Mocktail Minutes

Who is a Good Candidate to be on a GLP-1

• Mocktail Minutes • Episode 162

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We get asked this question literally everyday! So this week we are jumping on to talk about the different types of GLP-1's, how they work, and who we think are good candidates to consider this tool. 

If you have questions, or topics that you want to hear about, head over to our Instagrams https://www.instagram.com/bayleethedietitian/ or https://www.instagram.com/brianna.dietitian/ and send us a DM! You can also follow the podcast https://www.instagram.com/mocktailminutes/


Featured Mocktails: 

Just Ingredients 


**Disclaimer** We are not your dietitian. This info is for education only. If you would like to receive personalized nutrition guidance please speak with a dietitian personally. 

Click play, sip back, and be empowered.

Baylee

Hello, everyone. Welcome back to this week's episode of Mocktail Minutes. This is Bailey.

Brianna

And this is Brianna

Baylee

This week I made my own drink. I've seen people do these on TikTok, and they look so much prettier than But I mixed, so I smashed up blueberries and then I did chia seeds and then lemon juice, and I did, like, a Tru Lime packet and then water. So it tastes pretty good. It's refreshing, and you get some chia seeds in there, it's not as pretty as theirs. Maybe, I

Brianna

Like when it's like modeled? Yeah

Baylee

A lot of them that I've seen use, like, lemons and strawberries, and so, like, I feel like strawberries and stuff would be better because, like, when you smush blueberries, like, they're white on the inside.

Brianna

Oh, yeah. And then you have all their little peels. I mean-

Baylee

it's just like peels.

Brianna

As long as it tastes good.

Baylee

good

Brianna

Yeah. It also feels like a very inexpensive option. I'm doing, I'm doing the Grape Ultima again. I got a big packet off Amazon. I don't know why I'm so into grape right now, but

Baylee

And we used to hate on it so

Brianna

I kind of love green

Baylee

my Just Ingredients package yesterday from their electrolyte sale, and I got two of their new ones, and I'm gonna try their pre-workout. We'll see

Brianna

I haven't tried a pre-workout in so long. I should, I should do it

Baylee

I, I don't really necessarily need it, but I'm just, like, curious. I've tried a few pre-workouts in high school, and I hated the itchy, jittery feeling, so I never used them.

Brianna

Yeah.

Baylee

But today we are going to talk about a very common question, again, that we get all the time, and it's, do I need a GLP-1? Because they, medications, they are not new. They have been around. gained popularity, I don't know, probably like four, three, three or four years ago, I would

Brianna

Yeah, I'd say less than five for sure.

Baylee

Yeah.

Brianna

Yeah

Baylee

they're not new. They are older than five years. They just have become more popular in their use for weight loss.

Brianna

Mm-hmm.

Baylee

So with that comes a lot of questions when you are a weight loss dietitian with, should I use a GLP-1? Do I need a GLP-1? Is this for me? So today we're gonna address that question for you

Brianna

Yeah. And I think, like we were talking before we got on, I think I get this question almost every day that I work is should I... Am I a person who should be on it? Am I a good candidate? So if you guys don't know what a GLP-1 is right now, it's a, I don't wanna say a weight

Baylee

of people have heard of

Brianna

loss- Yeah

Baylee

but you may not know what exactly it does. 'Cause I think

Brianna

Mm-hmm

Baylee

thing, why people are asking is because they're fed up with not losing weight. They're fed up with being stuck, and they're like, "Everyone else is just doing this and just dropping weight. I kinda want that. That kinda sounds cool."

Brianna

Mm-hmm. Yeah. And it's, I don't wanna call it a weight loss injection, but it, it is, but it's also used for diabetes, which is why it helps with losing weight, which is why when you and I are screaming from the mountaintops, like, eat for blood sugar management. It's such a weird concept, but these work in a couple of ways. So one of the ways is by slowing gastric emptying, so food stays in your stomach longer. It helps you feel more full. You feel more satiated. It can reduce appetite, so reduces cravings, makes you less hungry. You don't have to eat as big as portions. It improves your insulin sensitivity, so your body becomes more efficient at processing sugar, which is helpful because then you have less insulin floating around, which is insul- interesting 'cause it makes you make more insulin, but that's a weird mechanism. And then it helps to stabilize your blood sugar, so it helps to prevent, like, energy crashes that can trigger overeating, that sort of thing. So there's a couple of ways that it's working, and I feel like that's important to know because I have told so many people how they work, and they are like, "Oh, no one ever told me. That's cool."

