An Amber a Day: The Functional PCOS Podcast

GLP-1 Medications and the PCOS Weight Loss Journey: A nutritionist's nuanced perspective

January 31, 2024 Amber Fischer, MS, CNS, LDN Season 4 Episode 1
An Amber a Day: The Functional PCOS Podcast
GLP-1 Medications and the PCOS Weight Loss Journey: A nutritionist's nuanced perspective
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Show Notes Transcript Chapter Markers

GLP-1's like Ozempic and Monjauro are everywhere these days and being used frequently for PCOS- both for insulin related concerns and weight loss.  My opinions and concerns about these medications have been met with real life experience helping many clients use them effectively over the last couple of years and today I'm sharing insights gleaned from this.  

Basically, this episode will cover what GLP-1 meds are, how they can help PCOS, if they are worth taking, the biggest concerns, pitfalls, and cautions, and how to lose weight safely, efficiently, and effectively while on them.  

If you are currently on a GLP-1 medication like Ozempic for your PCOS or considering taking one, this is my nuanced take on them and I hope it helps!!

 

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Speaker 1:

Welcome back to an Amber a Day. I'm your host, amber Fisher. This is season four. I'm so excited. I can't believe that I have been doing this since 2018 and that so many of you have been along for the journey. So thanks for being here. We're gonna talk today a little bit about some of my thoughts on GLP-1 medications, so things like Ozympic Majaro I think it's pronounced with Wagovi Wajov I'm not actually sure how it's pronounced, but these kinds of medications that people are using these days for insulin resistance, pcos and particularly for weight loss. So we're gonna talk about some of those today, but before we do, I want to do a little bit of housekeeping. First, welcoming you to season four. That's what's on my notes. So welcome to season four.

Speaker 1:

This year, I've got some stuff planned out for us that I'm really excited about. I've got a podcast that's already in the editing works with my good friend, dr Kalia Waddles, who runs the functional fertility account on Instagram and TikTok, and her and I are going to be discussing mitochondrial health in PCOS, and I know that maybe sounds a little bit boring or overly sciencey, but, trust me, we make it very interesting and the mitochondria actually make a really big difference in PCOS. So if you're interested in managing your PCOS from a cellular perspective, you're gonna want to listen to that podcast with Kalia. I've also got some other great guests coming up with topics all around eating, disordered eating, behaviors in PCOS, and new research that's come out about PCOS and pregnancy, and you know just lots of other things that I have in the works for you guys, topics that will come up as the year goes on. So I'm excited to share all of this with you.

Speaker 1:

I want to mention because it is the beginning of a new year and it's typical this time of year for people to want to start doing something about their health, and when you have PCOS, you know it often times in new years when you're like, okay, I'm gonna actually buckle down this year and start taking care of some of these symptoms that I'm having. So if that's you, if that's the case for you, then I just want to recommend to you a course that I've created called PCOS Foundations. It's a four-week course, itself-paced, so you can do it at whatever pace you'd like. You don't have to complete it in four weeks. You have lifetime access to it, but it's a series of lectures that I created with like PowerPoint presentations for you guys all about the foundations of PCOS nutrition, so what I think you need to know and to do in order to really address your PCOS symptoms from the root cause. So it's all based on principles of functional nutrition and it's all based on the work that I have done with clients for the last nine years.

Speaker 1:

We're going on a decade of private practice working with PCOS. So I have a lot of experience under my belt and I've seen a lot of success stories and I kind of distill everything that I've noticed, learned, researched, all that into this course in a way that is not going to be super overwhelming. So I have another course called Functional PCOS and you know some other stuff going on, and one of the things that I have heard consistently about functional PCOS is it's very interesting, there's a lot of information and it's a real deep dive, but it can be a bit overwhelming when you are first just trying to make changes. You know, not all of us want to be like me and think about PCOS all the time. Right, you just want someone to tell you this is what you, how you need to eat. These are the things that you need to do. Let's implement them and get on with our lives. So that's what PCOS Foundation is all about. It comes with a meal plan, recipes, grocery lists with those recipes, so it's organized for you. All you have to do is, you know, buy the food, watch the lectures, learn, look at my face and yeah, and you'll come away with that knowing a lot more about PCOS. So if you are, you know, starting off your new year thinking about that, then that may be a good resource for you and I will link it in the show notes below.

