Tales & Trails of a Traveling Wiseguy

A few weeks ago I was chatting with my friend, David, about our experiences using GLP-1 medications. (I'm taking Rybelsus, the pill form of Ozempic; he's taking Zepbound.) I mentioned, "I weigh myself every morning" as a segue to talking about the results I'm seeing so far.

"Oh, you're not supposed to weigh yourself every day," David admonished, gently. "I was weighing myself every day at the gym, and one of my gym-friends there saw me and was like, 'Nooooo! You're only supposed to weight yourself once a weeeeek!'"

I understand why that friend-of-a-friend thinks you should only weigh yourself once a week. He's almost certainly aware that there are mistakes people make when weighing themselves every day. Thing thing is, "Weigh yourself just once a week" is the wrong solution. It's better to understand what those potential mistakes and work to avoid them. I call it Measure Frequently, Judge Less Frequently. (Okay, that doesn't quite roll off the tongue. I'm working on a snappier version of it! 😅)

The basic problem with checking your weight every day when you're working on losing weight is that weight loss doesn't happen smoothly and evenly. The first phenomenon that trips people up is that your body plateaus. The body tries to maintain equilibrium, so even if you're eating right and exercising to lose weight you'll see yourself weighing in at the same rate for 3 or more days at a time. Then your body will shed a week's worth of weight loss over a few days, then you'll plateau at the next level down for several days.

There are also instances where you'll actually gain weight, like a pound or two, while on a losing-weight plan. Those instances can be really frustrating! Thus it's important to understand they can happen even when you're doing everything right and not overreact. What can cause weight gain? It could be as simple as water retention. Eating salty food can cause the body to retain a bit more water. You'll lose it later; you've just got to get past the blip in weight.

I know my body tends to retain when traveling. I'm not sure why; I just know it does. So when I get back from a trip I know I'm going to weigh in at least 2 pounds higher than when I left. I know it's another type of blip so I don't overreact, e.g., by punishing myself with an austerity diet— "OMG, 2 pounds?! I can only eat rice cakes and celery sticks for the next week!" I know if I continue doing whatever's normal for my weight loss plan, those extra pounds will come back off soon.

So, yeah, go ahead and weigh yourself every day. Just don't overreact when you see plateaus and upward blips.

Today is the start of Month 2 on "the pill" for me. That pill, of course, is Ozempic. (Actually the brand name for the pill is Rybelsus; it's the same medicine, semaglutide, as Ozempic injections.) The start of Month 2 is significant because, first, it's a chronological milestone. And second, because I'm switching up to a higher dose.

In terms of milestones, how have I done so far? Pretty well, I'd say. In one month on the starter dose I kept bad side effects to a minimum while reducing my blood glucose 15% and losing 10 pounds. That weight loss was more than I expected in the first month, but I'll take it, gladly!

I'm a bit nervous about starting the higher dose. It's more than double the starter dose, 7mg now vs. 3mg last month. I expect side effects will hit harder. Today, Day 1 on the 7mg dose, I haven't had any bad side effects yet. But I expect in another day or two to be facing challenges of increased stomach pain and bowel irregularity. Meanwhile I'm doing what I can in terms of eating carefully to avoid the worst of these.

Today at lunch, for example, I continued to indulge my habit of dining out regularly but eating only 2/3rds of what I used to eat. Hawk and I went to a cheesesteak restaurant! This time I ordered a half sandwich instead of a full, with a small side of fries. I'll see in a few days if this proactive adjustment continues to be enough to manage the 7mg dose or if I need to make bigger changes.

I've been taking Ozempic— or, as I call it, "The Pill"— for three weeks now. How's it going? Overall better than I expected.

The biggest part of "overall better" is managing side effects. All my friends and relatives who are on a GLP-1 medication prepped me for absolute gastric disaster. They regaled me with dire warnings from their own experiences of constant stomach pain, frequent vomiting, alternating between diarrhea and constipation, and having to make severe changes to their diets to avoid stumbling around in painful misery and throwing up on the daily. Compared to all that I've had it easy so far.

