Bariatric Surgery to GLP-1s: Weight Maintenance and Patient Advocacy w/ Zach Niemiec

Why does maintenance feel like quicksand even after you've lost the weight? And what do you do when even people in the obesity space tell you you "don't look like you need" the meds anymore?

Patient advocate Zach Niemiec, a former bariatric patient who lost 150 pounds on a GLP-1, joins Ana to break down the messy maintenance years — and why he calls this moment in obesity medicine a Renaissance.

About the guest:
Zachary Niemiec, MBA is a patient advocate, Certified Health & Wellness Coach, and Vice President of Global Partnerships & Patient Advocacy at ProCare Health. Zach has been on a lifelong journey with obesity, navigating bariatric and metabolic surgery, medical weight management, and the realities of long-term treatment and lifestyle change. His work focuses on advancing compassionate, evidence-based obesity care, addressing nutritional gaps that can arise during treatment, and helping ensure patients have access to practical tools that support long-term health.

Connect with Zach on TikTok: @lucky_finz | Instagram: @lucky_finz | LinkedIn: Zachary Niemiec

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🤝 This episode is sponsored by Brello Health
Online wellness care plans for women, including GLP-1 and NAD+ therapies under medical provider guidance. Learn more at https://www.brellohealth.com/

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*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

Transcript

SPEAKER_02 0:00

The word that I did not realize describes this period in obesity medicine the best is Renaissance. We are in a treatment renaissance. There's even newly endorsed bariatric surgeries. There are new techniques of doing the previous procedures, including endoscopic gastric sleeves now. Safer, less invasive. And I do know that there are also investigations into doing different styles of bariatric procedures too. So we could be getting more surgery options. We could be getting more GLP1 options.

SPEAKER_01 0:34

Welcome to the GLP1 Hub Podcast. I'm Anna Reisdorf, registered dietitian and GLP1 user. Today I'm joined by Zachary Mimick, a patient advocate, GLP1 user, and former bariatric patient who lost up to 150 pounds with GLP1 treatment. In this episode, Zach shares the complicated path that led him from bariatric surgery to GLP1s and how a fatty liver diagnosis and a painful professional stigma experience shaped his passion for advocacy and why he describes maintenance as messy and sometimes like quicksand. We also talk about body composition, protein, resistance training, access issues, and why patient stories matter in changing the conversation around obesity. And if you enjoy our podcast, please consider leaving a quick review on Apple Podcasts and Spotify. And if you're listening on YouTube, make sure you share your thoughts in the comments. Now let's get on to the episode. Welcome to the GLP1 Hub Podcast. I want to welcome today Zach Nimick. He is a patient care advocate and also a GLP1 user. And he has a very, very interesting story to share about his own personal journey. So could you introduce yourself, Zach?

SPEAKER_02 1:51

Sure. Yeah. My name is Zach Nemick. I am a GLP1 user. I'm also a former bariatric patient. Um, and we'll dig a little bit into that uh too as we, you know, talk today. Um, because I I think it's a very uh unique side of my story that that I like to share with people. But uh I've been utilizing a GLP1 now for a little over two years, um, and my max weight loss was 150 pounds with it. Um and aside from that, uh I do uh work in the dietary supplement industry as well as in that industry. I've been blessed with a role that allows me to continue patient advocacy as well and fight uh stigma, you know, making sure that language is getting updated, working with practitioners to just serve this community and the the broader obesity management community. Um I I'm kind of everywhere right now. I'm gonna be all over the conference circuit this year, and um, you know, I'm just really excited to be jumping more than headfirst into this this world.

SPEAKER_01 2:58

Sure. So why don't we start from the like I guess the beginning? So yeah, where did this struggle start? And then kind of what is the timeline around the bariatric surgery and what were the results there? Like whatever you want to share about that. Yeah.