Speaker 1:

So, today's episode what are we talking about? Well, I just got off of a call with a client Interestingly enough, I plan to record this podcast already and then her and I met and one of my clients I won't mention her name, but she is on the GLP1 medications. She's taken ozympic and then recently was switched by her doctor to manjaro, and her and I have had a lot of good discussions about these GLP1s because her observation in her community has been that a lot of her girlfriends have kind of gotten on these medications, and with some success. Right, they've lost some weight and everything, but aren't changing their dietary habits at all. They're basically, you know, they're still going and mostly eating, you know, fast food and not really watching the makeup of their diets at all, and a lot of them are kind of stalling out in their weight loss or some of them are continuing to lose weight, and her frustration was why are they losing weight while they're not paying attention at all to the quality of the food that they eat? And yet I'm paying attention so much to the quality of what I eat and to you know the ratios and the macronutrients and all of that stuff, and I'm losing weight, but it's slower. And so I had some thoughts on that that I thought I would share with you, because from the outside, it might look like she is not as successful as her friends, and a lot of people will say things like well, this is just clearly fact that calories are the only thing that matters, and you know these women are clearly they're just not eating very much. They're appetite suppressed and so they can eat whatever they want, but they're not hungry for that much, and so that's why they are losing so much weight, and that's the success right.

Speaker 1:

So often in our culture and this is the case not just for the culture at large, but even in our medical culture, like when you go to your doctor. What is the one symbol of success that they hyper focus on? It's the number on the scale and how much you weigh. It's not how inflamed you are or aren't. It's not how flared up your autoimmune condition is or isn't, you know. It's not how balanced your hormones are. It's all about how much do you weigh, how much weight have you lost, and if you starve yourself to get there, well, good for you. You've done it, you know you. You conquered the, the weight beast, and that's all that matters.

Speaker 1:

So I have a lot of like really complicated feelings about these drugs, and that's why I kind of thought I'd do the podcast today. So I wrote down some notes. My talking style, as you guys know if you've listened to the podcast before sometimes I go all over the place. I think this topic in particular is going to send me in a lot of different places, but I just want to get these things out there because I get a lot of questions from followers on social media and from clients. They're being offered these medications and they want to know what my advice is or what I think that they should do. I think my answer tends to surprise them, because I'm not anti-GLP ones. I actually think, in the right context, that they can be very, very helpful. Let's talk about some of the things that I think are helpful about GLP ones. The most helpful thing is that they balance your blood sugar and insulin levels quite a bit.

Speaker 1:

If you are very insulin resistant, and particularly if you're insulin resistant and leptin resistant, which means that you have the insulin resistant stuff going on but also you have trouble with your hunger cues and signals, you tend to be hungrier than your body necessarily is. You feel hungrier than you necessarily are. Glp ones are great because when you're on them this is what I hear, what I've observed, because I've never taken them myself what you experience is a huge reduction in food noise. Food noise is like the mental chatter in your brain around food when you have insulin resistance and when you have leptin resistance, when you have PCOS, you know that oftentimes running in the back of your mind, as if it's a computer tab that's open all the time, is your thoughts about food. You think about what you're going to eat next. When you're going to eat, it can't wait until you can have this or that, or go out to this restaurant or whatever.

Speaker 1:

I think it's human nature to think about food because food is survival right. We're programmed to think about food. With these sorts of medical conditions, we tend to think about food like we're thinking about it a lot. In a lot of cases it can be debilitating when you're so hungry all the time that all you can think about is food and you can't focus on other things. You struggle really hard with dieting or restriction of any kind because of those thoughts around food. It can make things like a weight loss journey very difficult, because a weight loss journey kind of includes a little bit of restriction in certain areas, right? One reason why people tend to not be super successful with long-term weight maintenance when they have these sorts of conditions is that food noise. It's always there in the background. The GLP ones do a pretty good job of cutting back on that food noise, at least insofar as we know, because they haven't been around that long. Right, people haven't been using them for weight loss and PCOS for that long. I don't know what things are going to look like in 10 years on a GLP one, but at least currently that seems to be the feedback that I'm getting from a lot of people. That's a gift. That's a real gift and a real plus in the corner of GLP ones.

Speaker 1:

There are also a lot of long-term risks and implications of having insulin resistance things like heart disease and just all kinds of other chronic health conditions diabetes, things like that that can cause a range of issues. You're at increased risk when you have insulin resistance and a lot of that is that underlying sort of insulin blood sugar volatility, all that stuff. It's not great for your body, right. It's damaging for your cellular health and kind of ages your cells maybe faster than what they normally would. That's one reason why people I don't know if you've ever seen this before, but I've seen a lot of talk about using metformin another kind of drug that manages insulin responses as an anti-aging drug, because that blood sugar volatility and the ups and downs with it is one of the things that ages the cells. Aging is not just how we look, but also how our organs and cells and everything function. There are some real long-term risks with unmanaged insulin resistance for sure. I think the GLP ones have the potential to be a really big gift for that.

