I love my six-pack so much that I protect it with a layer of fat
- Yasmeen Emilia
- Feb 3, 2023
- 8 min read
What? Like you haven't used the comedic reprieve to dodge or diffuse a weight comment?
I'm pretty sure I'm not alone in saying I've battled my weight pretty much since I became aware that I could be "overweight". While it's been something I've struggled with my entire life, specifically, 2021 up through August 2022 was tough. After exhausting different modes to help my body naturally lose weight and pretty much every idea my nutritionist had (macro tracking, protein priority, strength training, smaller meals more often, bigger meals less often) - nothing worked. I easily went from my normal 165 lbs. to 195 lbs., and the only thing that changed was my age. I went from 29 to 31. I have always been active (meaning I work out 4 to 6x a week when my body allows me to). Nothing made a difference.
During this time James and I had moved into our dreamy old craftsman, and everything was good. My #hidradenitissuperativa was a little more active than usual but nothing to be overly concerned with. Except, the weight kept piling on. I was battling the scale to keep the numbers consistent. Excess weight has dire consequences for my chronic illness, but nothing seemed to help. It was a very intense time.I felt like being 195 lbs., was going to be the new norm for me, and it was terrifying.
During the intensity, I learned something that had literally never been shared with me. It was like a dirty little secret that had been swept under the rug with dust bunnies, lost coins, and kids' buggers. Something that could have easily been shared with me at some point over my ongoing 20-YEAR BATTLE with my #chronicillness and all the shit (including being a chubby teenager, subject for another day) that came with it
So here it is, I hope you're sitting down:
Did you know, it is exponentially harder to lose weight if you're already struggling with a chronic illness? Your body is battling higher CRP levels, higher cortisol levels, potential insulin resistances, AND, wait for it, likely some type of hormone dysregulation.* And, if you'd been raised in a household where dieting was a common theme (iykyk) here's the reason why nothing short of straight starvation ever worked.
Your body was likely never optimized properly to support you in losing weight and keeping it off in a sustainable manner.
If your experience with weight loss is like mine, you were probably told that losing weight is a matter of decreasing intake, upping exercise, cutting out food groups, and finding your inner supermodel discipline and willpower. I had always been raised and taught that discipline and willpower are what you need to lose weight. I'm not going to get into the mind f*** that is decreasing intake, upping exercise, cutting out food groups, etc., etc. Shit, someone tell my parents they were fundamentally wrong about nutrition and how they explained it to me.
MVMT is something my body craves. But there are months when I am in a hospital gown more days than I am in the gym. No one ever taught me how to deal with that and balance nutrition, movement, and intake. I had to learn it myself, the hard way. Trial and error.
You can reduce your intake all you want. BUT, if your intake isn't supporting you in maintaining or increasing your muscle mass, you're not supporting your metabolic rate. Ultimately, you are doing your body a disservice. When you reach that fated number on the scale. The one you tell yourself will make you happy (shocker, it doesn't). You will struggle to maintain what you've mind-f***ed yourself into losing. Simply because your body is struggling to maintain itself. All that work done in the gym? Gone, erased, the second you step off the supermodel hamster wheel. You have to optimize your body to support and maintain this change, or else your body will revert back or worse, gain back more.
For people like me, that live with a chronic illness and all of the things that often accompany it (fatigue, symptoms, anxiety, depression, etc.,). Sometimes, control over intake or exercise is the only thing that feels real and tangible. Losing that perceived sense of control is awful. It became the definition of insanity for me. I was in the gym all the time, on my yoga mat all the time, fasting, counting macros, making recommended swaps, and nothing made a difference when historically it had. Until I learned something new, a solution to the nugget I had found earlier.
“Did you know, the only way to maintain or increase metabolic rate is by maintaining or increasing muscle mass?”
If you lack the muscle mass to maintain your metabolic rate, weight gain will occur. So here's the proverbial 'skinny', after exhausting all the modes listed at the start of this post - I turned to my providers for pharmaceutical help. If you've read part 1 (and 2 when it goes live) of "The Plight of My Wedding Dresses", then you know being overweight with hidradenitis is a death sentence. It's a one-way ticket to compounding issues. I was not getting on that train.
Enter, semaglutide.
I was and am a good candidate for semaglutide for several reasons - I work out regularly and watch what I eat and I am religious about tracking, journaling, and communicating with my providers about my experience. I have good muscle mass but we couldn't seem to hack my metabolism and find the right lever to get my body to start shedding body fat.
When you take semaglutide or drugs like it, your appetite is suppressed, and your digestion is slowed, all of which is designed to help your body metabolize your stored fat and thus lose weight.** While all of this sounds great, you have to think about what will optimize and maintain your results. If you don't prioritize the foods needed to support muscle mass, your body will take it from existing stores (aka fat and muscle). You need muscle mass to maintain you're metabolic rate and what you've lost. You see all of these headlines about people gaining everything back and more after 6, 8, or 9 weeks on drugs like these.
