147. You Can't Get Ozempic, Now What? 5 Expert Physician Advice to Reclaim Your Weight Loss

Has your health insurance recently swiped your Ozempic or other weight loss drug, and now you're struggling to figure out what to do? 

Have you ever faced weight gain and thought, 'What's the use anyway?' and then given up on the things that could actually help you get back on track? Can you see how giving up only makes the problem worse?

In this episode, Dr. Adrienne Youdim explores the potential causes of weight gain and loss, as well as provide insights on how to prevent it from occurring in the first place.

If you're someone who feels defeated because you got your Ozempic swiped, or you feel defeated because you never qualified and had access to it to begin with or someone who has experienced a recent weight regain or is simply interested in learning more about maintaining a healthy weight, this episode is a must-listen. 

What you’ll learn from the episode:

• Understanding the impact of health insurance changes on weight loss medications
• Recognizing potential challenges when insurance coverage for weight loss drugs is altered
• Learning surprising expert physician insights into weight loss and weight management and discovering effective sustainable strategies to prevent weight gain or regain despite insurance limitations

“Don't let the disappointment of not having gotten Ozempic impede or interfere with your effort. Let your effort be independent of all of that and know that your effort matters.”

- Dr. Adrienne Youdim

5 Expert Physician Advice to Reclaim Your Weight Loss

1. Stick to Your Food Habits: Even without medication, it's important to maintain the healthy eating habits you've developed. Increase your portion sizes of protein-rich foods, such as chicken, to manage hunger effectively. 
2. Create an Environment for Success: Plan your meals in advance and bring your own lunch to work to avoid ordering unhealthy food.
3. Manage Cravings without Catastrophizing: Cravings are normal, and occasionally giving in to them is okay. Instead of beating yourself up, accept what happened, show yourself kindness and compassion, and move on. 
4. Don't Lump All Behaviors Together: Separate your eating habits, exercise routine, and sleep patterns. Just because you had a setback in one area doesn't mean you should abandon all healthy behaviors
5. Stay Accountable to Yourself and Others: Maintain accountability by tracking your progress, whether it's through regular weigh-ins or sharing your journey with a trusted friend or healthcare professional. If stepping on the scale triggers negative emotions, consider using a blind scale or relying on someone else to monitor your progress.

Recommended Reso

Ways that Dr. Adrienne Youdim Can Support You

1. Join the Monthly Free Mind-Body Workshops: Participate in engaging mind-body practices designed to help manage your stress response. Register here.
2. Sign Up for the Newsletter: Stay updated with valuable insights and resources by subscribing to the newsletter. Sign up here.
3. Freebie alert. Register for our monthly free MindBody Workshop and receive a downloadable guide on emotional labeling to help you manage your emotions effectively.

Connect with Dr. Adrienne Youdim

• Website :https://www.dradriennespeaks.com/
• Instagram: https://www.instagram.com/dradrienneyoudim/

Transcript

Are you like many of my patients, your health insurance recently swiped your Ozempic or other weight loss drug, and now you're struggling to figure out what to do? or maybe you're bums because you never qualified for these drugs to begin with? I have some thoughts on this one, and I'm gonna tell you a surprising reason why you may be gaining or regaining your weight and what you can do to prevent it. 

My name is Dr. Adrienne Youdim. I'm a triple board certified internist , obesity medicine, and physician nutrition specialist that has worked with thousands of patients, not only to help them eat well, but to redefine nutrition so they can live well, physically, mentally, and emotionally. I just love this stuff. So let's get to it and dig into this week's bite. 

So I know that many of you can relate to this experience. My patient, I'm going to call her Jenny, she's a mother, a lawyer, and has been juggling life's responsibilities for the past 20 years. Last year, her youngest went off to college, and she finally took a second to take stock of her life. 

And like many of us, mothers and busy professionals, realized that she had neglected herself and in the process found herself with an extra 40 pounds. 

She also was just diagnosed with prediabetes and metabolic syndrome, and so she was an excellent candidate for Ozempic. So Jenny started Ozempic and was thrilled with the results, not only for the weight loss, but it seemed like the noise around food had dialed down. She started cooking at home more. She had virtually stopped drinking any alcohol. She started walking with friends a few days a week and had hired a trainer one other day and was getting at least seven, sometimes eight hours of sleep per night.