Baylee

Yeah, a lot of times I feel like it's like, oh, it's that magic wand we've been wanting. But in reality, it really isn't. It's not just this magic fix, and if you view it as that, and you don't use it how it's supposed to be used, because it's supposed to be used with lifestyle

Brianna

Mm-hmm.

Baylee

along with it. When you don't have the lifestyle modifications with it, that is when people are like, "Oh my gosh, I gained the weight back. Oh my gosh, I have no butt. Oh my gosh, I'm losing my hair. I can't digest my food well. I can hardly eat." All these things come into play when no one teaches you how to properly use it. So there are specific qualifications for can you be prescribed a GLP-1. However, if you find, like, a med spa or wellness spa, you'd- there are people that can still get it without meeting these qualifications.

Brianna

Mm-hmm.

Baylee

is, like, if you want it to go through insurance or be prescribed by your doctor, there are typically qualifications that you have to meet. Now, I mean, there are also times where there's not a lot of questions being asked at appointments, and they're like, "Here, you're overweight. You're obese. Here, try this for a month and see what happens. See you later." That is what's really frustrating as a weight loss dietician, because we're not giving people the support they need. I've actually just created a new limb of my business to be a GLP-1 support partner because I, when these GLP-1s became more popular at first, I this is so annoying."

Brianna

Mm-hmm. Yeah

Baylee

like, that's what it was, and it was like, dang, another person on a GLP-1. And when I started looking into it more and researching more, I've really changed my brain around to be, and really recognized, like, what was the actual annoying part. It wasn't that people were on a GLP-1. It's more that people were on a GLP-1 and not properly supported or not taught how to properly use

Brianna

Mm-hmm. Yeah

Baylee

Because to be, to, like, qualify to be on a GLP-1, there are BMI requirements. So primary eligibility usually requires a BMI over 30, so this is when you're classified as obese, or a BMI over 27 with at least one weight-related health condition. So your BMI is calculated just with your height and weight, but it's important to remember that BMI also doesn't tell the whole story about your health.

Brianna

Mm-hmm.

Baylee

Healthcare providers consider multiple factors beyond just this number. So if your BMI is between, like, 27 and 29.9, you may still qualify for GLP-1 medications if you have type 2 diabetes, pre-diabetes, high blood pressure, high cholesterol sleep apnea, cardiovascular disease, metabolic syndrome, insulin resistance. These conditions are often interconnected with weight- weight and GLP-1 for weight loss can help address just multiple health concerns simultaneously. so those are a few things that can initially qualify you

Brianna

And it's good to note that even if you meet these qualifications, it doesn't mean that your insurance is gonna be okay with approving it. So insurance kind of does what it wants, and there's a lot of people's insurance who will say like, "Oh, well, have you tried metformin for X amount of months? Have you tried insulin for X amount of months?" So it's not as easy as it seems, which is why I think so many people just skip the insurance route and they go to med spas. But again, unless you're working with, like, a healthcare practitioner, there's so much, like, gray area. And I would say that would be something to seriously consider before jumping on it is, like, who am I working under, and are they offering support? Like, someone to teach me how to use it, how it works, how to adjust my lifestyle

Baylee

Yes, and even I've seen insurance, like, they want to see that you have tried other approaches

Brianna

Mm-hmm.

Baylee

too. what's hard is, because we talk about this all the time, is so many people are already undereating.

Brianna

Yeah

Baylee

So then we're telling them to eat less.

Brianna

Mm-hmm

Baylee

And so then we're just putting their body at more metabolic damage, and then this... So we're gonna do a part two of this, of who does not need a GLP-1 right now,

Brianna

Mm-hmm.

Baylee

and part of that is if you are undereating because we already know that is a foundational problem. Now, I have reverse dieted people who are on a GLP-1. It is a lot harder, I'm not going to lie, because you're already struggling getting enough food in, and then you put it something that makes your appetite even more suppressed. It's going to be harder.

Brianna

Yeah

Baylee

some insurance do require that you have to show previous weight loss attempts through diet and exercise and just have a history of it to show you've tried other routes, now you need medical intervention.

Brianna

Mm-hmm.

Baylee

fact about dieticians, we're the ones legally able to provide nutrition therapy.

Brianna

Yeah.

