What Happens When You STOP Taking Ozempic? Weight REGAIN Prevention

If you're considering or you're on one of the weight loss drugs like Wegovy or Ozembic or Mounjaro, this video is for you. I'm going to outline what you need to do to avoid the rebound, weight regain and muscle mass loss. Oh, and the dreaded Ozembic face that you've heard about. These are these known side effects of these drugs. Now if you're wondering if these drugs are right for you, check out my video linked below on what you need to know before or you go on these drugs. So these drugs work by helping you tame your appetite and balance your blood sugar. That sounds great, right? And the bottom line is if you are weight loss resistant, these drugs could give you that edge that you need. However, the last thing you want to do is lose a lot of precious metabolism supporting muscle or gain the weight right back when you go off of them. See, the drug costs a lot, but let's be honest, these side effects are going to cost you way more than that in the long term. Now fortunately, there are some specific simple diet and lifestyle strategies that you can do that can minimize these effects. So first thing I want to do is address the issue of muscle mass loss and why this is such a devastating blow to your metabolism and then what you can do to minimize it. Now, I love Dr. Peter Attia's the Drive podcast. He and he said that Ozembic may prompt equal muscle to fat loss. That means that even though you see the number on that scale drop, your fat to muscle percentage is skyrocketing. In an Instagram story, he noted that some muscle loss is of course always expected in weight loss patients, but drugs like Ozembic can exacerbate the issue. So here's the deal. Let's pull this whole thing apart. When you're losing weight, you're always going to lose a little fat free mass. So your body, just so you understand this, your body is made up of fat and fat free mass. Fat free mass is everything but fat. So fat free mass is going to be your bones, your organs and your muscles, both your smooth and your skeletal muscles. It's also going to be all the things that support all of that. So when you lose fat, you'll never just lose fat because you also have some things that are just supporting the fat. Remember, fat is alive, but that's only like 3%, 3%. Like if you lost 10 pounds of fat, you would only lose like 0.3 of a pound of that supporting the fat. So what we want to do is we're losing weight is we want to minimize the amount of fat free mass we lost. We lose. And we want to really hold on to, or better yet, we want to build skeletal muscle. And here is why. Muscle, and these are said very carefully because I want you to be able to remember them right? Muscle is your metabolic Spanx. What does that mean? That means it's going to hold everything in tighter. By the way, you know, if you're worried about I'm going to lift weights and get bigger, it doesn't happen. You lift weights, it holds everything in tighter. Muscle requires more energy to be on your body because muscle is constantly in this, breaking down and building up, breaking down and building up. It's very energetic. So that is why it's metabolic Spanx. It's going to give you a better metabolic rate. That's how many calories you burn. Right? But it's also a sugar sponge. This means that it gives a place for carbohydrates in the diet to go rather than get stored on your butt or your thighs or your belly as fat. And along with being a sugar sponge, it is the first place that you can start to restore insulin sensitivity. When your body is better at hearing insulin, then it's going to have better blood sugar control. One of the things that these weight loss drugs do is these weight loss drugs help you have better blood sugar control. So resistance training is one of the ways that we can do this. One things that can happen when you go on a diet is that you will start to lose muscle, right? You'll lose muscle and you'll lose fat. Here's why this is a problem. And I actually talk about this in another YouTube video where I talk about weight rebound. And it was all based on a study that looked at the biggest losers six years later. And the deal is, is if you lose muscle and fat, you're going to have this thing called metabolic adaption. After the diet, this is where your resting metabolic rate is lower than it was before the diet. This is always going to happen. What you don't want to have happen is have it be lower than it should. So we have a predicted resting metabolic rate that should be based on our body composition. But what can happen here is if you lose more muscle, it will be even lower than it should be, which means that it's going to be a lot harder to maintain that weight because now you can even eat even less calories. And in fact, one study showed that people who had stopped using semaglutide gained back on average 2/3 of the weight that they lost on that drug within one year. So think about this, though. If all of a sudden you're losing fat and muscle and then gaining back mainly fat, can you see how that's really going to disrupt your whole metabolic rate? Because losing muscle and then gaining back fat means you're never going to get that metabolic rate back up to where it was. So that is the really key, important thing here is we want to make sure as we're going through this that we are holding on to our building muscle, right? We are minimizing any of that muscle loss. And you want to make sure that you don't gain the weight back and especially don't gain that weight back as fat, because again, if you do that now, you're