GLP-1Medicines are a Tool, Not Magic
Slower than expected, and three days of notes showed why
Hey everyone -
We recently had a patient whose weight loss was moving slower than either of us expected. Taking the medication on schedule. Showing up to visits. Frustrated, and honestly so were we.
So we asked for the one thing that almost always clears it up: three days of food, written down. Nothing fancy. A sheet of paper folded in thirds, lunch and dinner for Friday, Saturday and Sunday.
Wow. It told the whole story in about ten lines.
The guardrails we give every patient
We don't hand out a rigid diet. We give everyone three guardrails, sized to their own body:
A calorie range. Built from your BMR sheet, roughly 20 to 30% under what your body burns in a day. Enough of a deficit to release fat, not so much that your body digs in and holds on.
A protein goal. 100 grams a day for most of our patients, and higher for larger frames. Protein is what protects your muscle while the fat comes off.
A fluid goal. Half your body weight in ounces. A 200 lb person is aiming for about 100 oz a day.
Hit those three most days and the medicine has something to work with.
What the journal showed
Here's what three days looked like, in plain terms:
Calories were close. About 1,680 a day, just under the bottom of this patient's range. Not the problem. Honestly a little surprising.
Protein was way below. About 47 grams a day, roughly a third of their goal.
Fluids were about a third of goal too. Two waters with dinner, and a small root beer a couple of days. That's it.
Nearly every calorie was fast food or packaged. A burrito and tater tots, a burger and fries, pizza, Lunchables. Cookies alone were about 28% of everything eaten.
No fresh fruit or vegetables. Not one, in three days.
Two meals a day. No breakfast. No snacks. Lunch, then dinner.
The medicine is a tool, not magic
This is the part I want everyone to hear. A GLP-1 is a fantastic tool. It turns down food noise and hunger, and it makes it a whole lot easier to stop eating when you're full.
What it doesn't do is pick what's on the plate.
Low protein leaves your body less to protect muscle with, and muscle is a big part of what keeps your metabolism going.
Low fluids make digestion harder (constipation is one of the most common complaints we hear on these meds) and leave you more tired.
Highly processed food is calorie-dense and easy to eat, but light on protein and fiber, the two things that keep you full and regular.
Two meals a day with nothing until lunch makes it really hard to land enough protein. You can't fit 100+ grams into two meals of crackers and pizza.
Same calories, very different plate. That's why the scale was slow. Not willpower. Not the medicine. The mix.
What we suggested (nothing drastic)
We didn't take away a single favorite food. Just a few swaps and adds:
A 30 gram protein breakfast, like a protein shake or eggs with Greek yogurt.
Four more bottles of water spread through the day.
A protein shake in the afternoon instead of the soda.
Keep one cookie after dinner. Swap the rest for a high-protein yogurt.
Two hard-boiled eggs and one fruit or vegetable next to dinner.
Put together, that lands this patient right inside their calorie range, with their protein goal met and their fluids most of the way there. Same Lunchables. Same pizza night. Just more of what their body actually needs.
If your scale has been slower than you'd like, bring us three days of food notes at your next visit. Handwritten is perfect. Our clinical team will run it and show you exactly where you land on calories, protein and fluids. No grades, no lectures.
Not a patient yet? Book a FREE consult and we'll walk you through it.
-Daryl and Jennifer
Puyallup and Federal Way clinics