SPEAKER_02 3:12

Uh so like many, my weight struggle started when I was young. And I actually had my first, let's call it a surgical intervention when I was 16. I had the lap band and it did work well for a while for me. I was able to reduce my weight about 80, 90 pounds in that range, and you know, for the most part, keep a large majority of it off for a long period of time. However, in my early 20s in college, at some point that band had slipped. And first I noticed that the weight was kind of slowly creeping up, but it wasn't a lot. But then my reflux got really bad. And so I went and, you know, sought a new uh bariatric surgeon. They did tests, they were like, yes, your band has slipped. This needs to come out, and you know, we'll convert you to another procedure at that time. Well, they went in, but my body had coated the band with so much scar tissue and my stomach that they spent the entire surgery actually removing the band and chiseling scar tissue out of my stomach, essentially. So they closed me back up and I had neither a gastric bypass or a sleeve at that point. I was so I remember coming out of the anesthesia and being like so disappointed. I was like, I why is it my fault? Like, I I remember all of that, and um it it was not a good thing. But when my tool was gone, guess what happened? All the weight came back and then some, and I had to wait a year before I could go through revisional surgery at that point, and so you know that's and takes a toll. And I ended up getting up to 327 again. Um, and then I went in and I had to consent to either getting a sleeve or a bypass because they weren't sure exactly what they were going to see, you know, going back in again. Um, and when I went in, they did a sleeve and I had a hiatal hernia. So they did a repair, unbeknownst to me at the time because I was still relatively young and maybe didn't know to ask the questions, but they only removed about five or ten percent of my stomach. And they did a method of repairing the hiatal hernia where they pull it down below the diaphragm and take that retained fungus, that round, stretchy curvature of the stomach for someone who doesn't know what fundus is, and they tack it into place so that the hernia can't go pull back up above the diaphragm. Uh, at you know, I was very successful with my sleeve. Uh I lost a hundred pounds, uh, it was doing great, and my sleeve came undone. So it came undone because that tack, like that they had done to prevent the hernia, it failed.

SPEAKER_01 5:43

Your body just didn't want it. It didn't want anything. Like, nope.

SPEAKER_02 5:46

No, it just and so I started gaining weight and my reflux started getting bad. So I went and I was basically told, you know, your option at this point is probably to go get a gastric bypass. I kind of dragged my feet on that for a while. I then that kind of put us in that COVID era. And the reflux was just getting so bad. And I was like, I really don't want to bypass right now. My mentality on that has changed, but um, I ended up going and getting a reflux procedure. Well, I got a second opinion, got a reflux procedure done called the Lynx device, and my reflux is now largely controlled, and I'm thankful for that. But that didn't really do anything to address my weight. And shortly after I got that is when we really got on the road to my GLP1 journey. And that is I started, I had several years of very unexplained digestive dis uh, you know, and and just symptoms. And I saw four gastroenterologists, I had five colonoscopies and an endoscopy during this time. This, like it was like a two and a half year window. And finally I ended up at the Cleveland Clinic, and I was very fortunate that a doctor there walked into the room and said, I'm not the doctor for you, but I'm going to help you. And he's like, based on everything that I see, um, I'm gonna prescribe you a medication that's for cholesterol, actually, but I'm prescribing it to you off use because what this medication does is it binds to your liver bile. And this is gonna tell me if too much or too little is potentially entering your digestive tract. Lo and behold, two weeks on the medication, it was like I was completely brand new. And I called him back up and he was like, I didn't fix you, I've just masked what's going on. You need to go see a heptologist. So I got on a waiting list to see a heptologist where I was living or a liver doctor for those of you I don't know, heptologist. And in between there, I actually experienced a let's call it a fat-shaming event in a professional space where I was told by a superior that I didn't look like other people who should be talking to professionals in the obesity space that I was in. And I went back to the hotel room that night and signed up for compounded GLP1s, but it was still a couple of months uh before then, before I actually had started. But uh I ended up starting December 1st, 2023 while I was waiting to see the liver doctor. I was not able to see the liver doctor until March of 24. Oh my goodness. First time because there was just that high of a waiting time. And I started losing weight, and I got to the liver doctor, and the liver doctor said, Well, unbeknownst to you, you've started treating your non-alcoholic fatty liver disease. Um, and that is what I ended up getting diagnosed with, and I was at about a mid-stage of it, where if I would have progressed much longer, the scarring and fibrosis would have developed rapidly at that point. Thankfully, I've now reversed it as of May of 25. I was declared in remission from it because of my weight loss. And now I'm being monitored yearly by my new heptologist. And yeah, that's that's kind of getting to that point. You know, I mean, I I cut out a lot of details in there, but um my my journey had that's the weight loss portion kind of of the journey, if you will. Um I was actively losing between December of 23 and May of 25.

