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The Rejuvenating Health Podcast
Join Women's Health Nurse Practitioner, Lindsey VanSchoyck for a weekly dose of Precision Medicine as she addresses the hot-button topics specific to Women's Health, Fitness and Nutrition, interviews expert guests and hosts round table discussions with the team of dedicated functional health care specialists.
The Rejuvenating Health Podcast
E159 | The Hidden Costs Of GLP-1 Weight Loss And How To Avoid Them
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GLP-1 medications are exploding, and we get why. When they’re used well, drugs like Ozempic, Wegovy, and other GLP-1s can be an incredible tool for weight loss and inflammation. But we’re also watching a wave of preventable fallout: people losing weight while losing muscle, feeling exhausted and depressed, wrecking their gut, tanking their libido, and rebounding hard the moment they stop.
We walk through the physiology in plain English. GLP-1s flip down hunger signals in the brain, but your muscles, thyroid, and mitochondria still need nutrients. If your intake drops too low, the “results” can become malnutrition, metabolic adaptation, and a body that’s trying to survive, not thrive. We also dig into the practical stuff most people never hear: why escalating the dose can be a mistake if you’re already losing, why protein has to come first, why resistance training matters for muscle preservation, and how bone density and osteoporosis risk enter the conversation for women.
Then we cover the under-discussed issues that make people feel awful, including sodium loss and electrolyte imbalance (not just “drink more water”), slowed gastric emptying, constipation, diarrhea, SIBO risk, and poor nutrient absorption that can snowball into low iron, low B vitamins, low magnesium, and an energy crash. Our north star is simple: GLP-1s don’t create health by themselves they create an opportunity, and your habits decide whether that opportunity builds you or breaks you.
If you’re on a GLP-1, considering one, or watching a friend struggle, listen through and share it with someone who needs the full picture. Send us your questions so we can help you use these tools safely and effectively.
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Medical Disclaimer And Cold Open
SPEAKER_01Any views, thoughts, and opinions expressed on the Rejuvenating Health podcast are solely those of the speakers and are intended as such. Please consult your trusted healthcare practitioner for medical advice. Let's go, girls.
SPEAKER_00All
GLP-1 Hype Versus Real Risks
SPEAKER_00right. We're just going to say it. The LP ones are not going anywhere.
SPEAKER_01We haven't done an episode on these in a while. And they are not even close to going anywhere. Um, they're exploding right now. And honestly, I don't want them to go anywhere. I think that they're great drugs if used in the right situation.
SPEAKER_00Yeah, like if they're used correctly, that's the thing. And I mean, they can be a super powerful tool, but I think what we're gonna talk about today is that that's not always the case.
SPEAKER_01Yeah. I mean, to be honest, like here's my hot take. I'm seeing just as many disasters with them as I am success stories.
SPEAKER_00But we only get the success stories and the highlight reel and the promo and the advertising versions.
SPEAKER_01Exactly, exactly. So here's kind of the reality that doesn't get talked about. I'm talking about like your sunken in face, your hair literally just like falling out, the muscle wasting, the osteoporosis. They can be gut wrecking, wrecking. I mean, we're talking like full-on malnutrition that these people are having.
SPEAKER_00Yes, and you would think that those things would be enough to stop people in their tracks, but no, people will do anything to get skinny. Right.
SPEAKER_01And it's not even skinny, it's like skinny fat. Sorry, like you know what I mean? But okay, here's the part that matters it's not the drug that's doing it. The drug is not bad. Like the drug is amazing. Like the stuff that that drug can do, as far as weight loss, inflammation, the drug is amazing. Like one of the best tools and things that has come out of medicine. It's how the drug is being used. That's the issue.
SPEAKER_00Yeah, and the reason why we're talking about this today is because this side of it doesn't get talked about enough. And unfortunately, we're probably not that far off from seeing a pretty massive health crisis when it comes to the use of GLP1s.
SPEAKER_01Yeah, and some of this is why I mean, I talk to people all the time that don't lose any weight on a GLP1. Zero, zero pounds. So let's talk about like what GLP1s
What GLP-1s Do In The Brain
SPEAKER_01actually do. And I know that we've done this before, but it's good to rehash it out. So it's grammas and some physiology. GLP1 receptors live in your hypothalamus, which is part of your brain that controls hunger. So when you take a GLP1, it activates lots of sciencey it activates these neurons for satiety, it suppresses neurons for hunger, so it makes you less hungry and feel fuller.
