Expert Advice for Launching Your GLP-1 Weight Loss Journey in 2026

James Hill:
Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:
And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

James Hill:
Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:
Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

James Hill:
Ready for the “And” factor?

Holly Wyatt:
Let's dive in.

James Hill:
Here we go.

Holly Wyatt:
Hey, everyone. Okay, we need to talk because 2026 is coming. January 2026 is coming.

James Hill:
Oh, my gosh. It's right around the corner.

Holly Wyatt:
Yeah. And we already know what's about to happen.

James Hill:
What?

Holly Wyatt:
One of the biggest surges of people starting GLP-1 medications that I think we've ever seen. I think people are ready.

James Hill:
Oh, wow. I think you're right. And here's the truth that nobody says out loud, Holly. Starting a GLP-1 the wrong way can cost you results, muscle, money, and momentum.

Holly Wyatt:
Oh, I like that. Yes. We see people unintentionally, I know it's not on purpose, but they're sabotaging themselves before they even get going. Not because they're doing something wrong, but because no one ever taught them how to start smart.

James Hill:
Oh, I like starting smart. And that's why when we were putting together our free guide on the mistakes people make when stopping GLP-1s, we realized something.

Holly Wyatt:
Yes, people need clarity when they stop, but people need just as much clarity at the beginning of their journey. So we said, all right, if we were starting a GLP-1 in 2026, if I was starting one, Jim, how would I do it? How would we do it? And what would we absolutely not do?

James Hill:
Yeah, I think there's definitely a right way to start. This is a big deal, going on a GLP-1 medication. It's a big deal. There's a right way to start. There's a smarter way to think about it, and developing a strategy that protects your muscle, your metabolism, your mindset, and ensures your long-term success.

Holly Wyatt:
Exactly. And that's what this episode is going to be all about. It's going to be your kind of insider roadmap, the don't make these mistakes. We're going to talk about that. A chance to set yourself up for the best possible start in 2026.

James Hill:
And you know, Holly, we're excited to tell our viewers that we now have a companion guide. This is really exciting. We've worked on this for a long time. It's weightwisdom.com. Weightwisdom, all one word, dot com. We will talk about that more, but that's where we have put together so many resources to help people who are trying to manage their weight. But now for this episode, Holly, let's jump in.

Holly Wyatt:
This is exciting because I think there's going to be a lot of people in 2026 that are going to say, “Okay, I want to try the GLP-1s. I'm ready. And they've kind of been waiting.” They've been watching. And now they're going to jump with both feet. So I think this is really timely for us to talk about if we were going to go on and what we would do, what mistakes we would try to avoid to really set them up for success, not just when they're losing weight and then obviously success if they decide to stop the medicines in their long term. But first mistake, this is, I guess we'll do it as mistakes. What do you think? Should we do it as mistakes?

James Hill:
Yeah, let's do it.

Holly Wyatt:
Okay, mistakes. So the first one I would say is doing it alone instead of partnering with a healthcare professional.

James Hill:
Oh, that's a big one, Holly. Very important.

Holly Wyatt:
And there's so many ways you can get these medications. And I want to just say, because I've been asked this, I've been on a lot of podcasts and news shows and people are confused. You do have to have a prescription to get these medications. Someone has got to be writing a prescription for this. Now, there's different ways to get that prescription, but you have to have a prescription, whether it's the real drugs, which is what I would recommend, or if you're even getting some of the compounding ones, you still have to have a prescription. And that's important because if you need a prescription, that shows that there's some risk involved.

James Hill:
These are powerful drugs, right? That's why people want them. They're very powerful, but they come with some real risks. And like any medication, there are positive and negative aspects. And this is why you need to partner with a health professional to help you navigate that.

Holly Wyatt:
Yeah, a healthcare professional, because they should know these risks, someone who understands what these risks are. Yes, there's a big, huge benefit, potentially weight loss. But I see people all the time, they end up in the hospital. They go to the emergency room. They get dehydrated. They can't keep anything down. They end up having gallbladder problems. I mean, these drugs aren't without risk. And so you need to have someone who can help you manage those. It's not that that should scare you and to say, “I shouldn't try them.” But you don't need to be out there alone or with someone who doesn't know what they're doing or don't have someone that you can call and talk about the side effects. If I'm not able to keep any food down or any liquids down, what do you do? You need that. You need a partner that can help you choose the right starting dose, decide when you go up on the dose, monitor your labs, your hydration, the cytobex, and manage complications early.

