. It's a very, very complicated disease. It is also progressive, it continues to change, and we have to continue to change our treatments around it. So people look at this like a weight loss journey often, right? And that's because of all the bullshit we've been told forever. And like then that same as me, you know, Weight Watchers at eight. You know what I'm saying? So that it really fucks us up. Sorry, sorry, dad. And um, and when it does, we get to this place where we're like, we're doing everything wrong. We feel like crap, right? And at the end of the day, you're you're not like, you know, you're doing the things that you can do and the things that you can do, like that can control, but your body is gonna do what your body is gonna do. And that's where these interventions come in play, right? So different kinds of surgery, different kinds of medications, combined therapies. And during this time, if you don't have proper guidance, which I'm trying to like have on this podcast for you, because I know that a lot of you guys don't have access to this, okay? You can have issues with disorder eating, just like we had before GLP. Okay, we can have issues with disorder eating here, and that can mean a couple different things. So Nanette and I have talked about this in the past, right? Of whether it's binge eating disorder, whether it's bulimia, right? All these different things that can happen and how they are different, maybe when you have obesity versus when you don't. And I was just thinking it'd be kind of cool to talk about that. What do you think? Sure.

SPEAKER_02 19:06

The body fights back biologically, but psychologically, we fight back too. If somebody says you can't have this, what's the first thing you want? You want whatever they just told you you can't have. Um, you know, and if you grow up in environments where you're not uh accepted and loved and feeling worthy and judged for body size and have bullying for weight, be that within families or friend groups or in school, in the workplace, the internalized narrative becomes really negative. Like I am not worthy, I am not loved, I don't love myself. The self-hatred that can develop in that is toxic. And so learning to love yourself is complicated and it sounds really pretty, but it's deep oftentimes because we've been told that we were not worthy, we were not lovable. Um, you know, the and often can get into abusive relationships because we don't have the the strength to say no, right? We just want to be belonging to chronic people pleasing, right?

SPEAKER_01 20:11

I always say that like I'm not in recovery, but I'm working on it.

SPEAKER_02 20:15

And and that's where we all have to be, right? We all have to be uh working on our better version of ourselves.

SPEAKER_01 20:21

Friends, the GLP1 math is just not mathing. When I look and see 104 million people in America are struggling with a disease of obesity and about 11,500 obesity specialists, that breaks down to like one obesity specialist per 9,000 patients. I saw the stat that said 72% of GLP1 users say that they want more support on their journey. Because I think we all realize you start on these medicines and you think, oh, it's just gonna be like better and mean or anything else ever taken the past. This ain't like that, bro. Like it's just not. It's different, you know? And I provide a lot of that here by interviewing doctors and things like that. But I've had people been asking me, emailing me for years, asking me to do one-on-one consults, which I do do, but they're expensive, right? So I decided to make a group where 10 people at a time would come in with myself and with Kat. We could talk about recipes, we could talk about exercise, we can talk about side effect management. Um, we could talk about, you know, ideas on breaking stalls or things that we've tried. None of it's medical advice, but it is community support. It costs $50. If you're interested in that, there's a link in my bio. You just fill out that form. If you're not and you just want to go this route, that's okay too. I love you. You're not alone, it's not your fault. And hopefully you'll sign up to hang out with us. All right, now back to the show.

SPEAKER_02 21:36

And so it gets really complicated. So the disordered eating behaviors often go overlooked in patients affected by obesity. You know, we don't identify them in ourselves. We see binge eating disorder, often diagnosed, but coupled with ADHD, which was a struggle for me. Uh, I got into mental health counseling and started working in an ADHD clinic from the start, right out of grad school. So the um level of uh ADHD executive skills function skills came into play. And then you add the layer of struggling with weight and the frustration of struggling with weight and the cycles of giving up because I'm trying and it's not working. Right. Such a challenge. And particularly about eating disorders, most eating disorder programs are not built for us. Yeah. You know, if you struggle with obesity and you go into a traditional eating disorder program that treats uh anorexia and bulimia and orthorexia, binge eating disorder is the outlier oftentimes.

SPEAKER_01 22:35

What is orthorexia? I don't mean to interrupt that, I've never heard of it before.

