Those are all good suggestions for doing GLP-1 drugs the best way possible.

Unfortunately there are confounding factors that can and do often result in problems trying to follow those suggestions.

Take for instance the recommendation that if you're going to take the drugs to lose weight, then you need to be prepared to take them for life. But since most people taking those drugs can't possibly pay the $1,000+/month for a year (much less for life), they're reliant on their insurance company approving the drugs.

Two factors (that I've heard of so far) get in the way there:

If you aren't losing enough weight to satisfy the insurance company's requirement over a given period of time, then they will cut you off - and that does happen. In some cases, the individual simply isn't responsive to the drugs. Or maybe their body will not be responsive until they reach a much higher dosage - but if the insurance company cuts them off before they reach that dosage.

A second insurance company ploy is to require the patient to be moved up to the next higher dosage every single month. Doesn't matter if the patient is doing really well on a lower dosage, or if the weight loss/side effects balance on the lower dosage is better for them. The insurance requirement is to keep moving up the dosage to what's considered optimal therapeutic or maintenance level. They won't approve another month at the same level until you reach the highest dosage.

A possible third factor in continuing those drugs for life: What happens when the patient is finally no longer obese? The insurance company will cut them off because they've achieved their weight loss goal. It's possible that some of the health improvements could come into play here - they might be able to convince the insurance company that the drugs are needed to continued health improvements. Depends on whether the drug is classified as needed for an ongoing condition that has not been cured by the drugs, or if it's considered to be no longer needed once the condition is no longer as serious of a problem, and if the condition continues at a lower level once they reach goal weight, the insurance company determines it should be treated with cheaper drugs.



As far as making sure to get enough protein to minimize muscle loss - even whey protein can be difficult to get down, much less keep down when the drug makes you barely able to consume anything and keep it down... a not uncommon occurrence when getting used to a higher dosage. It also still takes longer to digest whey protein than starches, hence the heavy use of starches in the diet routinely suggested with these drugs. And of course there's also the problem of completely forgetting to eat while on the drugs because it turns off all thoughts of food. They would need to truly force whey protein a few times a day. Also keep in mind that every package of whey protein (at leaset all those I've ever seen) cautions that it is not a balanced diet, only a supplement, and that you should never rely on a diet of nothing but whey protein for weeks at a time, much less months or years at a time) I know he's not suggesting eating nothing but whey protein


Weight based exercise to maintain muscle will be fine as long as the person has not messed up their back and joints to the point that any weight based exercise will just cause more back and joint problems. But who is most likely to have messed up backs (and knees and hips and ankles) to begin with? Those who have been carrying around an extra fifty or hundred pounds or more for years. In other words, the people who are using GLP-1 drugs.


So much of this is just d***ed if you do, d***ed if you don't.

They're so much better off if they can somehow do a lower carb/higher protein diet without the drugs. The drugs are the easy way out... until the problems associated with using the drugs and continuing to use them long term surface and make things even worse.