James Hill:
These medications are different from a lot of medications where you just prescribe them and you take them the same way over and over. Here, you have to start slow and ramp up. And that ramping up may be a little different for different people. Some people may tolerate it, ramp up quicker. Other people may need a slower ramp up. This is why you need to work with someone who understands that.

Holly Wyatt:
Yeah. So if I were starting a GLP-1, I would 100%, this was without a doubt, I would partner with a doctor or a healthcare professional that understands these meds, that has experience with these meds and is willing to talk to me about it. It isn't just someone in the background, someone that can actually follow me and can help me as I go on this journey. I think that is critically important.

James Hill:
Unfortunately, there aren't enough of MDs who are obesity specialists. If you can find one of those, it's great. I think the primary care physicians are learning and they're getting better and better, but you really need to have a conversation with your healthcare professional and feel that they are a good guide as you really go on this journey.

Holly Wyatt:
In some states, NPs can prescribe medicines under the right circumstances, coordinating in a certain way. So there are other options. You know what, guys, you get to shop around. If your health care provider doesn't feel comfortable doing this or doesn't have the expertise, then I would go find another one. That's how important I think this is. You don't want someone that's just going to prescribe the medicine and walk away because you don't know if you're going to need some help. You don't know if you're going to have some of the side effects. You don't know the best way to titrate this drug up so that you can get the results and not end up in the emergency room or not end up with a gallbladder issue. So I think this is really critical.

James Hill:
Yeah. And Holly, I'll put in a plug here for registered dietitians too. They can't prescribe the meds, but they can really help you manage side effects, make sure you don't have nutritional deficiencies. I know we'll talk about that a little later, but you need a health professional to prescribe the meds and then think about working with a health professional that can help you with your lifestyle.

Holly Wyatt:
That's a good point. So it may be that the doctor or NP can prescribe the drug, and if they've partnered and they have access to someone that can then meet with you and talk about what to eat and help manage the side effects, because a lot of times how you eat really impacts the side effects that you can have with these drugs, that is another option. But the key is not to do it alone. Make sure you're plugged in.

James Hill:
Yeah. Okay, Holly, mistake number two. I love this one because I think a lot of people, unfortunately, they do it. It's just, I'll just start and see what happens. I've heard about them. They're out there. I have friends that do them. You know what? I'm going to give it a shot and see what happens.

Holly Wyatt:
Yeah. Instead of being strategic, let me just see what happens. I'm going to go with the flow. With these drugs, I wouldn't go with the flow. That would not be when I would go with the flow.

James Hill:
Again, we've said it over and over. These are very powerful medications. They're fantastic in producing weight loss. But you have to have a strategy. Just taking the drug doesn't give you a strategy. You need to plan.

Holly Wyatt:
Yeah, this is what I tell people, and this is how I would think about it. I'm going to go on a medication that I know is going to decrease my appetite. I know also that that's a benefit and that's something I want because it's going to produce weight loss. I want to maximize that benefit because with those drugs, there are risks. We've already said that there are risks. So if I'm going to take my time, my money, if I'm going to put myself potentially at risk, I'm going to maximize the benefit, meaning I'm going to get the best and most and safest weight loss I can.

James Hill:
You know, Holly, if you think about it, traditionally, when people have tried to lose weight with lifestyle, it's like, okay, I'm going to be hungry. I have to restrict. I'm going to be tempted. I'm worried about my willpower. With the drugs, they do that for you. You don't have to worry about that. You can think about other things of how you're going to avoid nutritional deficiencies, how you're going to maintain your muscle mass. It's a different way of planning for weight loss.

Holly Wyatt:
Yeah. The medication is powerful, but it doesn't create a strategy.

James Hill:
Yes.

Holly Wyatt:
You need to create the strategy. That's really the key. So if I were starting one of these drugs, I would definitely have a plan. I wouldn't just start it and see what happens.

James Hill:
Yeah, and we're going to talk a little bit later about having a diet plan, a physical activity plan, and a mind state plan. You need all those. Even though the drug does the heavy lifting, because it allows you to eat less and not be hungry, there are some other things you can work on that are going to help your long-term success.

Holly Wyatt:
Right. Another way to think about it is you know that your appetite is going to be decreased. You know that food noise is going to be quiet.

James Hill:
The drugs do that. We know that.