SPEAKER_02 22:39

Orthorexia is the extreme of healthy eating, a very restrictive eating, very clean eating, um, taken to extreme, like oh yeah, like no GMOs and no gluten and like all of the extreme dieting and diet culture narratives literally exist in the orthorexia uh diagnosis. And so, you know, even within post-operiatric patients or people uh on GLP1s, that can happen too. So there's always an extreme, a lot of all or nothing thinking happens within this population because we try and make attempts and do all the things the dietitian told us to do, or the exercise physiologist told us to do, or the obesity medicine specialist orders, or a bariatric surgeon told us to do, and we're trying to put it all together, and we give it a good shot. We give it, you know, many weeks or several months, and then we're like, this isn't working, and I'm not losing as much as I thought I would, because that's a key. What you expected to lose when it doesn't match what you know you actually lose becomes this other frustration. And so that issue there is they told me this was going to be how it looked, and this is not how it looked, and now I'm disappointed, and now I'm giving up again because nothing works. Yeah, and that becomes another component of what needs to be addressed because then we have the betrayal.

SPEAKER_00 24:09

Yeah.

SPEAKER_02 24:10

Those of us who had complications and revisions and medical trauma, conversions to other surgeries, issues with addiction, it becomes a very complex disease to treat on the psychological side, yeah, as well as biological. Like it's both.

SPEAKER_01 24:28

You know, I sometimes I tell people, I'm like, I almost feel like the physical piece of it like is easier than the mental piece. You know, like I don't know about you, but when I when I had the food noise turn off for me, first of all, my my my food noise and my um appetite turned off at the exact same time. And that was terrifying. I thought I was having a stroke because it was so quiet. I was like, what's happening? You know, I was for you to add but you said not thinking about food all the time. I was like, oh my God, this is what normal people feel like. And then I was like, I need to know everything about this, right? And that's where this podcast came from. It's like totally selfish. Like, and also I was trying to control stuff because my dad and my sister both had cancer, and I just was like, I needed something, right? That I would like distracting.

SPEAKER_02 25:17

Curiosity. We need the curiosity, and we all need to be curious about ourselves because each of us presents differently with obesity. Yeah, each of us have a different story, our lived experiences are so important, and telling your story is so powerful. Definitely where you know, the disordered eating behaviors or obesity has had its jaws of life or grip on us. Telling your story is powerful to loosen the grip to say, oh wow, I'm not alone. There are other people who have stories like mine or similar to mine. And you know, the empathy and compassion, I say this all the time, community is the intervention. Yeah, because it normalizes that we have all struggled with this disease and our voices need to be heard to heal. Yeah. And you bring up, you know, the grief component with the loss of, you know, or the addition of maybe a cancer diagnosis. There's many people like I'm one of my best friends in this space, one of the first people I brought to your waste matters convention passed away this June from ovarian cancer. I had the honor of bringing her daughter. It was so wonderful to see her daughter in this space too. And so, but she, you know, had that complex component of adding that to it. And we had the best time when we went to Vegas for this convention. I uh rented a red uh Mustang convertible so we could drive down the strip because I didn't know she was going to go to a uh convention. So the the beauty of the relationships you make in this space and getting back to the grief. When my dad passed away three years ago, I almost overnight put on 40 pounds, and it was from the stress and anxiety living with my mom for a year, trying to make sure she was okay, because it was very tragic, very sudden. And you know, life will still happen. Yeah. And it's your responsibility to make sure you get the help to manage the emotions, manage the thinking, understand your body. One thing I talk about a lot with my patients, and I work with, and I say patients and clients interchangeably, because in the medical side of it, I have to switch to the patient gear, and on the therapeutic side of it, I say clients, but it's the bringing it all together and helping people see that this is normal that you're struggling. And maybe you weren't living in your body, maybe you were only living from the head up, maybe you weren't sensing or feeling how your stomach felt. I hear all the time from my clients that I am not full until I'm over full. Oh, yeah. Yeah, that reads an interceptive issue. The nerve endings in your stomach, are they numbed? Are there certain branches of your nervous system that are just completely cut off? There is no, you know, electricity going to that to sense that fullness. What's going on there? So I'm always curious. Always asking those questions and always trying to help my clients see that we don't understand everything about this disease. No, so it's not your fault. Yeah. And the responsibility you have is to understand yourself so you can change the behavior from a meaningful space.

