Weaning Off Obesity Medications with Aliza Olive and Kellie Bader [Ep. 103]

0:00 This is the well think. Well, Well live well podcast. I'm Lisa Salisbury, And this is episode 103 weaning off obesity medications with Aliza Olive and Kellie Bader. Aliza and Kellie are the co-founders of med free maintenance. Aliza is a pediatric intensivist and Kellie. He is a pharmacist, but they both have extensive backgrounds in macro coaching and nutrition. In this podcast, they are functioning only as coaches, not as medical professionals, as they make it clear, they are not prescribers of these medications. However, I do think it's interesting to note their professional background. They founded med free maintenance as a tool for women and men coming off GLP one medications to prevent weight regain today, Aliza and Kellie, and I discuss what it takes to lose weight, regardless of medication status, what it's like being on these medications and especially what to do.

0:52 If you think you might want to try weight loss medication, but you don't want to be on it forever. Please note this is not medical advice and you definitely should consult with your own doctor to see if you are a candidate for weight loss medication. You may also need to ask her or him if weaning off is reasonable and in your best interest. Now, please enjoy this episode. Welcome to Eat Well, Think Well, Live Well; the podcast for women who want to lose weight, but are tired of counting and calculating all the food. I'm your host, Lisa Salsbury. I'm a certified health and weight loss coach and life coach, and most importantly a recovered chronic dieter. I'll teach you to figure out why you are eating when you aren't hungry, instead of worrying so much about what you are eating.

1:40 Welcome back to the eat well, think well, live well podcast. I am super delighted to welcome Aliza Olive and Kellie Bader here. They are the co founders of Medfree Maintenance and they are all about helping women and probably men. I'm not sure. Um, I'm getting some nods. Yes. Wean off some of the weight loss medication. So I'm really excited to have a great conversation about These medications that a lot of us are curious about. So if you guys could just introduce yourselves, tell us a little bit about what you do, and then we'll just jump into our conversation. Yeah, Sure. So I'm Kellie. we started this business to help women that decided that they wanted to use these medications, but never really intended to be on them long term have a solution to be able to transition off of medication without that big fear of the weight gain.

2:33 And we hear in the studies that, weight gain statistics are so incredibly high and it's, it's okay. Common question, like, can we avoid this? Is that the way it has to be? And so we've found a solution for that. I'm Aliza. I'm Kellie's partner. I personally took some aglutide to lose about 20 pounds, uh, postpartum, after I finished breastfeeding my second baby. and same as Kellie, we both have a macro coaching background, and really just wanted to have a space for people who don't want to be on the medications forever, for whatever reason, to be able to wean off without gaining their weight back.

3:13 Okay, perfect. So my first question is always when I talk to someone about these. drugs. First of all, let's kind of define, if you would, what class of drugs we're talking about. So I think we've seen a lot. There's so many now because it used to just be Ozempic and now there's a lot. So if you could speak to what these drugs are, and then maybe who should consider using them. Yeah, so, we are generally working with people taking any version of a GLP 1 medication. So, the brand names are Ozempic, Wegovy, there's a ton, and then the more generic names, I always pronounce it wrong, but Semaglutide, uh, Terzepatide, In general, we're going to be working with people who are on the compounded medications because if somebody's getting it from a physician and their insurance is covering it for diabetes or some reason where they should be on it long term, we are not here to tell anybody stop taking your medication against your doctor's advice.

4:12 We're just here for people who are using it for weight loss and want to come off at some point. I think that's an important distinction that you're not really coaching people that are on these drugs for the type two diabetes. You're, Really looking to the folks that are using it for weight loss, and those are my clients as well. I'm not a type 2 diabetes coach, and so, yeah, I'm definitely coaching folks that are, generally their blood work is okay, but they want to drop weight. And I think the 2nd, half of your question was. Who should be taking the medications. Kellie and I both agree that these medications are a great tool for your toolbox. We have so many tools out there that can be used for weight loss.

4:53 There's macro coaching, there's calorie counting, there's 8 million diets out there that generally fail and people gain weight back when they come off of them. Um, and this medication is here and it's easy to get at this point and it just really. Helps people who have struggled to lose weight, get the weight off with a lot less. don't want to say hard work because there is still mental work and everything that needs to be done and that's what we're here to help with, but the actual weight loss is just much physically easier because you don't have that constant. I'm in a calorie deficit and I'm hungry. When can I eat next? How much can I eat right now? And so on. still lose weight. It just takes away that component and helps you get the weight off.

