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May – Ozempic Update with Our Clients

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May – Ozempic Update with Our Clients


Our patients are inundating us with questions about the new weight loss medications. Here are some of the good and bad lessons we are seeing. Ozempic benefits include helping slow down food absorption in the stomach so you feel fuller longer, regulating insulin and blood sugars and telling your brain you are full. Without making diet, activity or lifestyle changes, weight loss can still be achieved because suppressing your hunger can reduce your calorie intake. However, these medications do have significant side effects such as nausea, GI upset, eating too little, dehydration, losing weight too quickly and loss of muscle mass from being malnourished. Approximately 39% of weight loss comes from losing lean body mass.

Many patients are taking breaks from using these weight loss medications either because they feel satisfied by results or they become unavailable due to a shortage of the product. When they stop taking the medication research suggests that participants gained an average of two thirds of the weight loss back even when they maintained the lifestyle changes they implemented with the medication. This happens because if people go off the drug at a lower body weight, the appetite drastically surges because the body fights to get back to its preferred set point weight. They are not being taught they must restart at a lower dose and titrate slowly back up again per their health care provider’s advice.

It is our job as dietitians to tell our patients that by choosing to start these medications you are accepting the work and responsibility to make sure you are meeting your basic nutritional needs even if you do not have a sense of hunger.

Here are a couple of client case studies to consider.

Diana’s Food Diary
Breakfast : 1) Carnation instant breakfast (2) homemade protein shake (3) avocado toast and
(4) bagel with cream cheese
Lunch : (1) 2 egg veggie omelet with avocado, tomatoes and toast (2) grilled cheese sandwich
(3) cheese & crackers {made at home since Diana works remotely)
Dinner: California rolls which are her favorite
Reported feeling filled up too quickly by water.

We liked her homemade protein shake in the morning because she used pea protein powder providing 2 oz. of protein, adding veggies and an apple, which gave her the appropriate amount of protein with fiber. For lunch we calculated she was getting only 2 oz. of protein from the two eggs in the omelet or less from the grilled cheese and cheese crackers. For lunch, we had her load up on protein by adding 3 oz. sliced meats or a few strips of turkey bacon in her omelet with avocado, with a slice of whole wheat bread. This provided a well-balanced meal giving her the protein, healthy fats from the avocado, fiber from the veggies and carbs from the toast. For her sushi dinner we suggested that she switch to having 2 oz. of sashimi, cucumber salad and a serving of rice which she was open to it.

We saw that she was consuming only approximately 1100 calories even adding the extra protein. We ideally wanted at least two to three times the amount that she was eating for her height and weight. This was when we recommended the patient discuss lowering the dosage of Ozempic with her doctor so that we could meet that sweet spot of achieving a 20-25% calorie reduction while meeting her nutrition needs. We discussed the risk for dehydration by taking Ozempic.

Carol Food Diary
Breakfast: Chobani Complete Yogurt drink
AM Snack: Quaker oats granola bar
Lunch: Trader Joe’s frozen Butter Chicken with spinach
Dinner: Lean Cuisine meal
Carol explained how she was not getting any benefit from Ozempic and not getting that fullness
feeling that she heard other people getting. She was not losing any weight.

For breakfast, we were happy to see 20 grams of protein to start the day. For lunch, we told her she need not be afraid of rice, even having been told she had insulin resistance and PCOS. In Indian restaurants when you order entrees with chicken you get a few cubes of chicken and lots of sauce with Naan. We recommended Carol add rice to her dinner meals with more protein rich entrees like Trader Joes Chicken Fajitas. Lean Cuisine is marketed as having only 300 calories and the protein content is minimal. She needed to increase protein for muscle protein synthesis since she was going to Orange Theory and feeling very sore. Carol is no longer feeling sore after her workouts because she is eating more protein and placing more emphasis on hydration, adding an electrolyte packet to her water bottle. Ozempic is working more effectively because she is getting a fullness with more protein and fiber which she was not having before. We believe if you are taking one of the weight loss medications you need to be working with a Registered Dietitian to get the best success.

We are contracted with most insurance companies, Aetna, Blue Cross, Blue Shield, CCHP, Cigna, Hill, Sutter and UHC. We are happy to call your insurance and check on coverage.

Refer to my website for information about my services. Please call me at (925) 855-0150 about your nutrition concerns or email me at and refer to my website