In addition, she was practicing the breathing exercise I had taught her when she was stressed in the office and overall was feeling and doing great. By the way, I always prescribe exercise and sleep prescriptions and mind-body exercises for stress reduction because nutrition is not just about the food that you eat, as you're about to hear. And after a year of taking Ozempic, Jenny had lost 30 pounds. 

Then summer rolled around and the insurance company requested another prior authorization for the drug and then promptly denied it. 

We appealed and appealed, but to no avail. And the cost without insurance was $1,300 a month. The decision had been made and Jenny had to come off the Ozempic. And she was upset, really upset. And to be honest, I was too. I'm always really upset when these decisions are made without thought to a person's clinical situation. 

And without the drug, of course, people's hunger comes back. And for those of you who've never been on these drugs, you may still understand the experience because anytime we lose weight or limit what we eat in order to lose weight, our body fights back by revving up our hunger. And Jenny, who is seeing me every few weeks for accountability and support, kind of fell off the grid. 

And when she came back, about three to four months later, she'd already gained nearly 15 pounds. Now, before I go on, I want to say this. I know more than anyone that obesity is a chronic medical condition. I understand that these medications are indicated for long-term use. And the studies show that without these drugs, people do regain weight. 

But what I want to address here is what I saw with Jenny and with many of my patients, which is what I call the throw-in-the-towel effect.

Actually, this is not my term. There was a psychologist who coined it. But there is this concept that is described by throwing in the towel. And you don't have to  have been on weight loss drugs to know that one. It's what we do when one leg comes undone. We throw in the towel. In Jenny's case, once she stopped taking Ozempic, she stopped taking lunches into work and started to eat the food her colleagues had ordered. 

She stopped her attempt to get eight hours of sleep at night and resumed that late night TV and therefore the late night snacking that went along with it. Her walks started to dwindle and eventually she decided to cancel her trainer too because, well, she was gaining weight anyway. In essence, because she lost the drug, she threw in the towel on all the behaviors she had adopted. 

And you know, there's a psychology behind this. We lump behaviors together. We're more likely to exercise when we eat well, for example, and we're less likely to exercise if we binge the night before. Or if we're on vacation and we plan to eat and drink anyway, we throw in the towel on exercise. And when we feel defeated, we do the same. 

Have you ever had this experience? I know I have. Have you ever responded to weight gain by saying, oh, what's the point anyway? And stopped the very behaviors that would have helped you get back on track. But do you see how throwing in the towel only exacerbates the problem?

I'm not saying that Jenny would not have gained some of the weight off the medication anyway. And I am not minimizing the frustration and disappointment of losing a tool that was helping her. Or for those of you who could have never gotten the medication, the frustration of knowing you did not have access to something that you felt you needed to help you. 

But I wonder, what would have happened if she didn't throw in the towel on all of it? Perhaps she would have had a fighting chance.

So to those of you out there who feel defeated because you got your Ozempic swiped, or you feel defeated because you never qualified and had access to it to begin with, this is what I suggest.

Don't throw in the towel with these five steps:  

• Step #1: Stick to your food habits.

 Now wait, before you roll your eyes, I get it, perhaps you're hungrier now. But that doesn't mean you cannot stick to the basic habits you've implemented. You may need to eat more to manage your hunger, but do so with wholesome food. Double your portions of protein, if that's what you need. 

That, by the way, is the macro that secretes your endogenous or your body's own GLP-1. That's the active ingredient or hormone in these drugs. Eat the whole damn chicken if you have to. Let's face it, no one gains weight from chicken. But, I promise you, if you commit to eating the stuff that serves you first, even if it's eating more of that stuff, Eating that in abundance, then there is less room for the stuff that does not serve you. So eat more if you have to, but stick to the basic food habits that you implemented. 

• Step #2: Create an environment for success. 

Perhaps you have cravings and will eat the stuff that was ordered at the office even if you do bring your lunch. But guess what? If you don't plan in advance and don't bring your lunch, then you have a 100% chance of eating what came from Uber Eats. And the same goes for your home. Make the same effort to prepare a healthy meal or go almost homemade with a pre-cooked store-bought chicken or a plant-based salad. 

