I’m unhappy with my body, and I’m seeing so many ads for weight loss drugs. Should I start taking them?

Dear Grace,

When I was younger, I was a little chubby, but I didn’t mind having curves. Since having kids, my body isn’t the same. My weight just keeps going up. Everyone is getting skinny now and I keep seeing ads for weight loss shots like Ozempic, but I’m scared to take it. Do you think it’s safe? I do want to lose weight. I can honestly say I love myself, but not my body. What do you think? What’s the best way to lose weight?

– Can’t Stop Dieting in PA

Dear Can’t Stop Dieting,

There is so much to unpack in your question, but let me just say that you’re not alone. I think that just about every woman I know has felt what you just described–feeling unhappy with the number on the scale or uncomfortable in our skin. It’s no coincidence, Can’t Stop. Companies in the diet, exercise, drug, and growing alternative health industries make gobs of money (especially this time of year) by telling us that our bodies are wrong and that their product could “fix” them. 

That said, we all deserve to have a happy, healthy relationship with our bodies, and I have struggled with some of the same feelings you’re describing. I don’t always have the answers, Can’t Stop, and with so many people out there claiming to be experts on healthy eating and dieting, I decided to reach out to a registered dietician to get advice we can all trust.

Hannah Winston is a dietician with a holistic approach, meaning that she looks at the whole picture of patients’ health, rather than just a diagnosis. Hannah doesn’t believe in strict diets, food rules, or ultimatums. Instead, she focuses on helping patients find balance with food and in everyday life, in a way that feels sustainable and supportive. 

Love,

Grace

Hi Can’t Stop Dieting,

I’m so excited to connect with you and the whole Dear Grace reader community. I can assure you that you’re in good company when it comes to questions and stress about weight, body shape, and dieting. Here is my advice for you and the many others that feel just as conflicted and overwhelmed when it comes to questions of weight, body shape, and health:  

Understand your body’s natural changes.

Even though aging is a normal part of life, it’s amazing how little we talk about it in popular culture. Most people don’t understand how much our bodies change throughout our lives, particularly after major events like having children or going through menopause. I have people come to me all the time wanting to drop their weight back to what they weighed in their 20s, but the truth is that your body is simply not the same as it was 10, 20, or even 30 years ago, and that is normal! Women in particular experience changes in our hormones over the course of our lives (particularly around pregnancy and menopause) that impact how our bodies hold onto fat as a way to protect us. This isn’t a condition you need to fix, it’s a perfectly healthy part of aging.

Ditch the dieting.

I have seen countless patients, friends, and loved ones jump from one diet to the next, but as a professional, my advice is to steer clear of anything that asks you to cut out entire food groups (like carbs, for instance). The truth is, if dieting worked, it wouldn’t be a massive industry with a revolving door of new ways to lose weight. We need a balance of all kinds of foods, the more variety, the better. 

One thing that all fad diets have in common, Can’t Stop, is that they blame individuals for challenges that are so much bigger than us. Getting access to quality produce and the time to cook meals at home rather than rely on processed or fast food has a lot more to do with your zip code and income than diet companies want to admit. Instead of focusing on following the “rules” of a diet promising dramatic results, try out these simple tips to establish sustainable healthy eating habits and a good relationship with food. 

• Eat a good breakfast within 2 hours of waking up to get your metabolism going.
• Get consistent, good-quality protein throughout the day. That includes chicken, turkey, lean cuts of red meat, Greek yogurt, cottage cheese, nuts, and beans. 
• Try to get some color on half of your plate. Color can be canned, fresh, or frozen–the nutritional value is the same, no matter how you get it! 

Talk to a registered dietician or doctor before taking any medication.

You’re right to be skeptical of medication that seems to be handed out like candy! Any decision to start medication should include a conversation with a registered dietician or primary care doctor to make sure that it’s safe and in the best interest of your health. While I can’t give you medical advice, I can share some information about what GLP-1s are:

• These medications were made for people with diabetes. A side effect of the drug is weight loss, but like any side effect, different people respond differently and may not see the same amount of weight loss. 
• GLP-1s are designed for long-term use (5+ years), and there aren’t many studies on the effects of using them for a short time. 
• Losing weight quickly can come with side effects, like GI issues and a loss of muscle tone. Talk to your doctor about how to make sure any weight loss is at a healthy pace.
• Not all are created equal. After seeing the potential of this drug for weight loss, companies have created compounded versions of the original drugs that, while cheaper, are not FDA approved. If you’re not sure about a particular drug, search for it in the FDA database to see whether it’s been approved for safe use.

Pay attention to how you feel about your body–it matters more than any number.

It’s okay to not love everything about your body all the time, but when that feeling holds you back from experiencing life the way you want to, it’s time to get support. I tell my patients to think about their bodies the way they think about their hair: if you have a bad hair day, you put a hat on and go about your day. But if that bad hair day causes you so much stress that you cancel plans, that’s a sign that something is wrong. Some days you might feel better or worse about your body, but if the way you feel keeps you from doing the things you want and need to do–going to that holiday party, wearing an outfit you once loved—then it’s time to talk to a dietician or therapist focused on body image to get back on track. 

I get questions like yours from patients every week, Can’t Stop Dieting, and really empathize with where you’re coming from. I hope my advice gives you the support you need to think about your goals in a healthier way this year. So many people are grappling with the same worries and insecurities, and it’s good to remember that we are all beautiful and worthy of love.

Wishing you a happy, healthy new year!

Hannah, Registered Dietitian