Utilizing GLP-1s at a standard BMI? There are advantages and dangers : NPR

[ad_1] <img src="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/2718x2174+0+0/resize/1100/quality/50/format/jpeg/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F2c%2F8a%2F3f2884644b2f9601b24e0516874a%2Fchristy-woodard-nm.JPG" data-template="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/2718x2174+0+0/resize/{width}/quality/{quality}/format/{format}/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F2c%2F8a%2F3f2884644b2f9601b24e0516874a%2Fchristy-woodard-nm.JPG" class="img" alt="After deciding to try to run a half marathon in all 50 states, Christie Woodard completed one in Las Cruces, N.M. , in 2023. She's working to stay fit and strong since getting bariatric surgery and going on GLP-1" fetchpriority="high"/> After deciding to attempt to run a half-marathon in all 50 states, Christie Woodard accomplished one in Las Cruces, N.M., in 2023. She's working to remain match and robust since getting bariatric surgical procedure for weight problems and happening GLP-1 medicine to keep up a wholesome weight. Christie Woodard cover caption

toggle caption

Christie Woodard At simply over 5 foot, 5 inches, Christie Woodard weighs a lean 125 kilos. She's additionally open about counting on a low-dose GLP-1 to maintain her weight there. She says generally folks query why she's on the drug, "as a result of they take a look at me and assume I am at wholesome weight, or possibly they even assume I am skinny."

What folks do not see is Woodard's earlier struggles with weight problems, which started in her 30s, and landed her at 260 kilos. She took up operating half-marathons, however at that weight, it was painful.

"I used to be not quick," she says. "I had large points; I used to be in bodily remedy always. I tore my meniscus."

Woodard, now 53 and residing in Easton, Md., obtained gastric bypass surgical procedure 4 years in the past and reduce her weight in half. Elated, she set a aim of finishing half-marathons in all 50 states.

Her weight remained steady till final yr, when kilos started creeping again, regardless of adhering to a strict weight loss plan and many train.

"I really feel it in my knees, and primarily I really feel it in my soul," she says. "I really feel it in my confidence. It is messing with my head in an enormous method. I used to be terrified that I used to be going to return to what I used to be."

So her bariatric surgeon, Dr. Betsy Dovec, prescribed a low dose of the drug Zepbound, although Woodard's physique mass index did not technically classify her as chubby.

Dovec says Woodard is not her solely normal-weight affected person on GLP-1s. "I prescribe drugs for all sorts of individuals," she says. Although, she clarifies, she doesn't give the medicine to folks for purely aesthetic causes, like somebody making an attempt to shed a number of kilos earlier than an occasion, for instance.

GLP-1 medicine are supposed to deal with metabolic illnesses like diabetes and weight problems. However as they turn into extra obtainable, some individuals who haven't got extra weight search them, generally simply to slim down. The medicine — whereas nonetheless pricey — are getting cheaper, and can be found in tablet type. There are additionally loads of on-line sellers providing GLP-1s and compounded variations of them, making it comparatively easy to get a prescription for folks for whom they don't seem to be medically indicated.

That is controversial, as with many points regarding weight and weight administration.

However Dovec says classifying the usage of these weight problems medicines for people who find themselves with regular or mildly extra weight as purely "beauty" misunderstands the varied circumstances sufferers face. The medicine deal with excess of weight, she says: They tackle metabolic illnesses like diabetes or hypertension. Some docs prescribe them off-label to handle alcohol use dysfunction, which the medicine seem to assist for some folks.

And weight problems is a continual illness, she says, so some sufferers like Woodard may have a number of methods to assist handle their situation — together with surgical procedure, weight loss plan, train and GLP-1s. Dovec says these usually are not medicine for use for, say, kick-starting a weight loss plan. She says she's not had sufferers pursue them for these causes, or misuse them to the purpose the place their physique mass index falls to under regular. "I've by no means seen that in my profession," she says.

However Dr. Jennifer Manne-Goehler — an weight problems specialist with Mass Common Brigham and guide to the World Well being Group — is anxious that individuals will entry them and medicate themselves to fulfill a thinner supreme.

And that comes with some dangers. Particularly, she notes folks utilizing GLP-1s are inclined to lose muscle first, however regain fats after they cease utilizing the drug. Periodic use, due to this fact, creates potential for yo-yo weight-reduction plan results recognized to be dangerous to the physique.

"I feel the issue with giving this medicine to individuals who actually haven't got a sign for it's they assume all of the dangers of it, plus the danger of weight regain, which can be antagonistic for his or her well being," she says.

There are additionally dangers to taking the medicine for folks with disordered consuming, particularly since sufferers usually are not evaluated for these issues when prescribed GLP-1 medicine.

Christie Woodard is not any stranger to those controversies — and the judgment round weight and weight administration. Initially, she felt ashamed to confess she wanted GLP-1s, particularly having already undergone bariatric surgical procedure. "I did not inform anyone at first. I felt like I would failed," she says.

However she got here to know that surgical procedure alone didn't remove the illness of weight problems, which in her case additionally means starvation hormones conspire towards her sustaining her more healthy weight. "We do not choose folks for being on statins for ldl cholesterol," she says. "Why ought to GLP-1s be completely different?"

Woodard, who's head of human assets for a big firm, says her new perspective helped her efficiently advocate to incorporate protection of GLP-1s in her employer's medical health insurance plan, which she says will not be the norm.

In making the case together with her boss and the insurer, she cited herself for instance: By taking the medicines, she now wants far fewer physician's appointments, bodily remedy and drugs to handle numerous illnesses related to weight problems. "The corporate I work for not pays any of that," she says.

Plus, says Woodard, feeling accountable for her weight makes her a lot happier — and more practical at every part she does.

"I can put on what I would like and the arrogance is there," she says. "That exhibits up in every part I do, whether or not I'm negotiating charges with our medical health insurance firm or whether or not I'm speaking to an worker a few delicate state of affairs or whether or not I am negotiating one thing with my boss."