#187: How Do I Transition off Ozempic Without Regaining the Weight?

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I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyn health and your overall And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies.

We're talking root cause resolution on this show.

So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Hello. Hello. Okay. This week I'm going to answer a question from Tracy out of Iowa. Okay. She has been using Ozempic for weight loss and she has lost 20, over 25 pounds. She is feeling really good about that, but she's nervous because she's starting to notice that she's having some stomach issues. She's getting bloated when she eats. And her bowels have changed and she's at the point where she's ready to try and go off of it, but she's really scared. So Tracy says, what can I do to prevent weight regain after going off Ozempic? This is a great question because I've been getting it every single day in my DMs, you guys. I am listening. I promise. Thank you for messaging me and letting me know what you want to hear about. I am honored that you would even ask me for your guidance, so I take this so very seriously. And this is a really hot-button topic right now because everybody and their sister is on a weight-loss drug, it seems. Every celebrity, every patient I talk to either knows somebody or is on it themselves, and they're coming to me with issues or, like Tracy, they're like, what's the next step? Okay, it worked. I can't continue injecting myself my entire life. What's next? And so I've really been doing a ton of research like, how can I best support women like Tracy? And maybe this is you. Maybe you're listening today and you've been on Wegovy or Trulicity or semaglutide or all of the other options that are available. And for some women, it can be really helpful to break carb or sugar addictions, to get control of eating, and really to break that cycle. I keep getting so many comments on Instagram like that, like, well, Ozempic has worked for me. I'm forever grateful. For this drug, but we have to figure out what are you going to do when you're done with the drug. So I am not saying that people should not use these medications. I'm saying that there are other issues, root cause issues that we need to tackle and address. And sometimes this is enough to shift those behaviors and those issues, but sometimes it's just another bandaid and you're. trading one problem for another, or when you take the Band-Aid off, the problems come back, right? When you stop the medication, the appetite issue, the cravings, all of that can come back, and sometimes they can come back with a vengeance. And so very soon we're going to start seeing weight regain. We're going to start seeing the downside of these medications because we're still in the honeymoon phase. Everybody's still enjoying their weight loss and everything. It's the magic shot. And I'm going to be here for you when you need to do the deeper work and figure out how to come off of it and sustain that weight loss that you've, you know, worked so hard to obtain. So I want that for you. I want you to keep all the gains that you got and then continue to move forward in a very healthy way. Okay, so these weight loss medications, they really do help suppress your appetite. For some women, they even have to like force themselves to eat because they really are not hungry. So be careful on that piece of it. Some of you, it seems to break some addictions and some behaviors and wakes you up to the fact like, oh yeah, I guess I was eating that pretty mindlessly and I was quite addicted. So. Stay tuned for my episode next week, actually, because I am going to talk about emotional eating and what we can do about that. Like, how do we really tackle emotional eating? Because that is one of the biggest pieces to this Ozempic issue is some of the time we are eating our feelings or we're eating mindlessly or we're eating out of habits, and we're not really aware of it. And this drug does intervene and shift that. But if you go off of it, very well all of those things could come back— all of those bad habits, those feelings, all those things. So we need tools. We need tools to handle potential emotional eating issues.

Okay.

So I'm going to do a whole episode on that next week, so please come back and listen to that. But for now, how the heck do I get off this weight-loss medication and not regain the weight? So you really need to focus, you know, on a few things. Number one, you've got to create healthy habits. You have to break up with the standard American diet. And I really love teaching women my 2-10-20-30 meal method. So 2 teaspoons of salt with every meal, 10 grams of carbohydrates, 20 grams of protein, 30 grams of fat. If you don't have a gallbladder or you struggle to digest and absorb fats, sometimes you want to flip that protein and that fat ratio. But if you really focus on making sure you're getting enough healthy fats with every meal, you're getting the protein that you need, And you're getting in a little bit of fiber along with salt, which is super important for your adrenal glands and everything else, that is going to keep you satiated longer. It's going to keep you feeling full and happy and satisfied longer than a carbohydrate-based diet where you're eating like 50 or 60 grams of carbohydrates in a meal. That's just way too much and it's going to put you back on the sugar roller coaster, okay? So it's about going from being a sugar burner to a fat burner and regaining your metabolic flexibility so that your body can eat carbohydrates, but it's not relying on only carbohydrates for your fuel source, that you can tap in and use fat for fuel. And then you need enough protein to do all the processes in your body. So you gotta learn some healthy habits during this time that you're on these medications. Take the time to work with a functional nutritionist like I have on my team, or work with someone that's going to teach you about food and how your body specifically thrives with certain foods. Like, there's science to all of this, you guys. Monitor your food intake. Number 2, like, pay attention to when you're hungry and when you're full and be mindful of, are you eating something because you're actually hungry and it's time to eat, or are you eating because you're feeling stressed out? Are you eating because you're bored? Are you eating because you're in a social situation and it's expected of you? Are you eating because it's a certain time of day and that's what you're told to do? So that is all really important. And like I said, these weight-loss medications can shift your hunger cues so that you're not hungry. And when you stop them, that might come back with a vengeance. So you have to have a game plan in place. So, you know, my team and I have been really working on this for women. Let's have a game plan in place. How do I learn my hunger cues again? Versus, I'm just eating because it's time, or, I'm ravenous because I just came off this medication. So that's going to be a key thing for you. Number 3, stay active, okay? This is super important when you're on Ozempic or any of these medications because not only are you losing fat, but you're also losing muscle mass, and that you might not get back, especially if you're over 40 or 45, definitely over 50. You're going to lose muscle mass that you might never reclaim, and that is going to affect how your body functions for the rest of your life. And muscle is actually a sugar-burning organ. And so the amount of muscle you have actually determines how well your body's able to regulate its blood sugar. And so in the short term, Ozempic is helping you regulate your blood sugar, right? That's part of the point of what it's doing. But in the long term, if you're losing muscle mass from it and then you go off of it, your body no longer has that ability to regulate its blood sugar effectively. So you've got to be careful with that. And it's not true for everyone, but it is true for some women. And so if you are already going into the menopausal transition, you're more likely to be affected than a younger person, honestly. So you have to stay physically active, move those muscles, use those muscles, build those muscles, get enough protein in there.