SPEAKER_01 9:17

Okay.

SPEAKER_02 9:17

Um, and that's kind of when I believe I started to shift into a uh flexible maintenance period, if you will. Uh, because I view maintenance in two different ways.

SPEAKER_01 9:27

Okay. So which medication are you on now? You said you started with compound.

SPEAKER_02 9:32

Yeah, so I'm still on compound. Um, I've unfortunately not had insurance access to branded, um, and I still find the cash pay options a little out of my range, but I'm hoping to transition to them at some point. But I started with compounded semaglutide and I was on it for a little over a year. Uh, and then my provider and I moved me to trzepatide and I'm on compounded. I'm still on that, and we're now trying to figure out what an appropriate maintenance dose will be for me for the long run. And that's why I say it's that kind of like messy maintenance um, because it's it's not quite figured out. It's kind of like quicksand a little bit.

SPEAKER_01 10:06

Yeah. So it's been about a little less than a year then that you've been on maintenance.

SPEAKER_02 10:11

Yeah. I yeah. So in about two months, I'll be approaching that year in maintenance.

SPEAKER_01 10:16

Okay. And so for this particular period with the GLP one, how much did you lose with the GLP one itself?

SPEAKER_02 10:21

So my max weight loss was about 150 pounds.

SPEAKER_01 10:24

Okay.

SPEAKER_02 10:25

Um, uh, yeah. So I started a GLP one at 305 and I got down to 154. Um, I'm I'm now back up a little bit, but that's because of my body recomposition journey that I've really aggressively started last May, I would say, as I was entering maintenance. Um, I was doing mainly cardio during the whole losing phase and wasn't doing a lot of resistance training. And now I've kind of completely flipped it where I'm now like 99% resistance training and like not very much cardio anymore.

SPEAKER_01 11:01

Taking charge of your wellness starts with knowledge and guidance from a provider. Brello Health offers wellness care plans for women focused on longevity and overall health. Their programs let you explore GLP1 and NAD plus options in consultation with a medical professional. Everything is handled online, making it simple to review available care plans and speak with a provider about what might be right for you. Visit Brello Health today to learn more about their wellness care plans. Disclaimer: any information provided is for informational purposes only and should not be construed as medical advice. It is not a substitute for professional medical consultation, diagnosis, or treatment. All patients must consult with a health care provider prior to the prescription or dispensing of any medication, which will be done only pursuant to a valid prescription. Compounded drug products are not FDA approved, and the FDA does not evaluate their safety, effectiveness, or quality. Patients are encouraged to discuss the risks, benefits, and appropriateness of any medications, including compounded products, with their healthcare provider before use. So talk to me a little bit about maintenance. Like, what is that looking like? Like what are you, how are you working with your provider on that? Because I'm on maintenance too. It's been about a year. And I tried a little lowering my dose experiment and gained three pounds last month. So I'm like, eh, well, maybe I'll just stay where I am. Um so I don't, I don't have an answer. People ask me all the time, what do I do for maintenance? What I'm like, I don't, I don't know.

