I’ve been noticing on social media and the gossip pages that skinny is back.

Are you seeing this?

 

In the past year, I’ve had conversations with young women in their teens and twenties, and their number one request is to be skinny.

 

I spoke with a woman who’s 24 and has reduced her calories from 1000 to 800 to 500 calories a day, and wonders why she can’t lose weight.

 

Her body is literally starving.

 

Rather than take their money, I tell them I’m not a good fit.

 

I saw my younger self in these women as I spent too many decades of my life trying to be as skinny as I could.

 

Restricting calories.

 

Fearing food.

 

Over-exercising.

 

I’ve freed myself from that grip when I learned how to eat to nourish my body and build muscle.

 

For me, strong is the new skinny.

If you’ve lived through the 80s and 90s, you’ve seen this trend before.

Most Gen X women grew up in an era of the skinnier the better.

Then norms changed, and in the 2010s, we ushered in the era of body positivity.

 

The pendulum has swung again, and skinny is back.

 

What’s driving it?

 

I think it’s a class of drugs called GLP-1s.

 

It’s meant for type 2 diabetics to control their blood sugar.

 

But look around and you’ll see everyone from celebrities to soccer Moms injecting themselves.

 

What are GLP-1s?

 

• It’s a hormone that your body makes in the gut. Tells your body you're full: When you eat food, your gut naturally makes GLP-1. This hormone travels to your brain and tells it, "Hey, we've had enough food, time to stop eating!" This helps you feel satisfied and less hungry.
• Slows digestion: GLP-1 slows the movement of food through your stomach. This means you feel fuller for longer, and your body absorbs the energy from the food at a steadier pace, preventing big spikes in your blood sugar.
• Manages sugar levels: It tells a part of your body called the pancreas to release more insulin when there's too much sugar in your blood. Insulin is the key that unlocks the cells and helps move sugar out of your blood, where it can be used for energy. It also prevents another hormone (glucagon) from making more sugar. 

Some of the most common side effects include nausea, diarrhea, constipation, headache, and fatigue.  

I’ve known people who end up in the emergency room with gastroparesis.

 

In this condition, the stomach's emptying is significantly delayed, leading to symptoms such as nausea, vomiting, and early fullness.

 

The concern this raises for me, as someone who views gut health as foundational to overall health, is that delayed gastric emptying may create an opportunity for SIBO (small intestinal bacterial overgrowth) to develop.

 

We want waste to move through the body and not linger, so toxins don't recirculate.

 

I hear people say that GLP-1 has helped them quiet food cravings.

 

This makes me wonder if they’re having a lot of sugar cravings, are they eating well-balanced meals, or are they experiencing blood sugar spikes and crashes?

 

Food cravings can be due to poor gut health and an overgrowth of bad bacteria.

 

Or they can be fueled by consuming a lot of refined carbohydrates, such as bread, pasta, crackers, and cereal, to name a few.

 

One of the biggest risks with GLP-1s is muscle loss.

 

As noted in the medical journal The Lancet, the crucial role of skeletal muscle has come to the forefront of public attention due to data on GLP-1 receptor agonists, which are effective for weight loss but can cause substantial muscle loss. 

 

Studies suggest muscle loss with these medications (as indicated by decreases in fat-free mass [FFM]) ranges from 25% to 39% of the total weight lost over 36–72 weeks.

 

I’m sure you’ve seen celebrities who seemingly lose weight overnight, and their faces look very drawn and gaunt.

 

They’ve lost muscle.

 

Lifting weights and eating adequate amounts of protein are imperative when taking these drugs; otherwise, you risk losing muscle.

 

We know that, as we age — especially for women — muscle is the fountain of youth.

 

It is what will keep you independent and supports bone health.

 

While GLP-1s seem like the easy way to lose weight if you’re not making significant nutrition and lifestyle changes, the weight will rebound once you stop the drug.

 

But now you likely have less muscle.

 

Muscle is a metabolic sponge, soaking up glucose.

 

Another problem I’m seeing is that as people have no appetite, they eat fewer and fewer calories.

 

With less energy (calories), your metabolic rate decreases.

 

Over time, you develop metabolic adaptation.

 

Meaning your body gets used to running on 1000 calories a day.