5:37 And it's a really great launching point for people. I So, that kind of answers my next question, which is, what are the benefits? Why, why do we want to take these? So, clearly, what you're saying is it helps you feel not as hungry. When you're in a deficit, anything else that you find as benefits over and above, just most people try to lose weight by managing their nutrition, which is. the tried and true method, right? That's how we, that's how we lose weight. what are the benefits on top of that? I think that this works really well for people to gain momentum. So when you're trying to lose weight and you're in a traditional diet, a lot of times, like Aliza was just saying, you're struggling every knuckling to, and as a coach, like, We don't want you to be struggling through that.

6:28 So we help you build momentum. These drugs help you build momentum. So once you start seeing that weight loss, you're like, Oh, wow, this is, this is working. And so then that feels really, really good. Right? And so then you start building these habits alongside of the medication so that you can, Make this sustainable long term and not sustainable as in using the med, which like I said, like we already said, we're not against you continuing to use the medication, but most people that we are talking to are trying to get off the medication. So if you can gain that momentum, you know, we talked to so many people and they've tried everything and then we get someone that's like, oh, you just don't have enough willpower and determination.

7:13 And it's like, no, These people do have enough willpower and determination. It's just not working. It's, and so now we have this drug in our toolbox that we can use to start to build momentum and start to see some of those wins so that we can gain that momentum to start drinking more water, start exercising regularly, start strength training, start eating your protein, start eating your fiber, do all those things that merely make you feel good. And then you're like starting to sleep better. You have more energy. It's just like this wonderful cascade so that you're building those habits while you're on medication so that you can eventually transition off.

7:54 Does that make sense? Yeah, definitely. I, I always wonder too, if when you're on these medications and you start to see some of the portions that are actually, you're fine with basically, you're like, Oh, I guess I don't need an entire, like a whole sandwich. I guess really what is fine for me is a half sandwich or three quarters of a sandwich. And I actually feel fine as far as energy levels and concentration and those kinds of things, not like all of the other things that are. Not associated with hunger, because a lot of times I think, well, if I don't eat enough, I'm going to have low energy, or I'm going to have this afternoon slump, or I'm going to, like, other reasons besides I'm going to be hungry if I don't eat enough, and so I wonder if it helps people realize, like, wow, I really don't need as much food as I thought I did.

8:44 Do you find that to be true? I think that sometimes people on the medications do struggle with getting enough, and we really have to work on that. So, making sure that you're not it. just eating 800 to 1200 calories. So getting enough so that you have those energy levels so that you're not losing your hair. So like all those side effects, disrupting your hormones that can come along with not eating enough. It's very important. So, but yes, you're also seeing that like, okay. This is maybe what a correct portion could look like and I now I have the time because I don't have this enormous food noise to look at the label and see what's the serving size even what what does that mean and how much is that because a lot of time like before.

9:28 I started looking at labels. I thought peanut butter was a great source of protein. I was like loading up on the peanut butter. And then when I started looking at the label, it's like, Oh, wow. Okay. No wonder I was gaining weight. so it gives you that opportunity to slow down, look at those food labels. And another, you know, points that I want to make is This is your opportunity while you're on medication and you don't have as much food noise to address some of those, like, emotional eating things that come up that we deal with as coaches, stress eating. Why are we stress eating? Because that's, that's a possibility that it still happens even with the medication.

10:09 And so when you can identify it and start making those changes while you're on medication, it'll make coming off of the medication so much easier. You can go, okay, when I was on the medication. When I was in this super stressful situation, what did I turn to? Because I wasn't hungry. How did I deal with my stress in a different way then and starting to, um. Pick up on some of those things is certainly, I think, an advantage and is another way that the medication can make you gain some momentum. If that makes sense. Definitely. Speak a little bit, if you could, about food noise. This is something I hear a lot about the benefits of taking this medication.

10:53 And I do have clients on this, and they, they tell me, like, the food noise is reduced. But for people that maybe, you know, If you don't have that, or they wonder, is what I'm feeling termed, quote unquote, food noise, if you could just speak a little bit about what you believe that to be and how, how it reduces that. personally don't think I have food noise. I am hungry all the time. I am just one of those people. I probably have a relatively high metabolism. and I could eat All day. I'm one of those, like I had breakfast, it was full of fiber, full of protein. And two hours later I'm like, okay, well I need second breakfast. I need my protein bar.

11:33 and so the main benefit for me was not feeling like I needed that and being able to actually space my meals out more appropriately. So I had breakfast and then I had. Lunch. Um, and maybe I had a smaller, you know, protein snack in between, but not like a full second breakfast. and, you know, I personally never went on a very high dose. I didn't want to be on a very high dose. I didn't want, as Kellie said, I didn't want to be in that 800, 000 calorie point where your metabolism is really just Um, and so I ate breakfast, lunch and dinner and probably a little bit of dessert and still had red wine in the evenings while I was on the medication.