Okay.

That helps control your weight, control your metabolism, everything. The next one, have realistic expectations, okay? Did you drastically lose a large amount of weight in a short time in a way that wasn't healthy or sustainable? Like, you have to be honest with yourself and understand the truth behind that. And so when you have realistic expectations, You'll understand that it might take me longer to get to my goal in a slower, safer, healthier way, but it's going to be more sustainable. So this is really evident when people eat like a 1,200-calorie diet. We saw this on the show Biggest Loser. People were dropping like incredible amounts of weight, 100 pounds. But it was never sustainable. All of those people gained that weight back because they were doing it in such a quick, drastic, unhealthy way. So have realistic expectations, okay? Number 6, address the emotional eating. So I'm going to cover all of this next week because that's a whole episode in and of itself. And I think a lot of us might not necessarily know that we are emotionally eating and that's contributing to this bigger picture of why our weight is stuck or why we keep regaining. Monitor your progress. Keep track. Have some health metrics that you're aware of. You know, you could get an Oura Ring and see how your sleep is doing. Has your sleep improved as you have lost the weight? And then what is it doing after you go off the medication? Use those data points to help you monitor your progress and keep track of things so that you don't slide back into old behaviors and not realize it. You know, get a continuous glucose monitor, see what your blood sugars are doing with certain foods at certain times of the day, with certain stressors. I love that. That's so helpful. Like, getting all that data can help you pivot in real time and make different choices. And lastly, The best way to stop the regain after you go off Ozempic or these other weight-loss drugs is to seek professional guidance. And unfortunately, it's probably not going to come from the conventional doctors. You know, they're going to say, eat better and exercise, lose weight, and that's probably going to be the extent of the recommendation because I know I'm a conventional doctor. I was not trained in nutrition. I wasn't trained in health or wellness. I was trained in diagnosis and disease, and that's the truth of it. And there's a time and a place for conventional medicine. It's great for acute care. If you break your arm or you're in a car accident or something like that, we need the medical system, but they're not good at helping you navigate health and wellness, okay? So you might need a functional medicine practitioner, someone like myself. There are associations you can search. You can go to ifm.org and search for a provider in your area. That can be super helpful. Or if you want to work with me and my team, we are creating a program that helps you transition off of these weight-loss drugs because, honestly, You need to figure out what's going on in your gut because your gut microbiome is being affected by the shifts in your weight, the shifts in your blood sugar, the shifts in your diet. And sometimes it's for the good and sometimes it's for the bad. And we now are seeing that because it slows your stomach function, it slows how quickly your stomach Your food leaves your stomach and goes into the intestines. It's slowing all these processes down. Women are now having issues with not enough stomach acid and bacterial overgrowth because the food is sitting in their stomach too long and not enough enzyme production. And this is showing up as constipation, diarrhea, bloating with eating. But not always. Sometimes it's just weight regain from all the inflammation being driven by these gut issues. So it really is important for you, if you're feeling like you're backsliding after getting off these medications, like, to figure out what the heck's going on in your gut and get that addressed and taken care of with someone like myself. Get on a gut-healing regimen. Figure out what foods are nourishing you and helping you and which ones are harming you and causing inflammation. And evaluate your thyroid and see if your thyroid has been affected by this huge shift in your weight and in your calorie consumption, because sometimes the thyroid will downregulate and show up as hypothyroidism under times like this. Sometimes this is enough to wipe out your adrenal glands and send you into adrenal fatigue. So if you feel like, oh my gosh, I need some handholding, I need some guidance on how to transition now that I've lost the weight, we're here for you. We can help you with that, okay? And please, please understand there is absolutely no judgment. Even though I'm not a fan of these weight-loss medications, I understand that they can be super helpful for some people and that they are, you know, the initial momentum that you need to make this shift. And so there's no judgment here. I just want to keep you on the right track to keep those gains that you've worked so hard to get. So if you feel like you want our help, we are more than happy to help with you. So we are here for you, okay? I hope you found this helpful. Share this with every woman you know. I would be forever grateful if you would take 30 seconds to leave me a 5-star review and just, you know, share your thoughts and feelings about the podcast. It's, you know, so important that we use our voice as women and let it be known what we want more of because We have the ability to change what's available for us and to have a voice and another choice, but we have to activate that and use that. So you, you tell Apple, you tell Spotify, you tell Google, all of the podcast places, like, this is the kind of stuff that's important to me. And they know that by the reviews. So I love you. Go have an amazing week.

Bye.

And I'm here if you need anything. All right, bye-bye.