SPEAKER_01 28:22

Yeah. Yeah. You know, I think it's interesting, then that I hear everybody, like you said, everybody presents different and everybody's experience is different. And a lot of times because of what I do, I kind of end up crowdsourcing. And um, because of what I do as a product marketer, I'm I'm I try to find the through line, right? And I I almost always, it's almost always people tell me when they're on these treatments, and it seems like specifically trazepotide, they their habits, if you will, right? The way that we refer to them change because the meds work. Like so they've I find that, you know, the because when people say habits in diet culture and people don't understand this, what they mean is stop eating like crap and eating too much and exercise. The exercise piece is different. I feel like that's quite the choice, you know, and decision. But there's something about the meds that a lot of people experience where they just don't want the food, like not, and it's not because they're motivated because they lost weight, they just are not interested in the things they used to consume a lot of, whether that's hyper-processed foods and they tend to want things that are more, you know, I would say like more nutritious, more of the whole. It doesn't mean they don't want those things sometimes, right? Um, but I have seen this and heard this from people over and over again. And when I ask doctors about it, they don't know why. They they don't know why. Um, but I tell people all the time, I feel like that when people say you got to change your habits or you're gonna gain it back, well, yeah. Yeah, but a lot of times the habits change because I think it was driven by the disease. Do you know what I mean? Yeah. Well, so that it's okay to disagree. It's okay to disagree with me, by the way.

SPEAKER_02 30:10

No, no, I don't disagree with you. And I think it's so complex. But what I find, at least in clinical practice for me, um, clients who are going on these medications in the first month, when they start to identify this food apathy, I try to still have a conversation toward the then we need to make the best of the choices you make by choosing whole real foods, right? Choosing things that your body is going to know what to do with, and not just, you know, energy sources that are easy to grab. And so I lean onto the dietitians on when it comes to what to eat. And I know that's even very complex because I've seen the issue of food allergies and inflammation from food playing a role in this, um, particularly um just what it does to the brain. I'll give an example only because it's very personal, but my niece has ADHD and um my sister has uh rheumatoid arthritis, right? Like two kind of unrelated conditions, but inflammatory responses. And my sister went off gluten. Hey, you know, her flare-ups cleared up. Uh, my niece went off of her daughter went off of gluten. Uh, the really loud, crazy outburst, because she's very behaviorally sometimes off the wall, completely different child. So the and her brother has a number of allergies, very unusual allergies. And so the on my radar, since he's 16 now, um, seeing how those allergies impacted him and like, you know, we don't always think through the lens of maybe I'm eating things that are not good for my body, and that becomes an issue. But capitalizing on the lack of desire for the things you used to like or gravitate toward, um, the anedonia component of I'm just not feeling compelled to eat that. Uh, the addition of, so we we don't have data on this, but the alcohol use disorder and then pulling that, um, just preliminary understanding of it, people are backing away from alcohol in that regard. I have some thoughts on that, some complicated thoughts on that. Yeah, we'll get to that. It becomes easier to make the decisions to choose wisely and with great intention rather than being more impulsive with those choices. Grabbing the convenience foods and the uh fast food, the to-go uh culture that we have. Um, really try to help people like understand keeping around the things that are in your best interest to energize and nourish your body with. Yeah. Because when it's there, yes, you may lean into it. You know, if you put a bowl of candy on the table, you're probably gonna have the candy, right? Even on a GLP one, I'm not gonna deny myself uh the Snickers that's on the counter in my office when I go in, but now there's a conscious response to go, oh, let me have one. Yeah, because I enjoy it in the moment. And that moment when I have it, it tastes different. Yeah, it tastes different. I had to have multiple ones to feel that same pleasurable response. Yeah, yeah. It was like three or four, right? And now it's the I have one, and it's funny because I'll grab one when I come in and I'll put it on my desk when I come in, and then I'll eat my lunch and then I'll have it. It's very intentional. Yeah, cravings. I talk to my clients about cravings, and I say you can have a craving, but do you cave to the craving immediately with impulse, or do you redirect it to intention? If you redirect it to intention and you really want a piece of cake, then you decide, okay, what kind of cake do I want? When do I want to have it? Oh, I'm gonna have it this weekend because I really like going to this cafe and I have a really good cup of coffee and I'm gonna have this kind of cake, and it's gonna be this like date with myself. And I'm gonna enjoy it in the moment rather than be like, I'm gonna grab this grocery store cake and I'm gonna gobble it up immediately because I cannot stop that. With the GLP ones, it does seem like there is this intervention point of I don't need it right now, but I still want it and I can wait to have it.