SPEAKER_02 12:41

So that's why I call it messy maintenance or quicksand, because it really is ever shifting. And again, it's a great time to remind people that obesity is a chronic relapsing remitting disease. And so, like, I like to say sometimes when you give the disease back an inch, it's gonna try to take more than that inch. Um, and that's not to say that we have, but like, you know, the little tweaks that we do here and there, we're trying to see if it adds positive or does it go the other way? And so I for maintenance for me, I've split my journey a bit. So maintenance has been primarily about staying within a 10-pound range on the scale. And then the second half of that is all of my body recomposition goals. I view them as both maintenance journeys, but parallel to each other because what happens in one may affect the equation in the other. Like I am now at a point where my provider and I are having conversations that my 10 pound range needs to be updated because we've not we've not touched my 10 pound range since May of last year. It was between 155 and 165. That was the 10 pound range we had set for me. Um, and it was like, hey, even if you pop slightly out of that, as long as you kind of fli ebb and flow back into it, like let's not panic. Well, I'm now about 169 and since my lowest, I'm now, you know, you could say I'm up about 15 pounds since my lowest weight on this journey.

SPEAKER_01 14:09

Sure.

SPEAKER_02 14:10

But I know that's largely due to my recomposition journey on the other side. And I work out five days a week doing resistance training. I've I'm on the road to skin removal surgery in September, and that is what's driving a lot of this movement and the routine that I am doing. In fact, tomorrow, I know we're recording this, but tomorrow I'm headed for my next DEXA scan. DEXA and SECA scans are very important data points to me. The scale, I'm almost completely broken up with at this point. I've moved to relying more on these other data points, such as my blood work and then these body composition scales, to inform me and my practitioner about how we're continuing on. And then I also work with a dietitian, big fan of dietitians. And between me, the dietitian, and my provider, we're now trying to figure out my dose.

SPEAKER_01 15:00

Okay.

SPEAKER_02 15:01

And because I was on compound, uh, there is a lot more dosing flexibility.

SPEAKER_01 15:05

Sure.

SPEAKER_02 15:06

So when I switched from semaglutide to trusepatide, I went from 2.4 right to 10. There was no titrating between the two. That's just how they started me. I didn't have any side effects with it and I was fine. But I never actually went above 12 milligrams of trusepatide. I'm now back on 10. That is where I am. And we're now having conversations of well, we you've been on 10 now. This will be your fifth week, back on 10. Maybe after a couple more weeks, if things are still calm and food noise is controlled, but you're able to eat more. And I'll get back to the eat more part. Maybe let's try nine. Let's like continue to, you know, kind of move down towards that standard dose of 7.5. Now, when I say eat more, is because of how much I'm working out. Sure. My macros have greatly changed and they're different than someone who's in that weight loss period. And um, my dietitian has me on a 22 to 2400 a day calorie range. I'm also between like 180 and 210 grams of protein per day because of just how intense I'm I'm going. I do about 90-minute workouts each time I'm in the gym, but my body composition has radically changed. And I've I've gotten the data to prove that as well. My last DEXA scan was in September. Um, my prior one to that was last March. So there was a six-month window between the two, and I went from um 20 um 22.7% body fat on that scan to 12.4.

SPEAKER_01 16:45

Oh my goodness.

SPEAKER_02 16:46

So there was a 10% body fat reduction between those two. Now that's just one, you know, methodology. So, and then I'm I I've used Sika body composition, which is a BIA uh bioelectrical impedance uh type of evaluation. And my numbers with Sika have been showing similar things except a lower lean adipose mass. They have me just under 9% body fat on Sika. So I'm getting a DEXA scan this month, and I'm getting another SEC uh scan next month, and then I'm gonna coalesce the two data points together again and then reassess where I need to go. And for me now, it's not weight, it's not the body fat percentage, is both of my last sets of scans have showed that my trunk and chest have been growing at a slower rate than my arms and my legs. So I've changed my workout behaviors over the last six months based on that data to try and help my trunk along more. And this is going to be the measurement, the first measurement of hey, did we achieve getting a faster growth rate in the trunk? But also did we continue to add lean tissue overall to the whole person? And how much did we add?

SPEAKER_01 18:02

So between those two for initial six months, did your that was already while you were in maintenance?

