GLP-1s and Diabetes: What's Different w/ Erin Palinski-Wade, RD, CDCES

If you have diabetes and you're on a GLP-1, the rules are different, and one of them can land you in the ER. A 20-year diabetes specialist walks through it.

Ana Reisdorf, MS, RD sits down with Erin Palinski-Wade, RD, CDCES, a registered dietitian and certified diabetes care and education specialist who has been using GLP-1s with patients for blood sugar control long before they exploded for weight loss. They cover what diabetes patients need to do differently on Ozempic, Wegovy, or Mounjaro, how to tell a side effect apart from a dangerous drop in blood sugar, what protein and fiber actually need to look like on your plate, how to break a plateau, and the mindset shift Erin says separates the people who keep the weight off from the ones who don't.

IN THIS EPISODE
- Why GLP-1s were used for blood sugar regulation long before they became weight-loss household names
- How to tell a GLP-1 side effect apart from a dangerous drop in blood sugar
- The "balance plate" — protein, fiber, and slow-digesting carbs — and why it matters more than carb counting
- Why most plateaus aren't actually plateaus, and the three things to look at when you're truly stuck
- The mindset shift that separates people who keep the weight off from those who lose and regain

ABOUT THE GUEST
Erin Palinski-Wade, RD, CDCES is one of the most-quoted dietitians in the country and a sought-after speaker, spokesperson, and media source on nutrition and diabetes. She is the author of four books, including the bestselling 2 Day Diabetes Diet and Belly Fat Diet For Dummies, and has appeared on Good Morning America, The Dr. Oz Show, The Doctors, and QVC. Erin contributes regularly to The New York Times, The Washington Post, and Parade Magazine, and USA Today named her TikTok one to follow for relatable nutrition advice. She maintains a private practice in New Jersey and runs the Healthy Mom Happy Family YouTube channel.

CONNECT WITH ERIN
Website: https://erinpalinski.com
YouTube: https://www.youtube.com/@HealthyMomHappyFamily

SPONSORS
Tyde Wellness — sustainable weight loss with support, for women.
https://tydewellness.com/GLP1Hub — use code GLP1HUB50 for $50 off your first month

Timeline (Mitopure) — clinically studied Urolithin A to support mitochondrial renewal and muscle health.
http://timeline.com/GLP1HUB — 20% off your order

CHAPTERS
00:00  Mindset is the difference
01:21  Meet Erin Palinski-Wade, RD, CDCES
03:14  GLP-1s before they were famous
07:32  Diabetes on a GLP-1: what's different
09:09  Hypoglycemia risk and how to spot it
13:13  Protein, fiber, and the balance plate
15:09  Carb counting in 2026
16:37  Side effects and how to manage them
22:49  Why plateaus happen and how to break them
30:31  The mindset shift that separates winners from yo-yos

MORE FROM GLP-1 HUB

📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub

*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.

*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_00 0:00

Yeah, I mean doing this for two decades. There's always a new trend. There's always something new coming out when it comes to weight management. Used to be, you know, gastric bypass surgery. Now we have GLP1s. There's always something. The end of the day, the underlying thing that makes people be successful long term is really mindset. It 100% comes down to the fact that you have to understand this is long term. You're not doing anything for a quick fix. The goal is to get there and stay there.

SPEAKER_01 0:24

Welcome to the GLP One Hub Podcast. I'm Anna Reisdorf, registered dietitian and GLP1 user. And today I'm joined by Erin Polinski Wade, a registered dietitian, certified diabetes care and education specialist. She's been working with diabetes patients for two decades and was helping with GLP1s for blood sugar long before they exploded for weight loss. And we're talking about what diabetes patients need to do differently on a GLP1. How to tell the difference between a side effect and a dangerous drop in blood sugar, what protein and fiber actually need to look like on your plate. And the mindset ships shift, she says, separates the people who keep the weight off from the ones who don't. And as always, if you're enjoying this podcast, please leave a review on Apple Podcasts or Spotify. And if you're watching on YouTube, drop us a comment below and let us know what you think. Now let's get on to the episode. All right, welcome to the JLP OneHub Podcast. I want to welcome today another one of my wonderful colleagues. This dietitian has been in diabetes care for many years, well known across the media landscape and all the things. Erin, thank you so much for being here today. Can you introduce yourself to the people and tell them what you do?

SPEAKER_00 1:40

Sure. Thank you so much. I'm thrilled to be here. My name is Aaron Plansky Wade. I am a registered dietitian. I'm also a certified diabetes care and education specialist. So I really focus on weight management, insulin resistance, and diabetes specifically with type 2 diabetes. So I have a private practice where I work with clients. I have a team of dietitians that work with me. And then I also do a lot of media work in the field of blood sugar regulation, weight management.