Holly Wyatt:
What can you work on while that's going on?

James Hill:
Yes, yes.

Holly Wyatt:
You want to take advantage of that.

James Hill:
Different way of thinking about weight loss.

Holly Wyatt:
Yeah. You want to take advantage. Let's not throw that away. Let's use it to our advantage. All right. Mistake number three.

James Hill:
What's that?

Holly Wyatt:
Letting intake drop too low.

James Hill:
Ah.

Holly Wyatt:
I never thought I would say this, Jim. Right?

James Hill:
So, so many people are saying, wow, I'd love to have that problem.

Holly Wyatt:
This rarely happens. Sometimes people a little bit don't eat quite enough, but rarely. I mean, we're seeing this big time. So extremely low intakes, people eating only 200 or 300, 500 calories a day for long periods of time.

James Hill:
People say they forget to eat. They forget it. It's like I went all day. Oh, I didn't think about it. Wow, that's different.

Holly Wyatt:
Yeah. It's okay to go if you're sick or to go for a few days with very low, very low calories. Your body gets used to that. You can even go for a week. Fasting. We know short periods of time is not a bad thing. But people get on these drugs and they go week after week after week at very low calorie levels. And what that triggers is starvation. The body thinks it's in starvation mode, and I don't think that's where we want it to go.

James Hill:
It can actually work against you, I think.

Holly Wyatt:
Yeah, at that low a level, when you really get the calories low.

James Hill:
But Holly, these are people that never in their wildest dreams thought they would worry about eating too little. And now, gosh, how things have changed. But it's a problem, and it's a serious problem that you need to think about and plan for.

Holly Wyatt:
Yeah. So if I were going on the drugs, I would set a calorie goal of at least 1,000 calories, maybe closer to 1,200 calories a day. And Jim, they aren't going to like this, what I'm about to say.

James Hill:
Uh-oh.

Holly Wyatt:
I'd food log. I would log my food.

James Hill:
Oh my gosh.

Holly Wyatt:
So they're hoping they don't have to log their food anymore, right? Because they've logged their food forever. People who've struggled with their weight have definitely done some food logging. And now they're hoping I don't have to log anymore because I don't have the drive to eat. And I would say, yes, if I was starting a GLP-1, I would log my food because I would want to make sure I'm not in this super low level where starvation is going to kick in. And when starvation kicks in, that's not the physiology, that's not the metabolism you want to set up in your body.

James Hill:
And you're going to lose plenty of weight with those target calorie intakes.

Holly Wyatt:
Yeah, yeah. So I would food log and I would try to stay at at least a thousand calories a day. You're going to burn plenty of fat at that level. And it's going to keep you from going into that starvation mode.

James Hill:
All right, Holly, mistake number four. You know this is my favorite. Waiting until maintenance to start exercising. A lot of people believe that exercise doesn't matter during weight loss. That's false. It does. Yes, the drugs are causing you to eat less, and that is really fueling your weight loss. But exercise is critical for preserving muscle. That's a big one because you're going to lose a lot of weight, and you want as little of that weight as possible to come from muscle. It's going to improve your metabolic flexibility. We've done lots of podcasts on metabolic flexibility and how important it is to adjust to your diet. Supporting mental health. We know that exercise affects physical health, but also has fabulous positive effects on mental health. And it lays the groundwork for maintenance. If you're exercising, you're much better to handle maintaining your weight if you stop the drugs for any reason.

Holly Wyatt:
Yeah, so I do hear people say, when I get the weight off, my joints are going to be better. I'm going to feel better. And then I'll start exercising. And Jim, I think we may be a little bit responsible for that in a sense that we talk about the food doing the heavy lifting for weight loss and physical activity doing the heavy lifting for weight loss maintenance. And that's true. We've talked about that in many, many of our episodes, but you still need that physical activity when you lose weight.

James Hill:
I think it's a different way to think about weight loss. Okay, the drugs are going to do the heavy lifting. They're going to produce the weight loss. What you can work on is other aspects of health. And increasing your physical activity is probably the number one way to hit the other aspects of your health other than just weight loss.

Holly Wyatt:
And like you said, set yourself up for weight loss maintenance in the future and for long-term health. And then also, like you said, that quality of the weight loss, that comes in too. I think that that may be important.

James Hill:
And even quality of life. If we know over and over, exercising, regular physical activity improves quality of life. So it's one of the best things you can do. Again, let the drugs do the heavy lifting on the food side. It gives you the opportunity to work about some other aspects of your health.

