Hello everyone and welcome back to the Rebel Nutritionist Podcast. Today I am going to be having another conversation about the GLP ones and really post GLP one because I’ve talked about them before, have introduced them to you. The idea we’ve talked about a lot of different things. And I feel that it’s important to revisit this because we’re seeing more and more people now start to segue off of them, do some segmenting of on and off.
And I feel like this is a really timely. Topic about talking or talking about why appetite suppression is not the same as metabolic repair, and what do I mean by that? The GLP one, medications like Ozempic and Wegovy and zeep, and now even some of the ones that you’re getting, whether it’s the pill or it’s off label, or you’re getting it compounded or however you’re getting it, even though I wouldn’t recommend the compounding, these have now completely changed the weight loss conversation, like completely overhaul. So for many people, this is, these medications are the first thing that has actually worked. And a lot of people expect me to say, oh, I’m against them and how bad they are. And look, there, there are certain benefits and there’s definite downsides to them.
And we’ll talk a little bit about that today. But people are losing weight and. If you’re using it as a jumpstart and that kind of thing, then there’s an appropriate time and place. Again, not gonna get into the whole conundrum of how people are using them, but people are losing weight.
Their appetite is feeling like it’s under control and for the first time in years, they feel hopeful about their health. So I think that’s really important. But here’s a question that I feel no one is asking. What actually happens to your metabolism after the medication? And this is a really, really important conversation to be having because appetite suppression is not the same thing as metabolic repair.
And if your underlying metabolic signals have not changed, the body will often return to the same patterns once the medication is reduced or it stopped. So today what I really wanna talk about is. The post GLP one plan. What needs to happen in the body if we want weight loss to be long lasting and sustainable?
And here’s the thing, the answer doesn’t have anything to do with willpower. Let’s take that out of this equation. It has everything to do with what we call metabolic flexibility. Mitochondrial health and stress physiology, and I am going to break all of that down today and give you a real understanding of what’s going on.
Underneath your system. So let’s understand first why these medications work so well. GLP one stands for glucagon like peptide one. It is a hormone that your gut naturally produces after your eat, after you eat, and its job is to help regulate blood sugar. And communicate satiety to the brain, meaning communicate.
Okay, we’re full. Stop eating The GLP one medications mimic that signal, so they do a few important things. They slow stomach emptying, meaning they slow the rate at how quickly food goes through your system. So the more time the food stays there, the signals get shifted in the brain like, okay, wait, we’re full.
Don’t eat anymore. The other thing that they do is they reduce the appetite signals. They actually change the signaling in the brain in the area called the hypothalamus. And they improve in insulin. Insulin signaling because they affect, it, affects how insulin is released from the pancreas. So people are naturally eating less, blood sugar becomes more stable, and then we see weight drop.
So for many people, it’s the first time in their lives that the hunger signals feel quiet and that can feel incredibly. There’s like tremendous amount of relief there Now. I think the bigger question also with that is what created those that noise in the first place, and there’s a lot of psychology and emotion behind that, not the topic for today’s conversation, but I do want you to recognize.
That the hunger signals don’t just automatically like ramp up for no reason. There is typically some kind of trigger early on in our lives, and I know you guys can all kind of think back to what you were told about your weight as a younger person, how you were made to feel, what the implications were, food, you know, , in your culture and in your household.
So. Again, a bigger conversation, but the fact that for a lot of people that hunger noise is diminished. It creates a very different scenario for them. But here’s what I want you to really understand, is that the GLP one medications. Help regulate hunger signals, but they don’t repair the deeper metabolic environment that created the weight gain in the first place.
So we have two things. We’ve got that mental emotional part, and then we have the physiologic metabolic environment. So you see this goes much beyond just, okay, here’s what’s, you know, here’s just the GLP one medication, take it. And then there’s no, you know, that’s it. End of story. So. , Appetite suppression is not the same thing as metabolic repair.