worse off than before you went on the drug. Okay, so the question I hope that you're asking right now is how do I avoid this? And I'm so glad that you asked this because it doesn't have to be this way if you put the right diet and exercise parameters in place. But here's what it has to start with. It has to start with information. The first thing you're going to want to do is ideally go get a DEXA scan. Now, a DEXA scan traditionally has been used for bone density and we go in and find how your bones are doing, right? But it can do so much more than that. A DEXA scan can actually go in and, and it can look at how much muscle you have, how much skeletal muscle you have, where that skeletal muscle is like are your arms and leg, legs even. It can also look at your visceral adipose tissue and your overall body fat. So in the perfect world, you get adexa. If you can't do that or for ongoing measurements, you're going to want to get a bioimpedance scale for home. And a bioimpedance scale sends a little wave up through your body so it can check the resistance to the wave to identify how much of your body is fat free. Mass versus fat. Now, these scales now can predict how much of that skeletal muscle and how much of the fat is actually the visceral adipose tissue. So ideally, get one of the scales that really breaks everything down for you. Now, the scale is predictive. It's not, it's not an absolute. Right? The only way to know this for sure would be to do a cadaver dissection. And that kind of negates the whole purpose of this. However, if you're doing the same thing every day, it's going to give you really good relative change and that's what we're looking for. That's what you're going to want to monitor. So you're going to want to get a bioimpedance scale and you're going to want to use a tape measure around your waist and around your hips. Because if you lose weight without losing your waist, you're making yourself worse, not better. And I want you to vigilantly monitor your fat free mass and especially your skeletal muscle. Here's the thing, we can only lose 2 pounds of fat a week, basically, and we have a little bit of fat free mass supporting that. So realistically, we want to really make sure that we are focused on holding on to and building muscle as we're losing fat, which might mean that your weight is changing much more slowly, but you're improving your body composition and that is everything. Okay? So one key part of this is that you're going to need to do resistance training and minimally you're going to need to move each major body part two days a week. Three would be better. Let me walk you through those. So we have upper body pushing, upper body pulling and hip and thigh hinging. So upper body pushing, this involves your chest, your shoulders, front of your shoulders, top your shoulders, your trapezius and your triceps. Right? Pushing exercises, things like a push up, a chest press, an overhead press are simple things that you could do. And by the way, those are simple things that you could do at home. Yay. Next ones are upper body pulling. That would be things like a pull up or a bent over row, things that involve your bicep, your lats and the back of your shoulders, hip and thigh hinging, things like a squat, a step up or a deadlift. Now here's the thing. In order for you to build muscle, you have to go to near failure. So the ideal range is going to be somewhere in the 18, 15, 8 to 15 rep range and doing multiple sets. And I also explain this in another video which we'll, we'll link to below. But if you can't lift heavy, if you're afraid of injuries, work with a trainer. Ideally. But what you can do is you can do longer sets, like 20 to 30 repetitions and then you could use blood flow restriction cuffs so that you still get that failure. So there's always a way to do this, but it is mission critical to have that muscle to help maintain or build muscle and help with satiety and blood sugar. Let's talk about diet. So these Drugs work to mimic what peptides produced in the gut do to help with satiety and blood sugar balance. Now we can do that with diet and we need to focus on some gut microbiome rehab too, because these peptides are produced in the gut. Your gut's all messed up, going to have trouble producing it. So first let's talk about satiety and blood sugar. Now, I like to say protein first. And your ideal amount of protein is going to be based on what your target body weight is. Basically, you're going to want your daily range to be somewhere between 0.7 to 1 gram per pound of target body weight. I put your minimum daily dose of protein at about 100 grams and your minimum dose per meal at 30 grams. The reason I've done this is you want to get about 3 grams of leucine with your protein. And most of these protein sources come with leucine. Right? Especially high quality animal protein. But also pea and soy do too. So if you're not intolerant and it's the leucine that's going to trigger muscle protein synthesis by triggering something called mtor and muscle protein synthesis is what we need to go through to build that muscle. So with your protein, we're going to want to choose lean, healthy sources. So that would be like a lean grass fed, grass finished fillet, turkey, pastured chicken, and if you're not intolerant, eggs and eggs whites. If you're not intolerant, whey protein. If you are intolerant, bone broth protein, pea protein. So look for some great lean sources of these. And what I want you to do is I want you to start tracking this and you might say, oh, I can't eat that much protein. Here's what's super