Almost two years ago, September 4, 2023 to be exact, I posted a blog entitled “Walking or Hiking?” It recounted an experience Gary and I had at Minnewaska State Park. We took a trail that was more demanding than expected and it was a hot day. We made it, but not without struggle, and not without Gary providing me necessary support. You can read that account here.
This past Friday we went back to the same park with the intention of doing the same trail. When we got to the visitor’s center and asked about the condition of the trail, we were told it wasn’t a wise choice because they had gotten over three inches of rain the day before and that route, which crossed a stream, would have taken a beating. We decided to take a different trail that would end at the same view but would likely be in better shape.
The reason we returned to the scene of that challenge was that some things were different this time around. I am 52 pounds lighter and more fit. I wanted to test myself. I told Gary a few months ago that when I had reached the 50-pound milestone I wanted to try the demanding hike again.
This weight loss journey has been an interesting one. A little over a year ago my bloodwork revealed I was prediabetic. I was not especially surprised given my family history. Diabetes is epidemic in my family. In some ways I knew it was just a matter of time. I hoped the fact that I was always active would stave it off, but the Covid lockdown had added yet more weight to my already heavy body, so I was losing the battle. I needed to do something.
I have done many diets over the years and found some success with Weight Watchers but I had never been able to sustain it. The Covid shutdown, which wreaked havoc with my emotional state and limited my exercise, did me in and I never recovered. It was time to consider a new option. In the past I had always been leery of fad diets, surgery or meal replacement approaches because I didn’t think any of them addressed the root problem. Now the weight-loss landscape has changed with the introduction of medications (GLP1’s). My doctor recommended Wegovy. After much consideration, and consulting with my husband who has hundreds of patients using these drugs, I decided to try it.
The first hurdle was getting preapproval from my insurance company. There were hoops and loops to jump through, but the reality was that I met the criteria, and they did ultimately approve me.
The second hurdle was that it is an injection. That turned out to be a non-issue. The medication is not delivered by syringe, it is a pen. You barely see the needle and it comes pre-measured. It wasn’t particularly painful either. That was a relief.
Next issue, was side effects. This I did have to deal with. When I started, I felt some queasiness, but that resolved. The bigger issue, and this may be TMI for some readers, was constipation. I am prone to that to begin with and this made it worse. Some folks have the opposite problem on these drugs. Anyway, it took a while to work that out – making good dietary choices and generous amounts of Metamucil or sometimes MiraLAX helped. Eventually I got to a tolerable place.
But there were other side effects that built up. I have reflux (heartburn). These medications slow digestion. Again, I have a slow system to begin with. The food sitting in my stomach created more reflux. That is my unscientific explanation for what was happening. For a while this was manageable. As time went on, it became worse. The low point was when I experienced episodes of water brashing, a situation where your glands overproduce saliva not unlike what happens before you vomit in order to neutralize the acid in your esophagus. (My doctor explained this to me when I asked what was happening.) It was very unpleasant. Three weeks ago, I decided to stop taking Wegovy even though I believe I still need to lose weight – at least 15 pounds. But the discomfort was too intense to continue. Thankfully, within a week I was so much more comfortable! I had been on Wegovy a little over a year.
For me, Wegovy was not a miracle drug, even in terms of the weight loss. Yes, I lost 54 pounds and my recent bloodwork showed that I was no longer prediabetic. But it wasn’t magic. Aside from the side effects, it didn’t entirely change my appetite or remove my issues around food. I still wanted more pasta than protein or vegetables. I still have a sweet tooth. And, the impulse to eat for emotional reasons is still present.
It is interesting to me how this drug has different impacts on people. According to Gary, who has prescribed GLP1s for soooo many diabetic patients, some folks entirely lose their appetite and are unable to eat. They have to stop taking it since it becomes risky. Some folks have no impact on their appetite and experience little weight loss. Others report that the noise in their head about food, the craving or the urges, are greatly reduced or for some is gone entirely. I had the experience of the noise lessening. If there were cookies in the house, they were no longer calling to me, at least not loudly, more of a whisper.