What does that mean? Well, one of the most important distinctions in this entire conversation is this. The GLP one, medications suppress appetite, but appetite suppression is not the same thing as metabolic repair. So when hunger decreases, people naturally eat less and weight drops, but that doesn’t mean that metabolism is healed.
The deeper metabolic signals that regulate energy storage, how do you store fat? The stress response and insulin sensitivity are still very much present in the body, and if those signals themselves don’t change, the body will often return to the same pattern once the medication is reduced or stopped. So that’s why the real question here isn’t just, did the weight come off?
The real question is, did your metabolism actually become more resilient? And so what is the metabolic piece that we’re missing? Well, weight gain is rarely just about calories. Anybody who told you calories in, calories out, and there’s still a lot of people out there talking about calorie deficit. I’m gonna call bullshit on that, okay?
Because here’s what we know. We know it is about how the body actually handles the energy. Not everybody processes calories in the same way. And if you have struggled with weight for years and years, we see deeper patterns. We see insulin resistance. We see something called chronic stress signaling, and we’re gonna get to that.
We see inflammation, we see loss of muscle mass, and we see mitochondrial dysfunction. So these patterns don’t automatically resolve because the weight decreases. So when the medication is stopped, the body can still be operating under the same metabolic signals, and again, they’re disconnected metabolic signals.
And this is what drove the weight gain in the first place, typically. So this is why we’re seeing weight regain not just happen so frequently, but because it’s and we see it quickly, and it’s not because of. The fact that you failed, it’s because your biology never fully rebalanced. So let’s talk a little bit about what does metabolic flexibility mean anyway?
Okay. Because people have a hard time really understanding. We just think, oh, metabolism is this one broad topic, and that’s it. It’s not. So I think one of the most important concepts in this whole conversation is understanding what metabolic flexibility is. And it is basically your body’s ability to switch between fuel sources.
In simple terms, it’s that your body should be able to burn both glucose and fat efficiently, depending upon which fuel source is available. So if you eat a meal, your body. We’ll primarily use glucose. If you go several hours without eating, your body should smoothly transition into burning, stored fat.
That’s what a healthy metabolism looks like. But many people with long standing metabolic dysfunction lose this flexibility. They lose the ability to transfer from sugar to fat utilization. And so instead of smoothly switching between fuels, their metabolism becomes locked. Into glucose dependence.
What that means is when this happens, we see a few things. First, we see that blood sugar becomes more volatile and more unstable, and when glucose rises quickly after a meal, insulin comes in to bring it down. But if the body has become resistant to insulin itself, the system has to work harder to control these swings.
And here’s a really scary statistic, okay? Not that I wanna scare you, but I really want you to understand just the depth of this and how far this goes. Okay. In the United States, several analyses, the National Health and Nutrition Examination survey, the NHANES survey data the data serve that we’ve seen about 30 to 40%.
Of US adults have insulin resistance, and in some studies we looked at younger adults anywhere between 18 to 44, we see that number around 40%. And so this is why so many metabolic researchers you hear all the time, say about one in three American adults have insulin. Resistance. So if you include pre-diabetes, which is basically reflective of insulin resistance, the numbers become even more striking.
The CDC estimates that over 96 million adults, that’s one in three people have pre-diabetes and pre-diabetes is essentially advanced insulin resistance. And about 80% of those individuals don’t even know they have it. So most people are walking around with insulin resistance and pre-diabetes and either are brushing it off or not paying attention or don’t even know.
And over time, this insulin resistance creates a pattern of repeated blood sugar spikes and crashes. And when blood sugar crashes, the brain interprets that, as energy emergency, like bing, bing, bing, right? And so this is when we see symptoms. Like sudden and voracious hunger, right? We call it hangry, but that’s really what it is.
Strong sugar cravings, irritability, brain fog, energy crashes, and this is one reason that we hear people say, I feel like I have to eat every few hours. It’s not because of a lack of discipline. It is a me metabolism that has lost its ability to access stored energy efficiently. It just can’t get to those fat stores efficiently.