12:20 so I can't personally speak to the food noise, but I know a lot of people who struggle with their weight have that where They just think about food all day. I think about food all day, but it's because I'm actually hungry and I just want to eat because I have that feeling. But I think the food noise part of it is a lot more mental where it's just like, I love food or I love that feeling that sugar gives me and being on the medication, as you said, sort of can train your brain where you're not having that feeling all the time where it's like, Oh, I need candy. I want candy. I want soda. I want this. And you realize. I don't need that. I've lived for however many months you're on the medication without having that feeling.

13:01 And so then when you come off, you can use what you learned from having coaching while on the medication to then change the way you feel about that. Or it may just go away entirely. Yeah, and to add on to that, like, I think the food noise, it has so many levels to it. Like, I don't know that there's like a true. Exact definition of it, but I think it's a combination of emotional eating stress, you know, which is also stress cravings and hunger. Like it's this combination, this triad of all the things. And so if we can, while we're on medication, we don't feel that. And so we can start to, okay. Okay. I don't feel hungry now.

13:42 If I go off medication, some of the food noise is going to come back. But how can we prevent as much as possible with your fiber with your protein? kind of like spacing out your meals. Another thing to go along is while you're on medication, we don't want you skipping meals because that's not something that's going to be done in the future because otherwise it's going to cause that food noise to be even higher. what I've heard people explain that come off the medication, they still have the food noise. They've learned to deal with it better while they were on medication and they've improved their relationship with food.

14:24 So, I think that that piece of it is really important. That's why, that's why coaching while you're still on medication is really, really valuable and while you're transitioning off because we've got to get past that. This is me in the past. I'm either on a diet or I'm F it. It's either one of those two, right? And so it's like, on or off, the food is good or bad. And you can discover while you're on the medication that like, Oh my gosh, I still can have some of these things and still lose weight. Oh my gosh. That means that I should be able to maintain my weight while still having, you know, 20 percent some fun foods and, and then making sure I'm getting enough.

15:07 I like to use the word enough and getting nourishment. Because getting that enough, getting all that protein, that fiber and those vitamins from fruits and vegetables and all those good things, that's going to reduce that food noise a little bit because your body is nourished the right way. So just like Aliza said, like it's a combination of all of this stuff together that really makes it work. I like that. You talk about not skipping meals because that's not how we're going to maintain. Yes. You're talking to women who don't want to be on medication long term, but you're also trying to create lifestyle change, which is what this, these medications and what, I mean, frankly, what I'm trying to do with coaching without the medications.

15:53 Which works great for a lot of people, but since we have this other tool, if I have a client ask about it, I'm like, yeah, totally ask your doctor. Totally, you know, like, obviously I can't make a recommendation because that's I'm not a doctor, but when we work on changes, I'm always working on things that we want to do as a lifestyle, not as a short term thing. If you don't think that you can exercise six days a week, like let's not make that a goal just for the weight loss period. If you want to be a person that goes on a walk every single morning, great. But Only if that's the way you think you're 60 and 70 year old self lives as well, right?

16:34 So, I think that's really important that you're building a lifestyle even on these medications. It's not just a short term diet The other thing I want to just bring up is you're talking about enough This I think is such a key when people are on the medication, so many people, when we talk about some of the side effects, which I do want to ask about, but one thing I think that has been really scary to people is the muscle loss. Oh my gosh, you're going to lose muscle. And I'm always like, Hey, you're going to lose muscle. If you drastically diet any kind of way, if you cut. Your calories, any kind of way, if you're going to eat like a toddler and only eat 1200 calories, you're going to lose muscle. Like, I'm sorry, that's just the way it is.

17:16 Am I correct? Absolutely. not the medication causing you to lose muscle. It's because you're not eating enough protein. Because you're not eating enough. Period. Yeah? Absolutely. Yes, you're absolutely correct. This happens on all like all low calorie diets. This will happen. So it's not specific to the drug. Yeah, it's not the medic, it's not the medication that causes muscle loss. It's a low, low caloric intake with not enough protein and no strength training that's going to cause muscle loss. Perfect. tell me a little bit about why protein helps preserve muscle, That's the whole concept behind macro counting and what makes it superior to pure calorie counting.

17:58 So, you know, back in the eighties and nineties, it was count your calories, eat as little as possible. You will lose weight. Sure. You're going to lose pounds on the scale, but you're going to be losing muscle along with fat as well as water weight. And macro counting really came from more of the, CrossFit bodybuilding worlds where people wanted to have a lean physique. With muscle mass, and they realize that the thing that you need in that calorie deficit is protein. Our muscles are made out of protein. So if you are eating 1200 calories a day and 40 grams of protein, your body is going to preferentially break down muscle because it's more available to the body to break down what it goes to first.