SPEAKER_01 2:03

Awesome, awesome. So how many years have you been doing diabetes care? I feel like you're you're one of the OG ones.

SPEAKER_00 2:09

Yes. So yeah, I know. I feel like I'm aging myself, but I've been I've been a dietitian for two decades now, for 20 years. And then I was, I've been a certified diabetes educator for about 15 years now. So I really, you know, you had to be an RD for five years before you could really get enough hours and get enough experience to um get that credential. So I really tried to do it right out of the gate because I've always been working in diabetes. It was something I've just been really passionate about since becoming an RD. Um so I was really excited to kind of improve my knowledge there and then be able to help more people.

SPEAKER_01 2:39

Awesome. And so this whole time, have you had a private practice or were you working because you to get those hours, you have to have like somebody kind of sign off on them or document or whatever? Yes.

SPEAKER_00 2:49

Yeah. So I actually started my private practice about eight months after I graduated. I worked out with other dietitians and then other physicians in kind of like different outpatient settings, so I could start to build up my practice. And then so what I did with the continuing ad was there was a combination of doing practical work in other settings as well as in my private practice. And then the physicians that actually refer to you and sign off on the clients are able to count as hours there too. So I was able to accumulate the hours that way.

SPEAKER_01 3:14

Awesome, awesome. So you were using or helping people who were on GLP ones before this exploded.

SPEAKER_00 3:22

Yes. I was actually trendy before I even knew it. So yes, I was very aware of GLP ones beforehand and not in the way that we think of them now, where we think of them really associated with weight management. It was really more kind of cutting edge as far as blood sugar regulation goes and helping people to have better control of their day-to-day blood sugars as well as their long-term, like their A1.

SPEAKER_01 3:41

Mm-hmm. And so were people at that time, because the first one I believe was a daily injection. Is that correct? Yes. And so were they being compliant with that? Because I feel like the once a week is already a little rough.

SPEAKER_00 3:52

Yeah, you know, you'd be surprised. So sometimes daily is actually easier to be compliant than once a week because sometimes when you're not doing something every single day, you start to forget. So I feel like, you know, you have to set a reminder and be consistent with that particular day. But I definitely think, especially in the beginning, it was it was a little harder to convince some people. Um, just the concept of an injection, especially somebody who has diabetes, they're really trying to avoid the need for insulin for type twos. And so when they hear about an injectable medication, it almost felt to them like, oh, I'm a failure. I need to inject something. And it wasn't insulin, it was a GLP, but it was there was a lot of education around it and kind of convincing. And also finding the right person because it was really important that they would be compliant, um, not just with the injections, but with the side effects and making sure they were being compliant with their diet. So it you would kind of see, especially in the beginning, that physicians were not recommending it to everyone, but kind of wielding it out to maybe plants that had tried everything and it hadn't been working, or to those they knew would be really compliant and and follow what they needed to do.

SPEAKER_01 4:49

That's interesting because it's so, I know it's so powerful for blood sugar. And to think that they weren't like widely, because I think back then, at least I worked a little bit in diabetes care. It was like metformin was always the first you know, that was what they were given. And then there were these others that we didn't talk about quite as much. I did like a health education class and we would kind of brush over the rest of them at that time. Was that what you were seeing too?

SPEAKER_00 5:11

Yeah, definitely. So it felt like, you know, a lot of it wasn't even so much that the doctors were saying, okay, I don't want to give this medication because we knew the value of the medication. It was more really coming from the clients that they weren't widely discussed. You know, now everybody wants a GLP1 because everybody wants the benefits. Then it was like, oh my gosh, don't talk to me about something with a needle, an injectable. It's bad enough. I have to check my blood sugar. Because remember, too, this was pre-CGM. So people were already sticking themselves daily, multiple times to check their blood sugar. And now they had to take an injection that they were trying to avoid. So it was more of a convincing to the client to say, you know, this medication is going to be really beneficial, but without having it out there for a long time to really have that data or social proof. And also what I found a lot of clients were very nervous about the concept of even like family or coworkers finding out they were taking an injection because people didn't understand the difference between a GLP one injection versus like insulin. And they felt it was a sign that they were not controlling their blood sugar or maybe had failed and had to go to like this next step.

SPEAKER_01 6:09

That's so interesting how much like psychology is involved. And even now with I think even now with the GLP ones, a lot of people wanted to try, but injection was just like a no way for them. And now we have the orals, obviously. But like I think that that was holding a lot of people back.

