Approximately 12.5% of Americans are currently on a weight loss drug and usage is growing. Rapidly evolving research demonstrates significant secondary health benefits from these medications including a reduction in visceral fat, chronic inflammation and improved metabolic control. Chronic conditions such as diabetes, high blood pressure, lipid disorders, PMOS, sleep disorders and depression may show improvement along with quickly emerging, supportive cancer and liver research. Individuals who struggled for years to lose weight have improved metabolic, physical and mental health paving the way for a healthier future provided their results are reasonably well sustained and they lean into health goals that extend beyond scale weight.

The Many Benefits

1. Weight loss

• Appetite is significantly reduced. Food leaves the stomach more slowly, increasing fullness and putting a lid on hunger. Food noise goes away.
• Calorie intake is reduced. This often happens in conjunction with a reduction in desire for highly processed foods as the individual is coached to focus on nutrient dense, whole foods. Alcohol also becomes less desirable for many. These combined changes can break the dopamine reward system to junk foods and addictive substances, further improving weight loss efforts. Focusing on nutrient dense foods and cleaning up one’s food environment must be an important focus during nutrition counseling sessions.
• Harmful, visceral fat that releases inflammatory proteins and fatty acids, causing chronic inflammation, insulin resistance and raising cardiovascular risk is reduced.
• Metabolism may slow. This often occurs during significant weight loss and can be mitigated through healthful, protein forward food choices, weight lifting and good sleep habits. Improving lifestyle habits on a variety of fronts is the key to longterm success.

2. Improved blood sugar control in people with type 2 diabetes

• The pancreas is stimulated to release insulin upon eating, allowing blood sugar to get into the cells to be used for energy.
• Glucagon release is suppressed, which would have normally raised blood sugar.
• The stomach empties more slowly, slowing down digestion and minimizing post-meal blood sugar spikes.
• Improved blood sugar control reducing chronic inflammation and enhancing weight loss efforts. Well controlled blood sugar prevents damage to major organs, nerves and blood vessels.
• A1C laboratory measurements in people with type 2 diabetes improves.
• Working with a registered dietitian to create a higher protein, higher fiber, balanced carbohydrate diet enhances the medication’s positive impact on blood sugar control.

4. Cardiovascular benefits

• Major cardiovascular events such as heart attack and stroke may be reduced.
• The heart pumps more efficiently as there is less strain on the cardiovascular system.
• Triglycerides are reduced. The speed at which the stomach empties slows, improving insulin sensitivity and suppressing the production of very-low-density lipoproteins (VLDL) that transport triglycerides into the blood stream.
• Blood vessel linings become healthier as chronic inflammation is reduced and blood pressure improves.
• LDL cholesterol decreases as the body’s response to insulin improves, signaling the liver to produce less LDL cholesterol and allowing it to be more efficiently cleared from the body.

Stopping GLP-1 therapy abruptly rapidly reverses all of these cardiovascular benefits and has been referred to as “metabolic whiplash”, elevating the risk of heart attack and stroke. Always work with your doctor to determine how to safely taper off these medications or transition to one of the many alternatives.

5. Improved metabolic markers

These are my favorite labs to watch improve as a person loses weight, makes healthful nutrition choices, exercises regularly, gets good rest and improves their response to life’s stressors.

• Blood pressure goes down
• LDL cholesterol goes down
• HDL cholesterol increases
• Triglycerides go down
• Insulin resistance improves
• A1C improves
• Waist circumference decreases
• Lean muscle:body fat ratio improves

I suggest my clients view weight loss as their short rather than long-term goal. Long-term goals are reserved for the maintenance phase. What are these?

• Reduced medication usage
• Stronger body, toned muscles
• Movement with less pain
• Improved metabolic markers
• New, healthy culinary skills
• Engaged and energetic parent, grandparent or friend
• Active vacations with friend who share in their health goals
• Confidence in new mind/body pursuits
• Contentment

Creating healthy, sustainable lifestyle habits during the active weight loss phase including good nutrition, hydration, exercise, sleep and a supportive environment is critical, but maintenance is where the true work begins. It is highly rewarding when your lifestyle changes have become a part of who you are and you begin to celebrate long-term goal achievement.