SPEAKER_01 34:31

Yes, it's like it slows you down and puts you like I I describe it a lot, like in the beginning. I was like before a GLP, I lab in or no lab in, I was like a car, but I had no buttons. It was just drive and it was eat consume, consume, consume. And then when I got to a certain level of treatment on GLP one, I had all these other tools. Like I could break, I could roll my windows down, I could reverse. Like, and it was sort of like that in my mind, like this mental gymnastics that I was able to do around this decision making that I had never been able to do before ever. And so it has, it has been good because one thing I realized for me, I'm like a lot of that was driven by my disease. And I can kind of forgive myself for sort of the quote, what feels like choices that I made and realized it was less choice and more to driven by my disease. And then once I was in a place of controlled disease, if you will, like maybe not because of the size of my body, but just of the medicine, then I made different choices. And if I did choose something that maybe wasn't the most optimal for nutrition, at least it was my choice. You know what I mean? And usually when I did, I just had a little bit and then I was done. You know what I mean? I mean, that's that's how it goes. I mean, it's a little different on Shark Wake. You know what I mean? Or and it is a little different too during stress. Stress, it seems to be harder to have those gear shifts. Sometimes it is kind of quick, but it you still isn't usually over consumption. But everybody is different. Everybody is different. That's the thing. But I agree, there's something about that gear shifting, like that thing that you can do that you just described so beautifully in your brain. It does seem like people do need to get on the certain level of treatment for them. I say level of treatment, dose, can't, because on TikTok you can't say dose because I think you sell drugs. I don't even know. Um, you know, and uh, and so like that I fan it does feel like that. It does also seem different on all of them. So I've been on all of the subcutaneous ones, right? And I think I have a little bit of a different experience on all of them, you know what I mean?

SPEAKER_02 36:29

I was on sex vendor as well before I went on WeGovi. And then when I went on Trazepatite or actually Zapbound, and I was on both WeGovi brand and uh compounded. Uh I lost coverage um under policies. Uh, I went from an employer race policy to an um independent contractor or like you know, small business owner policy, and that one didn't cover it, so I switched to compounded. And when I found what compounded was, I was able to maintain and I still get the benefit of the kind of regulation control, but I wasn't losing weight anymore. So that was a nuance of just noticing that that wasn't happening in that space of being on a compounded, and then when I switched to Zbound, employer um specific, um, so you know it's not an outrageous copay, that I finally got got back to because I was on WeGovi and got back and got down to my goal weight that I'd always had in my mind. That's a whole nother component. I have some some language around that, but the got back to again, because my dad died, put on 40 pounds. When I got on the Zoom, I got back down to where I want to be. Now I tightened my range because I've always kind of lived through this. I want to be in a range that I can manage wisely, but I don't want to weigh myself six times a day and stress over the number of the scale because I did that for a long time post-bariatric surgery incidence, right? Okay, there was a point in time where I put the scale in my trunk of my car, so I wouldn't weigh myself six times a day. And now I can go a month without getting on the scale and not stress out. And then when I get on the scale, I'm not affected by that number as much because I stay in a tighter range and I understand what my body needs when it needs it. I eat regularly on a schedule every single day. Um, I get enough protein, enough fat, enough fiber, enough carbohydrates. I minimize sugar. Like I really try to think consciously about my day overall. And I'm not gonna deny myself something. I went to this wonderful dinner uh over the weekend at the Louisiana OBC Society at Arnold's restaurant in New Orleans because from New Orleans, we have no lack of good food and wonderful dinner. Um, it was put on by Nobanordisque, so it was great. I was like, I'm making some of my money back from when I was paying cash paying $1,400 a month. I better eat my and I'm like this meal cost them maybe $50. Come on. So I had two bites of the dessert, which was this beautiful rich chocolate mousse, and then I'm looking at it, going, as much as I would love to eat the rest of that, and it was like a little bit of peace. I know I can't because of the physical restriction from surgery, but also the sugar and acknowledging that the what happens to me when I have sugar, I still dump that I didn't want it, but it was really good that I could eat those two bites and know what it tasted like, and then put it away, yeah, and not have the regret. And so GLP ones have changed my perspective on it. I blamed myself for so long about being from a foodie family. My sister is a pastry chef, my mom's written three cookbooks, she owned a food company, and living in that household where good food was always plentiful in a city where you can't have a bad meal, thinking it was my fault because I just couldn't control myself to going, you were in an environment that encouraged it, in a body that craved it, with biology that compelled you toward it. And you know, I like to use the car analogy too. It was like once I was in a gas-guzzling pinto, and now I'm in an uh electric sports car, right? Like I can actually regulate and it feels so much different. And I know that it's just not my behavior, it's my biology, it's the medication, it's the surgery all working together.

