Doing everything right and the scale won’t budge?

I hear it almost every day, and I get how frustrating that feels. You’re eating well, you’re exercising regularly, and yet the scale won’t budge and fat is settling around your middle in a way it never did before.

In midlife, your body really does work differently. As estrogen shifts, we lose muscle, which means less strength, less metabolic reserve, and worse blood sugar control, leading to more fat storage.

The advice most women keep hearing — just eat less and move more — assumes your body works like it did at 30. It doesn’t.

What I see work, again and again with my own patients, is treating the whole system. Improving insulin sensitivity with nutrition and exercise; addressing hormones, sleep, and stress; and adding medication when indicated.

Most patients spend less than 15 minutes with their doctor to get a prescription for a GLP-1 — with no guidance on nutrition, muscle loss, side effects, or how to ever come off.

GLP-1s are routinely prescribed now, but there are major gaps in care.

And that leaves so many important questions unanswered:

• How do you come off a GLP-1 medication without regaining when you hit your goal?
• How do you manage side effects like nausea, constipation, or hair loss?
• What about nutrient deficiencies?
• You’ve heard high fiber and high protein are important, but how much, and how do you actually do it when you’re not hungry?

GLP-1 medications can be incredibly helpful and we prescribe them regularly. But they are not a magic bullet. They don’t diminish the importance of diet and lifestyle. In fact, they make it more important.

Studies consistently show you can amplify the benefit of a GLP-1 with diet and lifestyle — both the weight loss effects and the cardiovascular effects.

One study found a GLP-1 alone reduced heart disease risk by 20%. The combination of GLP-1 and diet & lifestyle resulted in a 40% reduction in heart disease risk.

This is our philosophy:
Lifestyle FIRST and Lifestyle ALWAYS. More important than the drugs alone.

And a battery of evidence shows that if you want success in changing something, you should meet up with groups of people doing the same.

That’s exactly why we’re hosting our Weight Loss Group Visit Series — to fill in the gaps, facilitate group support, and provide comprehensive care that you simply can’t get in a 15-minute appointment.

Hosting these group visits is undoubtedly one of my favorite parts of my job — a connection to the “aha,” to the behavior change, to the “this could work for me.” I love showing people healthy doesn’t have to be hard and can taste good too. I’m thrilled to be joined by Dr. Prentice and Dr. Carrera, our skilled GLP prescribers.