18:39 So if you're eating protein and feeding your muscles, what they're built of. your body will then start preferentially breaking down your fat cells instead of the muscle. and so that's really where this whole concept comes from. Most Americans don't eat enough protein. We've actually had arguments on social media with people who say, well, the ADA says, you know, you only need 60 grams of protein. So why are you telling people to eat more than that? Well, because the ADA is wrong. Like some of our government bodies and the recommending, you know, we have the food pyramid for how long? And that That's just not how life works either. so, we really think that people need to be getting about 0. 8 to 1 grams per pound of ideal body weight. If someone weighs 250 pounds and they want to weigh 150 pounds, no, they should not eat 250 grams of protein.

19:24 That's just, you know, That's crazy. Um, but getting over a hundred grams a day doable and a huge shift for your goals and your ability to be able to keep on, losing fat and not muscle. And our big thing is slow, sustainable changes. So if you're eating 40 grams a day, let's get you to 50. And then we'll take it from there. We'll go to 60. We'll go to 70. But having that protein intake is going to be so important for preserving your muscle mass. I hope that answered your question that's actually perfect. And honestly, it's like the way I explain it as well. I just. I just like to hear other people say it too, to confirm my own biases. right. It's not a bias. It's actually biology. So there you That's true.

20:05 I better, better way to say it there. Thank you. Well, and then the other thing that she was saying about, the recommended amount that they're recommending right now, that's the minimum to like, just sustain. Like, that's not what we're going for. We're, we're trying to optimize, like, we're not trying to like, just. Prevent deficiency. We're not trying to prevent deficiency. We're trying to optimize. We're trying to be effective and efficient. So that's like, when I get that argument, it's just really hard to, it's really hard to hear that one because we're talking about the same things here. We're not talking about what you should get it. Like, we don't want to prevent it to deficiency. We want to, we want to, Optimize.

20:46 So, I think there's such a big difference between normal and optimal, like on anything, like what's normal cholesterol. What's optimal cholesterol. What's a normal a one C what's optimal. So I think it's the same thing with protein intake. Well, what's normal isn't necessarily what's optimal, especially when you are Actively lifting weights. You're actively trying to build your muscle. And for those of us women in midlife, I hope that we are all, I mean, I'm constantly saying this, trying to build our muscle mass as well as bone health by strength training so that we have that. It's an insurance policy going into menopause and going So you don't break your hip when you're 75. Seriously. Yeah. Like we must have enough protein to do that.

21:27 And I think that's why we see so much frailty in our mothers because they lived through the 80s and 90s because aerobics and all SEPA aerobics and snack wells. Right? I mean, Yeah. we had a subscription to Cooking Light magazine for years and years, and come to find out Cooking Light and, I mean, I still make some of their recipes, but one of the ways that those types of things made their recipes lower calorie or fit into what they qualified, it had to be lower fat. And so what they would do is they would jack up the sugar so that the overall fat percentage, the calories coming from fat met their requirements to be in the magazine.

22:15 So, I mean, I make literal cakes that I still enjoy as a dessert from cooking light, but I have to cut the sugar because they're so sweet. I'm like, that makes no sense. That makes no Exactly. Yes. So, okay, let's talk a little bit about the side effects. I do have some clients that have had one client in particular that finally decided to go off just because of the vomiting. So just could not tolerate, could not find a dose that worked. And, and that's okay. Like, you know, we're still working on, other things but tell me a little bit about why that happens and percentages and that sort of thing. Like what, what can we expect for negative side effects?

22:57 So I'll, I'll clarify with this, with the caveat that Kellie and I do not write for these medications, and we are here for nutritional support, but the physiology behind how these medications work is important to understand how they work. So they do two things. They act on your brain, and they slow stomach emptying. So there are medical conditions that also come with slowed stomach emptying, and people don't want that, right? It's called gastroparesis. It's something that can come with diabetes or other medical conditions. And it's not good, right? It's not ideal, but the medication does it so that you feel full. it works in conjunction with the changes in your brain to take away that food noise and the hunger to actually have the physical feeling of being full.

23:41 And some people react differently than others. My husband and I both took some of glutide from the same compounded pharmacy. And the dose that he started on And I was on three times of a higher dose. He weighs a lot more than me. He's, you know, eight inches taller than I am. For all intents and purposes should have been on a much higher dose than me and he could not tolerate even going up from the initial dose that he took he had to go down and he eventually stopped the medication. He could not eat. I'm not trying to scare people away from the medication, but everybody reacts differently. And so that's why Kellie and I want to stay very far away from dosing recommendations.