Holly Wyatt:
And what I like is while you're losing the weight, while the GLP-1s are doing the heavy lifting and keeping that appetite low, you can go slow.

James Hill:
Yes.

Holly Wyatt:
Increase your physical activity. You don't have to get it up there overnight. You can figure out what you like. You can try some things. But don't wait. Don't say, “I'll start that when” and push it into the future. Start working on it right away as you've started the GLP-1s. And if you're keeping your calories at about 1,000 or more, 1,200, you can start some physical activity. I hear other people saying, “Oh, I'm not eating enough to be physically active.” What do you think about that?

James Hill:
Oh, no. You've got to do your physical activity. Whatever your diet thing is, your physical activity can add. And actually, it helps sort of better manage your appetite. There's a tie between your physical activity levels and your appetite regulation. So it can only be a positive impact on appetite.

Holly Wyatt:
Yeah, I always say the type of physical activity we're doing, walking and going to classes, if we were running and wanted to run our best 5K or we were in the Olympics, then yes. The food would really make a impact on us running our very best race. But walking and moving and the type of physical activity we're talking about, you can do that even when your calories are low.

James Hill:
Just look for ways to move your body during the day. Incorporate movement into your life.

Holly Wyatt:
Yeah. All right. We're up to mistake number five. Ignoring mind state. Just like they ignore physical activity, they will ignore mind state until it's too late.

James Hill:
Yeah.

Holly Wyatt:
And I'm going to tell you what I think I mean by that, but until it's too late. So when you're on the drug, that's when you want to start developing a mind state that's going to be helpful if you decide to stop the drug, but also just good for your life. I think so many people have learned to or do use food as a coping mechanism.

James Hill:
Yeah, definitely.

Holly Wyatt:
When they feel a negative emotion they don't want to feel, what do they turn to to try to feel better in that moment? Food. Or when there's a big life curveball and they're overwhelmed or whatever, they kind of turn to food as a solution. And you can't do that while you're on the medication because the medication kind of keeps your food level low. But you want to start learning new strategies. Those aren't really effective strategies anyway. And so while you've got the medication on board, work on that mind state so that you can say, what am I going to do? What other strategies? Well, how can I be more emotionally resilient when I do feel these emotions? What's a better way for me to handle them, to move through them, to deal with them instead of food, which is what I've used for maybe many, many years?

James Hill:
You know, Holly, in our book, Losing the Weight Loss Meds, we have a whole chapter on reevaluating success. So, success really isn't just the number on the scale. Yeah, it's great to hit the number on the scale, but what a healthy mind state can do is help you learn to enjoy your life, to increase your quality of life. So it really, really is important.

Holly Wyatt:
Yeah, so I would work on this. This is probably one thing that I personally would very much work on. I would want to develop some emotional resiliency skills. So just like while I'm not having to think about how much to eat as much, while my appetite's down, I would be working on getting my activity minutes in and I would be working on getting my mind state minutes in, which means strengthening my mind state, coming up with new skills and new strategies, whether that's breath work. I mean, there's a whole bunch of different things you could do. But once again, I would start working on it now while I was taking the medication, while I was losing the weight.

James Hill:
Unfortunately, a lot of healthcare professionals won't emphasize this, but it's so important that the drugs can work, they can get the weight off, but working on your physical activity and your mind state can both set you up for the future, but it also can enhance your quality of life. And that's what we're really after.

Holly Wyatt:
Yeah. Yeah.

James Hill:
All right. Mistake number six, not beginning with the end in mind. I've started asking a lot of people who start the GLP-1 meds, what's your long-term plan? You know what the answer is? I don't have one. I'll worry about maintenance when I get there. I just want to lose the weight. Okay, I get it. You really do want to lose the weight, but you need to think about the long term. What's your plan? Is your plan to go on the meds and stay on them forever? Is your plan to use the meds, get the weight off, work on your lifestyle? There's no right answer here, and you can change your mind, but it's important to think about it. And as you move forward and lose the weight, think about how you're going to maintain the weight.

Holly Wyatt:
]Yes. And even if you're saying, I'm going to stay on these medications long term, which is definitely a possibility, I still think it's important to think about weight loss being a phase and weight loss maintenance be a phase. Because even on the medications, eventually you will stop losing weight. You will plateau.