Baylee

is

Brianna

That's what we do

Baylee

big thing of being a dietician Like, we legally can do that.

Brianna

Which is important because we understand more than just like, oh, macros, increase your protein, decrease your carbs, or like you could be someone with a couple of these, you know, different diagnosis like hypertension, or you do have obesity or, like, chronic kidney disease or something like that that's very common. Unless someone knows how to take all of those things and figure out the best plan for you, you could be taking advice that's more harmful than good, and I have seen that a lot. Because usually with a lot of people who qualify at least to get a GLP-1, you have other things going on also, your insurance doesn't care about a nutrition coach. Which your insurance might be more likely to continue allowing this if you are working with a dietician. I have seen that as well, because then they go, "Okay, you're getting support."

Baylee

and that's another qualif- like, not qualification, but it helps get, get covered by insurances, showing commitment to lifestyle changes. So GLP-1 eligibility can also require that you show that you're ready to make diet and exercise changes along with the medication. Because, again, that's how it's meant to be used. It's not meant to, let's just keep doing what we're doing

Brianna

Mm-hmm.

Baylee

not change anything. And there are some situations, yes, that's appropriate, but that's a whole different conversation.

Brianna

Yeah

Baylee

But if what you're doing right now is grabbing fast food for lunch, we're not exercising, we're skipping breakfast, doing all these things, having binge episodes, just binging episodes, it's like, okay, things need to change with utilizing GLP-1

Brianna

Yeah. No, GLP-1 is not for someone who just doesn't wanna work out and doesn't wanna put effort or energy into what they eat, in my opinion. I feel like the... And obviously,

Baylee

harder

Brianna

yes

Baylee

when you're on a GLP-1 if you're using it correctly, and this is what I tell people all the time. And it's often the people who I know will put in the work who are most scared to start it because they're like, "I don't want the easy way out."

Brianna

Mm-hmm.

Baylee

that's what really sucks about these GLP-1s, is just the stigma around it's the easy way out. So then people who truly need it, lot of them are nervous to do it because they don't want that, "Oh, she's just on Ozempic," type of thing.

Brianna

Yeah. They don't, because if you're someone who's been trying to lose weight for a long time, it feels like the easy way out, and you ju- don't want people being like, "Oh, yeah, you're lazy." Like, oh, that... And most of the people that I have working on it are people who are actually good candidates for a GLP-1. Like, they've done the foundational work. They have, you know, some sort of biological reason why weight loss is harder for them, 'cause that is a thing, right? Like, especially if you have these metabolic conditions, weight loss is gonna be harder regardless if you are doing all the things right. It's like while everyone else is hiking with nothing on their back, you're hiking with, like, a 60-pound pack. Okay. Like,

Baylee

Mm-hmm.

Brianna

everybody needs to be doing the same thing, but it is harder for you to get where you're wanting to go. So I would say the people who should be on it or who are the best candidates, 'cause you can have all these issues and not be on it. Like, you don't have to be on it. But anyone that has the metabolic conditions that we talked about, anyone who has been trying to lose weight, I would say for at least a good year. Like, you have done foundational work for a good year. You're eating appropriately. You have good habits. You're making your meals at home. You're monitoring sleep, your strength training, your steps, your all this. Give it a good year, and then if you're a stalemate, maybe you're ready to bring in another tool online. And then I think, honestly, and only because this has been coming up a lot for me too with clients, is if you are someone who's on, like, a mental health medication that makes you gain weight, because you can't just... You could be doing all this stuff too. You're not gonna, like, get off, like, your mental health meds

Baylee

Yeah.

Brianna

to lose weight.

Baylee

We

Brianna

Don't do that.

Baylee

that.

Brianna

Don't do that. But a lot of people will want to, 'cause it's like, "Oh, this made me gain 40 pounds, and I can't lose it." Okay, well, we want...

Baylee

feel good either.

Brianna

Right. Exactly. So, like, we want... But other than that, if you don't meet those requirements, I'm not gonna say, if you ask me for my honest answer, I'm gonna say it's probably not appropriate for you yet

Baylee

Mm-hmm. And what's great about... This is what I tell my clients all the time when they ask me, like, "You can ask me. I'll give you my opinion if you want it,"

Brianna

Mm-hmm.

Baylee

because we have no skin in the game, no matter if we tell you yes or no to do a GLP-1.