And, here's why, they didn't adjust anything about their lifestyles to support the drugs' purpose - to suppress your appetite. No dosage reduction to wean off, no nutritional support, and no mindset sanity checks. If I had not been told by my InBody Comp Scan and my Doctor to prioritize protein (even if it's just a shaker bottle with water and 2 scoops), then carbs, then fats, and knock out the fiber requirement with athletic greens and supplements - I'd probably still be losing muscle mass in addition to body fat.
The support while taking the drug has also changed my perception of control. I know I need to weight lift at least 2x a week, and I know I'll want to practice yoga 2x a week - I have to hydrate and fuel to support those goals. So when I'm hungry we (James is along for the ride) prioritize the protein (plant-based, animal-based, whatever, you should be using a #nutritionist to guide you here, but protein matters) and ditch the booze. There's literally no shame in using semaglutide, but set yourself up for success before, during, and after. Cause lets also be honest about this, semaglutide isn't cheap - it runs me about $150/month. I've been on it for almost 9 months. (9x150)=1350, roughly.
So here's my challenge if you're thinking about taking it, do it for the right reasons, not because it's as easy as taking a weekly injection
Also, stabbing yourself with a needle on a weekly basis isn't fun. TW if you don't like needles.
So, on to the tea - what is my experience with semaglutide? Semaglutide is a weekly injection that I administer at home into my tummy fat. Shout out to my husband for doing this every Sunday like clockwork. In my first six weeks of weekly injections, I had severe nausea, almost complete appetite loss, and some serious fatigue - it was also roughly 8 weeks before my wedding. I'm also really surprised I managed to work my actual job and finish up the #weddingdrama. Did the scale drop? Yeah, from 195 lbs to 162 lbs. Roughly 32 lbs in 8 weeks, but at what cost? And I don't just mean the tailoring bill for my wedding gowns. Sorry again Colleen!
I lost close to 10% of my muscle mass in those 8 weeks. Muscle mass I had been working to maintain and gain, and it went out the window. In my first 16 weeks on the drug, my muscle mass loss broke down to losing a significant % of muscle from my arms, and upper body and the rest from my trunk and legs. I've course corrected the muscle mass loss but at the expense of the quickness with which the number on the scale decreased. And I am okay with that.
I also lost quite a few other things I wasn't mentally prepared for. My appetite for booze, my friends know I love a good quality German Pinot or dry champagne. My hunger cues changed dramatically, and my mental indications of what was hunger v. what was stress and/or boredom rose to the surface.
I was forced to confront cravings for food (or booze) that masqueraded as appetite but were not my body actually telling me I needed fuel. This process was (and is) really uncomfortable. I often used a glass of wine or food to deal with family affairs, a super symptomatic week where the pain just wouldn't dull, or as a way to unwind after a work week #formerconsultant. This experience isn't short-lived. I continue, 9 months in, to still work these masquarades.
However, I gained freedom around foods and beverages that I thought I'd have to maintain strict discipline around for the rest of my life. Like, I finally actually craved a baked potato - I had always been told, no taters have too many carbs and are not good for you, stay away. It's a freedom I hadn't had since I was a pre-teen - it was akin to rewiring everything I'd ever been taught about food intake. My body was starting to tell me what it actually wanted, not what I thought it wanted, or had been told it wanted.
I will be on semaglutide until the following factors have been achieved:
Visceral fat (the dangerous fat that settles around your organs) is considered low for my height and 'ideal weight'
'Ideal Weight' or just below is achieved because we all know there will be a rebound period once the pharmaceutical support is removed
Muscle Mass is gained and maintained to support 1 & 2 as well as overall healing
The factors above are things I never imagined as important if I didn't have the support of Stat Wellness in Atlanta, GA. They meticulously check my labs and my body composition through the use of Inbody Scans, and routine check-ins with their head DNP and Nutritionist. Also, shout out to my husband for being the number one, and shutting down my family when they scoffed at my use of medically prescribed help that is meticulously followed up on weekly to get my body back on track. You'll learn that James will support 90% of things that support my longevity and health.
If you're researching semaglutide because you're struggling, I highly recommend reaching out to #statwellness and understanding what you need to do for yourself because #wellnessfeelsgood.
With brutal honesty, wrapped in good intentions,
*This post is in no way intended to be used as medical advice, it is a satirical recollection of my experience that I am sharing on my platform in hopes that it destigmatizes asking questions when you express your concerns to your healthcare providers.
** Everyone is unique and everyone's body has unique needs - this blog is written from my point of view and designed to help provide more information around things that are impacting my health journey
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