James Hill:
Absolutely. And that's a good thing.

Holly Wyatt:
Yeah. And we did a whole episode on what it means to plateau, why you plateau, kind of understanding the plateau. And so you will plateau and you will move into weight loss maintenance, even with the drug on board, even if you continue taking the GLP-1. So I think it's important to say, why do I want that period of my life to look like? Weight loss is going to be a finite period of time, maybe a little bit longer on the GLP-1s, could be up to a year. You may lose weight just depending on how the drugs affect you, the effectiveness of the drugs. But at some point in your whole life, you're going to be in maintenance. And what do you want that to look like?

James Hill:
And we've talked over and over about the fact that the skills required to lose weight are different than the skills required to maintain gain weight. And so many people have great weight loss skills. They've worked on these over and over and over, but they've never worked on their weight loss maintenance skills. And this is where eating patterns, movement patterns, routines, environment, mind state all come into play.

Holly Wyatt:
Yeah. So, they don't begin with the end in mind. So the idea is you need to begin with the end in mind. I can tell you where you're going to end. You're going to end in weight loss maintenance. I know that, right? I can tell you that. I feel confident with that. At some point, your weight loss is going to stop. And so if you begin shaping this weight loss maintenance lifestyle now, it's going to be so much easier to transition and it's going to be a better outcome for you.

James Hill:
Agreed.

Holly Wyatt:
All right. Mistake number seven, ignoring body composition, focusing only on the scale weight. And Jim, I don't know that we have data to support this, but I broke this down because it was me personally. Starting a GLP-1, I would follow my body composition. Although I don't know that we have data to support this exactly.

James Hill:
Yeah, we're still in the early phases of research on using these medications for weight loss. We have more research on using them for diabetes. What we know is if you lose a lot of weight and on those medications, you can lose 15 to 20 to 25 percent of your body weight. That weight is going to come off as fat, muscle, connective tissue, other kinds of things. And I think the goal is to have the reduction in muscle mass as little as possible. The more muscle you can keep, the more your metabolic rate is higher and your chances of keeping weight off are the same. We don't have enough information to know for sure whether these medications result in more loss of lean mass, whether that may be true in certain populations, etc. We will learn that over the next few years. But right now, I think it's fair to be concerned about losing muscle. And there are some things you can do to limit that.

Holly Wyatt:
Yeah, that's why I think I would use some technique. I would specifically go out there and be measuring body composition, not just scale weight. And I can't tell people exactly what that should look like. And that's the problem. Well, you're going to lose some lean mass, but not too much. But I personally would want to know that because I would make some course corrections if I thought it was too much. If I was looking and I was losing 50% fat and 50% muscle and I was being measured by a reliable way to look at body composition, I would change what I'm eating. I would change the rate at which I was losing the weight. I would do something. I wouldn't wait to the end. And so I would want the data.

James Hill:
I think roughly, Holly, you could anticipate no more than 25% of your weight loss should come from lean body mass, however you measure that.

Holly Wyatt:
Yeah.

James Hill:
And if it's a lot more than that, I agree. But there are some things you can do to try to limit your loss of muscle mass.

Holly Wyatt:
Right. People always say, okay, how do I measure my body composition? What options do I have to do that?

James Hill:
Well, if you have access to sort of a DEXA, most medical centers will have a DEXA, and sometimes you can just go in and pay and get a DEXA and get body composition. There are things like Bod Pods, which are easy to measure body composition. Those are pretty accurate. Then you have bioelectrical impedance. You can buy scales that give you body composition, et cetera. They're not quite as accurate as the others, but they're still maybe useful for tracking your body composition over time.

Holly Wyatt:
Yeah, I think you would look for trends, but I think I would try to do that. And that's where bringing in that healthcare professional, having someone there helping you could be important so that you can interpret the changes in body composition.

James Hill:
Okay, mistake number eight, not prioritizing key nutrients. With overall intake being lower, you need to make sure that you're eating smarter. What we're seeing is deficiencies, nutrient deficiencies in people using GLP-1s for weight loss. That can be too little protein. We're seeing people not get enough fiber. They are often deficient in some micronutrients. And hydration becomes an issue, making sure you stay hydrated. So nutrient density maybe becomes more important than calorie density. You're going to eat fewer calories. You're going to lose weight. Make sure those calories are packed with the right kind of nutrients to prevent nutrient deficiencies.