So another issue that develops is something called chronic insulin signaling. Now, I’m not trying to get too sciency on you. I’m trying to keep it as simplistic as possible. All to say is that we think. Metabolism is, like I had mentioned this simple thing, but it’s not. And there’s a lot of nuances. And if we don’t pay attention and if we don’t recognize all of this is going on, we’re missing the big picture.
So when insulin levels stay elevated for long periods of time, the body becomes more, or excuse me, less responsive to it. That’s what we call insulin resistance. And so when insulin is elevated, the body has a much harder time. Accessing stored fat as fuel. So even if someone has plenty of energy, plenty of fat stored in the body, their metabolism actually acts as if they are in like starvation mode.
So this is why we say a lot of people are overfed and undernourished because their body cannot access the very stores of energy, of nutrition that are stuck in the system. Okay? So this creates a really frustrating situation where people feel hungry and tired. And metabolically stuck at the same time.
And this is a oftentimes why people will, go on diets or those of you out there is that I’ve tried everything or I’m eating the same and nothing’s happening because there’s this metabolic instability. So GLP one medications helps stabilize blood sugar by slowing gastric emptying and reducing out appetite.
And then the glucose swings become less dramatic when you’re on the medication. But that doesn’t mean that the metabolic flexibility itself has been restored. The deeper issue of insulin resistance and muscle loss and mitochondrial dysfunction are pretty much still there. And this is why the metabolic work after the GLP one medications becomes so important because restoring metabolic flexibility literally requires retraining the body to use fuel more efficiently.
And here are a few key levers that really help restore this. One of the most important is muscle tissue. You have heard people say this over and over, and I can tell you it doesn’t matter how many times we say this. I still have people who come to me or who I talk to out, out in public and they’re like, no, I’m losing weight.
I don’t need to do any kind of resistance work. I don’t need to do weight training, and like I really wanna take my head and bang it into the wall because muscle is one of the most important. Factors in metabolism and it’s what is gonna restore your metabolic functioning because muscle is one of the largest metabolic organs in the body.
It is the one of the only things that actually burns calories, and it acts like a sponge for glucose. So the more muscle someone has, the easier it is for their body to store glucose safely and then use it for fuel. Instead of leaving it circulating in the bloodstream. So this is why strength training becomes critically important for long-term metabolic health.
And I really, I mean, I want you guys to let this land, if you are not doing resistance training. Your metabolic flexibility will be shot when you come off of the shot. Okay? The other thing we wanna talk about is mitochondrial capacity and mitochondrial energy, and just mitochondria itself is like now the buzzword everywhere.
Okay, but let’s break this down a little bit. Mitochondria, those little structures inside the cell that converts nutrients into energy and when mitochondrial function is impaired. The body becomes less efficient, like I said, at burning glucose and fat. And this is what leaves you metabolically sluggish even after you’ve lost weight.
So this is where that fatigue comes in and you know, those kinds of things. And so the other major factor that we’re looking at is consistent metabolic signaling. So your sleep patterns, your meal timing, your movement, and your light exposure. Will all influence the body’s metabolic rhythm. This is why we say getting out in nature, getting out first thing in the morning, getting the sun’s light energy onto you because that is part of a metabolic rhythm.
And so when these signals are chaotic, irregular sleep, constant snacking, chronic stress. This causes your metabolism to become completely dysregulated. So restoring metabolic flexibility isn’t about extreme diets. It’s not about calories in and calories out. It is about literally retraining the body, how to handle more, how to handle energy in a more stable and resilient way.
And when metabolic flexibility improves something really interesting happens. You start to experience more stable energy. You don’t have those crashes in the middle of the day. You have less frequent hunger. You’re noticing that those sharp cravings are just, are not, you know, that hangry feeling isn’t coming on.