Brianna

Yeah

Baylee

does not affect us bit. And with being dieticians, we can tell you how to really utilize it

Brianna

Mm-hmm.

Baylee

There are people, too, that I have recommended to microdose

Brianna

Yep

Baylee

where they did not really have a lot of weight to lose, which providers don't necessarily agree with this, that's okay. One thing I've learned healthcare provider is people are gonna have different ways. It doesn't mean that someone's is wrong. It's just we have different experiences, different things we've seen work, and that's okay.

Brianna

Mm-hmm.

Baylee

So I have had people use it when they had, like, 15 pounds to lose. They microdosed it. They didn't change anything else they were doing. Like, they were people, they were literally tracking their food. They were strength training four times a week. They were getting their sleep in. They were taking care of their nervous system, like literally doing all the things. Weight wouldn't change.

Brianna

Mm-hmm.

Baylee

was the only thing we added in. So are certain cases, but overall, meeting that other criteria we talked about and attempting all these other pieces first, and I think it is hard to do the year-long because it's like, "Ugh, well, what if I do this for a year, and I still don't lose weight? What a waste of time." It is not a waste of time if you're trying to implement things that you're not doing right now, you're gonna set your body up better to utilize the GLP-1 because

Brianna

Mm-hmm.

Baylee

GLP-1, now, it, m- it's going to set up your environment that is better for weight loss. It's not just gonna be, like, a direct weight loss

Brianna

Yeah.

Baylee

type of thing.

Brianna

Mm-hmm

Baylee

It basically just sets your body up for better success. You're in a better environment. Your body's in a better environment to lose fat

Brianna

Mm-hmm.

Baylee

lose weight in general. It's not just targeting fat loss. So many people who are obese or who have chronic- chronically dieted often experience that constant hunger, the strong cravings, the food noise. They have difficulty feeling full. They just, they don't have satisfaction with meals. They have low energy, and they do have a tendency to regain lost weight.

Brianna

Mm-hmm.

Baylee

So when calories are reduced, the body is going to respond by increasing hunger hormones, increasing reward signals around foods, decreasing satiety signals, and just making highly palatable foods hard to resist, which that is a big thing that I see.

Brianna

Yeah

Baylee

all of those things that I mentioned, like the constant hunger, the cravings, the food noise, lot of those can actually be helped by simply balancing your blood sugar. So if you started there, it's like, okay, those things are still happening, then you add on GLP-1. If you start there, and you're like, "Oh, wow, I feel so much better," okay, now you don't have to get a GLP-1

Brianna

And it's gonna work better. Okay? So I know a year, like you said, sounds like a long time. It's not. It's not. It goes by so fast, and if you have the foundation set, the GLP-1's gonna work better, you're gonna feel better, you're gonna be able to come off of it. Because the only reason why people are being told that if you're taking it for weight loss, that's a lifelong thing, is because we know people have such a hard time with lifestyle changes. But I'm gonna foreshadow and say that's incorrect, because we said that with gastric bypass. People regain weight after gastric bypass. So eventually there's gonna be a time where people have been on a GLP-1 for five years and s- because your body adapts. Okay? So it's gonna work better. It's gonna be cheaper, 'cause that's the other thing is it really, really sucks to be relying on a high-dose GLP-1, totally ignoring any foundational stuff, totally never feeling hunger, all that. Like, your body is still hungry, you just don't feel it, and then all of a sudden your insurance going, "We're not gonna cover this anymore. It's 1,500 bucks next month," and you go, "Oh, I don't have that." And then you gain 30 pounds in a month and a half because suddenly you're like, "Oh yeah, that's what hunger feels like, and now my body's pissed."

Baylee

Mm-hmm. And that's why it can be harder to be on it, because you have to be able to be like s- like, stop for a second. You can't rely on your body to tell you you're hungry.

Brianna

Mm-hmm.

Baylee

gonna be intuitive eating here.

Brianna

Mm-mm. No

Baylee

I don't really have many people being intuitive. Now, I have people who still have a little bit of an appetite, which is good. If you have absolutely no appetite, it's usually because your dose is too high. We want you to have a little bit of an appetite. But yeah, a lot of people, they literally have to schedule their meals, set alarms, and plan their day out so that way they remember to eat,

Brianna

Yeah

Baylee

'cause those hunger and sate- satiety hormones, we're just not picking them up as well. And that can happen without a GLP-1.