Speaker 1:

I should mention here in this podcast that I'm not a medical doctor, I'm a nutrition professional. You need to definitely. What I'm doing here is dipping my toe into a realm that's like it overlaps with my scope but it's a little bit out of my scope because these are prescription medications that you couldn't come to me to work with me one-on-one and I could prescribe you a simpic. It doesn't work that way. I take everything I say with a grain of salt and make sure that you discuss all this with your healthcare provider. I think there are some really big positives to them. The negatives, however, are concerning to me, and mostly from the standpoint of a person who doesn't want to or doesn't have the energy or the desire to sort of manage the other side of their health. What I mean by that is let's take my client, for example.

Speaker 1:

So she's kind of the best case scenario of being on a GLP one. She came to work with me soon after she was prescribed it so that she could use the opportunity of having reduced food noise and, you know, having the weight loss sort of happen in the background. So she could use that opportunity to manage her food habits, to kind of get onto a routine, to make better choices and to come up with sort of a solution to a lot of these overeating, you know, binging and restricting behaviors that she'd done in the past. And so, while she is in this sweet spot of like she's not having to really worry about the weight loss, because it's kind of taking care of itself, she's also learning how to eat enough protein, she's learning how to manage her macronutrients, she's learning how to get her exercise in order, she's learning how to eat in moderation the things that she really wants to eat. So there's a lot of positives to her journey with that, and the Monjaro or the Ozympic or whatever is just a tool that she's using as part of that journey, whereas some of her friends, for example, they're using these medications as, like, weight loss easy ways out.

Speaker 1:

And don't get me wrong, I would love, I would love nothing more than for there to be a weight loss easy way out, like I would take it if it was like safe and easy. Sign me up, okay, because I have PCOS too, I have insulin resistance too, and I've been open recently with some people about how I'm currently on a little bit of a weight loss journey myself. Over the last few years since I've become a mom, particularly once my son started walking my life got a lot more hectic and complicated and stressed and a lot of my healthy habits sort of didn't go out the window completely, but I had trouble sticking with them, especially during those kind of stressful times, and so I've gained some weight back. So I'm in the process of trying to lose about 20 pounds that I've kind of regained, and it's tough. I haven't had to do this in a long time, and so I'm being re-confronted with all the uncomfortableness about weight loss, not just, you know, emotionally. Of course there's a lot of discomfort emotionally with, like having to take stock of my behaviors and and my thoughts and all these things around food, but also physically. It's not fun to be hungry, and in order to lose weight you do sort of have to be a little bit hungry sometimes. So all of that is tough.

Speaker 1:

So I understand the desire for a weight loss miracle and I'm kind of hopeful that one day they may find something right, because it does seem to me that a lot of weight issues there's a genetic component to them that is part of the evolutionary process of like humanity sort of getting to where we are now. We've gone through our historically humanity has gone through a lot of like things like feasts and famines and all these other things that are out of sync with the modern context where we tend to have a lot of low quality but cheaply available food at our fingertips. So we're not set up to handle that, particularly if we have PCOS, and so I'm hopeful about that and I'm like totally on board with you know, keep looking for it, right. But what makes me nervous about these is that I don't think they're quite good enough to be used as just complete miracle drugs, the reason being that one of the main ways that they work is not just by managing the insulin responses, but also by suppressing appetite, and so what I'm seeing with with certain people is very similar to what I see, what I've seen before, when clients have been prescribed something like Adderall, like maybe they were diagnosed with ADHD and they got an Adderall, and at first it's like this wonderful feeling because it's like, oh, my appetite suppressed. Less food noise like that's amazing. But with time it becomes this thing where the appetite suppression actually is, causes problems around the relationship to food, because you start having what we call food aversions. So, particularly healthy foods that would be good for you to continue eating because they're nutrient dense and because they contain a lot of the things that your cells need to function. Vitamins, minerals, all that kind of stuff become disgusting to you or you don't really want to eat them, and so you end up doing this thing where, like well, your appetite suppressed so you could just not eat, right, or you could just have a protein shake and call it a day, and you don't have to think about it and you're losing weight and that's great and you feel good because you're kind of in that fasting mode and you're, you know the weight's coming off without you having to try, and so it's exciting and you're getting positive reinforcement for those behaviors.