SPEAKER_01 40:31

Yeah. You know what I really like to talk about, and we can dabble a little bit more sort of in the disordered piece too, before because I know we're coming up on time. But when it comes to your patients and they're on GLPs, at some point we experience not everybody, some sort of regain for whatever reason, right? And I was thinking about the OAC president and uh Joe, right? Joe, Nick Osley. Yeah, he was up on the stage at OAC. It was like the first night, not everybody was there yet. And he said, basically, I'm over like I'm oversimplifying, but he said, Look, I know that I look like I'm in like a smaller body, right? And I look like I got it together. He's like, Um, I have obesity. Everybody in my family has obesity. I've had it forever. My disease is just currently control controlled. I am on my seventh medication.

SPEAKER_02 41:23

You know what I mean? Well, and and I never take the remission, and I don't even know if remission is the right word for it. Um I never take it for granted now because of the ups and downs. Actually, recently wrote a uh Substack about this because I've had significant regain cycles in the last you know 12 years. And it's you look at year to year uh OAC pictures from your weight matters, like which version of Nanette is showing up? Is it gonna be skinnier or fat version of Nanette? And I'm like, I don't get upset about her anymore.

SPEAKER_01 41:55

Don't you love the when you go to OAC that nobody cares? Like, I I nobody gives a shit like if you were if you've gained weight or not, they they aren't even looking. No, yeah, and I'm not afraid of it. We all get it because they all get it.

SPEAKER_02 42:08

We all get it, we all understand it. Everybody like who's been there for a long time has seen the cycles. We've all seen each other in it, and we care about one another to show up and to support each other. And I look back on those pictures and I don't feel shame towards that girl that was struggling so much. There's a picture of a friend of mine, uh, Jen and I in the lobby in New Orleans, and I'm looking at the picture, going, I don't know what year that was because it was so blurry because it kept on happening. And putting the pieces together was so complex. And now I look back, I don't feel shame for who she was because she was figuring it out and she was curious and she showed up for herself. And when I get up and I tell everybody I love them and that I love that they showed up for themselves, I do that from the fact that I had those struggles and people still cared about me in that space, and they still wanted me to figure it out, and I still wanted them to figure it out, and we were all supportive within that community. And I actually said this in a live last night. Um, Mike, uh Mike Bonamission was there and a couple other folks. Uh it was Amanda Vanello and um the Sunday stories. And um uh I said, it's so nice to have you guys show up because I've been holding all this weight myself for a long time. And now I can switch gears to the mental health and obesity piece because the fact is then just getting coverage, right? And so that took away from the ability to focus on the narrow down of what the mental health journey is like, you know, that is my passion piece to help people see that therapy needs to be destigmatized. We need to normalize going to therapy, we need to help people see that there's no shame in where you're at, what you're struggling with. Show up, tell your story, get the help you need. You know, if one treatment doesn't work for you, especially in the therapist. I tell this people to my clients all the time. I am working through many lenses, uh many theoretical orientations, and I am searching for which one's gonna fit because therapy is both an art and a science. And trying to tell that to doctors, I was telling that to one of the doctors at OAC, and I looked at me crossface and I was like, it is both an art and a science. Yeah, it is. I'm always searching for the framework of what fits this person in front of me right now with what they're struggling on in this moment that they're willing to work on, which is a lot, right? But putting those pieces together and giving them something meaningful every single week when they show up for themselves is so important to me because that's a meaningful work.