But once again, if the fridge is empty of the healthy options, if you haven't prepared by bringing in your healthy option to work, you will order in 100% of the time and that is a fact. So give yourself a fighting chance to make the right choices, to manage the cravings by creating an environment for success. 

• Step #3: Manage your cravings without catastrophizing. 

And this is a big one. Invariably, you will have cravings and perhaps you will give in to them. Heck, you may go out on a full-blown binge. You know what I say? So what? So what that you binged? The real question is, what are you going to do the moment after? You can accept what happened, hold yourself with kindness and compassion, and then move on. Or you can catastrophize and act like it is the end of the world, hating on yourself and badgering yourself. If you do, do you know what's going to happen? Yeah, you're going to do it again. 

So remember, you do not have to be perfect in order to be effective. So if you gave in to a major craving or even a ginormous binge, it's okay. Don't catastrophize. 

• Step #4: Don't lump all the behaviors together. 

What you eat is in one bucket. Movement and exercise is in another. Sleep is another. Just because you binged or gained weight doesn't mean you should cancel the trainer or stop the walks with friends. And it certainly doesn't mean you should go back to late night watching and late night snacking. 

Don't forget, sleep deprivation impacts your hunger hormones, making you even more likely to have cravings the next day. So keep each habit in its own place, independent of the other, and resist that inclination to throw in the towel on it all just because you let one of your buckets tip over. 

• Step #5: Stay accountable to yourself and to others. 

Just because you're not getting on the scale doesn't mean that you're not gaining weight, my dear. And I know that's a tough pill to swallow. And here's a really important disclaimer. The point here is not to hate on yourself or self-deprecate. I know all too well it's not fun to be disappointed by the numbers of the scale. But if you can use this information as just a tool, as just a reminder, just as a form of accountability, without beating yourself up, then do it. 

Ideally, you use this information to guide your behaviors and to course correct before you lose sight of your goal. But if this is too much of an ask right now, and it's triggering to get on a scale, then don't do it. Instead, be accountable to someone else. 

Maybe consider getting a clear scale. This is a technology where you don't see the numbers on the scale, but your doctor or your coach does. I use it in the office all the time. Let them be the keeper of the numbers and guide you. In the end, Jenny agreed that staying away from the office and from that accountability was to her detriment, making it that much harder to get back in the game when she was ready.

So stay accountable to yourself or to someone else in a way that feels self-compassionate and right for you. So there are my five things, but one more note here. 

There's a point I wanna make about placebo and nocebo. 

So placebo, as you all probably know, is the benefit we get from believing that something is working for us, while nocebo is the opposite. It's the negative expectation that we assign to a treatment, or in this case, to not receiving a treatment. Now again, I am absolutely not saying that the drug works by placebo. But I am saying that there's a certain effort that we make when we believe we are receiving a treatment that will help us. We are more engaged. We are all in. On the other hand, there's a certain barrier to making an effort when we feel like we're not getting that treatment or that it has been taken away. Like, oh, I'm not getting the drug anymore, so what's the point? That is what I'm speaking to. Because there is a point, and what you do does matter.

Don't let the disappointment of not having gotten the drug or tool or help you want it or the fact that you can no longer get the drug impede or interfere with your effort. Let your effort be independent of all of that and know that your effort matters. 

So there you have it. my formula for managing the weight regain of being swiped off your  meds. Stick to your food habits. Create an environment for success. Manage your cravings without catastrophizing. Don't lump all the behaviors together. And finally, be accountable to yourself and to others in a kind and self-compassionate way. 

It may not be equivalent to being on that drug, but I promise you, it is far, far better than throwing in the towel. And of that, I can be certain, my friends, because I have used this formula in the office with my patients time and time again. Well, that's a wrap on Throwing in the Towel. 

If you enjoy what you hear on this podcast, it would really help me if you head over and write a review. It would really help me personally grow this show and create the impact with a message that I want to share. And don't forget, head over to your show notes and sign up for my newsletter, and I will send you my integrated approach to nutrition. Five ways to redefine nutrition, mind and body.

I'm Adrienne Youdim, and I'll be back here with you next week with another episode. Until then, have an awesome week. Bye now.