The Unexpected Side Effects of a Year on a GLP-1

CW: Discussions of eating disorders, weight and body image. I also may be popping off about some stuff. And, as always, I am NOT a licensed physician. I did not go to medical school. If you are considering using a GLP-1, please consult a doctor.

If you are new, you may have missed my posts about starting a GLP-1 a year ago. If you are interested in the background of my decision, please start here. These are two of my most read posts, and I’m glad I documented my progress, as sometimes I can’t even believe it.

With that background out of the way, I’m here to tell you about where I’m at today, a year later. For this neurodivergent perimenopausal woman with an autoimmune disorder, Zepbound has been nothing short of a miracle drug.

I’m not going to rehash or greatly revise everything I wrote about in those two posts. But here is a list of statements I made before, with any necessary edits or updates, because I love a list:

This is a big part of why I call it my miracle year. Even if none of the other good stuff happened, this is a miracle. Not only am I off Xolair, I don’t even really take antihistamines anymore, which is WILD.

Not only am I not having reactions, I am enjoying a whole host of foods I used to avoid — most Japanese food, shrimp, kimchi, scallops — and it’s making it far easy to eat better. I don’t wake up covered in hives for no reason, I rarely if ever get stomach sick, and my joints and skin are not constantly inflamed. I really didn’t understand how sick I was until I wasn’t sick anymore.

I still have MCAS. There is no cure, and if I went off Zepbound tomorrow, my symptoms would return.

After a full year, the COVID 40 is gone. My slow, steady rate of loss — I lost it at a rate of approximately 0.8 lbs a week — has paid off. It was a healthy pace, and I treated this as a complete lifestyle change, not a quick fix. I am very very close to my target weight, and then I will begin maintenance. I am hoping to just do a lower dose once a week, but we’ll see what insurance says about it.

I had learned to appreciate my body before I started this process. While I was not where I wanted to be, I was grateful for all the things my body could do, and I had to separate out the beauty standards that were imposed on me from my own personal comfort. I had to really ask myself what I valued. I’m glad I was able to do that work first.

While the health benefits of the weight loss far outweigh the aesthetic ones, I have to say, it was nice to put on a small black dress for my husband and my anniversary dinner in Mexico. I was FEELING MYSELF. I looked AND felt good. It had been a hot minute before both of those things had happened at the same time. And that is okay. I don’t think I am a failure as a woman because I like to look hot in a dress once in a while.1

Still true. I have more focus. But I also have more clarity, which I’ll talk about in a second.

Still true, even truer. Part of what I thought was perimenopause was actually me not eating enough mid-cycle. Turns out that now when I am stressed, I don’t eat enough. That is the opposite of how I used to be, so it took me a minute. I am still dealing with some hot flashes and general unpleasantness, but its less of a hell ride than it was a year ago.

Still true, but less. It also depends on a lot of variables. What I choose to eat and drink on shot night and the day after has a LOT to do with this, and I have adjusted accordingly.

Turns out, when your dopamine seeking brain isn’t hitting the FOOD or WINE button every three seconds, and things regulate, your brain gets quiet. The day after I do the injection feels like the first time I took Adderall. The noise turns down. And in that quiet, you are forced to sit with some discomfort.

I hid so much of my pain in food and alcohol. The fucked up thing is that it works, at least in the short term. Nothing would turn down my brain like a big ass plate o’something and 2 glasses of wine. NOTHING.

Now, when I have a plate o’ something and a drink o’something, the palpable relief that used to accompany it isn’t there. I am not chasing it. The question “What do you want for dinner?” no longer feels like a threat. I still enjoy food and wine, quite a bit, but the key word is enjoyment. I’m not self-medicating with it.

Because of this clearer head, and more space in my brain, I was also able to unpack some issues I was having with people in my life. People I had poured a lot into.

I always over-invest. If you are my friend, or family, I am loyal and steadfast. I will drop everything to help you. I will give you the shirt off my back. I will give you the benefit of the doubt even when no one else will.