SPEAKER_02 18:09

It was it was the tail end of losing and then a large part of maintenance because it was March to September. So my weight did go down a little, but it was about 10 pounds between March and May. And then after that, it was fairly stable.

SPEAKER_01 18:22

Okay, so not really a huge amount. So the body fat change was really due, not necessarily to like weight loss, but the effort that you've put in at the gym.

SPEAKER_02 18:32

Yeah, it was the the technician was blown away because like it was the same guy. Uh uh, and I'm going to see him again. This is gonna be my third DEXA with him, same machine, same office. Like I'm trying to stay consistent with you know the things that I'm doing. And I'm very much looking forward to it. I I kind of expect because I've weighed more than I did the last time, that maybe the the fat percentage will show more. And DEXA doesn't quite know how to interpret the loose skin. So there is that part of it as well. But it's a general data point for me, and that's why I use both methods and then kind of average together to make sure that the trends are there. And that's also why I'm not freaking out about the scale, because I'm technically about four to five pounds outside of my maintenance range right now. I don't know about you, but at any point in my journey prior to this, if I was outside of where I needed to be, I would have freaked out already.

SPEAKER_01 19:28

But with a 9% body fat, you're clearly very metabolically healthy. I mean, if that's where you still are, you know. So we'll we'll see a smarter way.

SPEAKER_02 19:39

Yeah. And and so for me, these next set of body comp scans are actually about validating that I don't need to freak out about the number on the scale. And it's almost like the final nail in the scale's coffin for me. Because if lean tissue is still going up and improving, I'm doing everything I need to be doing, and my labs continue to be good, that I'm healthy. And then we know BMI, like, of course, my BMI starting to go back up because I'm putting on more muscle. We know it's a flawed system. So it might actually show that I'm overweight again at some point because of muscle mass. Sure. Now, I'm not trying to become a bodybuilder by any means with any of this, but this is all now connected to my skin removal journey that's coming up in the fall.

SPEAKER_01 20:24

Sure, sure. So let's switch gears a little bit and talk about your patient advocacy that you do. Yeah. So what inspired you to do some of that and and really try to educate the people? Because before we got on, I was scanning on Facebook and there was a an article that came up about somebody's deaf now from Ozempic or whatever these articles are. And the comments are just horrifying. Like it makes me want to cry. So share with me a little bit about that experience and and what you're trying to help the people with.

SPEAKER_02 20:53

Well, so it boils down to the core that I believe that anyone who needs uh whether it's this class of medication, other obesity management medications, or other obesity management treatments like bariatrics should have access to them, but not just access, they should have the ability to utilize the care that they have access to as well. So that's that's you know the mission, so to speak. But for me on this journey, I've had to do this all out of my own pocket. And but I've seen the results that I've gotten, and I'm like, don't you dare take this away from me. I will, you know, climb every mountain, go through every, you know, forest and river I have to to get my hands on it to stay, keep my obesity well treated. It because I know it's still there. I still have obesity, it's not gonna go away, but it's well managed right now. My skin removal surgery, denied. No coverage for that either. Again, another thing that I'm paying for. And guess what? The insurance company just gets to benefit from the fact that they didn't pay for my meds or they're not paying for skin removal. But they're collecting premiums and I'm healthier and I'm gonna be utilizing my plan less. They're the real winners here. I hate to say that, but that is part of the reason why I'm doing my advocacy work is we have these treatments. They need to be available to people, and people need to be able to use them if they are actually covered. I just went through a huge fight with my mom's insurance. Denied, denied, denied. They sent her a letter at first that said, hey, Wagovy is no longer our preferred GLP one on your plan. You need to switch to Zetbound. This was at the end of, it was like mid year last year. And during that whole CVS care mark thing. And they then denied her for Zetbound and then wouldn't put her back on Wagovy.

SPEAKER_01 22:48

Such a game.