awesome about protein. Yes you can. Let's just start to add it in. It's three meals a day. Put it in between those three and start to track it in that Carbon app to make sure that you get the protein. So that app again I like is called Carbon. Check it out on the app store and start to input. So you really make sure that you're getting what you need. Because remember what you measure and monitor, you improve. So we're checking your body composition. We're also going to make sure that you get your macros right. So specifically we're really looking at protein. But when we think about both blood sugar and satiety, let's talk about how you can really help trigger that. Because we know that protein and fiber can really help stabilize blood Sugar, right? And we know that when you eat protein first and you also add fiber, especially from things like non starchy vegetables and some healthy fat, maybe put some extra virgin olive oil on that salad, right, that the protein and fiber slow down. Stomach emptying, help you feel fuller, longer, and the fat triggers a release of those peptides in the small intestine to tell your brain that you are full. And that's what we want our body to naturally do. Super duper important. So I teach people, eat your protein first, then make sure that you are getting in your fiber first from non starchy vegetables. And this is where you want to eat from the rainbow. And here is why. And you are doing this to feed your gut microbiome. That is the key, mission critical thing. So you want different types of fibers, prebiotic fibers, resistant starch. So you want different fibers and you want different colors because they represent different plant nutrients, different polyphenols. They all have different impacts on your gut microbiome. And we're rehabbing your gut microbiome here so it works well so that as you start to taper off of these drugs and your own gut can start to produce what it needs to produce to tell you that you are full. By the way, what's super interesting about your gut microbiome is 70% of it is made up of these two bacteria, Bacteroides and firmicutes. Now if you've got a bunch of firmicutes, you will also be someone who is higher body fat. If you've got a bunch of Bacteroides, this helps you burn fat. So your status, your gut microbiome is really important, not just for your immune system, not just for your nutrient absorption, not just for your mood, but also helping with your body composition. Super important. I also throw in there to do those five plus servings of non starchy vegetables, a cup of raw half cup of cooked, and then also 2 servings of fruit a day. And when I say fruit, it's fresh or frozen, it's not juiced, it's not dried. Okay. It's not turned into a syrup. Those are all candy, just two pieces of fruit a day. So that might be an apple, blueberries, Right? Get your diversity in. It's really easy to get into a food with your veggies. Ask me how I know. Okay? But I have been working through that. And so you want to try to get as many different things as possible. And this is where a little bit of frozen can work great too because they've been frozen at the peak. So you know, if you travel a lot, make sure you always keep some frozen veggies, frozen fruit at your house so that you've always got something, all right, lots of diversity. They're super duper important. Now the third thing here is healthy fats. Now here's the deal. If you're eating fish four times a week, which I hope you are right, you're going to get some healthy fats. If you're making those smoothies like I make smoothies, and might throw in some freshly ground flaxseed meal, a little avocado or a little coconut, you're getting some healthy fats in there. If you're making your vegetables, maybe you're using some extra virgin olive oil, maybe some ghee. So likely you're probably getting a lot of the fat you already need and you won't need much more of it. But if you do use the whole fats first, things like avocados, nuts and seeds. But again, track all of this to make sure that you're getting what you need in. Since you won't really have much of an appetite. We got to really make sure we're getting in that protein, we're getting in those vegetables, we're getting in those two fruits with a little bit of healthy fat. And if you need to divide it over four meals, just make sure you're eating within a 10 to 12 hour window. But track, track, track. And if you have to do a green drink with some extra fiber in it, like throwing in like doing a great green drink like my girlfriend Dr. Anna Kabeca's mighty Maca, and then throwing in some extra fiber or some chia or flax bean, you can do that too if you can't quite get all those vegetables. And we got to get the greens, we got to get the diversity of the polyphenols and the fiber in there to get that gut rehab going, okay? And also here's what's cool, all of that, the protein, the fiber and those phytonutrients give you great detox support as well. So repairing this is going to help you with your appetite and fat burning after you taper off again. What I'm looking at here is really getting the things in place that we need to so that when you taper that you don't end up with that weight regain. That is like my sole goal here. Now one more thing that happens with these drugs is dehydration. Now hydration is a huge, huge deal. First of all, we need to be hydrated to detoxify well, and by the way, you're losing body fat. When you start to burn body fat, guess what you are going to need to detoxify. Well, because toxins store in your fat. And as your body starts to liberate fat, if your