Brianna

Yeah

Baylee

if I am running through my day with work, it can easily be 2:00, I'm like, "Hmm, I haven't ate today. That ain't great."

Brianna

yeah, absolutely.

Baylee

out my lunch.

Brianna

Mm-hmm

Baylee

so that's where being an informed versus intuitive eater, honestly, I think more people just can't rely on int- intuitive eating

Brianna

Mm-mm.

Baylee

our society, based on our schedules, based on chronic dieting getting us into these crappy situations.

Brianna

Yeah

Baylee

yeah. So sometimes intuitive eating, we just

Brianna

I don't think...

Baylee

on it

Brianna

Well, and that's the conversation I'm having with people who are on it, 'cause I've had a couple people who have finally been brought on as a tool. They were ready, and they're like, "Oh, wow, you weren't kidding. Even though I'm on a microdose, I know I'm undereating." And so they're actively making sure they're eating, 'cause they don't wanna be undereating. We've gotten way past that, and it's this weird contradiction, because the reality is if people were great intuitive eaters, like if you knew to eat when you were hungry and stop when you were full, weight maintenance would be so easy. And so now it's like we're kinda going against that. But you can't, like you said, go off intuition, 'cause I've had people who are like, "Oh, I didn't eat at all yesterday." And I'm like,

Baylee

Listen, Henri. Mm-hmm

Brianna

I'm like, "Well, I'm gonna have to be intentional now." Like, and yeah, like you said, if you don't feel hunger at all, your dose is too high, and it is very hard to keep these good lifestyle habits when you don't need to. And that's the other thing I'm trying to tell people is like what is our long-term goal here? Do you long-term wanna like have all these good habits? Well, then maybe you need to pull back on your dose so that we can actually do those, which is why you can't do it if you don't have a foundation, 'cause you will never ma- Why? Like don't bro- don't fix it if it's not broke. If you don't have to make all these changes, why? Why would you start working out and walking more and cooking at home? Like, people are not... People don't wanna do that

Baylee

And I have seen people start a GLP-1, their insulin comes down, A1C comes down, glucose comes down, weight comes down for about 15 pounds and then it stops

Brianna

Mm-hmm.

Baylee

So if you don't ha- You have to do the pieces with it, otherwise you're gonna be stuck. And that's why many people plateau at, like, month six. Usually it's around month six they plateau because they don't have that foundation. Now they got metabolic adaptations happening,

Brianna

Mm-hmm.

Baylee

everything kinda slows down. And as... I feel like we're kinda conditioned with the GLP-1 to be like, "Oh, I stopped losing weight, I need a higher dose."

Brianna

Mm-hmm.

Baylee

they ask me, "Do I need a higher dose?" question is, "Are you eating three meals a day? Are you eating at least 100 grams of protein?" Most adults are gonna need more than that. "And are you strength training?" If the answer is no to any one of those, do not increase.

Brianna

No.

Baylee

Don't recommend it

Brianna

Yeah. Are you eating fiber? An appropriate amount of fiber? Are you monitoring alcohol? Are you sleeping? Are you s- are you walking more than 2,000 steps a day? If all of that is a no, absolutely not. You're, we're not gonna go up. Now, there's people who are gonna do it, and, you know, us as practitioners, we support them where they're at, but it never really turns out well

Baylee

Yeah. Yeah, 'cause we, we truly don't have anything to do with the dosing. We are not going to adjust your dose. I will give you my, again, I will give you my opinion, but that's also something to discuss with your provider.

Brianna

Mm-hmm.

Baylee

are things I kind of look into, like if we're not doing them, then it's a no for me

Brianna

Yeah. Sorry. I don't... And then you're gonna do what you do, and that's what we're here for. But

Baylee

In a lot of diets, they don't fail because people don't know what to do. People know they're supposed to eat protein. People know they're supposed to eat fruits and vegetables, and go to the gym, and lift weights. Oftentimes, we don't know the why. We don't know how much we need to do. We don't know what's accurate- actually needed for our bodies and for our goals. But when we are trying to white-knuckle our way through weight loss, hunger is gonna eventually win. Cravings are gonna eventually win. Fatigue is going to build up. That motivation you had when you started two weeks ago, by week three, it's pretty much gone, and now you have to rely on your commitments and just do s- deciding to be committed and consistent. It's merely a choice.

Brianna

Mm-hmm.