Speaker 1:

But long term, what happens when the appetite suppressant effect wears off? I don't know. I have had some clients who've told me that with time, these medications stop being as effective for them and so they have to go and get more or they have to switch to a different one, right, and so I've seen that happening and I'm wondering, like, okay, what happens a year from now? Right, when we need to switch again, but there's nothing else to switch to, or we've kind of hit our max with how helpful it's going to be. Or, like in the case of, like, true appetite stimulants or whatever, like Adderall, what happens when your body pendulum swings into this mode where it's like I've been starving and I need to eat and so it really kicks up your appetite and everything. The long-term risks associated with that are what kind of concern me from a nutrition perspective?

Speaker 1:

I'm not talking about from, like, a medical perspective or a health perspective, because that's outside of my scope, but I'm talking purely from a nutrition standpoint, like what happens when a person has been essentially in starvation mode for a couple of years, hasn't been eating their veggies, hasn't been getting their nutrients and they've depleted a lot of their resources and then they either the appetite suppression wears off, they run out of you know things to switch to if they need to switch, or they get off of it completely and all of that pent up energy comes back. You know the body's like we've been starving, and this is very similar to the concept of like. If you've ever done your typical diet before, right, the whole yo-yo effect. You tend to be excited at the beginning. You lose a lot of weight.

Speaker 1:

A lot of people push themselves too hard to lose too fast. They lose all the weight and then, as soon as they get to the point where they're, you know, maybe five pounds from their goal, or they've reached their goal or whatever, and they're happy. All of a sudden, the hunger signals kick back up and now they're twice as hungry as they were before, because their body is trying to reach a certain equilibrium. I think that's just human nature, that the body likes to have an equilibrium. It doesn't like to feel like it's starving. People often forget that body fat is a survival mechanism. So maintaining that body fat is deeply primal for the body. It wants to hold on to it right?

Speaker 1:

So what I have heard through the grapevine I will not reveal my sources, but I have spoken with some people who run a popular weight loss DLP1 program and I know somebody who's associated with them. Anyway, what I heard through the grapevine from them is that a lot of doctors are thinking now that the most effective way to kind of use these medications or utilize these medications would be to keep the person on it permanently. So essentially, the idea is there's something fundamentally wrong with the way that your insulin responds and so, because of that, this medication is going to even you out and you're going to need to be on it for life so that it can continue to do its job, because there's something fundamentally wrong with you and with the way that you process carbs. And while I do think that there may be some truth to that, right, like those of us with PCOS always, kind of say, with diet changes, one of the hard things about having PCOS is that we do have to try harder than other people right, to get the same results, to maintain those results, because there are all those genetic influences. So I think there's some truth in that.

Speaker 1:

But my concern is if you, if the medication is necessary to kind of maintain its effect, you need to stay on it for life, what happens when these insurance companies don't want to pay for it or this or that? I mean the whole like the insurance company stuff that's going on with getting these medications covered. The pharmacy is not being able to stock them, people who really, really need them, like type two diabetics, not being able to get them because so many people are using them for weight loss. I mean these are a lot of like systemic issues with this drug that may over time, you know, fix themselves. I mean there's, since there's a run on them now, right, but the interest will die down or there will reach some sort of equilibrium.

Speaker 1:

But I guess my concern is like what if they stop being covered or they're not covered to begin with? These aren't cheap drugs, right? They're very expensive, at least currently. So until that changes, I'm not 100% sure that it would be worth it for most people. Maybe somebody who has unlimited financial resources could pay, you know, five to $900 a month for their Zimpik, until the prices go down. But you know what I mean. It's just like that kind of concerns me from a financial perspective, like throwing all of this money into something that eventually, I may not be able to afford anymore. I may have to go off of it anyway. So that's why, then.

Speaker 1:

That's not to say that you shouldn't do it, but that is to say that you need to have a clear vision of what the whole process looks like. So, instead of focusing on the beginning part of like I'm going to get on this, I can afford this now. It's going to make me lose weight. Think, while you are in those phases of losing weight, think about the future. Think about what happens in case you're not on it. What happens in case you can't afford it anymore? What are you going to do and what habits do you need to build now so that there's second nature for you when you go off of it. What things do you need to do to be cautious with your body so that you don't send your body into this like major starvation pendulum swing thing.

