Your First Month on Weight Loss Medication: Expectations vs. Reality

Thinking about starting weight loss meds? Read this first.  I have been getting lots of questions from clients and potential clients about weight loss medications so I wanted to chat with you about what to expect when you do or do not start taking a weight loss medication.  I know weight loss, accepting our bodies for what they are, and struggling with labeling foods as “good” or “bad” are all big topics that my clients face each day so I want to make sure you have all the facts you need BEFORE you start a weight loss medication. 

Taking the step to start a weight loss medication can be a significant and personal decision. It’s important to approach this journey with a blend of optimism, realism, and self-compassion. As a nutrition professional, my goal is to provide you with balanced, evidence-based information so you can feel empowered and informed about your choices, whatever they may be.

Understanding Weight Loss Medications

Weight loss medications can be an effective tool for those who have struggled with maintaining their weight through diet and exercise alone. Typically clients who have other comorbidities (as we say in the healthcare world) are offered weight loss medications. Meaning you may also have high blood pressure, high cholesterol or an increased risk for heart disease or diabetes.   Weight loss has been shown to benefit these conditions however,the question remains. Iis it due to the change in the quality of food in the diet and the increase in physical activity the person has been partaking in or just the fact that they have lost weight? To say that it is not a complex area is a lie.

There are so many medication on the market now and they work in various ways, such as reducing appetite, increasing feelings of fullness (slowing gastric emptying), or inhibiting fat absorption. It’s crucial to remember that these medications are most effective when used in conjunction with lifestyle changes, including a balanced diet and regular physical activity. 

If you have a history of yo-yo dieting you may want to work with a dietitian before starting these medications to get in a better headspace about the expectation of jumping back in to the calorie restriction and exercise world. It is also extremely important to realize that these medications are typically not meant to be used forever. It is a leeway of time for you to focus on behavior change that you may have struggled with in the past and to come up with habits to help you be more effective with managing your weight in the future.

What to Expect

1. Initial Adjustments: Your body may need time to adjust to the medication. Some people experience side effects such as nausea, vomiting, headaches, rapid heart rate, trouble sleeping or constipation. Certain medications (like phentermine) should not be used if you have thyroid issues, heart disease, or high blood pressure. Other medications like GLP-1 RAs like Monjouro or Ozempic will have their own way of titrating when you are using them so be sure to follow the instructions. The side effects of weight loss medications often diminish as your body adapts, but if they persist, consult with your healthcare provider, because that is NOT “normal.”

2. Gradual Progress: Weight loss might not be immediate. It’s normal for the process to be gradual, and that’s okay. A misconception about weight loss medication is that just because you start it you will automatically lose weight and that is just not true.  The average weight loss for one of the more common medications (phentermine) is about 3% of your weight loss in the first 3 months. Sustainable weight loss typically ranges from 1 to 2 pounds per week (this is whether you are on meds or not).  Rapid weight loss is not only harder to maintain but can also be unhealthy. And most of us know what happens if you lose it too quickly, you can’t maintain it and then it comes back two-fold. 

3. Emotional Journey: One of the most significant barriers that people don’t realize to starting a weight loss medication can be the emotional process of losing weight and accepting your body for what it is. It’s essential to address any underlying emotional issues related to body image and self-esteem ideally before you decide to start any plan to lose weight. This process can involve self-reflection, counseling, or support groups.

4. Regular Monitoring: Your healthcare provider will likely schedule regular check-ups to monitor your progress and any potential side effects. This is a great opportunity to discuss any concerns and make necessary adjustments to your treatment plan.  DO NOT miss these appointments.

5. Holistic Approach: Incorporate healthy eating and physical activity into your routine. Focus on nutrient-dense foods that fuel your body and find an exercise regimen that you enjoy. Remember, weight loss medication is just one piece of the puzzle and most people who are successful with weight loss medication ALSO change their diet and exercise routines.

6. Long-Term Commitment: Sustainable weight loss is a long-term commitment. Even after reaching your weight loss goals, maintaining those results will require ongoing effort and lifestyle adjustments. Most weight loss medications are not meant to be taken forever.  You must maintain your habit changes in order to maintain the loss. Honestly, this is probably the hardest thing for people to do whether they take a weight loss med or not so getting support from a reputable nutrition professional is a great way to make sure you succeed.

Tips for Success

Addressing the Emotional Aspect

Starting a weight loss medication without working through the emotional process of losing weight and accepting your body can hinder your progress and overall well-being.  Everyone is different. We all have different body types, metabolisms and food preferences. To ignore these facts is ignorant.  It’s vital to embrace your body as it is and recognize that weight loss is not solely about changing your appearance. I argue that weight loss that is fueled by a desire to improve one’s mental and physical health is easier to acheive than that soley derived from vanity.  It’s about enhancing your health, energy, and quality of life. Consider engaging in practices that promote body positivity and self-love, such as:

Choosing to start a weight loss medication is a personal decision and is not the sole reason for weight loss success.  Only you know if you are in the right headspace to try this. Some questions you can ask yourself are, “What happens if I don’t lose weight?” “How am I going to feel after restricting foods I usually eat 6 months from now?” By setting realistic expectations, staying informed, and maintaining a balanced approach, you can navigate this journey with confidence and self-compassion. Remember, you are not alone, and there is no one-size-fits-all solution. Taking a weight loss medication does NOT guarantee weight loss long-term.  Trust yourself, and know that you deserve to feel your best in your own body, with or without medication.

Jackie