Before You Say Yes to GLP-1s: The Questions Nobody Is Asking You

GLP-1s are everywhere right now, and the conversation around them has gotten loud, polarized, and honestly a little exhausting. You've got one camp calling them a miracle drug and another saying you're taking the easy way out. I'm not here for either of those takes.

What I am here for is giving you the full picture: the questions, the considerations, and the context you actually deserve before making any decision about your body. 

As a functional nutritionist who works primarily with women navigating endometriosis, hormone imbalances, and gut health issues, I'm seeing this topic come up constantly, from clients, from my community, from women who've been told this is their only option. So let's talk about it.

In This Episode We Cover

• What informed consent actually means (and why it matters more than you think)
• The real benefits of GLP-1s
• Practical questions to bring to your prescribing practitioner before starting
• What GLP-1s are actually doing inside your body
• The gut health considerations nobody is talking about 
• Muscle mass, nutrition, and why "eating less" isn't always the whole story
• How chronic inflammation connects to blood sugar, gut health, and your hormones, and why quieting symptoms isn't the same as addressing root causes
• The fertility and hormone questions that still don't have clear answers
• Why having an exit strategy matters if you do choose to start
• How to use GLP-1s as a tool alongside foundational work, not instead of it

Subscribe to the Aligned to Rise Podcast:
Apple | Spotify

Connect w/ Alyssa:

• Instagram
• Website

Work w/ Alyssa:

• Free Period Pain Playbook
• Work with me 1:1

Learn more about Alyssa

Disclaimer: This podcast is for educational purposes only. This may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. 

