In the previous post (here) I told you I started on a GLP-1 medication a couple of months ago, maybe partly for weight loss, but that wasn’t the main reason-- the main reason was for relief from the frequent migraines that have plagued me since I had COVID back in 2020.
As I told you, two months later, I’m not sure yet if my migraines are any better, but the weight loss has been way more than I expected. Before I started, I thought it wouldn’t hurt to lose ten pounds, thinking it would take 3-4 months. In two months, I lost 19 pounds, about 11% of my body weight.
I don’t care if people know I’m doing this, but it doesn’t exactly come up in conversation and people are way too polite to ask. Last week I went for a hike with a couple of friends and I was planning on telling them about it, but then we started talking about kids and grandkids and summer plans and I totally forgot. Maybe I will send them the link to these posts
So here is more about what I'm experiencing, in case you're wondering.
- I started with the standard starting dose for the medication I'm on, 2.5 mg. Since I responded so quickly, I'm still at 2.5 mg. Many people go up to 5mg or more (I just checked, and the maximum dose is 15mg).
- It's not cheap, and since I don't have diabetes or any of the diagnoses that insurance covers, we're paying for it out of pocket. The standard prescription is for an auto-injector, which is pre-filled with the correct amount and makes it simple to give yourself the injection, but it's also more expensive. If you or someone in your household is comfortable giving injections, you can get the vials without the auto-injector, which is cheaper. And since my spouse can give injections in his sleep, that's what I get. It's $300/month, plus the first month I had to buy a box of syringes and some alcohol prep pads. I can't remember exactly how much those cost but it wasn't a lot--maybe $30, and there's enough to last a couple of years. I'm grateful we can afford to do this. But if it works for the migraines, $300/month is not much compared to how much I spend (in both money and energy) on migraines and migraine meds.
- Side effects. the way that GLP-1s are supposed to work is by turning off whatever switch makes you feel hungry, so you feel full more quickly and the feeling of fullness lasts longer--thus you eat less. The first two weeks, I had terrible nausea, although I never threw up. It was bad enough that I thought, well that's why people lose weight, because they can't stand the thought of food. But that mostly subsided by the third week and has now gone away.
Also the constipation was terrible the first few weeks-- it's better now, but I don't know if that's because it has really improved or because now I take dulcolax and colace on alternating nights. I do also occasionally feel seemingly random abdominal pains, but they are pretty minor and don't last more than a second or two. Fatigue, headaches, and dizziness are listed on the label as side effects, and I have occasionally had those, but it's difficult to tell how much is due to the med and how much is just me being 64 and in recovery from weddings- ha. So far it has not been debilitating.
- one of the things that interested me the most was the claim that GLP-1s reduce "food noise"-- the constant thoughts of food that sometimes run through our heads, often at a level that we don't even notice. I have mixed feelings about this one. In the past, I’ve certainly had intrusive thoughts of food-- if I know there are cookies in the cabinet, I keep thinking about them and thinking about them until I go and get them. But for me, "food noise" was always tied to being hungry, so I'm not sure if it's actually the food noise that's gone away, or if it's that I don't have as much food noise because I'm not hungry as often.
- I definitely don't get hungry again as quickly after I eat. Before, I would eat a full meal, and within 30-60 minutes, my stomach would start to empty out, and I would feel hungry again (even if I had eaten a big meal and there was no possible way I needed additional nutrition). And as soon as I started feeling hungry again, the food noise would start up. I didn't always act on it, but I did notice it. Now that I don't get hungry as often or as quickly, I don't think that much about food. Is it an actual reduction in food noise, or is it that I'm not hungry as much? I don't know. I still do get hungry, and I still think about food, but not as often or as much.
- OK, so here are just some things I've been thinking about, probably just my usual thinking on overdrive, but you know, that's why I keep a blog— so I can write about what I'm thinking about.
So when the first dozen pounds dropped away, I had this very distinct feeling of recognition. Oh, yeah, this is what my body is supposed to feel like, what it used to feel like a dozen years ago. It wasn't even so much the weight dropping away (again, this is just my impression, I have no way to do a double-blind study), as it was something different about the way my body felt. I can believe that there was some switch, maybe something to do with inflammation, that had been stuck in the on position that suddenly seemed like it had been turned off.
Maybe it's just age. Maybe in the space of a few weeks, I got back to a feeling of how I felt ten years ago. Maybe it was just because of the weight loss. I don't know. But it didn't feel like it was because of the weight loss- I've lost weight before and I didn't have this feeling. I'm just telling you, it felt like something that had gone wrong in my body was fixed.
- And here's the other thing. As I told you in that previous post, the standard saw about weight loss is that it only happens if you eat fewer calories than you burn. Which makes it always, eternally, your own fault if you're not at your ideal weight. This is entirely within your control! If you eat fewer calories and burn more calories, you will automatically lose weight! Which, all right, yeah, it sounds very good and scientific and makes weight loss into a math class-- calculate the calories, burn some extra, and voilá, you look like a model.
But thousands of us, maybe hundreds of thousands of us, male and female, know that's not always how it works. You can cut calories and cut calories and not lose weight. Some people can eat and eat and not gain weight. There are all kinds of complications to that simple formula, the IT'S ALL YOUR FAULT formula. But when the opposite happens, the "super-responder" thing that happened to me with zepbound-- it's obvious that the mathematical formula isn't all that's happening. This isn't anything I did. It’s like the weight just came off with a whoosh. Like I said in that last post, I did calorie restriction in Weight Watchers for ten or eleven months, and I didn't lose this much weight.
There is no way I could lose twenty pounds in two months just because I wasn't eating as much. Something else is going on. It's like my body was holding on to extra weight for some reason, and the GLP-1 turned off whatever it was that was causing me to hold onto it. It makes me think that our entire weight loss industry is based on a bunch of partial truths. Maybe the question isn't how can I get the correct amount of calories in and out so that I can reach some random "ideal" weight? Maybe the question we should be asking is why do our bodies hold on to excess weight?
I'm not an expert, I'm just an overthinker. There are so many crazy ways that our culture's obsession with thin-ness can take over our psyches. There's the problem of women wanting to avoid unwanted attention if they look thin (sadly "thin" too often equates to "sexy and attractive," like having a HIT ON ME sign taped to your back.). There's the problem of pecking order, because often in a group of women, the thin women are the queen bees and the overweight ones are at the bottom. I don’t want to lose weight! I am in solidarity with my plus-size sisters!
There's the way that obsessing about weight can keep you feeling like a failure, so you obsess about that instead of other things. I even had the thought, somewhere around week 4 or 5: it's not food noise that is reduced, it's self-loathing. The feeling of self-disgust, of failure, that comes when you can't do something that should be so simple (controlling calories in/out)--something that is simple for some people.
So, yeah, there you have it, my experience with a GLP-1, nine weeks in. I have to take a week off from the injections this week because-- TMI alert!! -- I have a colonoscopy coming up. This is what happens when you read a boomer blog, people.
I've only done the most basic editing job on this thing because we are sort of on vacation this week (as much as you can be on vacation when you're retired), so I'm just sending it off. Have a great weekend. And don't overthink it.
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