You have better mental clarity. You’re able to focus, you’re able to concentrate. And you have a much easier time maintaining a healthy weight. Not because you’re eating perfectly, but because your metabolism is finally working with you. So weight regain isn’t just about the calories coming back, it is about a metabolism that never fully regained its flexibility.
So let’s talk a little bit about mitochondrial health. Okay, because again, this is something that is just not mentioned in weight loss conversations. Like I mentioned, mitochondria, the energy producing structures inside ourselves, they convert nutrients into something called a TP, which is, think of like the energy currency.
It’s the money of the body. And when your little mitochondria aren’t functioning well. This is where you experience symptoms like chronic fatigue, exercise intolerance, like you exercise, and then you just can’t get up off the couch the rest of the day. Brain fog, slower metabolism, because mitochondrial, again impacts metabolism directly.
And mitochondrial dysfunction is extremely common in people with metabolic syndrome and insulin resistance. So you see how one thing is connected and plays off of the other. So weight loss alone doesn’t automatically repair mitochondrial function. In some cases, it can actually do more damage. So mitochondria will respond to movement resistance training, like perks up those mitochondria like you can’t believe.
Okay? And muscle activity is part of that nutrient density, the better nutritional quality you have in your diet. You’re mitochondria and need that. Circadian rhythm, having not just adequate sleep, but a good circadian rhythm through the day, meaning you’re trying to go to bed earlier, you’re waking up more with the sunlight.
Your body is following the natural flow of the day. This is why a lot of people can lose weight and still feel exhausted because of this whole mitochondrial piece. So. Your metabolism is actually smaller, okay? But it’s not necessarily healthier. Real metabolic recovery really has to support mitochondrial repair.
And so again, strength training, making sure you’re getting adequate protein. Adequate protein does not mean. Protein excess. Everybody thinks it’s protein, protein, protein. No. Especially if you are an average person. Let’s take a woman, an average woman. If you are in the gym three to four times a week, even five times a week, and you’re working out for an hour, you don’t need a gram of protein per pound of body weight.
It just is too much and now you’re getting too much fat and it’s burdening your liver. And now your metabolism is tanking because of some of that adequate protein is about 0.8 to one gram per kilogram of body weight. If you wanna fill out, figure out kilo what your kilograms are, take your weight and divide it by 2.2.
So for most women, you’re looking at 50, 60, 70 grams of protein. Not 130. Not 150. Okay. And so that’s gonna be important to look at. And of course, healthy micronutrient status, meaning you need to be getting in your fruits and your veggies and your fiber because those give you nutrition beyond anything else.
Can’t just. Take the shot, take a supplement, call it a day. You gotta feed yourself nutritionally, a nutritionally supportive diet. Here’s what I wanna tell you, those little mitochondria are incredibly responsive to your lifestyle signals. They adapt based on how you move, how you eat, how you sleep, and how you recover.
All right, let’s shift gears just a little bit and talk about. W something called stress physiology, because a lot of people think stress is just okay. If I have stress in my life and if I just reduce the stress, everything will go away. And sometimes people don’t even pay attention to the stress.
But stress physiology is super important because it’s not just about you feeling overwhelmed or you feeling like you’re in fight or flight, or you feel like you’re stressed out all day. Yes, that is tremendously important, okay? But when the body perceives chronic stress and it’s feeling stressed.
Your cortisol is going to increase, right? So your cortisol could increase just because you are in a boardroom and you’re having a stressful event. Go on. Like your body doesn’t know the difference between that and a fight or flight, like being in an accident. Okay? So when your cortisol increases, and I’ve talked about this many times before.
Cortisol has several metabolic effects. Number one, it’s going to increase blood sugar because the idea is that you’re preparing to be in fight or flight. You’re preparing to run away from something, and if you have to have energy to run away, guess what? You have to have more sugar in the blood to be able to do that.