Transcript

Copy Transcript Copied

SPEAKER_00 1:15

Hey my friend, and welcome back to the podcast. Okay, so we're gonna be talking about a topic that, to be perfectly honest, I have been kind of trying to avoid, but so many people have been asking me about it that I just couldn't go on without addressing the elephant in the room here. And that topic, my friends, is GLP1s. GLP1s, in case you haven't noticed, are everywhere right now. And the conversation about them has gotten very loud and sometimes very polarized. There's one camp that is talking about how it's a miracle drug, and another camp that's saying that you're taking the easy way out. Now I am not here for either camp. I am here, my friend, to help you to make an informed decision for your own body because I fully believe that everybody should have the full picture, all of the information at hand, and then be able to make the best decision for yourself. So this is not a pro-GLP1 episode. This is also not an anti-GLP one episode. And I also want to be perfectly clear that I am not a medical doctor. I am not even an expert in GLP1s. That is not what I'm here for, right? If you want true medical advice, please go and speak to a licensed medical professional who can guide you on that front. What I am here to do today is to guide you on basically the considerations you should be taking before really diving into any medication, to be perfectly honest. But just because the GLPs have been so popular and so widely talked about, I just really wanted to touch base on that today. So that's what we're going to do. So what you should have by the end of this episode is a clear list of questions to bring to yourself and to your practitioner who you're working with on what to be asking before saying yes or saying no. So this isn't about hype. This isn't about shame or guilt or any of the things. It's just about finding clarity on what's going to be best for you and your own body because really that's what I'm all about here, my friend. So who am I to even be talking about this? I'm asking myself that question at the present moment, too. But I am a functional nutritionist. I work with women primarily who have endometriosis, who have maybe period issues, who have struggles with hormone health, gut health, things like that. And really the reason I'm talking about this, like I said, is it's because I'm getting so many questions about it. I've had clients who have been asking, women in my community who have been taking them or considering them. And I found that the loudest voices in the space tend to either be really heavily promoting them or really heavily being anti-GLPs. And so I just wanted to find that nice balanced approach. I will share my own thoughts and perspective, but I am not gaining or losing anything either way, really. I just want you to be able to make the best decision for your own body. So my lens is really coming from a functional and root cause perspective, but not necessarily anti-medication. I do believe that everything that we have available to us in this day and age are tools that need to be used in a manner that's going to be healthy for you. So this can be a tool. The question is just whether it is going to be used as a tool or as a substitute for deeper work. So let's unpack this. Let's start to really dig into all the pros and the cons and the questions that we really should be asking. So, first of all, I want to really be open about the benefits, right? Because I have had clients who have been on GLP once. I've had conversations with women in my community as well who have been on these medications and just stories that I've heard over time as well, because it's something I've I've looked into quite a bit myself, just because of the type of work that I do. And I have seen and heard many stories of women who have seen genuine reductions in inflammation, who have seen real reductions in pain and symptoms, have seen improvements in blood sugar regulation, metabolic markers. And for some women, just honestly, the emotional relief of finally seeing changes in their body after years of struggling. And there is such validation in that as well. Now, many, many, many way more women than I'd like to count have been through years of being dismissed, years of being told to, for example, if you're trying to lose weight or something like that, just to eat less and move more, which I don't talk about weight loss a whole lot on this podcast because it's not really my cup of tea, to be honest. But there's way more to the story than eat less and move more for sure, and just doing everything right and still not getting the results that you want, which is so incredibly frustrating. So if you have already taken GLP1s and this has given you relief, I am so not here to take that away from you, my friend. Keep on listening and again, just make the decision that's right for you and your own body. I know I'm probably gonna say that a lot in this episode, so just bear with me, but I think it's important to just continue to repeat because that's true of really anything and everything that you put in your body, to be perfectly honest. Okay. So before we dive into the ins and outs of the questions and considerations you really should be asking, I want to just take a brief moment to talk about informed consent. So, what does that really mean? Informed consent isn't about fear-mongering or just telling you all the horrible things that can happen. It's really not about that. It's about having the full picture of both sides of the equation, the the pros and the cons, all the things, so that the choice that you make for your body is actually yours. Because what happens oftentimes that I hear from so many women is that they're given a medication and they're not really told the full story. And that this happens a lot with birth control as well, for example, because that's probably the other most commonly prescribed medication that I see with my clients that I work with, just with the population that I work with. And so that's I'm gonna just guide you through today is a little bit of informed consent. And these can be feel free to even take notes. You can uh write these questions down and bring them to your doctor, your practitioner who you're working with. And that way you can talk through these questions with somebody and really find the answers that you want to so you can make that decision for yourself. So, practical questions. First of all, before you talk to that practitioner, I want you to ask yourself am I sourcing this from a legitimate knowledgeable practitioner? So I actually have a friend who is a nurse practitioner and she works with peptides and all kinds of things like that. And she was talking about how there is such a rise of finding things like this online and just, you know, black market kind of stuff. And that can be really definitely a huge consideration. Now, I know a big