Holly Wyatt:
Yeah, it doesn't have to have a lot of calories, but I would be thinking about the nutrients. I think some people think, okay, I am not going to be able to eat very much. I don't have an appetite. I'm going to go eat my favorite food. And my favorite food happens to be a food that maybe doesn't have a lot of nutrients in it, maybe some empty calories because I love it. I wouldn't do that. I would, for the calories that I'm eating, if I'm eating a thousand calories and I'm targeting, I would make those very nutrient dense because we are seeing these deficiencies develop and we are seeing people getting dehydrated. And a lot of times when people feel bad, when they've been losing weight with the drugs or even just losing weight otherwise, it's a hydration issue, Jim. They feel low energy. They feel they don't feel well. And when I have then treated them with, you know, for it may increase their hydration, they feel better. And the key is people always say, “Oh, Holly, I'm drinking a lot of water. I'm drinking a lot of water.” No, no, no. You've got to have electrolytes plus water for your body to hold on to it. So it's important that you're getting those electrolytes, that you're getting the B vitamins, that you're getting the micronutrients that you need to feel good to have those energy, to have energy. So I would say, really think about. So if I was starting a GLP-1, I would really think about making sure the calories I'm getting are high nutrients, vitamins, minerals, fiber. So what does that mean, Jim? It means some vegetables. It means, you know.

James Hill:
But it's planning, Holly. It's not just sort of, I'll figure out what I want to eat. And there again, I'll come back to, here's where a registered dietitian can really help. Talk to a health professional who understands the meds and understands that on that, say, a thousand calories, you're going to need to get the key nutrients you need and can help you plan a diet around your tastes and preferences.

Holly Wyatt:
Yeah. And this statement might help some people who are on the fence. If you prioritize nutrient-dense foods... It's going to keep your energy high. It can affect your hair, your skin. We talk about the skin and what happens when you lose a lot of weight in your face and your skin and your metabolism. It can keep them all strong, all work at the optimal level. So I would prioritize. I would definitely think about these nutrients.

Holly Wyatt:
All right. Number nine, mistake number nine. And I never thought I would say this, Jim. This is a first. It's coming out of my mouth. Losing weight too fast.

James Hill:
Oh my gosh.

Holly Wyatt:
Oh my gosh. I have never said this. This is new from the GLP-1s because before when we had just lifestyle or the older generation weight loss medications, my philosophy was let's get off as much weight as quickly as we can. Why? Because I knew we were going to reach a plateau around three to six months. And I wanted to get as much weight off as we could. And the data would show that it didn't matter if you lost weight slowly or quickly. It was the same. And I would prefer to get as much weight off as I can before the plateau hit. Now, suddenly, we're in a different situation. People are losing more weight and going out longer.

James Hill:
A year to two years of weight loss on these meds. So it gives you a chance to go slow and you still get to the place you want to be at.

Holly Wyatt:
Yeah. And so I think I would look at the rate of weight loss and I would try to hit it about 1%, maybe a tiny bit more, but 1% per week. And I would titrate it to try to get at that rate. First time I've ever said this.

James Hill:
Wow.

Holly Wyatt:
I don't know. I never thought I would say it. But I would do that because if you're losing weight quicker than that, it may mean your intake is too low. And now we have more time so we can get there and let's do it a way that I think is going to be more helpful, more beneficial.

James Hill:
And just trust that these medications are going to continue to work for a longer period of time, a year plus. So don't think, “Oh my gosh, I have to get it off because the meds might stop working.” The data suggests they work longer.

Holly Wyatt:
Yeah. Now, some people, Jim, they'll plateau in a shorter period of time. The meds are a certain degree of effectiveness, but I don't think it has to do with the timing. In other words, if you're going to be one of those people that's going to lose 10%, you're going to lose 10%. And I don't think it's like, oh, if I would lose more quicker. This whole idea of tolerance, we need to do a whole show on it. I don't really think we're seeing any evidence of tolerance. We do see effectiveness, meaning certain meds produce a certain amount of weight loss in certain individuals. And people are confusing that with tolerance. But I think given everything we know, I would target about 1% body weight per week. No data on this. So I will just say that. It's just anecdotal from looking at this. To slow down, to kind of protect my lean mass, to make sure I'm getting plenty of micronutrients.

James Hill:
But 1% a week, you can lose a lot of weight in a few months.