body can't detoxify, well, those toxins are now running around in your system. That is not good. What do you need to detoxify? Well, you need, number one, protein, because it's what carries the toxins out of the body. You need those greens and plants because those help you free up the toxins as well. And you need the fiber and then you need water as well. I tell people a, you want to have at least half your body weight in water a day, in ounces, half your body weight. And by the way, it doesn't just have to be water. It can be green tea, it can be some black coffee, but at least half your body weight. If you're sweating a lot, working out a lot, you'll want a little bit more. But here's why this is important. Beyond just detox support and beyond now that we know that these drugs can impact not only you're not hungry, you're not thirsty, we already don't have a good thirst mechanism. So we got to really focus, track your water, just like you're tracking your macros. But here's the thing. If you're mildly dehydrated, number one, it's going to slow down your metabolism. And then also it actually makes you store fat. Here's the wild thing that happens when you're mildly dehydrated, besides what it does with raising cortisol and lowering metabolism, because just, you know, when you drink water, you actually boost your metabolism a little bit. But what happens when we're mildly dehydrated is our body actually starts to make fructose from our glucose and store it as fat. It's the last thing you want to have happen when you're in this situation. So make sure that you stay hydrated. Make a commitment on that. And what I've been doing is using, is recommending doing some electrolytes as well. So I have a drink called Electro Replenish that I love and I would say one serving of that a day. Now let's talk about some other supplements that can really help here as well. So you need a good foundational supplement, a daily multivitamin, mineral antioxidant, essential fatty acid formula to make sure you're covering all your bases since your calories are going down. Right. We get our nutrients first from food and then we supplement with supplements to make sure we're optimized. So I have a daily essential packets, one of those a day. Here's another thing that I want you to take. Creatine monohydrate, super important here. So creatine monohydrate can help you. They've done studies in two different areas. Used to be like, you only heard about it with bodybuilders. But so much interesting research is now coming out to help people avoid sarcopenia that is losing muscle as we age. This is what we want to avoid here, sarcopenia. So creatine, the general dosing, and by the way, if you're more plant based, you definitely need this. If you're a woman, you definitely need it. We're like 70 to 80% less creatine than men. But the general dosing is 3 to 5 grams. So bigger person, 5 grams. Little person, 3 grams. Now what you need to do is take it every single day because you have to keep your tissue saturated to get to tissue saturation. You'll want to take five grams four times a day for five to seven days because that will help you get to that tissue saturation and then you just maintain it by taking it every day. So that's creatine monohydrate. Another one that I love is Mito pure from timeline nutrition. This is called urolithin A. They've done a ton of research on this. This is something that we should make from our gut microbiome. But only about 30 to 40% of us do that. And that's. We have a really well functioning gut microbiome too. But that's a genetic thing. If we can make this urolithin A from different foods like pomegranate, I take it every day because it's shown in a study. Like what it does is it helps our muscles clean out the gunk so that we can become stronger. And in fact, the study showed a 21 increase in muscle strength in just six weeks by using using Mitrepure. So I will also put the link to that down below. Now another one that I love and this one we may want to look at as you're coming off of it. But this is the product called berberine and the one I like is from designed for health, it's called Berberavail. But berberine can lower the blood sugar response to a meal. So hopefully as you're going through this medication, it's actually improving because you're doing the resistance training and you've got your diet dialed, you're improving your insulin sensitivity. But if you do see that you have any issues with your blood sugar, berberine for the win. Also some apple cider vinegar. And this is a great time to use a continuous glucose monitor to help you really see what's going on on. So I really like having all of this in place now because here's the deal. What we are doing is getting your body ready so that you will be primed and you'll know exactly what to do as you taper off the medication, right? So you got to be tracking your macros, you got to track your body composition so that when you do come off of this, you maintain and continue to improve on your results. Again, I look at these drugs and I go, if you've been weight loss resistance, if you're just stuck, if you're insulin resistant, nothing's moving. This could give you the edge you want, but I want to make darn sure that you don't get worse from it because of these rebound effects. Now, measuring and monitoring your macros works best when you have a solid strength building plan. So if you're over 40 and you want to make the most of your gym time, you're going to want to learn how to optimize your body composition. So watch this next video where I discuss exactly how to do that.