24:22 You know, that is between you and your provider and what works best for your body. the higher the dose you're on, the more side effects you're going to have. That's just a given. And the vomiting and the nausea comes from that slowed gastric emptying. So again, the higher your dose, the slower your gastric emptying, the worse you feel. I personally didn't have the vomiting that my husband had. I did have a little bit of nausea and I just took some medication for it. And that's why one of the many reasons why I stayed on a lower dose. But there are a whole host of, you know, some more serious side effects. Some just the nausea, vomiting. I had fatigue probably because I wasn't eating enough. Um, and so that's another reason to stay on a lower dose so you can get enough calories.

25:04 You know, you don't need to be eating eight to 1200 calories to lose weight. You can lose weight on 14, 1500 calories. but you know, we have the nausea, we have the vomiting, we have fatigue, and then there's things like pancreatitis, some of the more scary things that people talk about that you obviously want to avoid. And are there any regular blood tests or anything that you have to do while you're on these things? Or are you just mostly looking for symptoms that might indicate other issues? I would say that's more of a provider prescribing provider question. We, um, do not. No, that's okay. We don't monitor lab values. We're just here to make sure people are getting enough nutrition.

25:44 so, let me clarify, we were looking at Accutane for my daughter, and that's something where it's like, okay, when you're on this, you have to have a regular blood test, it's just kind of like part of the medication, there isn't anything like that, that's just kind of a standard that your provider will be like, because you're on this, we should standardly check this, it's more like patient specific, meaning what your history is, would determine what you might need to check. I would assume that yes, for the most, like, you hear me say assume, because we are not prescribing, but You know, if, if it's a little bit symptomatic. So if you're throwing up all the time, if you're not eating enough, like you might want to have like your regular just electrolytes check to make sure things aren't getting out of balance.

26:27 but again, that's just like what I would assume. I don't think that there's any, like, you must check your liver. Like, there's nothing like that I am aware of at this time. I will say with the side effects, we're not like telling you how to manage them. But a lot of times, like the general recommendations would be getting in your fiber so that prevent constipation. That's another common side effect. Eating small meals and regular, like more often sometimes can help when you, a lot of times people, like we talked about, aren't hungry. So when you're skipping meals, it eventually is going to backfire and eventually later in the day, you're going to get enough hungry that you're eating a bigger meal.

27:09 And then that's when all these side effects, and if we could just keep this a little bit more level and that's also practicing for maintaining as well. So having small, regular meals of, you know, all of the macronutrients, carbs for energy, fat for hormones, protein, we've talked about protein in depth. That's all very helpful for, the side effects of nausea, vomiting. making sure you're getting enough water. that probably doesn't get talked about enough, but you need to keep things like it slows your stomach down. And so you need enough water to keep pushing things through. So, um, keeping yourself hydrated because you're not eating as much is really going to be important as well.

27:53 Trying to think of some other ones, but. Obviously, like everyone has a little bit different side effects. So each side effects a little different to treat. And so we don't have like a going list of like, these are the best ways to do this. Definitely talk to your provider, so that you know, what your options are. no, your answers have been really helpful. I think because I mean, you do see some things just kind of commonly. So that's great. so let's get to the big question, which is, is weaning off possible? that's the biggest thing. I think that's the main reason why people don't want to start because they're like, I don't want to do this forever. And I think for some people, they think You know, I don't want to be on a quote unquote medication forever, but I mean, for me, I would just be like, I'm afraid to give myself a shot.

28:42 Oh, there's that that I don't want to do. but they feel like, well, if I'm on this, I'm going to be stuck. What would you say to that? Well, I'm our poster child for that. So Kellie, as we mentioned, has not taken the medication. She did this the old fashioned way, lost 40 pounds with macro counting and has maintained, with the same method that we use to get people off. I lost 20 to 25 pounds, on the medication. I have also done it the old fashioned way after my first baby. but I agree, people don't want to take it forever. You didn't mention expensive is one of the other big things, you know, um, Even with insurance, some people are still paying 500, 500 or more dollars a month.

29:25 And then when you're looking at the compounded ones through more of a, a med spa or some, a clinician, it's I think three to$500 a month. It, it can be very expensive. So this is not something that financially people want to stay on forever and the side effects. And also, yep. I mean, I'm fine giving myself shots. That actually doesn't bother me at all. I'd do that once a week forever. You know, there was no other problem. Um, but some people obviously don't want to do that either. So absolutely, it's possible to come off as we said before, it is the same as any other calorie deficit that you're in. It does help with the food noise. It helps with the satiety, but otherwise.