So that’s number one. . It increases your blood sugar. It also promotes visceral fat. That visceral fat that hangs around your middle because it thinks, again, if I am in. In starvation mode. If I’m in fight or flight, I need as much energy to hold onto because I don’t know where my next meal is going to come from.
This is all genetically and evolutionarily meant to protect us. Your genes have not our metabolism, our genes, our genetics. Have not adapted to 21st century lifestyle. We are still living back in the stone ages according to our genes. And so if your body is doing all of these things, you are going to see the effects.
And part of what cortisol does is it disrupts hunger signals. Again, if you’re in fight or flight, you can’t be searching for food. Okay? So what happens is many people who are struggling with weight. Have an underlying pattern of chronic nervous system activation. Again, this has been a buzzword everywhere, nervous system activation.
How do we control the nervous system? But basically, you are operating in a constant state of what we call low grade survival mode. And when that happens, your metabolism’s gonna become more defensive. It’s gonna be like, whoa, whoa. Wait a minute. Okay. So the bottom line is you can’t regulate a metabolism in a body that feels like it’s under threat.
And so when we talk about this this stress and this disruption we really need to pay attention again. What is my sleep? What is my light, what is my stress regulation? Because. Having consistent daily rhythm of things because this is what helps recalibrate your cortisol signaling.
And so one of the most fascinating clinical findings we see is that when cortisol patterns normalize, insulin sensitivity improves as well. Here’s what I wanna tell you though. It’s not two weeks, two months of creating this. It can be. Nine months. It can be a year, it can be two years. Because think about this, if you have been in a state of chronic stress for years and years and years, if you’re that person that in your early twenties, thirties, forties, you were building a business, you were raising a family, you were dealing with all kinds of stressful events, think about how long you have been in fight or flight years and years and years, maybe decades.
If you think cortisol rebalancing is going to happen in six, nine months or a year, you are setting yourself up for failure. And I see this every day because I’m people who reach out to me or with me four months, six months, even nine months, and they’re like, wait, we haven’t seen anything change. I mean, they’re starting to feel better.
You definitely start to feel better, but guess what? You’re not rebalancing in that time. It takes the body a long time. If you think about depletion, think about how far depleted you are and how you have to come up that hill. Okay? So stress and the metabolic system are deeply connected. So the real question here is not whether GLP one medications work because we know they do.
The question is, what happens to the body after the weight loss? And if we want results to last, we have to rebuild the systems that regulate our energy, right? So again, now that you understand metabolic flexibility, we have to rebuild that. We have to rebuild your muscle. ’cause the other thing is if you’re not doing resistance training while you’re, you, while you’re on the medication, rebuilding the lost muscle because you’re gonna lose muscle.
Will be an important part. We need to support mitochondrial health. We need to stabilize stress physiology because sustainable weight regulation isn’t just about eating less. Like I said, it’s about helping the body become metabolically resilient. So how do we help the body function better, not just way less?
Well, the real work of metabolic health begins after the weight loss, and this is not meant to be the long-term metabolic strategy. It’s how do we rebuild the systems that regulate energy and appetite and resilience, because when me metabolism becomes stable, weight regulation becomes much easier. And that’s the conversation I really believe we need to start having.
I hope this helped. I hope this helped enlighten you a little bit about. Kind of the nuances of really what’s going on post medication, because I don’t think too many people are addressing that and, and think really about what your strategy should be when you start to come off the medication even as you’re weaning off.
Because again, I would suggest that you don’t just stop the medication cold Turkey. And if there are questions about this, I would love you guys to submit your questions. We can do an open q and a because I get them all day long. And tell me what else you wanna hear about these topics.
I just think that bringing it all to light in a way that is not often talked about. You know, we hear the sound bites, but we’re not enough. People are going deep to really explain exactly what’s going on under. The system underneath the, you know, like that iceberg, right? So again, I hope this helped and hope you learn something.
Share it, like subscribe, and this is your rebel nutritionist signing off. Make it a great day, everybody.