Speaker 1:

There really are no easy ways out with weight loss, unfortunately, and so what I think the most effective way to use these medications is to use them as a tool to implement positive lifestyle changes, without a lot of mental noise and while actually having success with, like, those changes, getting the weight off. Because, yes, it's absolutely the case that there are some people with insulin resistance who I've worked with before who their insulin resistance was so severe that, even when they were doing everything right, still their body kind of wanted to maintain status quo and it was like almost a snowball that had to get rolling. They had to lose some weight before the weight would really start to come off, which is kind of frustrating. Well, isn't kind of frustrating, it's very frustrating. Here's what I think as far as how they should be used.

Speaker 1:

When you get on a DLP one, you should be also on a nutrition plan, if possible, working with somebody, one-on-one or in person, or taking a doing. You know, shout out to self promotion here, but like being in, like my PCOS Essentials Academy group program, right, which I'm currently in the middle of one of my cohorts right now, but we'll probably run another one in the summer or something like that so that can be a good resource that cuts down budget wise on what it would cost to see a dietitian one-to-one or yeah, like seeing a dietitian one-to-one, working one-on-one with a nutrition professional, somebody who's acquainted with your unique health circumstances, so somebody who has specialty in PCOS. And if not, that then taking some having some sort of course that you go through to get the basics, so that you kind of know what you need to be doing if you're very self motivated, right. So there are a lot of different ways to do it, but the mistake that people tend to make is they get on the medication and they're just kind of like let me relax for a while and not think about anything else. But this is really when you have this profound opportunity.

Speaker 1:

Top on your priority list needs to be reducing muscle loss when we don't eat enough whether we don't eat enough because we're not hungry, or whether we don't eat enough because we're starving or fasting or what have you. When we don't eat enough, we tend to lose muscle mass. We need to eat a certain amount of protein every day to maintain our muscle mass, and ideally we would even try to maybe increase our muscle mass, which, fair enough, is very difficult while you are losing weight, but we could at least try to maintain what we have. This is key because muscle mass is kind of the major factor in what burns calories at rest. So if you have more muscle, just lay it on the couch, you're going to burn more calories than somebody who has less muscle who's doing the same thing. And this becomes really, really key in the maintenance phases, because more muscle could mean as much as a couple hundred extra calories a day, which means an extra snack, which means eating a slightly bigger meal. There's a lot of different ways that it helps, and that's important because when you're in the maintenance phase you're not going to want to track all the time, right, you're going to be tired, fatigued from the process and so and I don't recommend that you track forever but if you have a little bit more of a cushion or a wiggle room, then it's easier to maintain.

Speaker 1:

So top priority is maintaining your muscle loss and maintaining your muscle mass, and the way you do that is by eating enough, particularly enough protein, and continuing to do strength training. So that's like priority one. Priority two is maintaining your nutrient status and remembering that weight is not the only indicator of health. Oftentimes, weight is a symptom of underlying issues that need to be corrected, and so this is where food quality comes in. Yes, if you eat less food quantity, you will probably lose weight, at least at the beginning, and many people can get all the way to their goal without really focusing on nutrient quality At all. There's truth in that, but that's not the best way to do things, because your body needs vitamins, minerals, nutrients, your gut needs fiber. You need all of these things, and so making sure that you are managing for your protein and that you're managing for your vegetables, fruits and other like plant based foods, legumes, particularly like things that are going to give you a lot of fiber, eating as many whole foods as possible If you can do those things while still being on these medications and losing the weight, then you're golden right, and so the question that my client had was why is her weight loss lower than her friends?

Speaker 1:

Well, likely it's because her friends, while they are still going to McDonald's and whatever, they're eating a lot of fast food. They're probably also just not eating very much at all compared to her, because maybe they're having one meal a day and they're getting whatever they want, but they're probably just eating a few bites of it because their appetites are really suppressed, whereas with her, I'm almost forcing her to eat more than what she wants to. She's not hungry for a lot of it, but she's having to eat more to meet her macronutrient goals, because what I'm trying to do with her is have her lose weight at a rate that's sustainable and healthy for her body. Just because we can lose weight fast doesn't mean we should. Several reasons for that.

Speaker 1:

I talked already about the kind of the pendulum swing effect, but another thing that's important to understand is that, especially if you've had hormonal issues, quick weight loss can be a trigger for gallbladder dysfunction. A lot of people, after a big weight loss journey, they often need to get their gallbladders taken out because it was so hard on their body. There are other things going on besides just losing weight Muscle mass, pendulum swinging, gallbladder health, hormone health in general can get a little jacked up during major stressors, and starvation is a stressor. What I'm doing with her is feeding her more than what she feels she needs on these GLP ones because her medication is suppressing her appetite, but I'm still feeding her significantly less than would be a maintenance amount of food for her.