SPEAKER_00 6:22

Oh, yeah, there's a lot of people out there that have a very um, sometimes it's a stigma, sometimes it's a fear of just anything with a needle. And so the concept of injecting themselves or even checking their own blood sugar is very stressful. And so even if there's benefits and they know it's going to help them health-wise, when it comes to that concept of a needle, there's a lot of people that just don't want to even hear about it.

SPEAKER_01 6:42

I'm not afraid of needles, but even but like I have a blood sugar monitor just because I bought one one time. I don't know. There's just like something nervous about it, like that makes noise.

SPEAKER_00 6:52

It's like the popping noise. It freaks me out too. I'm like, I'm showing a client how to do it. It does not hurt, but it is. It's a scary concept. Yeah, I don't know. I don't know.

SPEAKER_01 7:01

It's like that press the button is like, oh, I can't do it. But I'm I don't have a fear, you know, I just it's just like an anxiety thing. I think people there's definitely.

SPEAKER_00 7:09

And there's some people that are fear, some anxiety, and some it's just like another thing. You know, I mean, especially if we look at it from a diabetes perspective, it's a chronic illness. Like you're already thinking about everything, like what's my blood sugar, what am I eating, how many carbs am I having? So it's like another layer of now I have to inject and think about like how to do it and cleaning the area. So I feel like some people just get kind of this fatigue around like more things that are different that they have to consider.

SPEAKER_01 7:32

Yeah, that makes sense. So when you're taking the GLP one with the blood sugar, you you mentioned a couple of times you've got to monitor your sugars, you gotta eat these things. So, what are some of the special, maybe unique considerations that people with diabetes on GLP one have that maybe people just trying to lose weight don't have to consider quite as much?

SPEAKER_00 7:52

Yeah. So, you know, if somebody's on a GLP one and that's their only medication that they're taking for blood sugar management, we still have to figure that your blood sugar is gonna be more volatile than someone who doesn't have diabetes. You know, anybody on a GLP1 can experience some lows and highs in blood sugar, but when you are already experiencing insulin resistance and changes in blood sugar, or if you're prone to hypoglycemia, you have to be more in tune with what those can feel like and really be testing, especially when you think about some of the side effects for a GLP one, like you can feel a bit nauseous, you can feel fatigued. Those can also be signs of high or low blood sugar. So you really want to just know what's coming from the medication and it's the side effect versus what could be a change in blood sugar that you need to be aware of and and address. So it's you know, again, a lot of times that's just in the beginning or when a dosage is changed. And then once somebody's on a consistent dosage, they're usually not having a lot of side effects. We usually see more consistent blood sugar. But the biggest thing is because GLP1s do change appetite, we see a reduction in appetite, food is digested slower, there is more of a risk of low blood sugar. So it's just really being aware of that. And if somebody is more prone to that, really having um those emergency carbs on hand, knowing when to check, knowing what the signs and symptoms of hypoglycemia would be.

SPEAKER_01 9:03

So with the hypoglycemia, because sometimes I I'm a GLP1 user and I feel a little jittery if I don't eat enough. Yeah. Is that is it possible for it to dangerously lower your blood sugar if you have diabetes or maybe even if you don't?

SPEAKER_00 9:18

Yeah. So I mean, with the GLP1, unless you're for the dosage that most people are taking, especially for weight management, yes, it can go low for you where you'll feel shaky and tired and fatigued, but typically once you eat, it goes back to normal. It's unlikely it's going to go to a critical low level. When somebody has diabetes, however, a lot of GLP1 users, it's not their sole medication that they're taking for diabetes management. So if they're taking more medications, and especially if some days they're eating less than others, or maybe they're not paying as much attention and they're having more simple carbohydrates or not enough protein and fiber to slow down digestion, they can see more changes in blood sugar. And because some of those other medications can also increase the risk of hypoglycemia, there is more of a risk that it can go too low. For most people, it's not going to go to a super very, very dangerous level. However, you don't feel good when blood sugar goes really low and it can take a while to get it back up. So you're better to get ahead of it. And that's where regular blood sugar testing is important. Um, especially for my clients with type 2 diabetes that are on a GLP1. I do like to recommend a CGM if insurance will cover it for them because it's just so much easier to just have it on, be able to look at a glance and see what your blood sugar is doing.