Baylee

We do not wake up every day being like, "Yes, I can't wait to wake up at 5:00 AM to go work out." Like, you feel good afterwards,

Brianna

But you don't want to do it

Baylee

Yeah, I would love to just lay down for an extra hour it's so nice and cuddly in my warm bed, but I also like getting up, and getting my day started, and feeling so much more productive, and not falling asleep halfway through work when I have things to do.

Brianna

Mm-hmm. Yeah. And I think that's the big issue is we've kind of just told ourselves, like, You don't have to do that." Like, "You don't have to do it 'cause it doesn't feel good. You don't have time to cook. You don't have time to grocery shop. You don't have time to work out. There's just no time. We don't have to do it," which is such a weird, like, thought process. Is it... It needs to be one of these things where it's like, "This is just something I do because I need it to, like, live," you know? What do you mean you don't have time to cook? You absolutely need to make time to cook. I, I mean, you don't have to be a gourmet chef, but, like-

Baylee

You have to make time to do something. And that's why, this is p- why I teach, like, body intelligence in my course because I think we've, w- we've leaned a little too far into the soft girl era of like, "It doesn't feel good, I'm not gonna do it." Where it's like... Or, like, if you were actually... Like, if you're eating, you did get some good sleep maybe, or maybe, like, decent sleep,

Brianna

Mm-hmm.

Baylee

if you're hydrating, like, if you're taking care of the bare necessities, and if you wake up and you're like, "I'm being a little groggy," I would still work out. it's not like y- you're laying in a hospital bed and deciding like, "Yeah, we're not gonna go get a workout in on that day or probably the next day." But being able to really understand your body, I think, is super important, and that's what I call the body intelligence of just, what does my body actually feel like? Is it going to be more helpful or more harmful? Am I a little sore because I haven't worked out in two months? That's normal. being able to understand your body is imperative, and that doesn't go away with the GLP-1 either because GLP-1s do not just build your muscle for you. They do not just improve your fitness.

Brianna

Mm-mm.

Baylee

not teach nutrition habits or make sure you're getting your protein in or prevent muscle la- loss or solve emotional eating, which that's a huge one. Like, we can't just out sh- outshine our emotional eating habits. We have to identify that emotional eating habit, and that's where some people are like, "I'm still overeating." I'm like, it's not a GLP-1 problem. It's we are stressed. We are not eating throughout the day. why you're having cravings. Your response to a stressful day is go grab an ice cream every night,

Brianna

Yeah. Yeah.

Baylee

which is not helping.

Brianna

Mm-mm. No. And I think that's... I like the soft girl era. I or the, like, instant gratification. Like, it doesn't feel good right now, so I'm not gonna do it. Like, you need to look at, like, what's gonna make me feel good later? Moving my body, do- like, again, yeah, you know, if you're injured or whatever. Like, you can adjust your workouts, you can adjust how you do things, but you need to do things just because you need to be doing them, and you told yourself you're gonna do it. 'Cause that is one thing I see a lot, that mental exhaustion of I have eating healthy and working out on my list to do, and I'm not doing it, and I'm not doing it, and I'm not doing it, and that weighs on you. And the whole not being able to do the things that you said you were gonna do makes it worse on you.

Baylee

Mm-hmm.

Brianna

You getting up and doing it, you're gonna feel so much better 'cause it's like, "Oh, I did it. Like, I checked it off my to-do list. I kept my promise to myself." Great. And suddenly it gets easier and easier. It feels like a big task because you've been telling yourself for the past, like, two years, "I'm gonna work out."

Baylee

Yeah, so there's been a lot of build up there

Brianna

Mm-hmm. Yeah. So of course it's stressing you out, and you feel overwhelmed. The GLP-1 is not gonna help fix that. And again, if you are that person, and then you get on it, and then for some reason you have to come off, you are gonna be working so much more uphill than you already were, and that's what I really want people to know is, like... And again, when they first came out, I think I was annoyed with it too, but I think it's... And again, it's not the medication. They work great. They're a fantastic tool. I think they're, like, a game changer for a lot of things. It's the mindset of I don't have to change anything. I can just inject myself once a week. That drives me bonkers

Baylee

You still have to change things. And I guess the other thing we wanted to talk about in this episode was different types of GLP-1s because I think, like, Ozempic, Wegovy, those... That's, like, what people or that's what they hear about all the time. So to clarify, when we talk about GLP-1s, th- we are often lumping all these different medications together. In reality, there are two major categories. We have traditional and just GLP-1 receptor agonists, so these mimic the natural GLP-1 hormone. have dual activate GLP-1 plus a hormone ha- pathway which can produce greater weight loss. So the most commonly ones... So we have Ozempic, and then the active ingredient is semaglutide.