Speaker 1:

She's on a calorie deficit, but it's not just a calorie deficit, it's a structured calorie deficit, so it's not too much of a calorie deficit. She's not eating thousands of calories less than what she should. She's not eating to lose like three pounds a week. She's on a calorie deficit, but it's also a calorie deficit that's managed around her macronutrient needs. So how much protein she needs, how much fiber she needs. It's also managed around how many micronutrients she needs vitamins, minerals, all that kind of stuff.

Speaker 1:

This doesn't have to be complicated. I know it sounds complicated but at the end of the day, eating more whole foods and making sure that you're eating about a palm-sized amount of protein with each of your meals it's kind of all you have to do for most people, especially if you're on one of these meds, right? So it's not like this thing where she has to calculate out have I eaten this many grams of this or that? No, she just eyeballs like okay, I need to make sure that I'm eating like this much protein. And then, on top of that, I'll make sure that I'm eating veggies at each of my meals. I make sure that when I have snacks, that my snacks are whole food snacks, so they're like fruit with like some sort of protein source, maybe peanut butter or nuts or something like that. You know these kinds of things that can really become second nature over time.

Speaker 1:

And so her weight loss is going slower than her friends, but it's at the rate that I did the math so that we would expect and that's the key right Like it's going according to the plan. The plan was to lose weight slow and steady. Slow and steady really does win the race when it comes to weight loss. Now the research does show that whether you lose weight quickly or slowly, you're just as likely to regain it, which is kind of a bummer. But what I think that research doesn't take into account is things like muscle mass and what the long, long, long term implications of losing that kind of weight at a slower pace versus a faster pace might look like. I'd be very interested to see like a 30-year study on this or something like that. But regardless, if you want to have the most chance of success at maintaining strength training, making sure you're eating enough protein, making sure you're still eating quality food most of the time.

Speaker 1:

The other thing that's really powerful that I'm having her work on is moderation. So often we have insulin resistance. We tend to eat go all out. So we go get fast food and we're gonna get the whole thing, we're gonna get the basket of fries right. What she's learning, with the help of these GLP ones as a tool, is to eat a small portion and this is good for her muscle memory because, yes, later on, if she gets off these medications, she may be hungrier for more. But if she has built that habit of like I'm gonna be okay, I don't physically need to eat this entire thing, like I can stop, and that's fine. And if she's learned that like that's possible, not just with whole foods and like the healthiest healthiest foods, but also with things like fast food and restaurants and things that we're all gonna do right, it's not realistic to say you're never gonna do that stuff anymore. We build it in. So the majority of the week is whole foods. The majority of the week is you know, everything's managed, but a couple times a week, you know, maybe we're getting some Chick-fil-A and we're learning how to not order the 12-count with the extra large fries. Right, we're getting a smaller meal and we're just letting that be enough, or we're getting the salad or whatever you know. So just learning to make different choices, the muscle memory of that is good.

Speaker 1:

From a neurological perspective, like from your brain's perspective, food is not all about hunger and what you're putting in your mouth and discipline and willpower. It's also about just building second nature habits, muscle memory. I, for the last six months I've been salsa dancing and the difference between when I started to now is that I can do arm styling and all kinds of different things. Now, because my footwork is muscle memory, I don't have to think about my footwork anymore, it just comes to me. And so now I can play with the moves more, I can start adding more, and it's the same thing with nutrition. At first it's gonna feel like a lot just learning those first basic steps, but once those are down pat, once you've got a good grasp on them, then you can start to add more, to start thinking about things like you're you know meeting a fiber goal or you know what have you Like you can add to it and it's not so draining or stressful.

Speaker 1:

So I think those are all my thoughts on the GLP One, so I hope this was helpful. Let me know if it was. Leave a comment, leave a review on Apple Podcasts particularly the reviews really help and let me know if this was helpful for you on your GLP One journey or on your thoughts about GLP Ones and if I missed anything that I should have covered. Also, let me know that too. I again I'm grateful for you guys for sticking with me on the podcast here and hope I'm excited about the year to come and all the things that I've got in store for you guys. So I will see you next week. Bye.

(Cont.) GLP-1 Medications and the PCOS Weight Loss Journey: A nutritionist's nuanced perspective