SPEAKER_01 10:27

You know, I'm always talking about focusing on the fundamentals and not chasing extremes when it comes to health. This is especially important if you're navigating perimenopause, menopause, or using GLP1 medications. Because while a lot of the conversation around GLP1s focuses on weight loss, what I actually care about is protecting your muscle. Muscle is one of the most important indicators of long-term health and resilience as we age, especially for women. And muscle health is really about energy. See, inside your muscle cells are little tiny energy producers called mitochondria. They help support strength, recovery, and overall muscle function. And as we age, mitochondrial function naturally declines, and that can impact everything from energy to maintaining your strength. And that's one of the reasons that I've personally added mitopure gummies from Timeline to my routine. Mitopure contains clinically studied urolithin A, which helps support mitochondrial renewal, basically helping your cells produce energy more efficiently. What I appreciate is that this is foundational support. It's not about doing more or adding something complicated to your day. It's just a simply daily habit that supports healthy aging at the cellular level. And the gummies just really make it easy. They're vegan and independently tested for quality. If supporting muscle health, strength, and healthy aging is important to you, especially during midlife or while using a GLP1 medication, Idopure is absolutely worth considering. Timeline's clinically proven formula is now available at a new lower price starting at just $79. And you can still get 20% off when you go to timeline.com backslash GLP1 hub. Again, it's timeline.com backslash GLP, the number one hub to get 20% off your order. Right. If they don't have a CGM, I feel like I remember we used to recommend four times a day. After meals, so after each meal, is that still the standard? This was 20 years ago, Aaron.

SPEAKER_00 12:34

So just barely I mean, it depends on the person. So some people have very consistent blood sugars. And so maybe for them, it's testing three times a week because their A1C is normal and they've been doing really well. Um, but if you're seeing big changes in body weight too, blood sugar is going to also change. And sometimes medication needs to be adjusted. So in those situations, usually we'd recommend at least in the morning, you know, fasting in the morning and before bed, before and after meals can definitely be recommended. I usually tell my clients if they're just feeling off that day, you know, whether it's shaky or extra tired or thirst, just check because it could be hydration, it could be a side effect from the medication, but it could be blood sugar. And we're not gonna know unless we have that data in front of us.

SPEAKER_01 13:13

Sure, definitely. So, what about diet? Because people trying to lose weight on GLP one, I I I hear them not really eating that regularly, but with diabetes, that's not as much of an option. So, how do you balance that? Like you have a desire to lose weight, manage your blood sugar, but you got to eat to manage your blood sugar for the reasons we just discussed. And to lose weight, even, you know.

SPEAKER_00 13:35

Yeah. So the big thing you want to remember is yes, it's exciting to see the scale go down on a GLP one. And everyone wants to get to their goal weight like tomorrow, right? Every no one wants to wait. But if you lose too rapidly, you're not just losing fat mass, you're also losing muscle. And muscle is what makes up our metabolism. So, most of us, the goal is not just to get to our goal weight for a hot minute. We want to stay there long term. We want to actually be able to stay there. So we really want to make sure we're maintaining as much muscle mass as possible while losing weight. And that's where eating adequate protein and making sure we're not totally under our calorie needs day to day. Even on a GLP one, you want to see consistent weight loss, but you shouldn't be losing five, 10 pounds in a week because there's no way you're just losing fat mass then. You're losing a lot of muscle, you're losing fluids. So typically, I recommend this for everyone on a GLP one, but especially those with diabetes, is keep a food record. It doesn't have to be hard. There are so many resources out there now where you can even do just like voice memos to track what you're eating, but just to watch. If you have one day where you barely, it's not gonna affect you long term, but you need to be aware. Usually a consistent schedule is gonna be best because you don't always have those hunger and satiety cues on a GLP one. It's very easy to eat breakfast and then forget to eat until dinner time and not even realize you have any in. So setting an alarm on your phone or just keeping a track to make sure number one is you just want to get those protein in every day. If you're falling short on your protein, you're gonna be losing more muscle. So try to make protein kind of the hero of each meal and snack and then round it out with the high fiber foods, like the vegetables and the fruits. That's gonna promote blood sugar balance, but it's also gonna help to prevent some of those negative effects like loss of muscle.

SPEAKER_01 15:09

Do we do you still recommend like carb counting? I remember back in the day we used to do carb counting. So 30 grams per meal or whatever it was, I don't remember. Yeah. Is that still, do you still do make those recommendations for people with diabetes or is it more?