SPEAKER_02 22:49

So she moved to compound to maintain her care temporarily. Said her plan insurance said when your plan resets January 1st, try again. We did with her new primary care. Denied. I ended up putting together a 57-page appeal, including photos of her gym membership, notes from her dietitian, notes from her pri current primary care and past primary care. And I even put the surmount data in there and her sleep apnea report. And it was a huge, huge appeal. Finally got it approved. She now has access to these medications with a copay. Um, and an affordable copay. She's fortunate enough,$50 for a month's supply. Which that is really the mission here is having your doctor be able to write you the script for the treatment you need and be able to go to your pharmacy and get it at an affordable price. Or if you have bariatric surgery coverage and surgery is deemed what is uh appropriate for your care, that your plan approves it. Sure. And allows you to move forward and covers it for you for an affordable copay deductible situation.

SPEAKER_01 24:03

Mm-hmm.

SPEAKER_02 24:05

So that's really what drives it all. And I've seen a lot of stories. I've seen so many people like you have at this point who have had such benefit. And I was recently on vacation, group of people, I met this person, and the shots came up as dinner conversation. And I kind of was sussing out the direction, and I just kind of, you know, I was like, Well, you know obesity is a disease, right? And zipped and started to try to find out what the response was. And there was some hemming and hawing, and and someone was like, Well, I know someone who did the shots and then they stopped and they gained it all back. And I was like, Well, because it's a disease, if you stop treating it, it's bound to kind of come back and relapse. It's like if you stop treating heart disease, do you expect your heart to stay healthy? And so it was interesting, and it was kind of going back and forth, and finally I just said, I'm on the shots, it's like constantly coming out of the closet. Sure. Um, and the woman immediately next to me go, Why the hell are you on them? You don't look like you need them.

SPEAKER_01 25:04

I get that all the time too. And I'm like, now I can.

SPEAKER_02 25:14

And now I've I've chained, but I still need them to keep my condition in check. So there's a lot of education to be done, and that article you mentioned is a clear indicator that there's much work to be done. I unfortunately think a lot of the news sites are still picking the clickbaitiest headlines so that they can drive people to their sites. And that is why it's more important about the work that you're doing with this podcast, other ones that are out there, blogs, things that are that are putting real evidence-based materials out into the public, and also at the same time that working to reduce the stigma, not only about using the medications, but about obesity itself. Like this is a huge education push. And it's very interesting to me. I've seen data starting to come out that the younger generations are seeing weight less when like when it judgment when it comes to their like peers in their age groups versus the previous generations that they're actually having a less of a weight bias. And I'm like, amen, it's already starting to pay off. But now, can we advance these treatments and make them available? So maybe that we can have a generation in the next one or two that potentially we could get to grow up without childhood obesity. That is where I want this all to head because I want people to have a better shot than I did now. Of course, I still want to continue my treatment, but I just want to continue to make the system better for the people behind me. Sure. So, you know, that's where all of my work is based.

SPEAKER_01 26:44

Yeah, I think that there's, I mean, just with commentary that I get with this channel is you should have just tried harder.

SPEAKER_00 26:52

Yeah.

SPEAKER_01 26:53

And that is frustrating. I became a dietitian because of this. So I don't know what more I could have really done to try to manage it. So I I appreciate those of you know, you and a lot of the other, and I believe you're involved with the obesity society too.

SPEAKER_02 27:08

Uh yeah. So I'm a member of the Obesity Action Coalition. Um, and uh I I love what they're doing with patients. It's very important work.

SPEAKER_01 27:19

If you're in a GLP1 and you're feeling overwhelmed, confused, and trying to piece together information from random Facebook groups. I built something just for you. This is the GLP1 Hub membership. It's a supportive, evidence-based community led by me and a fellow registered dietitian designed to help you feel your absolute best, stay consistent with your goals, and understand what your body really needs while on your journey. So inside you're gonna find nutrition guidance, support around creating habits, vetted resources, and a community of people who really gets it with no judgment, no misinformation, and no extreme diet plans. So if you're wanting a little bit more structure around your journey and you want real answers and ongoing support, this membership is for you. Starts at just$9 a month, and you can learn all of the details at GLP-1Hub.com backslash membership or find the link in the show notes. And I hope to see you inside. And so I think that that that those of us like that are trying to get this message out that it really is an ongoing management and not just like a get on, lose some weight, easy way out thing, I hope that that will change these insurance companies because they do not want to pay for it.