Brianna

Mm-hmm.

Baylee

So this is approved for type 2 diabetes. It's been seen to help reduce cardiovascular ri- risk, and it has some kidney prote- protection in some people with diabetes and chronic kidney disease.

Brianna

Mm-hmm.

Baylee

So Ozempic is not FDA-approved specifically for weight loss. Many people lose weight on it because the appetite decreasing, but prescribing it solely for obesity is more of an off-label use here.

Brianna

Mm-hmm.

Baylee

So Wegovy, ingredient for this is also semaglutide. So FDA approval, this is approved for adults with obesity, adults with the BMI over 27 plus a weight-related condition, some adolescents with obesity and this is the same medication as Ozempic. The difference is it has higher approved dosing. There are, Insurance is gonna cover it differently, and

Brianna

Mm-hmm.

Baylee

is different FDA indication. So Ozempic for diabetes, Wegovy more obesity side of things

Brianna

Mm-hmm. Yeah. And then you have the Mounjaro, which is the active ingredient is tirzepatide. This is the one that a lot of people are like, "Oh, it works better for weight loss," because it's a dual agonist, so it's doing more than one thing. It's, you know, working on the GLP-1 receptors, but it's also a GIP receptor. So basically what that means is you are utilizing basically the energy you have first before creating... Does it... Eh, it's kinda complicated. I don't know if you wanna go into it. But just know it's working in two different ways, so sometimes your symptoms are a little bit higher. Some people are a little bit more sensitive to this one as far as, like, GI side effects. But tirzepatide is FDA approved for weight loss, weight management in o- obese adults, adults who are overweight, plus have one related condition. So technically overweight BMI is over 25, but they're having it be 27, which I think is appropriate so it's the same drug as Mounjaro. Mounjaro is for diabetes. Zepbound is for obesity. And I think everyone is just interchanging them, and I think it's because when you're getting them from med spas and different companies, they're usually compounding it with these active ingredients. And so sometimes that, that's why the, they get interchanged. Because unless you're getting it through, like, its actual dosing FDA, it's probably, like, a mixture of stuff

Baylee

Yes. Which isn't always bad.

Brianna

Yeah, it's not always about

Baylee

good med spas, but there's also some where you might not be getting exactly what you think you're getting.

Brianna

Yeah

Baylee

so just always look into the sourcing,

Brianna

Yeah. And we, yeah,

Baylee

know where you're getting it from

Brianna

especially with the compounding pharmacies, a reputable one because a lot of times there's restrictions on, like, you can't compound it or mix it the way you would, like, Zepbound, for example. You can't mix it the way the FDA says to mix it because you can't sell that through a compound, so they'll add stuff to it. A lot of times it's, like, vitamin B, other things. But you wanna make sure you know what they're compounding it with to get around the FDA. Cause the FDA's been trying for a while. Like, they're throwing out all the stops and places are just like, "Pivot. Pivot. Pivot." So know where you're getting it from. That's really important. Don't just look at price

Baylee

And people will also respond differently the different types.

Brianna

Mm-hmm.

Baylee

I mean, yeah, typically, if you're doing like Zepbound, the average weight loss is higher, like closer to 20, 25% versus Wegovy is five-- 15 to 17%.

Brianna

Mm-hmm.

Baylee

But yeah, people can just respond differently 'cause they're not all pharmacologically identical. Semaglutide has a strong appetite reduction and satiety for many people. Tirzepatide, it has that

Brianna

Mm-hmm.

Baylee

pathway. It's usually greater for weight loss, but not for every individual because that tirzepatide, when it's stimulating two pathways, some people be- to experience a larger appetite reduction than they did on semaglutide.

Brianna

Mm-hmm.

Baylee

Others notice little additional benefit or have more side effects with tirzepatide too.