SPEAKER_00 15:21

Yeah, it's it's a little more fluid. Absolutely. Like, especially in the beginning, the education around carb counting is helpful because you want to understand like carbs impact blood sugar. So if I have too many carbs at one meal versus spacing them out throughout the day, my blood sugar is gonna behave differently. A hard and fast rule of like 30 grams per every meal doesn't work for everyone. So generally, I'll say anywhere from you know 15 to 60 grams of carbs could be fine for somebody. We got to test to see how your response is. But more than just the carb counting, it's really the type of carbs. It's complex carbohydrates, rich in fiber, the combined. So protein, fat, and fiber is kind of that key formula. We want to have the protein, we want to have the slow digestive carb and some fat. That's gonna make a better response for blood sugar and for satiety versus just worrying about the carb content alone.

SPEAKER_01 16:07

Right, right. I think that the fiber is really the key that a lot of people are missing because that plays such a role in blood sugar, too. So it's not like we like to d demonize carbs, right? But it's not really accurate.

SPEAKER_00 16:19

Yeah. I mean, like a bean is completely different than, you know, eating candy. So we just want to look at the types of carbs. And carbs are not bad. They have a lot of health benefits, a lot of nutrients. Um, and like you said, the fiber, not just for blood sugar management, but also especially on a GLP one side effects like constipation significantly reduced when we get enough fiber every day.

SPEAKER_01 16:37

Well, I was just gonna ask you about side effects. Look at that. So, what are some of the ways you help people manage side effects? And what are the most common side effects that you are seeing with your with your patients?

SPEAKER_00 16:48

Yeah, the side effect management, I know um, you know, a lot of people that are considering GLP1, this is kind of like their area they're worried about. It really depends on the person. Usually you'll see side effects at their highest level initially when you're first starting a GLP1 and then when dosages change for a week or two. But typically, a lot of the reasons we're seeing side effects are if you're not eating at all, if you're not getting enough fluid, like dehydration, a lack of food, drops in blood sugar are going to exasperate symptoms like nausea, fatigue. So you really want to stay ahead of the game, drinking fluid throughout the day. Big thing is just, you know, like I always have my water bottle with me, like just carry a water bottle. Yes, see, perfect. So you see it, that visual reminder to drink. Um, sometimes adding some electrolytes can be really beneficial too because it's not just drinking, but you want to make sure you're getting all the electrolytes in so you feel your best, especially if you're having things like diarrhea or vomiting, you're gonna want to replace those electrolytes. Um, but really paying attention to certain foods. So if you're, I know a lot of times people are like, oh, my appetite's reduced, I'm not eating many calories, so I'll eat whatever I want. So they'll go and eat, you know, something greasy or really sugary just because they feel like they can, they're not eating much of it. But those foods are not gonna be tolerated as well. So if you're eating something that's really rich in fats, something that's really rich in simple sugars, like a candy, that more likely is going to increase those side effects. So, you know, more balance, same thing, like that balanced plate, lots of hydration and movement. Even if it's for five minutes after eating, just getting up and moving can really help to sustain some of those side effects.

SPEAKER_01 18:14

Yeah, definitely. So have you seen, you know, there's a lot of drama out there in on social media. Have you seen any very severe side effects with your patients in particular? Or is it more like these digestive things?

SPEAKER_00 18:27

Yeah, I mean, I feel like I'm slightly biased because I feel like somebody who's already seeing a dietitian to get the education around a GLP one tends to have less side effects because they are paying attention and they are asking those questions. I do a lot of corporate wellness and I do corporate wellness activations. And so sometimes we're working with clients that, you know, they're coming in one time for that event, but otherwise they're on their own. And so where I'm seeing more side effects is the people that are kind of on their own with their GLP one journey, whether it's they're going to a health spa to get it or maybe they're using telemedicine to get it, and they're not really having that education surrounding it. So they're focused so much on losing weight, they're not really being mindful about things like muscle, bone density, side effect management. And those are the people who are losing rapidly, but are not necessarily going to be able to sustain it and they're also not feeling very well in the process. So that's usually the group that I'm seeing the worst side effects on because they just don't have that education piece around it and they're not necessarily having someone to talk to when they are experiencing side effects on what they can do differently.

SPEAKER_01 19:26

Right. I agree. There's just, I think that even just one meeting with the dietitian would help you at least manage some of that. And I mean, every telehealth that provides that may charge a fee. You know, so cost is definitely an issue.

SPEAKER_00 19:42

Yeah. But I mean, like I tell my clients, yeah, cost is an issue. And it's the same if you come in, you know, some people are out of pocket or they have co-pays. However, if you think about the fact that you're saving money in the long run because you're gonna have other medical costs, or you're gonna have to go see a doctor because you're not feeling well, or maybe you have low bone density and down the road, you're gonna have to be on medication for that. Like all those things have cost. And I know it seems like it's in the future, but setting yourself up for success, even like you said, just a one-time educational visit, can be such a great investment in your health so that you can not only achieve your health, like your weight goals are one thing, but we really want to achieve our health goals and feel our best doing it. And so that's what you're investing in.