part of that is that these medications can be expensive and often aren't covered by insurance. So I under totally understand how people are looking for a more affordable route if they really want to take these. But at the end of the day, we really come back to the whole matter of safety and dosing and everything. I know dosing is a whole consideration in and of itself, which I'm not going to talk about a whole lot today because, as I said, I really don't have enough expertise to be able to talk about that. But just from things that I've heard, there seems to be a wide range of what is considered good and healthy as far as dosing. I will hear people talk about microdosing, and it seems like that is a very wide range that people are calling quote unquote microdosing. So just be very wary and and cautious around that. Do your research on what that actually means and the practitioner that you're working with and make sure that there is somebody who is legitimate, who is knowledgeable, who works with these uh type of medications a lot, has a full understanding, has done their research and really understands how these work in the body, all the things. So that's definitely an important piece of the puzzle is that you want to work with somebody who understands what they're doing. And then we want to also look at side effects. And that's obviously has to be a consideration anytime you're gonna take a medication. So, and are you prepared for the possibility of those side effects? How will your body handle that if you do have those side effects? Things that I've heard about can be things like nausea, vomiting, diarrhea, constipation, abdominal pain, reflux, fatigue, headaches. There can be more serious considerations that have come up for people like gallbladder issues, pancreatitis, uh, gastroparesis. These are conversations you want to have with your prescribing provider, and also consider are those side effects that you're willing to risk. It's not to say that everybody's gonna have those side effects, but those are some of the common things that are coming up. Uh, what I see sometimes is that people who are already experiencing some of those symptoms just from day-to-day life, is there a potential for that to worsen those symptoms? Is that something that you're willing to risk for yourself in taking these medications? The answer might be yes, the answer might be no, but I think it's important to understand what those considerations are. And then I think it's also important to understand what these GLP ones are actually doing in your body. And again, I think this is important to understand always when you're considering putting something in your body, just understanding how it actually works, what it's actually doing in your body, I think is so, so, so crucial. So, just to give kind of a brief overview of that today, because as I said, this is not my area of expertise, but just from having done my own research and understanding, is that uh GLP1 stands for glucagon-like peptide one. It is actually a hormone that your body produces naturally in your gut, and it does help to regulate blood sugar by increasing insulin secretion. It also slows down how quickly your stomach empties when once food enters it and helps to with the signaling to your brain that you're full. So basically, the GLP1 medications mimic that the effects of that hormone and amplifies that natural process, which, you know, may sound great up front. But again, I think this is also important to look at. Uh, and this is something we'll dive into more in a little bit as well. But just if that's something that your body is doing naturally anyway, are there ways to support that process without necessarily having to rely on medication, right? Because at the end of the day, when there is a process that your body's already doing, I think it's important to take a look at that. Just, okay, if that process is maybe a little bit sluggish in my system, is there something that I can do to support it? And we're gonna dig more into that in a little bit. So just stay tuned, stick with me here, and we're gonna dig into some of that because you know if you've been with me any length of time, that's really what I do is I like to, I like to dig deeper. I like to look at the things on the surface, but also dig beneath the surface and just what is actually going on underneath the hood? What can we actually do to support the body as a whole without just slapping band-aids on symptoms? Because I know I got super frustrated with that for myself. And I've seen many, many of my clients get frustrated with that as well, just wondering, wow, how can I actually support my body holistically and in the long term and you know, get to the root of why that's happening in the first place. The other thing I think women should be aware of is the whole thing with um muscle mass. I know I know there's an important piece of the puzzle with needing to protect your muscle, the lean muscle mass. Um definitely if you do end up going on these type of medications, getting yourself plenty of protein in your diet, doing resistance training, things like that, because that can really matter for the long-term health, uh, metabolic health, bone density health, all of the things. I think it's important to also look at just are you getting enough nutrition in the first place? So especially because if your stomach is emptying slower and those I'm full signals are being sent to your brain more quickly, are you actually getting enough protein and fiber and micronutrients and all of the things if your appetite is dropping? I think that is an important consideration because I know, you know, many, many women are taking these medications for the purpose of weight loss. So that you may be listening to this going, well, Alyssa, that's kind of the whole point is that I want to be eating less. I feel like I'm eating too much food and I'm gaining weight and I want to be able to eat less and still feel satisfied. And cool, but I also want you to consider am I getting enough nutrition in? Am I getting enough nutrients to fuel my body so that I can have strong muscles and I can have energy and my body can do all of the processes that it needs to do because, you know, there's just a lot that happens in your body. You are so much more, my friend, than just muscle and fat. Your body is just this incredible thing that we we need to be able to support and be able to give it all of the wonderful nutrients that it needs to do its job. And then I think it's also important to consider what's happening to my gut. How is this medication really impacting my gut? And I'm not sure that we even have the long-term answer to that question because this is all relatively new, that we're not really able to see the long, long-term effects. But I do think it's it's something that we need to really consider because, for example, even the delayed gastric