30:06 Coming off is the same as coming out of a calorie deficit. Your metabolism goes down when you're in a calorie deficit. And so you cannot go from eating 1200 calories a day to 2, 500 calories a day. In one step and expect to keep the weight off because your metabolism is lower. It's not used to having a high calorie intake and you will gain weight back. And so you need to be much more mindful about what you're doing when you come off the medication. You need to pay attention to your calories. You need to eat enough protein and you need to have a slow stepwise increase so that your metabolism has time to catch up. And you need to do the mental work. That's why you coach.

30:46 That's why we coach, to talk through that food noise, to talk through the other things that are going to come back as you come off the medication. I'm sure Kellie has something to add to that. yeah, please do. No, I, I, you did a great job on that. That was perfect. Yeah, I would agree that like, yes, you can get off, but you can't just. I mean, you can just go off, but my DMS are full of people saying I stopped it and I gained 20 pounds. And it's like, Ooh, I wish you would've talked to me first. Like we could have done this. We could have done this a different way. because we do have like a really strategic way to like Aliza was saying, like, first we need to increase those calories a little bit. More strategically, we want to find your maintenance.

31:29 You have a new maintenance now. You're a smaller person. find that, find it with the new macros that you're using. And I'm not saying that you need to track your macros forever. I'm not saying that you need to track all of your macros. We do macros simplified, tracking for a period of time to find your maintenance and then practice that maintenance. Like I said, I have gone up and down. Um, All around and I was never happy. So I didn't stay at maintenance. I was either on or off actually practicing maintenance is the key to being able to maintain and then maintain without tracking everything long term. And then you also want to get in touch with your hunger cues and your cravings cues and all those things when you are in maintenance, you don't want to like on the way up.

32:18 You're still going to have like you're still in a calorie deficit most of the time on the way up. So in that transition up though, you really want to get in touch with those cues that your body is sending to you. So you can say, okay, am I really hungry? Okay. Is this a craving? Is this food noise? Is this emotional? And then make the adjustments at that point, rather than just going off of medication and like hoping for the best. Um, you know, I was always told just like, get used to it. Like any other 80s kids out there? Like I was 82. Like, I was just told like, Oh, your body will just eventually get used to eating less food. And I was like, but.

33:00 But I can't eat three bowls of chicken noodle like it was noodle soup. No chicken in it. I can't eat three things of noodle soup and a grapefruit every day. That's just not like that's not enough. I'll never get used Oh, the grapefruit diet. Yeah. a grapefruit and noodle soup. That was the book. And I was like, how even taste good. I know it didn't. It was awful. And so it would only last a little bit, but I'd never be able to sustain that. And so that thought in your mind that like, I just have to get used to eating this low of calories is not correct. And I did not realize like it took me a long time for someone to get that through my brain that like you can like your 1800 2000 2200.

33:45 Um, almost 2400 calories and there's ways to like, make it work for your lifestyle too. Sorry, I'm getting off on a little tangent here, but like, If you have an event coming up on a weekend, then you need to like, you know, you're going to be eating a little bit more because you're going to a restaurant. Like, there's ways to like, adapt things. Like, I don't need to get really specific about calorie cycling. We've all, maybe we haven't all heard that, but that's a term that's thrown around. We don't have to like, call it something special, but we can use our lifestyle to like, make adjustments to what we're doing. And still make it work. It doesn't have to be like, oh, we have an event. So it's a nothing day. And then the other days are like these on days.

34:26 Like, it doesn't have to be like that. That could just like that off day doesn't have to be diff. Like, it's just part of the, it's part of the journey. Like, who don't who wants to go and not. Enjoy a restaurant out like we do every Saturday night is our night out. Like, I'm not gonna live without that. so that has to be part of my journey and part of the way I do things and finding that and practicing it. Like, it sounds so silly to practice maintenance, but it's not something that we're. We normally do and so that's part of the process is actually practicing and then We don't want you to track macros forever. I've been in maintenance for four years and maybe a month out of the entire year.

35:07 Do I like kind of track things a little bit more? and I would say like a month would be, I don't track even that much. So, we don't need to track every bite we eat. We need to be able to figure it out without tracking for the long term part of our life, but it takes a little bit of like educated, informed eating to get to that point where you don't have to. Track every bite and there's other methods other than like tracking macros. I want to be clear. Like, I don't think that tracking macros is for every single person. but that's the method that we currently use. Yeah. Well, I love that you want people to not track their whole lives because for me, macro counting incessantly and for years really led me down into like obsessive orthorexia, a lot of anxiety, just like if I couldn't get it right, you know, it was stressful to me.