SPEAKER_01 20:19

Do you have any advice for people to shift towards focusing on health goals? Because I see people very focused on weight. And I would love for them to focus on like what is your vision for your life when you are 80? And it's I don't think it's like wearing a size two. At least for me, it's not. For me, it's like carrying my suitcase on my world cross-world trip, right?

SPEAKER_00 20:39

Like, I want to be able to like chase my great grandkids and stuff, right? Like, I'm not worried about the bikini. But um, yeah, I think one of the things that I like to tell my clients is like, because whenever somebody comes in, you ask them what their goal is, and they number one, they always just share a number. And that number is great, but a number, you know, if you think about okay, I want to weigh 130 pounds, what you look like at 130 pounds at age 20 might be very different than what you look like as 130 pounds at age 50, because body composition changes and all that. So instead of just writing a number down, I like to ask them to kind of visualize what that feels like. So you waking up at that weight, what do you feel? Do you feel like you wake up with lots of energy? Do you feel like you can lift heavier things? Do you have more energy to keep up with your kids? And so we write those things down because most people will hit a weight loss plateau at some point. And when they're hovering steady at a weight loss plateau, it's very frustrating. But if you look and say, okay, this week, is your energy higher than it was two weeks ago? Are you able to lift more weight at the gym than you were two weeks ago? And the answer is yes, we're making progress. So I really encourage them to write down at least three or four other things. You know, what does that number feel like? Not just what does it look like, but what's it feel like so we can focus on that too and shift a little bit more towards that versus the number on the scale.

SPEAKER_01 21:57

Right. And I think that sometimes I've hear heard people tell me. I reached the number and I didn't think this was what it would look like because of those things that you mentioned, body composition shifts, or you don't see yourself clearly always too.

SPEAKER_00 22:11

Exactly. Yeah. And remember, you know, losing weight is great, but it's the type of weight you're losing. So if you lose a little slower, but you're lifting heavy weights and you're building muscle at the same time, you might see that your waist circumference is slimming, which is what we want, because we don't want that visceral fat that increases our risk for disease. But maybe at the same time your thighs or arms got a little bit bigger, but that's muscle. That's a great thing. You are able to lift more. You know, it's being realistic with yourself of where do you want to lose from? Because we can't spot reduce. But if you think about like, okay, I'm glad that this area is going down. But you know, if this area is getting bigger, we're staying the same, it's because I'm stronger and I have more energy, then that can help to shift the focus a little bit too.

SPEAKER_01 22:49

Right. You mentioned about plateaus uh really quick there. Can you explain like why people reach plateaus and if there's something they can do or, you know, anything that you want to say about that?

SPEAKER_00 23:01

Yeah. So plateaus can happen for a lot of reasons. Sometimes it can be your body's response. So when somebody says they're at a plateau, I like to ask them how long because staying at the same weight for a week or two isn't really a plateau. It just means that your body's kind of readjusting and then you're gonna continue to see progress. It's more where you're stuck at the same weight for over a month's period of time. You feel like you're doing everything right. So, first thing we do is take a step back because most of us really think we're doing everything right, and sometimes we aren't, or something has changed a little bit. So, food records, number one, because usually maybe you're picking a little bit more snacks or eating the kids things that they left over, or maybe a few extra glasses of wine on the weekend, something like that is sneaking in there. So that's the easiest to identify. The second is look at your movement because a lot of times you could be eating the same amount of calories every day, but maybe in the summer you're walking every day, you're swimming, and then the winter comes and you're staying the same, you're not losing anymore, but you're also less active. So look at how many steps you're taking per day. You know, look at your total activity. Those two things for most people break the plateau. And then the is to look at too, did you lose weight very rapidly? Because sometimes you lose so quickly, you lost muscle. And now your basal metabolic rate, the amount of calories you burn at rest, is lower. And so you can eat the same amount of calories, but it's harder to lose weight now. So now you have to build the metabolism back. And the number one way to do that is strength training. You know, two, three times a week, start lifting more weights. And of course, talk to your doctor first, see what's appropriate for you. But if you can build that metabolism back, then you can start to see that weight loss progressing again.

SPEAKER_01 24:30

Right. I think that the patient's piece is difficult for people because I think saying, Oh, you're not going to lose for two weeks, I've seen that pattern in myself. I'll I will lose and then not, or a little, and then all of a sudden, like I drop to two pounds. And I can't it's not correlated necessarily to anything that I'm doing differently. It's just more how it goes.