SPEAKER_02 28:35

No, they're they're really the ones benefiting. And I'm not really a big conspiracy theorist, don't get me wrong, but you know, I noticed they're the ones who have also kind of stayed quiet on this whole compound battle that's out there. Because if people are choosing to pay for compound and getting healthier, uh, they're again, like I said, they're the ones benefiting, and so they're not getting involved in the fight with pharma and you know, the FDA at this point, because as long as they're not paying for the meds, they're winning right now, so to speak. And I hate to say that because isn't the real win for the insurance companies the people on the plans getting healthier? Like, shouldn't shouldn't that be the plan? Because then then people would be going to the doctor less, right? Like, does it isn't that what the logic should be?

SPEAKER_01 29:22

Should. But I don't I don't think it, I don't think they think that at all. They think ROI, let's say just the perfect world.

SPEAKER_02 29:28

I'm in I'm in La La Land.

SPEAKER_01 29:30

Um, so what do you see as the future of GLP one or maybe even obesity care? Like, what are you hoping for?

SPEAKER_02 29:36

So this is where I'm blessed. I uh like I've gotten to go to many conferences like the Obesity Society's Obesity Week. I've gotten to, I'm going to the Obesity Medicine Association's conference this year. I'm actually about to head up to Montreal for the Obesity Canada conference. And then, of course, uh, I'll be doing ASMBS, the American Society for Metabolic and Bariatric Surgeries conference this year. So I'm being afforded a lot of educational opportunities and being able to sit through these sessions, like one at Obesity Week, that was talking about obesities, not just obesity, and that they're trying to phenotype or group different conditions together was very interesting and exciting to me because we know that there are so many different GLP ones or different combinations of agonists all being in clinical trials right now, whether it's stage one, two, or three trials. But it sounds like every day we're hearing about another one that's being evaluated. The word that I did not realize describes this period in obesity medicine the best is renaissance. We are in a treatment renaissance. There's even new, newly endorsed bariatric surgeries. There are new techniques of doing the previous procedures, including endoscopic gastric sleeves now, safer, less invasive. And I do know that there are also investigations into doing different styles of bariatric procedures too. So we could be getting more surgery options, we could be getting more GLP1 options. And the thing that I try to drive home to people who I talk to that they're calling themselves slow responders or non-responders is you might just not have the perfect combination yet for your version of obesity. Yeah. But I also tried to remind them are you getting any benefit out of this med? Like, are you getting the food noise reduction? Are you getting inflammation reduction? Did you lose anything? Um, and I said, well, we're waiting for that next generation one for you to try that might be the secret sauce for you, you're getting benefits. So work with your practitioner to try and keep your disease in check as best as you can. Take the benefits because the benefits are better than going back.

SPEAKER_00 31:51

Yes.

SPEAKER_02 31:51

And and so I'm very excited about where we're going. I I don't think we'll ever eliminate obesity, don't get me wrong. But I think this fight, both surgically and pharmacologically, is going to have other impacts on our system, including food.

SPEAKER_00 32:08

Yes.

SPEAKER_02 32:09

And and um, we're already starting to see it a little bit, but it's not, I I mean, our food needs to get cleaned up. And and I really hope that that this push helps to continue to advance that front of advocacy as well in in, you know, making food better for us here. Because when you're eating more fake than real, it allows the disease to kind of creep in.

SPEAKER_01 32:31

Yeah, absolutely, absolutely.

SPEAKER_02 32:33

More so a good method of it. Yeah, I'm very excited. I'm very excited to just continue to try and play my part in this community going forward, whether it be in my professional space or some of the like panel discussions that that me and another patient are starting to organize as well to try to bring practitioners and patients into the same room to have these conversations so that we're not talking about this disease or these conditions in silos.

SPEAKER_01 33:01

Yes.