Brianna

Yeah

Baylee

the body can just kinda see the drug differently. The drugs can offer-- differ in absorption, distribution, their half-life, their concentration over time. So when we look at like semaglutide and tirzepatide, they do not produce the same concentration curve in the body. So some people feel a strong appetite suppression for several days, and then a noticeable like wear-off effect. Some have more stable suppression throughout the week. Some have nausea that peaks at certain concentrations. These differences can occur even when average weight loss looks similar on paper

Brianna

And sometimes you don't really get to decide which one you wanna be on because your insurance is gonna say, "We cover this." And what I'm seeing is, like, half insurances will be like, "We're doing tirzepatide," the other half semaglutide, and then they'll, like, switch. So they're just all, they're just deciding who's gonna, like, cover what. So a lot of times people will switch, and they'll kind of freak out, like, "Is this still gonna work?" Maybe you'll have better results. Maybe you won't have as good as results. But also doing all that foundational stuff, too, is gonna be a big driver of the results that you have.

Baylee

Yes. Next week, we're gonna dive more into who does not need a GLP-1 and why you, in our opinions, you would not be good candidates. Again, this episode was not to tell you to go tell your doctor to get you a GLP-1. This is just for informational purposes only. Just if you had this question as well, kind of h- our thoughts on it and how we walk through, "Mm, should we recommend it? Should we not?"

Brianna

Mm-hmm.

Baylee

but yeah, we hope you found this helpful

Brianna

I think also just to make the conversation more normal, 'cause again, I feel like they're so taboo.

Baylee

that is tricky, and I think it is 'cause the stigma around it of being the easy way out. People are all the time is here to tell me they're on a GLP-1. I'm like, great." Like, if you're ordering it off the, like, the black market, maybe we shouldn't do that

Brianna

Maybe let's, like, find a different place for you.

Baylee

But if you're someone who has been working on weight loss, you've been doing the things, you are considered obese or you're overweight with like weight-related conditions, yes, utilize this tool. But it's just that. It's that tool that we talk about. It's not the whole strategy

Brianna

I also think if you're one of those people that's like, "Should I not be doing this?" Or you're really questioning it, you're probably a decent candidate.

Baylee

who needs it. Yeah.

Brianna

And there's a couple people I've had where I'm like, "Honestly, based on like all your anabolic markers, all the stuff that you're doing that I know you're doing, I think it might be time to like talk about this." And even still they're like, "Are you sure? Is this cheating? Should I be doing that?" It's like, "Okay. You're probably a good candidate."

Baylee

who your doctor's like, "No, I don't think this would be good for you," and you're having to go get it off the black market because no one will give it to you, not a good candidate for it. Let's

Brianna

There

Baylee

other

Brianna

is a reason

Baylee

But that's not necessarily true if, like, I have seen some doctors say they don't need it, like the microdosing

Brianna

Mm-hmm.

Baylee

parts, which is a whole 'nother conversation.

Brianna

That is only 'cause there's no microdosing, there's no standard microdosing, so a lot of doctors are like, "I'm not even gonna do it."

Baylee

Yep.

Brianna

Yeah

Baylee

And that's a whole 'nother thing. This is mainly focused on if you are obese or overweight, then you might be a good candidate for a GLP-1 if you are implementing the lifestyle modifications with it,

Brianna

Mm-hmm.

Baylee

have truly tried lifestyle modifi- modifications before doing it.

Brianna

Yeah.

Baylee

We hope this was helpful, and we will be back next week to discuss more on GLP-1s.

Brianna

Yeah, and to maybe, maybe make some people a little bit annoyed when we tell them you're not a good candidate. But it's okay, it's on a blog

Baylee

And I did have someone tell me last week how she was like, "You know, some of these episodes, I don't think they're gonna pertain to me," but I listen to them anyways. And she's like, always get something from it." so if you're like, "I don't even know about... I've never questioned a GLP-1," like, still listen next week because you're probably still gonna take away some little nugget that's gonna help you out

Brianna

Yeah. Or help someone else that you know, 'cause everybody knows someone on a GLP-1, and be like, "Hey, did you know?"

Baylee

Yes.

Brianna

Yeah.

Baylee

Mm-hmm.

Brianna

What's

Baylee

Yeah.

Brianna

up? All right.

Baylee

we just feel like this is an important topic to cover because we do have so many questions on it. I'm sure everyone knows someone on a GLP-1, and I'm sure many people listening have considered doing a GLP-1.

Brianna

Yeah,

Baylee

So

Brianna

probably

Baylee

be back next week, and we'll talk to you guys soon. Bye.

Contributor

Baylee

Host
Contributor

Brianna

Host