35:58 But what I do know is that I have that knowledge. And instead of being mad at myself for like not succeeding or not like, not doing a good job at macro accounting, I'm like, but you know what I do know, I know what A proper portion of protein looks like because I counted for so long and I think this is where chronic dieters go wrong is they think, well, I'm just going to throw all of that out what I used to do, but. Look at the value of what you have learned. Look at you know, what I learned from that is I actually do love having protein at breakfast. That helps set me up for the day. Just because I'm not counting macros doesn't mean I don't want to eat protein in the morning and I know what that looks like.

36:39 So Exactly. think counting and, and, and calculating calories and stuff. This is actually is something that I've recently kind of switched on because. When I was first coaching, because I just was like, I'm not counting ever anymore. Never because I felt like it was like bad for my own personal mental health. What I realized is that not everyone comes to me with the kind of obsessive knowledge about how much protein is in a chicken breast. Like not everyone cared as much as I 20 grams. Yeah. So I realized, you know what, if we track just for a couple of weeks, Yes. And use that for knowledge rather than a way of life, it can be super helpful because I, I have been preaching protein more and more, especially over this last year.

37:27 And my clients are like, but how do I know? I'm like, okay, we're going to have to start tracking just your protein, track your protein for two weeks. Like it's okay. We don't need to weigh and measure every single bite you're eating to track your protein. And one thing just as kind of a side note that I like to do with my clients is. I have them track their lean, um, or their, uh, sorry, their animal based protein. So like if you're having eggs or turkey sausage for breakfast or protein powder, and then for lunch, you're having some chicken rotisserie chicken and dinner, you're having a salmon cake. Measure that stuff. And you figure if you get 33 grams per meal, then the rest of your food is going to get you up into that one 2130 range. Cause you know, oats are going to have three or four grams and broccoli is going to have three or four grams.

38:11 And so now you're just ones and twos up to the one 2130 range. And then if you have a little snack, a little yogurt, a cheese stick or whatever. So I find that to also be really like a, an easy way to make sure you're getting enough protein without having to track every single bite. Okay. I 100 percent agree. It takes that like, I have to hit this exact number out of it. Um, I think that that's what people think of when they think of macros. I have to hit my protein within 2 grams. That's what I was told. But the very first time I tracked macros, you have to hit your You have to hit 142 grams and you have to be within two grams. So it was 140 to 145. and it's like, no, no, no, no, we, we don't have to be that exact. Like, let's work in a big old range so that we have some variability and we can live our life without, like, a food scale at a restaurant.

38:57 Like, that's ridiculous, right? And so I, I like that approach that you're taking. That is I would agree with that. I love that ones and twos ing. That was, that was Yes. Well, and that's why we have to count fiber too. Gosh. Like we're counting, we're counting protein in double digits almost every single time. You know, I want it to have 15, 18, 30 grams, but fiber, like I'm happy if it has five, like fibers, just more of a challenge because it is just a few grams here and there with your fruit and your vegetables and oats and things like that. So we've talked about protein We've talked about is weaning off possible. Yes. Yes. This the resounding answer is yes weaning off is Totally possible, but why do you think coaching is still a great companion to these drugs both while you were on them?

39:46 But also while you are weaning off Yeah, I was gonna go back to the last one. You said, Can you go off? Yes. Yes. And I just want to add an end to that. And you shouldn't feel guilty or you shouldn't feel like a failure if you decide not to. Okay. I just want people to realize, like, There's no shame. There's no guilt. Like if you want to stay, remain on the medication, that's a choice that you can make. And I think that that's a fine choice. I also think that having that support and doing this process of, you know, you can still lower your dose to more of a maintenance dose is still valuable. And getting coaching would also be valuable.

40:26 So like we kind of talked about at the beginning, like, we're not here to tell people that they should go off. You, if you want to go off, we'll help you. Um, but if, if you decide I don't want to, no guilt, no shame. Okay. So your other question was, why do you need coaching alongside of this? And Yeah. I think that's a really important question. And I think a lot of people maybe don't understand the value that coaching has. And just from personal experience, it has been what made it, I needed the personal accountability. Um, and I didn't give myself that personal accountability. So I had a coach to teach me how to be accountable.

41:07 I coach to teach me the educational things I didn't know. And it was just a lot of support. Um, a lot with the emotional eating going through some of, those exercises that as coaches that we do with clients, because a lot of eating isn't just overeating. It's emotional. it's stress eating. And I feel like that aspect of it, I mean, if it was just about like, don't eat so much, everyone would be fine. But we need more support than that. I've never had someone be like, Oh, the only problem I have is, I just eat too much. Like, there's a reason that we're eating too much.