SPEAKER_00Yeah. So it's basically telling your brain, sending messages to your brain that you do not need food.
SPEAKER_01Right. So if you're someone that's already eating 800 calories, you don't need less food. Like right. So you exact your body though, like your brain is saying, okay, I'm full. I don't need more food. But your body, your muscle, your thyroid gland, your mitochondria, which are your inner G cells, like they still need fuel. They still need nutrients to work properly.
SPEAKER_00Yeah. So now there's a mismatch because your brain is like, nope, no food needed here. No, thank you, right? When the salesman comes to the door with the food, and then your body's like, but wait, we actually really need that. Like, please feed us.
SPEAKER_01Yeah, like appetite's gone, but your biological demand is still there. Still there.
SPEAKER_00Our body's still, you know, hopefully functioning. Like if you're not using lifestyle habits, maybe it's not functioning as ideally as it should, but you're still breathing, working, doing all the things that you would do on a day-to-day basis. So the need for caloric energy is not, it doesn't disappear with the with the hunger hormone.
SPEAKER_01Yeah, exactly. So this is where we get fired up. No one's
Overdosing And Zero Monitoring Problems
SPEAKER_01telling people, like you go to your PCP and you get put on standard dosages, and every four weeks we're going to increase that dosage. No one's talking about how the doses are way too high. If you're losing weight on a GLP1, you should never be increasing the dosage. You're getting these from an online company. They're not monitoring your weight, they're not monitoring your side effects, they're not monitoring your duration, they're not talking about cycling on and off of them, they're not coaching your behaviors, they're not talking to you about your nutrient deficiencies, like your protein and vitamins and nutrients and all that type of stuff. It's like, here you go.
SPEAKER_00And they're definitely not talking about you know what's needed to support that weight loss journey as far as, like you said, like the protein, but also movement and lifestyle habits.
Protein First And Muscle Preservation
SPEAKER_01Yeah, like the muscle loss that you can get on them is is real. And it's a lot more than just eat protein. Your muscle, muscle preservation requires muscle protein synthesis. So NPS, that means that at every meal, you have to hit this 2.5 to 3 gram leucine threshold, which is essentially 30 grams of protein three times a day, and you have to have a resistance training stimulus. So walking is not enough. So you're looking at doing 1.6 to 2.2 grams of kilograms for protein, which is a huge math equation. Just eat 30 grams of protein three times a day.
SPEAKER_00Per meal, right? So we're targeting a minimum of 90 grams of protein a day. But most women, honestly, most women in general, let alone most women that are taking a GLP1, are maybe averaging 40 to 60 grams a day.
SPEAKER_01Yeah, and you should eat your protein first because here's what happens like you'll sit down and eat a meal, and you literally cannot eat any more on those GLP ones. They're like, I can't that protein, like eating another bite of that steak makes me want to like throw up. So you have to prioritize the protein first. And I'm not talking about protein shakes. I'm like, like eat, eat your protein. And if you're only eating 40 to 60 grams of protein a day, it puts you in a constant state of muscle breakdown instead of muscle growth.
SPEAKER_00Yeah. Yeah. And so, yeah, you're losing weight, but you're losing the tissue that you want to keep. You're losing the tissue that is going to drive your metabolism and your endocrine function and you know, all the things that that we talk about when we talk about muscle-centric medicine and the ways that it's beneficial. And um, not to mention how that affects women specifically when we look at bone density and osteoporosis risk and things like that long term down the line.
SPEAKER_01Which is why you if you do it this way, you stay on them forever. Because as soon as you come off, you gain all the weight back because you've lost all that protein or all that muscle. Not well, protein and muscle. Yeah. So we're we're really concerned about muscle mass. We're
Thyroid Slowdown And Rebound Weight
SPEAKER_01also concerned about metabolic adaptation, especially your thyroid. When your calories drop too low, we see this all the time. Reverse T3 goes up, T3 goes down, and your metabolism kind of just hold, we're done. And it's not like you can't just throw thyroid meds on it because then you're suppressing your thyroid function even more. You have to feed your you have to feed your cells.