emptying, meaning your stomach isn't emptying as fast as it had been before, is that going to affect your motility? Is that going to affect your bowel movements? Is that going to affect your microbiome? Uh, microbiome is something that I love to talk about. That basically refers to the population of bacteria and other microbes that live within your large intestine, which I know sounds gross, but they have enormous benefits for your body. They help to digest your food. They actually release a lot of byproducts that are actually really beneficial to your health. And when that microbiome starts to get depleted or the quote unquote bad gut bugs start to build up more so than the quote unquote good gut bugs, that can really affect your health and the way that you feel. I see that all the time with women who come to me who are maybe experiencing a whole lot of constipation, diarrhea, nausea, bloating, all of these things. And it really can come back to the balance of your microbiome. Not to mention things like fatigue and even pain and overall inflammation can really be impacted by your microbiome and just your digestive system as a whole. I think it's important to understand also that so much of your immune system lives within your gut, about 80% of your immune system lives in your gut. And I'm kind of jumping ahead here because we talked about gut and my brain just got going because I love talking about the gut. This is where we really we might as well just segue right into the whole root cause questions of, you know, if you have a little lot of inflammation in your body and that's why you're taking the GLPs. I know there's there's many different reasons that women take them. Sometimes it is more for weight loss, sometimes it's more for the blood sugar piece of it. But many women who I talk to are looking at taking it for inflammation because, you know, many of the women who I work with have endometriosis, have period pain, have pelvic pain, a lot of these things, because that's, you know, that's a lot of the population who I work with in my practice. And, you know, for me, I really come back to the question of why is there inflammation in your body in the first place? What is going on underneath the surface that can be impacting that? And yes, if you have endometriosis, absolutely the endolesions themselves can have an impact on that. I mean, this is a this is a complicated question. When I talk about inflammation or when I when I work with a client who has inflammation going on, it's one of those things where knowing that you have inflammation is such a small piece of the puzzle. I hear so many women say, oh yeah, well, it turns out I'm super inflamed, and that just becomes kind of the end of the conversation. And for me, that's the beginning of the conversation. I then come to the questions of why is your body inflamed? If you're struggling with blood sugar issues, why is your body struggling with blood sugar issues? In other words, why is your body out of balance in the first place? This is the question that as a functional practitioner, I always am coming back to anyway. I always want to dig another layer deeper, another layer deeper, another layer deeper. So coming back to that whole thing with the gut and the immune system and all of that, well, when we're talking inflammation, inflammation is a process of your immune system. Now, your immune system impacts your whole entire body, right? Your immune system can be on the rescue if you get a cut on your finger, which funny enough, I actually did yesterday. Got like a little paper cut or something on my finger. Don't even know how this happened. And it's funny because that's the example that I always use. And here I am living that in real life right now. I have this little tiny cut on the tip of my finger, and I can see it because this just happened yesterday. It's getting kind of red and puffy, and um, there's a little, there's some pain around that area. And what's really happening there is that that is inflammation. That is the immune system rushing to that area to help to heal it. And that's a normal process in your body. You want that to happen because that's how we make sure that we're clearing infections and that we're able to handle any sort of viruses, bacteria, things that your body may come in contact with that can have ill effects. But when you quote unquote have inflammation in your body, what's really happening there is that that inflammatory process is just happening all the time. It becomes chronic inflammation. And so, again, if that's happening, if you're having chronic inflammation, we want to know why. Why is your body constantly feeling like it needs to mount an immune response? And there's not a single answer to that question. Sometimes it can be related to dietary pieces because, especially if the lining of your gut is kind of compromised and large food particles are getting through, or maybe just digestion is compromised and allowing those large food particles through to your gut, which again, that's one of the questions that I ask when it comes to that slower motility. Are foods still being broken down well? Is digestion still happening well? Is all of that still going on so that we can maintain the health of all of this process? But that all those things can start to impact inflammation, right? Blood sugar can also really impact inflammation, which may be why many women are feeling better, feeling less inflamed when they're on these medications. But then I come back to this same question of well, why is blood sugar out of balance in the first place? What can we actually Actually, do to support your body's natural processes. So that can be something that happens whether you're on the medication or not. If you're currently on the medication, can you still be supporting those processes holistically so that you don't have to rely on that forever for the rest of your life? If you're considering these medications, is it possible for you to address some of these underlying issues first and see how your body does before you're considering these medications? These are all just questions I'm asking, not telling you what to do, what not to do, but just considering what I can address? What should I be addressing before taking this medication, while taking this medication, all of the things? And also, how else might this be affecting your body? If you do take these medications, could that be affecting your hormones, your cycle? I actually had a client recently who was asking me about the impacts on peptides and fertility. And the truth is I actually ended up reaching out to a fellow practitioner who does some of the functional work, but she also is a nurse practitioner and has a lot of expertise here and was just kind of picking her brain on that. And basically, the answer to that is very nuanced. There's a lot of layers to that. Depends on what you're taking, what