 

You come off the drug and start having an appetite again and eat more than a 1000 calories a day (which is too low for any adult), and you gain fat.

 

Now that the drug has been widely available, we’re starting to hear about the side effects.

 

As more people take it for weight loss and not just type 2 diabetes management, there are reasons for concern.

 

The FDA approved Ozempic in the United States in December 2017 for the treatment of type 2 diabetes.

 

There are now multiple class action lawsuits that have been consolidated, and the drug manufacturer could be facing paying out damages of $2B.

 

• Plaintiffs are suing due to: Failure to warn: Plaintiffs claim Novo Nordisk did not provide sufficient warnings about severe side effects, leaving patients and medical professionals uninformed.
• Defective design: Lawsuits allege the drug was defectively designed by failing to warn about potential dangers, such as gastroparesis and certain vision problems.
• Misleading marketing: Some claims suggest that marketing campaigns for Ozempic and similar drugs downplayed risks and overstated benefits, contributing to patients demanding the medication for off-label use. 

Alleged side effects:

• Gastroparesis (stomach paralysis)
• Bowel obstruction and other intestinal problems
• Pancreatitis
• Gallbladder disease
• Kidney injury
• Vision loss (NAION)
• Blood clots 

My dentist has been sounding the alarm on what she calls Ozempic teeth.  

She sees tooth sensitivity, weak enamel, dry mouth, gum irritation, and unexpected cavities.

 

Just as I’m questioning what happens to the gut microbiome, my dentist is questioning what’s happening to the oral microbiome while taking a GLP-1.

 

I’m concerned that people are using GLP-1s without adequate education.

 

They’re not making the nutrition and lifestyle changes needed to support maintaining muscle.

 

I’ve also seen telehealth companies jump on the bandwagon and cash in.

 

I’ve been approached by one of them to market GLP-1s to my audience.

 

This is a drug that needs to be dispensed by medical professionals, and you need to be followed closely while taking it.

 

Its original design was for disease management.

 

It’s not meant for influencers or nutritionists to market on social media.

 

Costco is getting in on the action and selling the drug for half off its monthly price tag of $1000.

 

Yet when I walk around Costco, as I did yesterday, I see most people pushing carts full of food that is completely devoid of nutrients, which is making them overweight and unhealthy.

 

I’m also seeing a trend in the menopause space that’s pushing a pharmaceutical stack of hormone replacement therapy and a GLP-1.

 

It continues the narrative that I spoke of two weeks ago, that your body is inherently broken in midlife.

 

I encourage you to do your own reading and research before jumping into a GLP-1.

 

I have a special program coming for you in January that will help you make lasting change without sacrificing muscle or causing digestive issues.

 

Here’s what one of my newsletter readers said after putting into action things she read here:

 

"Here is a tiny change story. I play tennis every day. I add in a few Pilates and sculpt classes. I still felt a little matronly, my back hurt, and I am way heavier than the Ozempic ladies. Boy, do they get they get thin.

I added more water in the morning. I added a short 30 minute walk to unwind at the end of the day because I thought of you walking in Idaho. Dropped 4 pounds, and my back feels better. Must have stopped some snacking."

 

I’m a believer in sustainable change that works day in and day out.

 

When you understand how to build a meal, whether you’re at home or traveling, you build habits that stick.

 

You stop fearing food and thinking you need a diet or a cleanse.

 

When you understand the lifestyle shifts that move the needle so you can have more energy and sleep better, the payoff can be weight loss.

 

Your body isn’t the problem.

 

Your habits are.

 

You don’t need discipline.

 

You don’t need perfection.

 

You need consistency.

 

And an understanding of how your body works.

 

I hope you’ll join me in January.

 

 

Watch this space for more details.

And a month ago, I wrote about how your thoughts drive your feelings and behavior.

I'd been resisting getting back to the gym and lifting weights.

My brain has been offering up so many thoughts of why I shouldn't bother going to the gym.

It's cold.

It feels like I can't lift as heavy as I used to.

Where to put my stuff is still a lingering brain drama.

I won't lie. It's been hard to push past them.

I'm aware that this is just my brain trying to conserve energy and keep me safe as I navigate a new gym.

Have you been challenging the thoughts your brain offers up?

I'd love to know.

Hit reply and tell me.