Holly Wyatt:
One reason I like 1% is you can take your body weight. So if you weigh 250 pounds, you know it's 2.5 pounds a week. Or if you're 300, we know it's 3.0 pounds per week. It's really easy to calculate 1% of your body weight and that be the target for the week and kind of follow that. And it doesn't have to be perfect, but on average, if you're doing that, that would be, to me, a great rate of weight loss. Not five pounds every week. And you see people doing that. Five pounds for week after week after week.

James Hill:
Okay. Last one, Holly. Mistake number 10.

James Hill:
Not having a plan for if or when you stop the medications.

Holly Wyatt:
Yeah.

James Hill:
Okay. We say this over and over and over. The medications are approved for chronic use. You do not have to stop them. You can go on the medications. You can take them to lose weight. You can take them to keep the weight off. However, one of the things that we know is that probably most people do not continue them long term. The data suggests that maybe half the people stop them less than a year out. So for whatever reason, people are stopping them. So if you want to stay on them, you're happy with your weight, you feel good, fine. But if you decide to stop them or have to stop them, unless you have a plan, you're going to regain the weight. So in the clinical trials, when people just stop the meds without a plan, they regain the weight very quickly. But it is possible to come up with a plan that helps you keep the weight off even after you stop the medication. The end of weight loss can be the beginning of maintenance, and you need a transition to go from the medication to weight loss maintenance.

Holly Wyatt:
Yeah, just like you have a plan when you're in the weight loss, it's important to have a plan when you decide to stop, if you decide to stop. And really have a plan for weight loss maintenance, whether you decide to stop the meds or not. But especially if you're going to stop the medication.

James Hill:
And Holly, we wrote a whole book on this.

Holly Wyatt:
We did. That's how important we think it is.

James Hill:
And the book, Losing the Weight Loss Meds, tells you it's based around three pillars. You have to have a food plan because when you stop the medication, your appetite's going to come back. You're going to eat more and that's okay. You have to have a plan for not letting it come back too far. You have to have a plan for making sure you're physically active enough to optimize your metabolism. And maybe even most importantly, you have to work on having a mindset that allows you to maintain your weight and deal with real life chronically and avoid gaining the weight back.

Holly Wyatt:
Yeah. And we talk about it's not even just a mindset. It's a mind state, right? It's about how you think about it and what you do, the skills, how you engage in life. That emotional resiliency that we talked about in this episode is so important. And you can develop that and you can start to develop those skills while you're losing and then you have them in place when weight loss maintenance comes around.

James Hill:
When you stop the meds, there are challenges. But if you have a plan, you can address those challenges, keep the weight off, and achieve not just a healthier life, but a happier life.

Holly Wyatt:
You know what? I think what my goal is, I want people to get excited about moving into weight loss maintenance.

James Hill:
Yeah.

Holly Wyatt:
And now I think people either don't get excited or they dread it. And it's like, no, this can be good. This isn't bad.

James Hill:
We see that in the National Weight Control Registry. These people that have lost weight and kept it off for years, life is better. It's not as if, oh my God, I'm keeping weight off, but I struggle and I hate it. It's like, I love it. I love life at this lower weight and with a healthy lifestyle.

Holly Wyatt:
It can feel good. And that's really what the book's all about. Let's go into weight loss maintenance. Let's feel good doing it.

James Hill:
It's really a book about weight loss maintenance. It tells you how to keep weight off permanently.

Holly Wyatt:
I say, it's a book about weight loss, maintenance, and living life.

James Hill:
It is, yeah.

Holly Wyatt:
Yeah. All right. A couple of listener questions that I thought fit with this topic.

James Hill:
Okay.

Holly Wyatt:
I'll take the first one. How do I know if I'm eating too little on a GLP-1?

James Hill:
Oh, yeah.

Holly Wyatt:
Great question. For one thing, log it, and you will know. So you can log it. But you can also look at your energy, your mood, your physical performance, how you're feeling. So, I would say for sure 1,000 to 1,200, you may need a little bit more. If you don't feel like you have enough energy, you can go up a little bit so you can fine-tune it. I think anything under 1,000 is maybe a red flag, but you can adjust it. It's really how you're feeling more than anything else. What do you think, Jim?

James Hill:
I agree with that. And again, take a long-term view. If you think I have to lose all the weight I can in three months, it's different. You've got a longer period of time here so you can adjust based on how you feel.

Holly Wyatt:
All right.