SPEAKER_00Yeah. And so then you have this unfortunate combination where not only are you just eating less, but your body is becoming more efficient on holding on to that weight because it's trying to adapt and achieve that homeostasis with the thyroid function.
SPEAKER_01So then when you come off, you've lost the muscle, but then also you've tanked your thyroid function. So now you have no metabolism and you have no muscle, and you're like, oh, where there's that weight, like right back on that I had lost. And this is why people rebound so hard when they come off.
SPEAKER_00Yeah, I was gonna say that's why like when they do go off of it, they see the weight come on even faster than they thought was possible or like how it's happened before when they rebounded off of diets.
SPEAKER_01Yeah, yeah, exactly. Exactly. And then there's a lot of studies about bone loss. Like, I've seen a lot of pictures and studies about the bone loss. And again, if you're doing this right, it's not gonna happen. But this one's massively under discussed. And for women, it's so important because we're such at risk for osteoporosis when we go through menopause, but rapid weight loss plus low intake, your your bones are gonna break down. You're gonna have increased bone breakdown, decreased bone formation.
SPEAKER_00Yeah, so you're like literally losing like the infrastructure of your body that's needed for support.
SPEAKER_01They're like becoming sponges, like your bones are becoming sponges. And without that protein, without some vitamin D and K2, and without strength training, like you're just gonna keep going on that path. And there is a certain age in women that once you have that bone loss, you're not getting it back.
SPEAKER_00Right.
SPEAKER_01It's done. You're osteo, you know, it's only downhill from from here. And you know, you're 80 and you have osteoporosis and you're one hip fracture away from death because you're not recovering from that.
Bone Loss Risks For Women
SPEAKER_01Then we also have this electrolyte issue that happens, which makes people not feel good essentially. So
Sodium Loss And Electrolyte Fix
SPEAKER_01let's talk about sodium because this is a huge mess with GLP1.
SPEAKER_00Yeah, I was gonna this one never gets talked about.
SPEAKER_01Yeah. So when your insulin drops, which a GLP1 is gonna drop your insulin, your kidneys excrete more sodium, and so your fluid loss increases. So then your RASS system activates. And this is why people start to feel really bad.
SPEAKER_00Yeah, they get like dizziness, fatigue. A lot of people will complain of chronic headaches.
SPEAKER_01Right. And everyone's like, drink more water, drink more water, but it's not water that you need, you need electrolytes. Like you need some sodium because of the fluid shifts that are happening, happening. And I think this is the one that we probably need to hit the most on is the gut.
SPEAKER_00Yeah.
Gut Motility, SIBO, And Malabsorption
SPEAKER_01I'm not sure that GLP1s can be healing for the gut or they can destroy the gut. And it depends on how you do it. GLP1 slow gastric emptying, like it literally slows down the movement of your food. I've also seen them if you get on too high doses, cause a lot of diarrhea. Like lots and lots of diarrhea. So you can get constipation, you can get SIBO, so bacterial overgrowth, you can get ploting, you can get poor enzyme activity. Like you're talking about not being able to absorb any of your nutrients that you're eating.
SPEAKER_00Well, and then there's like no motility. So the food that you are consuming, what little amount you are able to get in, is like just it's sitting there. And that's where many. Yeah, and that's where we have this disruption to your gut microbiome. It's like things are not processing the way they normally should. And so that the gut is a very sensitive ecosystem. Like everything has to remain in balance. And when we throw off the process that it's supposed to go through to naturally break down and empty, then we're, you know, we're causing a backup essentially.
SPEAKER_01Yeah.
Low Nutrients, Mood, And Libido
SPEAKER_01So then you've got really low intake and then really poor absorption of your nutrients. And I have also seen studies of people on GLP1s getting depression and it tanking their libido. And literally they're just feeling like trash. And I'm exhausted. Why? Well, duh, you're not eating food. So your low intake is causing low B vitamins, hello energy, low iron and ferritin, hello anemia, low magnesium, I can't sleep. All these things are required for ATP production.
SPEAKER_00Yeah, and like you talked about before with the mitochondrial need, right? Like your cells are underfueled or underfed. Like they don't have the energy to operate the way that they should either.