Part of this is because I felt this was a requirement of being loved, thanks to my fucked-up childhood and undiagnosed neurodivergence. Another part of it is because I think I am, at my core, a generous person. I don’t believe in the love languages as much as others, but Acts of Service is one of mine. I don’t like to keep everything for myself. I’d rather help, or share, if I can.

This has now fucked me over so many times that I had to bust out this old classic.

You hit a certain age where you realize that people are going to treat you how you allow them to. I’ve been on this particular path for a while, but instead of gingerly clearing away the branches blocking my way, I’m hacking through overgrown forest with a machete.

I am done getting back far less than I give. I am done being the spare, the one to call when someone needs something, the trusty backup when others said no. I am done being the person who looks at a text and know the only reason I am getting said text is because I need to get out my wallet or be an emotional support dog. It ends the same way every time — I finally snap and everyone wonders where the fuck it came from. I turn to ice, I stop taking the calls, and it’s “well she’s a bitch anyway”.

I’m fine with being a bitch, truth be told.

I’d rather be a bitch than a sucker.

Is this scary? Fuck yes it’s scary. Having to re-evaluate some of your core relationships is brutal. But at the same time, are they core relationships if those people don’t even really love you? If they don’t respect you? If your pain is invisible to them?

Now that I have figured out that I’m AuDHD, there is a lot of context for all of this that I was missing. I am grateful for the people who do see me, and those people sustain me. But I also had to learn how to sustain myself. I cannot rely on others for my sense of purpose or self-esteem.

Did a GLP-1 give me all that? Fuck no. That’s 14 years of therapy, life experience, and a hell of a lot of internal work. But it did give my brain the space to process it, and to feel the pain and grief I needed to feel, without numbing it out with food. It doesn’t work anymore. And I literally CAN’T binge eat. Not unless I want to feel super bad. And if it doesn’t bring relief, what is the point?

So, I can fit into my old clothes, I feel physically better than I have in years, my circle is smaller but higher quality, and I’m finally not sick all the time.

Worth it.

Lastly — I am getting pretty sick of cruel pieces about women’s bodies dressed up as concern.

GLP-1s have given everyone an excuse to write such impressive titles as “Demi Moore Isn’t Beautiful and Never Was” or some shit2, because she looked too skinny for someone’s liking. They have given people a new magnifying glass with which to burn women for not doing what they want.

I think people who have never been fat should shut up. If you don’t know what it’s like to be a fat woman in America, you have NO idea, and your opinion about my health treatment is irrelevant.

And truly, I think leveling the playing field has made “right sized”3 people mad, because their body might no longer hold the currency it used to.

I have written at length about body image issues and yes, some of these actresses are alarmingly skinny. But let’s not pretend this is “concern” when it’s really insecurity. Let’s not pretend it’s fear for your daughters when really its unprocessed grief for yourself. And let’s also not forget that adding to the scrutiny does not create less scrutiny.

I am not a doctor. It’s not my job to say who “should” and “should not” be taking these medications. And it’s not yours, either. And that’s where I’ll leave it.

In the meantime, here are some pretty new studies, in actual medical publications, about the health benefits and promising outcomes of GLP-1s.

There is still much research to be done, but please keep in mind that a form of these medications have been around for almost 20 years, so long-term effects HAVE been studied.

GLP-1s may slow biological aging

Benefits for bones and joints, with possibly fewer knee replacements

New study shows 30% less instances of breast cancer in women taking GLP-1s vs. those who don’t

This month is the three year anniversary of The Long Climb!

In July of 2023, reeling from my recent ADHD diagnosis, and wanting to write about it, I decided to start a Substack. I didn’t even import people from my mailing lists. I just started writing. I needed an outlet that wasn’t beset with expectations from the jump.

And so I wrote. And kept writing. What a RIDE it has been. Thank you all so much for being here.

I have a lot more to say, but for now, I am announcing my Third Anniversary Sale and a new perk!

Upgrade for 30% off!

Buy me a Coffee!

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Thank you thank you thank you ALL for these amazing three years.