I recently met a young neuroscientist at a women's brain health conference who is actively researching GLP-1s. She told me that her mother-in-law had explained her recent dramatic weight loss by explaining that she had been diagnosed with salmonella poisoning (!) and that her doctor had informed her it would continue for about six months (!!). That's a serious bout of poisoning.
I was struck by what must be a deep sense of shame that would lead someone to go to such lengths to fabricate a story while simply trying to prioritizing her health.
I admit I used to be a little unclear, maybe even a bit judgy, about non-diabetes use. Surely medication should be the last resort? But I've dramatically changed my mind. I've come to understand how much more there is to this conversation than weight loss. As a result, I've been learning as much as I can about GLP-1 medications, prompted by conversations with friends, clients, experts (reproductive psychiatrist, nutritionists, naturopaths, doctors) and research like this. What's clear is that this is a much bigger conversation than fitting into a smaller pair of jeans. And what has struck me, as much as the promising science, is the confusion and emotions layered into these conversations.
Damned if you do, damned if you don't
Sticking with the weight loss theme, we all know that the media is cruel to women. Women are judged when they struggle, their discipline is questioned, and their body size is treated as evidence of character. Now that some women have another option, there are even more ways to judge.
So, if you use a GLP-1, does that mean you took the easy way out? If you're considering one, does it mean you've failed at managing your health? And if you decide against one, does that mean you aren't doing enough?
Benefits vs trade-offs
This past year, a friend started taking Ozempic on her doctor's suggestion. She wasn't overweight to the point of endangering her health, but she had extra padding around her belly she couldn't seem to lose. She's active. She lifts weights, eats well and walks 10,000 steps a day. She's also a single mother working very, very hard. And she loves food.
The medication worked. She lost weight quickly. But she also lost her appetite and, with it, much of her interest in food. She went to one of her favourite restaurants and realized she didn't even want to eat. More troubling, she felt as though she'd lost some of her ability to experience joy more generally. After two months, she stopped taking it and, eventually, the weight came back. For her, the side effects she was experiencing came at too high a cost. But she wouldn't have known this unless she tried.
Of course, everyone's experience is different. The side effects one person experiences may not be the same as another's. My friend's story isn't an argument for or against these medications. It's a reminder that we each have to weigh the benefits and costs for ourselves, with the support of our healthcare providers and that sometimes an option is worth exploring.
Women deserve options, not judgment
As a women's performance coach and strength trainer, I want to encourage clients to have thoughtful conversations with their doctors about the risks and benefits of taking medication, as well as the risks of leaving a health concern untreated.
All women should be able to ask, without judgment or shame: What are my options? What are the potential benefits and risks? What happens if I do nothing? And what support will I need if I decide to pursue treatment?
Dr. Bev Young, a reproductive psychiatrist and partner at BRIA, has spoken about how women have come to accept suffering as something they simply have to endure, whether through the menopausal transition or challenges with their physical and mental health. Her company has done an amazing job at demonstrating that this does not need to be the case and that suffering in silence is not OK. Great podcast here.
Taking care of ourselves is the conversation
If this medication is part of your plan, nutrition, especially protein and fibre, and progressive strength training deserve a place in the conversation. Your body needs adequate fuel, and your muscles need to be used. When appetite changes, it can become harder to eat enough to meet your nutritional goals. If you are considering this route, ensure that you have the wraparound support you need on this health journey.
Side note: Progressive strength training means constantly increasing the challenge. Generally speaking, you should feel like you're working out at a 7/10 effort. As you get stronger, that will demand more weight to maintain the 7/10. Sorry, but it doesn't get easier.
My position is not that everyone should take a GLP-1 or that no one should. It's that women deserve dignity. They deserve to have their concerns taken seriously, to understand their options and to make informed decisions with appropriate medical support. They deserve not to suffer in silence, and they shouldn't have to defend their healthcare decisions to anyone around them.
I'm committed to being more curious, more willing to learn and more open to discussing the options available to women, rather than falling into the easy cynical critic camp. Women deserve to be heard, informed and supported. I'm asking you to join me in changing that conversation.
You don't owe anyone an explanation about your healthcare decisions. And you certainly don't owe anyone a story about salmonella.
Keep curious, keep challenging yourself, keep positive. At the end of the day love and kindness wins.