James Hill:
All right. Here's a question. should I keep titrating up my dose of medication if I'm already losing weight? This is the real reason you need to work with a healthcare professional. You don't know that. It depends on how you're doing in weight. It depends on side effects. It depends on how your intake is going. So this is not a decision you should make on your own. You should make this decision in collaboration with your healthcare professional.

Holly Wyatt:
And I think at the Obesity Society meetings, we talked a lot about this. There was a lot of talk about how we should be titrating or what are the options. To me, this is what I call the art of medicine. Yeah, there's a science behind it. We can look at the clinical trials and we can see how they ramped up the dosage. And we have that and we should use that. But this is where when you have your medical professional, this is where you're an N of one. You're an individual. and I'm going to look at what's happening to you and going to adjust it appropriately for you. And it is an art to it. You know the science, but there's an art to it. This is why you need someone working with you because you don't have to necessarily go up at the rate that the clinical trials went up. It might not be necessary for you or the best thing for you.

James Hill:
Figure out what works for you.

Holly Wyatt:
Yeah, and you need someone to help you do that. So you do have to balance the side effects and the weight loss and all these other factors. So I would say get help with that. But I love that someone's thinking about it because that is an important thing to think about. All right. One more. What should I do differently if I already know I don't want to stay on the medication long term? So someone says...

James Hill:
Read our book. And we wrote a whole book on this.

Holly Wyatt:
eah. Well, I think it's like, okay, plan for that. Definitely plan for that. And our book could help you. Other people can probably help you. But don't wait till you're going to stop the drug to be thinking about it. Think about it from the beginning. And there are things you can do.

James Hill:
You can do it with a plan.

Holly Wyatt:
Absolutely.

James Hill:
All right. You want to do a quick vulnerability segment?

Holly Wyatt:
Yeah, because I got a good one for you.

James Hill:
Oh, Holly, is there something you would personally be nervous about if you started a GLP-1 med, even as an expert?

Holly Wyatt:
Yeah. Yeah, I think personally because of my age and kind of what's important to me, I would be a little bit nervous and would be really monitoring that muscle. I'm older and I just don't want to lose that lean muscle for so many reasons. And I would just want to make sure I wasn't one of those individuals that maybe was losing more than the average. And that's just a personal thing for me that's important to me. So that's what I think I would be the most nervous about. All right, Jim. So here's the question I came up for you. What mistake do you think you would be the most likely to make if no one warned you?

James Hill:
Oh, that is such a good question. You probably know the answer to this. People that know me know one of my favorite quotes is from Mario Andretti, the race car driver. And Mario said, if everything's under control, you're not going fast enough.

Holly Wyatt:
Oh.

James Hill:
So my mistake would be trying to lose too fast. I would just go for it.

Holly Wyatt:
Yeah. Yeah. So you might fall into not getting enough calories. You might fall into getting some of the micronutrient deficiencies. You might lose too much muscle.

Holly Wyatt:
You never know. All right. I like that.

James Hill:
Let's put the pie on the plate. If you're starting at GL-1 med, start with support. You need a medical partner, not guesswork. Have a plan. You've got to deal with food, movement, and mind state. The drugs will produce weight loss. You have to work on movement and mind state and start from day one. Protect your muscle and pace yourself. Slow strategic weight loss is safer and more effective. And remember, the way you start shapes the way you succeed. Start with a long-term plan in mind.

Holly Wyatt:
Yeah, and can set yourself up for where you're going in that long-term success. I love that. So if you're starting a GLP-1 in January, you're in for an adventure. Get excited. It's a good adventure. And no, you don't have to do it with guesswork. You don't have to do it with fingers crossed. We would advise you not to do it that way.

James Hill:
And for those of you who like to peek ahead in the story, we do have a free guide at www.weightwisdom.com about what not to do when you eventually stop a GLP-1 medication. Think of it as your future you safety net.

Holly Wyatt:
Yeah, you know, we wrote that guide to go on the Weight Wisdom. And then when we wrote it, I'm like, well, we need to do the same thing for when you're starting, right?

James Hill:
Exactly.

Holly Wyatt:
Mistakes not to make. So that kind of came full circle there.

James Hill:
Okay. So if you're going to start at GLP-1, get excited, enjoy the ride.

Holly Wyatt:
Yep. And we'll see you next time on Weight Loss And.

James Hill:
Thanks, everybody. And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:
If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

James Hill:
We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at weightlossand.com. Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:
And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.