you're doing, the health of your body before you start it and during how your body's responding to the medications, if you're having a lot of rapid fat loss and things like that, how might your body respond to that? Will your body start to notice that it's in a crisis mode and shut down hormones? Again, these are just questions that I'm asking, not saying that this is what's happening. Is it going to affect your sex hormones at the end of the day? Is this going to end up affecting fertility? There's a lot of questions that I think we should be asking. And honestly, I think a lot of this still needs to be researched more. I mean, I don't know that there are clear answers to some of these questions because this is all just relatively new. So things, all things to consider. Now, the other thing that I think we should all consider too is just how long do you want to be taking this medication, right? Because I've known some women who maybe say, you know what, I understand that there may be some side effects, there may be some, you know, negative impacts on this medication, but I also really want the positive impact of this medication. Maybe I'm going to take it just for a few months at a small dose to kind of help me get over this hump and at the same time going to build a strong foundation underneath so that you have an exit strategy, right? So that you're building something to stand on if you stop. And I think that is really, really smart. Because I hear, I hear of many women who start these medications, go off of these medications, and then start feeling worse than they started. And we don't want that. You don't want to have to rely on these medications. And the more that you have a strong foundation, you're building up your own health underneath the surface as well, I think is so important if it's not something that you want to have to rely on in the long term. So the real question is: can I use this as a tool while still doing the foundational work rather than instead of it? And that's that's really, you know, again, I am a functional practitioner, so of course I'm going to think that way. I'm always thinking about how you can support your body foundationally. Um the medication can reduce inflammation and quiet the noise and all of the things, and maybe give you the breathing room that can allow you space to be able to then support your gut and hormones and blood sugar and nervous system and do all of that work that needs to be done. You know, that's that's really the way that I see it in the long term is thinking of it as a tool and not a replacement for doing that deeper work, right? Because at the end of the day, I always say this again and again and again, we'll continue to say this when you have symptoms coming up in your body, including those symptoms of inflammation, you know, maybe you're experiencing pain and fatigue and symptoms like that. And honestly, even if you're holding on to weight and haven't been able to lose it, that can also be a sign of inflammation because oftentimes your body holds onto weight because it doesn't feel safe to let go of it, essentially. It feels like you're it's in a bit of a crisis mode and just needs to hold on to some of that weight in order to feel safe and feel like it has some stores to hold on to. So doing a medication like this may help your body to release some of that. But at the same time, what we really need to understand is how to support those deeper foundations that your body really needs to feel good in the long term. So I think of it as a tool that you can choose to use or not to use, but not a replacement for everything else. I hope that makes sense. So again, after listening to this episode, I hope that you have more of an understanding of just what questions to ask, who to go to, who to talk to. But at the end of the day, I think the the most important thing to know is just that this is your body. This is your decision. You deserve to make that decision with the full picture. And never forget that, my friend. I feel like so many women I have come to me and just feel like after talking to their doctor that taking a medication is their only choice. You know, I went and saw my doctor and I was told that I need to take this and that if I don't take it, I'm just gonna feel terrible forever. And that's terrifying. Especially if you're already not feeling well, you're already having health struggles, you've had chronic symptoms going on that you just don't know what to do with, and you have a doctor telling you basically this is the only way. That's scary. And trust me, I've been there myself. I, the reason I'm so passionate about women going into these conversations with informed consent is because I've been there myself. I've been put on medications that I honestly either wish I wouldn't have, or at the very least, wish I would have had more of a game plan with it, but been better able to support my body at the same time, had a better understanding of how these medications are working in my body. I really wish I had had more of a picture before saying yes to these medications, because at the end of the day, any medication, you have the option to say yes or say no, right? And I do think it's warranted to have a solid conversation with a licensed practitioner about that before you make that decision. But I do think it's important to have a full understanding and do your research, my friend. Yes, it takes some time. Yes, it can be not very fun sometimes to take time out and read maybe boring research papers or whatever. But if you're even considering these medications, I do think it's very warranted to look carefully at what the side effects are, what's really in the medication, how it's actually working in your body. And especially nowadays that we have so many resources at our fingertips, you can find this information on your phone. Um definitely do that. Do your research, understand what's actually happening in your body so that you can make the best decision for yourself and for your long-term health, taking all of that into consideration. And my friend, if you are looking to have some of that foundational support, either along, you know, alongside whatever path you choose, alongside whatever decision you make, I would love to chat with you about that because that is the work that I love to help clients with every single day, working on supporting those systems so that you can feel really, really good in the long term. So uh there is always a link in the show notes where you can book a free 30-minute consultation with me, and I'd be happy to chat through your unique situation with you. All right, my friend, so much love to you. Thank you so much for being here in today's episode. Be sure to subscribe to the podcast so that you don't miss a single episode moving forward because we have so many more conversations to have. All right, my friend, have the most wonderful day.