I still had to make choices about my diet. I have heard from some friends that they know people who took Wegovy (or Zepbound, another weight loss drug widely prescribed) and would order mozzarella sticks or some other similarly unhealthy item for dinner, but just not eat the whole portion. In other words, they made poor choices, but lost weight. Or other people who only ate one meal a day. I didn’t do either of those things and wasn’t tempted to. The biggest change for me was in portion size. I am a carb addict. This is where I have my toughest challenge. I love carbs in all their forms, particularly pasta, bread and rice. Potato is low on my priority list, but I still love me a baked potato with butter. Anyway, controlling the amount of intake is a major hurdle for me. This is where Wegovy was most successful. I could have a reasonable amount because I would get full more quickly, I could feel that I was full (before taking the medication, I didn’t necessarily perceive fullness until it was way too late), and I knew that I would be terribly uncomfortable if I continued eating beyond fullness.
In sum, from my experience, the medication helped me to adhere to a Weight Watcher style eating program. I ate what I wanted, more or less, but modestly. Before Wegovy I had a relatively healthy diet, just too much of it, with the added bonus of having a sweet tooth. If it was up to me every meal would include dessert. With medication, since I was feeling full and the noise around cravings had quieted, I was able to control the sweet tooth. That’s how I found success.
When the side effects became too much, I stopped taking it. Now it remains to be seen if I can sustain the good habits. I already am aware of the increase in wanting sweets. I am trying to keep the portion sizes moderate. So far, and it is way too soon to reach any conclusions, I am managing it.
I am continuing to weigh myself. It isn’t hard to weigh yourself regularly when you are seeing weight loss. Other than going to the doctor, when I couldn’t avoid it, I probably hadn’t weighed myself at home for five years or more until I started taking the Wegovy. I was in denial. I can’t let myself do that again. After a week of being off the medication, I had gained two pounds. I freaked out. I told Gary I needed a pep talk. He is very good at that. He said some very useful things.
First, he pointed out that two pounds is a small fraction of what I lost. He told me not to panic; it was to be expected. He reminded me that I needed to give myself more time to adjust – that I had spent a year developing good habits, not only making healthier food choices, but incorporating more exercise (I took up yoga, as I also have written about). Even if I gained some of the weight back, I would still be better off than I was before. He reassured me that regardless of my size, he loved me (yes, he said that, and I needed to hear it). And, he suggested we go to Minnewaska and see how different I felt climbing that mountain.
Last Friday we went. Though we didn’t do the Millbrook Mountain footpath that we had done before, we took the carriage road to another footpath, Gertrude’s Nose, which was higher up and involved fewer streams/creeks. It was a demanding hike that was about 6.5 miles round trip. It was not as hot as it was two years ago, but it was probably longer and certainly as physically demanding with a couple of scrambles. I managed to sweat profusely. We brought more water this time. We reached Gertrude’s Nose, which has a great payoff with a beautiful view, and I was in good shape. I wasn’t winded and my legs were strong. Very different from how I felt the other time.
We returned the way we came. We stopped twice briefly to sit but otherwise got back to the car without issue. It was a spectacular hike, and I felt proud of myself. My body was tired, but it should have felt tired.
Hopefully the reward of being more fit, of fitting into my clothes and feeling overall better about my body will provide enough motivation to stay on the course.
I am continuing to navigate this path – I have weighed myself and it bounces around. I lost the two pounds I gained, then went up a pound. Maybe these are normal fluctuations. The weight loss wasn’t a straight line downhill either. I am trying to be honest with myself about portion sizes. I am trying to listen to my body to recognize fullness. It isn’t simple. And, I reserve the right to try the other weight loss drug, if I need to (and insurance approves it). Please don’t judge me.
Use of weight loss drugs is a sensitive subject. I see no reason to keep it a secret, but it is something people have opinions about. I could write a whole other essay about that and maybe I will. For now, I will end with this thought: taking care of yourself can be a complicated issue. Most of us struggle with it one way or another. Let’s wish each other well on our journeys. If we have something genuinely helpful to say, great; if not, spare the judgment.
Stories I Tell Myself 