SPEAKER_01Yeah, so you're not just like losing weight, you're you're literally having like an energy collapse. Like, yes, the weight is coming off, but your whole body is becoming depleted. And that ties back into what you're seeing with the mood and the neurotransmitters. Like we're seeing people on these really high doses that are losing weight really fast having anxiety and depression and feeling flat. And it's because they're literally have low intake, which means low amino acids from their protein, which means low serotonin and low dopamine.
SPEAKER_00Yeah. So they're not gonna be feeling like themselves. But you know, this also gets tied back to the gut function, right? We've talked before about the gut brain connection and like how much of our serotonin and our dopamine receptors are, you know, connected to what's happening in our gut. So all of that has to be taken into account. We reference all the time the fact that the body is a full functioning system. And when you disrupt part of that system, you're disrupting other things that are it's nothing's isolated. And exactly you know, the the terrain, thinking about it as a full terrain, that's gonna be a problem. When you think about, you know, I think that people really want to look at this as like as a drug, but at the end of the day, that's not necessarily the best way to look at it.
SPEAKER_01No, and the this is not a drug problem, it is a terrain that you're bringing the drug into problem.
SPEAKER_00Yeah, like it's not the drug that's that's the issue, but it's because like we're using it that way. We're using it. Like it's not yeah, not another like as a drug, not supplementally.
SPEAKER_01Yeah, like it if you're bringing it into a terrain that is already nutrient deficient, it's already chronically inflamed, it already has gut comp your gut's already compromised, you already have hormone dysregulation. GOP1s are not gonna fix it. They're gonna literally break open that bomb and explode it.
SPEAKER_00Yeah. It's going to exasperate whatever issues are coming up because it's gonna be able, you're gonna be able to highlight, like, oh, you know, imagine like a traffic jam is backed up and it's like just moving traffic slowly, but as soon as one of those cars hits and it comes to a dead stop, everything behind that down the chain is now disrupted, right? And now it's all at a dead stop. So it's not that you're just, you know, targeting one area, what we think of as like fat loss. It's disrupting all of these interconnected systems within the body. And then if one thing or two things, usually multiple things are already off, it's gonna sound alarms to say, oh, now this shit is really awry.
Use GLP-1s As A Tool
SPEAKER_01Yeah. And again, we use GLPs. Yeah. We think they're they're great. We have patients that use them that are crushing it.
SPEAKER_00So let's let's look at like, can we talk about what it looks like when they're used correctly?
SPEAKER_01Yeah, I mean, on our patients that are crushing it on GLP ones, we've fixed the root problem first. Like, we've made sure that their hormones are optimized, that their strength training, that their weight training, that they're eating 100 grams of protein a day, that they're getting in enough electrolytes, that they don't have these crazy gut issues, that their labs are getting monitored, that their nutrition is like adequate, like not pizza, it's like good whole foods. We're putting them on the lowest dose possible and not raising it unless we're like absolutely have to. And we have a clear exit strategy. Like we know exactly what we're gonna do to come off of it.
SPEAKER_00Yeah. So in that way it's treated again like a supplemental tool.
SPEAKER_01Yeah, not yeah, not a crutch.
SPEAKER_00Right.
Coaching, Bariatric Parallels, Exit Plan
SPEAKER_00Yeah, and I the the mindset component of this is really important too, because I think again, this is why the coaching is so important when we look at these processes, because you know, people people want the shot to replace their discipline. They, you know, a lot of times it's viewed as that easy button, and I can totally understand the appeal and why that is.
SPEAKER_01Yeah, I mean, the truth is the shot like create it, it's and it's very enticing. This is very enticing when your friend has like lost all this weight and you're like, What'd you do? And they're like, all I did was go on a GLP one. I didn't have to change my nutrition or exercise or anything. And then you go on a GLP one, you're like, damn, I spent $700 this month and I didn't lose a pound.
SPEAKER_00Yeah, but if we could look at it as the way that we were talking about before, right? Like applying it to an already solid foundation, at the end of the day, like the GLP one is creating an opportunity. And then what you do with that opportunity is everything. And this is just like anything else. It's just that this allows us to collapse the timeline a little bit more where we would be able to see results. We can see them quicker, but again, it's an opportunity to see quicker results. It depends on what you do with that opportunity and how you act accordingly when you're using it as a tool to aid you in that process, as opposed to, you know, surrendering to it and signing off and saying, Well, I don't have to do any of these things, these other things, because I'm I'm doing I'm taking this and it's gonna take care of it for me.