41:50 I haven't had anyone that's like that. There's no other emotional ties to it. And so I think that's the value that a coach brings into it is, finding those blind spots that we have and really being able to open your eyes so that you can find other ways to deal with, you know, Uh, with food as far as like doing the process when you're going off medication. This is a new process for a lot of people. They've never intentionally tried to maintain, um, they've never intentionally tried to eat more. Like, that seems like, why would I ever want to eat more? And so I think that that's such a new concept to people, that that's why, you know, The coaching is really valuable there. Anything else you want to add, Aliza?

42:32 Yeah, I think the two big things for me are the knowledge deficit. Most people don't know how to eat properly. You know, The food noise, the overeating, all of that is part of it. But also, as Kellie mentioned, most people think peanut butter is a healthy food. You know, it is sort of marketed as this health food. And so people don't know peanut butter is not actually the best choice. It's great. Have peanut butter. But don't scoop peanut butter out of the jar every afternoon and think like, oh it's fine, I'm getting a lot of protein. So the knowledge deficits that are out there, the misconceptions, all of the things that the diet industry has taught us for the last however many years that are wrong, need to be re explained and re learned.

43:12 And the other big thing that Kellie sort of touched on earlier is this progress over perfection mentality, where when she first started counting macros and when I first started counting macros, it was, you hit your macros, you hit them perfectly, and that's the only way to do it. And that's not sustainable. It is not sustainable. Too much work for anybody who has anything else going on to do. And it actually adds stress onto your body. And when you're stressed and your cortisol level is up, you're not actually going to lose weight or maintain your weight. And so letting go of that perfectionist mentality with a coach. is so valuable. Learning that if I get 100 grams of protein today, well that was better than eating 40 grams and I'm going to be fine.

43:53 One day of not being perfect is not going to derail the weeks and weeks and weeks of good work that I've done. And that, you know, being within a range that is ideal for you is so much better than trying to be perfect is such a valuable lesson. And people can hear that, but they're not going to be able to internalize it right away. Some people probably can, but I think most people really need to talk through it and understand it better. And that's one of the big values in coaching as well. Yeah, I remember I when I first was with a macro coach, it was plus or minus five every macro every day. I just felt like a queen when I would get all those Tetris pieces to fit together, like it is hard and I'm glad you said that, I definitely think my cortisol was just through the roof, I mean, I was bringing my kitchen scale to the table, weighing my portion in front of my children, like, no, it was, I mean, anyway, my girls know now.

44:53 And if you're using a food scale in front of your kids, like bakers. Like, this is just a side note, bakers that bake cakes professionally oftentimes use a food scale to weigh out their flour and their ingredients, so if you can think of it as getting enough when you're using a food scale instead of a restriction, I'm just saying for the times that you do want to be more exact, I think that that can be a really great mind shift, getting enough, using the scale to get enough, rather than, you know, as a restriction tool. So anyway, just side note there. totally. And especially in the context of using the medication, we definitely want to make sure that you're getting enough.

45:34 So that is perfect. All right. Thank you so much, you guys. It's been a delight to speak with you both. I landed on their page on Instagram, instantly followed, and I thought I've got to talk to these ladies. So thank you for making time for me and for our listeners. Why don't you let people know where they can find you Yeah. So we're at med free maintenance on Instagram. all one word med free maintenance, And then, um, we have a checklist. So basically almost any posts that we've posted, if you type in guide or checklist, you just read the post. Um, we have a, Before you stop GLP checklist, we recommend that I even have people that haven't even started using one, um, that are downloading that guide to just kind of get them started.

46:19 Like, okay, what are the things I'm going to need to start incorporating now? So we have that guide available for everyone for free. Alright, well, thanks again. We'll see you another time. Thanks, Lisa. I hope you're enjoying all of the great guests that I've had recently. These guest episodes are going to continue for probably most of the summer. As I'm taking a little bit of a break from individual content creation. On that note, if you have anything you'd like to hear on the podcast, there is a link in the show notes for a Google form. It's just two questions, basically. Hey, what do you want to hear on the podcast? I'd love for you to contribute. I'd love to answer your question on the podcast.

47:00 This episode in particular. I was a direct answer to a question I got in those farms. So. That listener out there that submitted this and wanted to know about weight loss medication. Thanks for submitting that. And I hope this answered all of your questions. If you enjoyed this episode, please share it with a friend or share it on Instagram and tag me and tag med free maintenance. And lastly, if you're looking for that extra bit of personalized help with your weight loss, be sure to schedule your free coaching call with me and see how much you can benefit from a relationship with a coach. Of course, that link is in the show notes, have a great week and as always, thanks for listening to the eat well. I think, well, live well podcast.