SPEAKER_02 33:01

Um, and that we're we're talking about them together.

SPEAKER_01 33:04

Yeah, I think that that's really, really important is to see the real perspective. I think we don't always, always get it. So where can people connect with you, Zach? Online or yeah.

SPEAKER_02 33:14

Um, so I am available on TikTok mostly. My username there is at lucky underscore fins f-in-z. That is the easiest place to find me. It's the same on Instagram as well. I'm on LinkedIn too. Um, full name Zachary Nimic. If you want to find me in the more professional channel, I also do uh blog posts on ProCare Health's website, specifically around patient needs and advocacy stuff. I do work for ProCare, so that is my one disclaimer that that it's who I work for, but I'm their uh partnerships and patient advocacy VP. So I I'm really truly blessed that I get to have all these educational opportunities and the chance to advance advocacy for patients all across, you know, the world with this.

SPEAKER_01 34:01

So awesome. Cool. Well, I'll make sure to put all those all those links in the show notes. And I really appreciate you sharing your story with such honesty and and bravery. I I really, really appreciate this conversation.

SPEAKER_02 34:10

Yeah, I I mean if I could leave one final note to just listeners about the sharing piece. You don't need to get on social media to share per se, but if you see the window to share and you're on one of these or have had a successful bariatric surgery, and if it's just a passing conversation with a stranger, you don't necessarily know how you're going to impact that person. I believe that sharing is like that tiny little snowflake at the top of the hill. And as it starts to roll down the hill, it gets bigger and bigger, and then all of a sudden you've got a snowball and then you've got a massive one. What you do might impact one person, but that can continue to spread out to a lot of other people. So don't think your story isn't worth sharing either, or that your story is the same as everyone else's, because I guarantee you it's not. So we all might have some similarities, but we all are dealing with something else too.

SPEAKER_01 35:06

Yeah, absolutely. And that's why I like to share some of these patient stories here on the podcast because they all are very different. That's what I'm learning. Everybody's got their own journey. So thank you again, Zach, for being here.

SPEAKER_02 35:15

Yeah, no, thank you for having me.

SPEAKER_01 35:17

All right. Thank you so much for listening to this week's episode of the GLP One Hub podcast. I hope you learned so much from Zachary's story. It was like just so many ups and downs and so much that he went through. As you can see, obesity is really not a just clear, straight line. It's definitely a journey. And it is time now for our question of the week. And this question comes from one of the members in the GLP One Hub membership. And she asks, How do I know if I am eating enough? I've gotten to my goal weight. I weigh 120 pounds, but how do I know if I am eating enough protein, calories, any of that kind of stuff? So here's my answer. If you are on the medication, unfortunately, you can't really rely on your hunger signals because medication makes you not very hungry. And so you really have to be a little bit more intentional about what you eat. A good rule, a good way to go about it is maybe consider downloading an app and tracking your calories for a few days. Put it on a maintenance level for your current weight if you're already on maintenance. Select the minimal weight loss. I know that some of the apps allow you to select like half a pound a week, one pound a week. I'm gonna really minimize that. So, like a pound a week max, select that for your calorie needs and it should fill out the uh protein and carbs and all the things that you need so you can get an idea. I don't recommend people always tracking their calories, but it can be helpful for a few days to see if you're getting anywhere near what your needs might be. If you really want to be very specific about it, or you're not feeling good, you're having low energy, or your hair is falling out, or you're experiencing other types of side effects. You can also consider making an appointment with a registered dietitian. 95% of health insurances will cover at least one visit with a registered dietitian. And so that person can help you identify if you are eating enough and getting the nutrients you need on a daily basis. I hope these questions are helpful and you can always text the show with your questions, and then I will answer them on Thursday. So you select text the show and you can send me a text message and I can respond now. So if you want to do that, I will see those messages. And make sure if you need more support that you check out the GLP One Hub membership and also our store where you can find all sorts of resources that I have created just for you, including meal plans, recipes, ebooks, all sorts of things. And I'll see you in the next episode.