SPEAKER_00 24:52

Yeah. And you know, I don't have any like scientific data on this, but I've worked with thousands of clients. And I will tell you that there are some people that lose weight like robots, like every week exactly the same. And the vast majority of people don't. I will see people that lose, you know, two, three pounds, and then they stay the same weight for three weeks and then they drop three or four pounds. And so what I like to look at with them is after a few months of this, we just look at each month and take an average and say, look, it's averaging out to one and a half pounds a week, which is on track with someone who's losing that consistently. For whatever reason, your body holds on to then drops and holds. But that's your pattern. So you start to see these own patterns in yourself. It's harder to identify when you're just that individual looking at it your own self versus comparing it to a lot of people. Um, but for anyone that's really frustrated, there's two things I usually have my clients do is I have them take their measurements once a month because if your weight's staying the same, but you're seeing reductions in measurements, you know that you're losing body fat, especially if you're exercising. Sometimes the weight can stay the same on the scale, but body composition's changing. So you're gaining a little muscle, you're losing body fat. Scale looks the same, but you lost a half an inch in your waistline. So it's nice to see that. Once a month is usually adequate with that. You don't really have to measure all the time. The other one I like is the body composition scales. If you really feel like your weight fluctuates a lot, because if your weight goes up, but your body fat goes down on those scales, it tells you you're holding on to fluid. So now you know it's just salt, it's water, it's that time of the month, whatever it is. And then other times, you know, if the body weight's going down and the body fat's going down, you know you're losing actual fat mass. So those, they're accurate to themselves. If you use them often, I wouldn't say they're 100% accurate, say, versus a DEXA scan, but it is another way to kind of get through that mindset of why is the weight staying the same. It kind of gives you a little bit more insight.

SPEAKER_01 26:31

Do you guys remember my conversation with Beth a while back, the one that became one of the most popular episodes? Well, Beth is from Tide Wellness, and that conversation is the reason I'm comfortable telling you about them today. So many people lose weight on GLP1, feel amazing, and then six months later, they're back to where they started because the program ended or the provider disappeared or they were never set up for the long haul. But Tide Wellness is built differently. Licensed providers who actually adjust your dosing as your body changes. A real care team you can message when you hit a plateau or have a question or need help. Nutrition guidance designed specifically for how GLP1s change your appetite. And if you've got questions, you can book a consultation and actually talk to a provider, a rare find in this space. If you're looking for more than GLP1s, they also do microdose GLP1 programs, hormone therapy, longevity peptides, and the kind of support that matters when you're trying to feel your best long term. Tide is built with support by a team that really cares. Go to tidewellness.com backslash GLP1 hub and use the code GLP1Hub50 for $50 off your first month. Again, it's TideT Y D E wellness.com backslash GLP, the number one hub, and the code is GLP1Hub50. And I think that some of us are just more like salt sensitive, like Mexican food and me. It's you know, where I'm just I just know, like just don't step on the scale after this.

SPEAKER_00 28:06

Totally. Or even like weather, like if it's humid that week, you're gonna hold on to more water weight. And it's so you don't think about these things, or if you forgot to drink as much, or you didn't go to the bathroom. You know, there's so many things that can impact the scale.

SPEAKER_01 28:17

Right, right. I think we always panic. Oh, it's not working.

unknown 28:20

Exactly.

SPEAKER_01 28:21

It's like stay the course, stay the course. Um, so I wanted to just shift gears real quick and talk really briefly about type one diabetes because there it is GLP is being used off label for people type one. I actually had a guest who's a dietitian who's using it for that. Are you seeing that at all in your practice? I don't know how much you work with type ones.

SPEAKER_00 28:39

So I see it in some. I specialize more in type two, so I don't have a large amount of type ones. However, there are people with type one diabetes that do develop insulin resistance. There are people with type one diabetes that are trying to lose weight. So I definitely do see that. Um, I think the biggest thing, for at least for me when I see it, is the biggest concern is just that increased risk of hypoglycemia. Now, most people with type one, especially when they've had it for a long time, they really have a good understanding of what low blood sugar feels like. They have a good understanding of their insulin regimen and their diet. So they do have a good amount of education in that aspect. But if there's changes, you know, as body weight drops and the body becomes more sensitive to insulin, we could see that all of a sudden now the insulin's working too much, they're more at risk for blood sugar dropping combined with the GLP one. So for those individuals, definitely think, you know, CGM or very frequent testing is really important to just understand how their body's responding.