SPEAKER_01Yeah, I mean, it's just like bariatric surgery. Why do you think people who go through bariatric surgery have to go through like months and months of counseling and show that they're gonna change their eating habits? Like GLP ones can be just as life-changing as bariatric surgery. And those people literally have to go through counseling and show that they can change their behaviors before they Yeah, because of the damage that can happen if they don't after they get the surgery. Right. But no one's talking about that with GLPs.
SPEAKER_00But it the damage is just as likely to have a different capacity.
SPEAKER_01If we keep at this rate on as a society of just like throwing GLP ones on everyone without adding a coaching component to it or without like actually fixing the terrain that it's going in, we're gonna continue to see more metabolic damage, more rebound weight gain, more nutrient depletion, like literally more unhealthier people, even though they're getting weight off.
SPEAKER_00Yeah. And unfortunately, because we're dealing with, you know, big, big pharma, big drug companies that are marketing these medications, it's not good, like people aren't gonna connect it back to the they have a really hard time connecting it to the like, oh, I didn't do the right things when I was taking this drug. It's just constantly what we hear all the time is, oh, it just didn't work for me. Or, you know, that's it, I I didn't, that one didn't work for me. So let me try this other one. Let me try this other name brand one and I'll just like cycle through all the different options. Now that's not to say that there aren't certain ones that are better suited for different people. There's a lot of nuance to that, and just like HRT, it's a little bit of an art form. And that's even more why it's important to work with a coach to be able to see how your body's responding to it. But again, the entire point is that you are aiding this medication. Like you're doing the everything that you can within your control to be able to prevent the worst case scenario as far as symptoms go and what the the bad things that it could happen to your body, and also to make sure that you are getting what you want out of it. Like it can be really great, like you said.
SPEAKER_01I mean, I don't know how many people that we've worked with that have been on a GLP one in the past and haven't lost any weight. And then we fix the terrain and they're like chugging away and they have a clear exit strategy and they're not just like throwing their money down the toilet.
SPEAKER_00Yeah. And I also want to name that it's hard to do those two things simultaneously out of the gate, which is why most of our clients, like if they come to us and they're itching to get on a GLP one, like that's not the purpose of the program. And we're very quick to say, we need to be able to improve lifestyle habits for a certain period of time first before we go there, because it's doing you a disservice. If we say, okay, we'll put you on a GLP one and then simultaneously we're gonna try to get you to increase your protein by double what you're currently eating. Start working out when you're feeling like shit because you're taking this medication and you're not eating enough on it. Like that's just counterintuitive and it's not actually serving its purpose. That is why we set the stage with improving the lifestyle habits first and getting you to a place where that becomes the new default, the new normal. And then we can introduce the aid of the tool of the medication. But if we try to do them at the same time, then it's going, it's not gonna serve you in the long run, and you're gonna run into the same issue that what we've discussed in this episode.
SPEAKER_01Yeah, I mean, there's not hardly any patients that we stick on one right at the beginning, unless there's like outliers. Yeah, there's gonna always be outliers. Like that's why everyone's an individual and we treat everyone like an individual. But there's, you know, that's why we built what we did. So
Share, Questions, Reviews, Final Takeaway
SPEAKER_01if you're on a GLP one, if you're thinking about a GLP one, if your friend's on a GLP one, if you're curious about a GLP one, like, you know, share this, send us a question. We're happy to answer. Um, you know, all of those types of types of things. But we just want people to use these safe and effectively because we do believe that they're a really, really great tool, but we do believe that they can also cause a lot, a lot of damage because we've seen it.
SPEAKER_00Yeah, and it's again, just like anything else, anything else that you're taking into consideration when it comes to medical intervention, there's always a good and a bad to everything. And so can you be an advocate for your health? Can you be responsible in the way that you're using it? And can you seek support and help to make sure that it's being facilitated properly?
SPEAKER_01Yeah. So like and share, give us a five-star review. GLP ones are not a tool to create health, they create a healthy metabolic environment, and then your habits decide whether you're uh whether it's gonna build you or break you, essentially. Yep. Yep, exactly.