Avoiding the Common Pitfalls of Rapid Weight Loss on Medications

The medications we’ve all talked about for significant weight loss, known as GLP-1 receptor agonists, seem like a miracle for anyone with excess weight or obesity concerns. However, as with any medical intervention, or surgery for that matter, there are potential risks and considerations. Whether choosing bariatric surgery or Wegovy / Zepbound in your weight loss journey, we must discuss the possible pitfalls of this rapid weight loss, how to mitigate its effects, and how to know you’re on the right track.

Muscle Wasting

When you eat too little, especially protein, your body needs to find an alternate source of sustenance. Usually, it would pull from the carbs, fats, and protein you consume daily, but when those macronutrients are not there, the body turns to muscle. This is why many patients on a significant diet tend to feel less strong, and their defined muscles diminish.

Mitigating the effects of rapid weight loss requires a few essential habits. First, you must prioritize your proteins and only cut some carbs and fats. It’s tempting to push harder in your weight loss effort, but you must be mindful that this is a marathon, not a sprint. Developing a proper nutrition plan, with or without a professional’s help, is essential to eliminate the worst offenders from your diet while incorporating wholesome and healthy foods that promote muscle maintenance and good health.

Osteoporosis and Osteopenia

Osteopenia and osteoporosis are bone density concerns that primarily affect middle-aged and older age patients, especially postmenopausal women. These concerns stem from inadequate calcium absorption in the body that may be caused by a lack of nutrients, hormonal changes, a lack of exercise, or a deficiency in vitamin D, which is very common across the adult population in the US. Osteoporosis can significantly increase the risk of fractures.

It may be difficult, as you may feel tired with your reduced caloric intake, but exercising is critical to minimizing bone density loss. Aim to get at least a few hours of vigorous exercise each week, but that does not mean hitting the gym full-on every single day. Consider taking a long walk or other cardiovascular activities that offer psychological and physical benefits on your slower exercise days.

Nutritional Deficiencies

Whenever somebody undergoes rapid weight loss, especially when significant caloric intake restriction is the basis of the drop, they must be aware of possible nutritional deficiencies. Most of these are easily managed when under the care of a qualified physician. Please be sure to speak to your primary care physician or weight loss expert to get periodic blood tests and adjust your diet and supplementation regimen appropriately.

Symptomatic Gallstones

Some patients who experience rapid weight loss will develop gallstones, and a subset of these patients will experience symptomatic gallbladder issues as a result. It’s critical to lose weight at a measured pace and avoid skipping too many meals. Even if a meal is much smaller than it once was, it’s important to keep bile flowing to prevent calcification and the painful possibility of gallstones. Hydration is also critical here, so do not skimp on water. Aim for at least 64 ounces daily.

Hair Loss

Significant and rapid weight loss may also cause hair to fall out. This is typically temporary and tends to resolve after several months as the body becomes accustomed to the lower caloric intake. Remember, the body needs to prioritize calories for its most essential functions. If these calories are limited, it will reduce nutrients to less critical structures, including the hair follicles. In cases where hair is falling out due to male pattern baldness or androgenic alopecia, it’s possible that the hair will not regrow or that some hair loss will be permanent.

Even after bariatric surgery, hair loss is something that most patients experience, albeit temporarily. Proper protein intake can mitigate some of this hair loss, but eventually, the hair will regrow as it returns to a growth phase. Be mindful of hair growth treatments and speak to your physician before trying anything new. The effectiveness may be mixed, or you may worsen the problem.

Aches and Pains

Rapid weight loss can trigger aches and pains, especially when the patient has started from a very high BMI. This is counterintuitive, as you would think that weight loss would relieve pressure on the joints. But ligaments and tendons around the body have been altered and stretched over the years of adapting to excess weight and obesity. As you lose weight, it takes time for the structures to adjust and provide support.

You can speed up this adaptation process by combining core workouts with moderate regular activity. Be careful about ramping up stretching or lifting weights too quickly, as this may cause problems. Speak to an exercise physiologist, trainer, or physical therapist to understand how to best move forward.

The Bottom Line

Many patients don’t realize that the weight loss process comes with its own set of challenges. You must be aware of some considerations, and the above is just a sampling of them. Some of these concerns can be managed effectively by discontinuing the medication, switching medication, or using other medical means. Some concerns surrounding weight loss, especially aesthetic ones, may be unavoidable or may need to be corrected with a cosmetic specialist. Be sure to understand what your body needs and get professional help when required.

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