SPEAKER_01 29:31

Yeah. And I'm hoping to see more research because from what I from what I've seen, there's only been a couple of studies on type one, and it's really technically not like approved right for that group.

SPEAKER_00 29:41

Yeah, exactly. And I think that's the big issue is again, it, you know, it has to really be an individual and it has to be them working really on target with a dietitian endocrinologist because there are a lot more risks, but there are there are a subset of people with type one diabetes that have technically developed type two on top of it because of the insulin resistance and weight management. So it would be a really interesting population to study and get a little bit more details on that.

SPEAKER_01 30:04

Yeah, yeah, I think that I think that's coming. But there's just so many different conditions which one that one needs to research and learn more about. It's kind of hard. Exactly, exactly. It's kind of hard. So, in terms of like just the GLP one world out there, diabetes, weight management, what is like, as somebody who's been doing this for 20 years, what is like your your message to the people trying to improve their health, whether it be diet or exercise or lifestyle, what would be your your general message to them?

SPEAKER_00 30:33

Yeah, I mean, I think, you know, been doing this for two decades. There's always a new trend. There's always something new coming out when it comes to weight management. Used to be, you know, gastric bypass surgery. Now we have GLP1s. There's always something. The end of the day, the underlying thing that makes people be successful long term is really mindset. It 100% comes down to the fact that you have to understand this is long term. You're not doing anything for a quick fix. The goal is to get there and stay there. So that is why we do not need to be perfect. You shouldn't try to be perfect because no one is. If you do, you burn yourself out. And those are the people that lose and regain over and over again because they're constantly feeling like they're failing. So you truly have to think small. You know, what are those small changes you can be consistent with each and every day? Think about your progress in the term of maybe it feels slow this month, but when we times that by 12, what does that look like in a year? And if it's takes longer to get there, but you know you can keep it there versus you can get there quickly, but you're just gonna go right back to where you were, it's not worth it. So it's, you know, getting away from that black or my uh black or white mindset shift and to that more gray area of good enough. You know, we don't need to be perfect, we just need to be good enough every day. Just make one small change. And honestly, those are the people that set themselves up for the best success long term.

SPEAKER_01 31:47

Right, right. And I think that the the really extreme diets or, you know, I'm never gonna eat a carb again, or I'm never gonna eat a piece of cake again like that's inevitably gonna fail.

SPEAKER_00 31:58

It's always gonna fail. And you know, honestly, like we all do it to ourselves. But if you had a best friend coming to you telling you what you just said to yourself personally, like if you said to yourself, well, I can't believe I ate that cookie yesterday, I'm a failure, I might as well just eat everything. I'm gonna gain 20 pounds. Like if someone said that to you, you'd be like, You sound ridiculous. You know, that's not gonna happen. But we're so mean to ourselves and we beat ourselves up. So if you try to ask yourself anytime you like have that negative self-talk, if someone else was saying this to me, what advice would I give them? And then you take that own advice to yourself, you're honestly gonna be much more successful.

SPEAKER_01 32:31

Yeah. I have my I've heard my husband say that to me before. Like, what would you tell your audience about this topic? And I'm like, God, you know, this is what I would tell them, but I don't want to follow that advice.

unknown 32:43

Exactly.

SPEAKER_01 32:45

Anyway, Aaron, thank you so much for all this. Where can people connect with you and find out about your wonderful work and if they want to work with your you and your practice as well?

SPEAKER_00 32:53

Sure. Thank you so much. Yeah, so my website is erinplinski.com. You can uh find my blog, my recipes, my books there, as well as all the information as making an appointment with my private practice. And if you want you know tips on managing blood sugar and diabetes management, I also have a YouTube channel called Healthy Mom Happy Family, where I really focus on that whole concept of you know small practical changes that can help you and improve your health long term.

SPEAKER_01 33:15

Awesome, awesome. That's such a great resource and all the books and all of the content that you've created to help people really live healthier lives. And I really, really appreciate it. And I'll be sure to link all that stuff in the show notes. Thank you so much for having me. Thank you, Erin. Always a pleasure. Thank you so much for listening to this episode of the GLP1Hub podcast. I'm so grateful Erin was able to come on to share all of her expertise around diabetes and this medication. If you're looking for more support around your nutrition on GLP1, I have a ton of resources over on the GLP1 store. You can find it at shop.glp-1 hub.com. I have meal plans and recipe collections and a full comprehensive guide for everything that you need to know to optimize your nutrition and get incredible results. So make sure that you check that out, and I'll see you in the next episode.