SPEAKER_01 44:42

Yeah, so true. Um, I know we're at time. First of all, I gotta have you come back again. But um, I would love for people to be able to follow you, to follow your substack and all those different things. I will put all of that in the show notes, friends. But if you can tell people, because we're our audio audience is quite large, like um, where to be able to find you, I think that would be lovely. And we'll have a part two. We'll have a part two.

SPEAKER_02 45:05

I mean, I'm happy to come back. I'm happy to co-host while Kat's out. I'm happy to host with Kat too, and we're gonna be in New Orleans all together next year.

SPEAKER_01 45:12

So yes, guys, um, OAC is in New Orleans next year. This is all patient-driven. You can come and listen to doctors, but we do so many different things, and it is really a lovely experience, and it is not honestly not that expensive, and plus it's gonna be in Orleans, so that's and I've been and I love love, love to be the hostess with the most us.

SPEAKER_02 45:31

I am very involved in the New Orleans community in Mardi Gras. I am the fruit lieutenant, so I'm always immersing myself in the culture, and I'm trying to put uh together some things so people can really immerse in the culture. So you can follow me on Weighted Wisdoms, uh, both website weightedwisdoms.com, Substack, same name, TikTok, same name, uh, page on Facebook, Instagram is my practice. It's uh Nanette Adams LPC. Um, but I'm happy to reach out, help people, help them find a therapist near them, and if I can help them, help them. Um, but yeah, it's been a long journey, and there's a lot more to talk about. So we can certainly do this again soon.

SPEAKER_01 46:09

Yeah, that would be wonderful. I think the mental health piece is really important, and we can even dive a little bit deeper next time. But um, thanks for coming on and sharing your story and kind of giving us an overview. Because I know the first thing when people have regained or the first thing when they go through stalls is first thing they say is what am I doing wrong? It is always self-blame. Guys, there's just so much involved in this, and having a therapist that gets it is just really, really key. And if you can't afford a therapist, I try to have them on here so you can at least have some good direction. Okay.

SPEAKER_02 46:41

The reframe too with that is what changed in your body. And that's deeper. Hormones, you know, perimenopause for women, all of the things that can change in your body that may be contributing to it. Don't forget about it. So show up for yourself, be curious, and understand that this is a complex disease. An engagement with your treatment process will get you to where you want to be. Hopefully, eventually, right? But you get there if you ignore it.

SPEAKER_01 47:11

Yeah. And and and the and the truth is too, is it may take right additional medicines and additional years and additional all these different things. And you just like, if you can get in a place of acceptance with that, it will help out a lot, you know. Um, so thanks so much for joining us today, friends. I will see you next week. I will have all Nanette's information in the show notes. And until then, I love you to bits and hostile pasta. Fantastic. Thanks. Great to be on. Are you interested in understanding GOP1 medications like Osimpic, Wolfovi, or Manjaro? Then join us on the Plus Side, cracking the Obesity Code, the groundbreaking podcast helping people change their lives one episode at a time.

SPEAKER_00 47:53

The Plus Sides podcast is a disruptor.

SPEAKER_01 47:56

We're breaking down barriers, smashing stereotypes, and sharing inspiring stories that'll leave you feeling informed and empowered. Join us every week to learn from doctors who are specialists around GLP1 medications, like Ocinfit, Bogovia Manjaro. They'll provide you with science and facts to validate these incredible stories. But that's not all. We'll also bring you the voices of the GLP1 Manjaro TikTok community, real people who face the challenges of obesity-related diseases and disorders and discover the incredible plus sides of GLP1 medications. Our episodes are filled with heartwarming stories, laughter, and moments of triumph. You'll connect with our amazing community members who are reclaiming their health and experiencing their fullest lives. Are you ready to embark on a journey of discovery and empowerment? Tune in to the plus sides cracking the obesity code, and together we'll change the narrative around obesity and in the stigma. Subscribe now on YouTube or your favorite podcast platform and join our incredible community. Let's celebrate the plus sides of life together because every story deserves to be heard. Every life deserves to shine, and everyone deserves access to expert knowledge and medication. The Plus Sides Podcast, you're not alone. It's not your fault.