• Yes, there are issues with stomach pain from how GLP-1s affect digestion.


• I've proactively made a modest change to my eating habits I call the Rule of 2/3rds. With this simple change I'm able to continue enjoying dining out, including two of my favorite cuisines Mexican and pizza.


• I haven't barfed. Not a single time in three weeks. Though I have felt close to it a few times.

And on the positive side, not just the not-negative side:

• My daily blood sugar level (measured at home with a glucometer) is down 15-20%.


• I've lost 8 pounds.

I don't know if dire stories from all my friends were because they were eating like clowns on the medication or all had severe, abnormal side effects, or were all embellishing the truth to make compelling woe-is-me stories. For my sister, I know "severe abnormal side effects" is the situation. "Severe abnormal side effects" might as well be her middle name. Everything hits her differently. 😭 As for everyone else... I doubt they all have idiopathic autoimmune disorders like my sister, so I figure it's some combination of eating like dumbasses and embellishing their stories for effect.

You might sense from how I'm chiding "all my friends" that I'm salty about their bad advice. Well, I am salty about it. I took what they said at face value. I believed them— and because I believed them I delayed starting treatment with a GLP-1. I delayed for a year or two. I could've been making these improvements to my health 12-24 months earlier if not for the henhouse full of clucking chicken-littles around me. If even one person, one single person, had explained, "Yeah, there are side effects, but you can totally manage around them without it becoming a full-time job involving frequent emergency dashes to the nearest toilet," I would have chosen differently.

I understand that my own situation could still become more dire. I am only on the starter dose of Ozempic. After a month or two most people have their dose doubled. Then doubled again. I have a check-in with my doctor late next week to evaluate progress and decide on next steps. I'll report back here what happens if/when my dose increases 2x or 4x.

Today was Day 2 on The Pill. I started by weighing myself— something I couldn't do yesterday because the bathroom scale I've owned for 20 years just says "D'oh!" when I step on it now. I've gained a lot of weight over the past 18 months due to 1 or 2 of the many medicines I'm taking. I'm now over the weight limit for a lot of bathroom scales. That's why I ordered a new scale on Amazon yesterday. It has a higher capacity. It arrived swiftly but not in time for an inaugural morning weigh-in. So I did that today. And I forgot to do it first thing in the morning, before eating breakfast. So I did it after breakfast... and after a dump. I figured, one meal in, one meal out; it's balanced. 🤣

I feel like I'm starting to see some of the side effects of the GLP-1. It didn't start that way, though. Yesterday, Day 1, I began with my normal breakfast. Okay, I figured; the pill doesn't take effect immediately, especially at the lowest dose. For lunch I tried cutting down my normal portion by half but was still hungry afterward. I then ate more, adding up to a typical lunch amount. I tried a reduced portion again at dinner, going with 2/3 the amount I normally eat, and that's when I started to see some appetite reduction. I felt full after a modest, 2/3-sized dinner... though that feeling of fullness came partly from a mild discomfort that felt a bit like stomach gas. I had the burps for a few hours after dinner. When I went to bed 3.5 hours later it felt like the food was still siting in my stomach and trying to crawl back up my esophagus. It wasn't painful, thankfully; just a bit weird.

Today, Day 2, I downsized my breakfast and lunch to about 2/3 of what I'd normally eat for each. I was a bit hungry after breakfast and just waited until lunch. I was a bit hungry after lunch, too; I treated myself to a small dessert of two cookies. That was enough to hold me over until dinner without any mid-afternoon munchies. Come dinnertime, though, I was hungry. I ate a full portion at dinner. Now I feel bloated from that, like I overate. Part of learning to deal with this medication, and part of why doctors start everyone on the smallest dose, is becoming familiar with new signals and developing new habits. I'll see how I feel in about 2 hours when it's time for bed.

Recently I was talking about cooking and dieting with one of my sisters. "It's such a pain to measure how many ounces or grams everything is," she complained. "Fortunately I've gotten better at estimating so I'm not overeating constantly."

"Do you have a digital kitchen scale?" I asked. "They make it so easy to measure everything, and they're inexpensive, too!"



She was still working with an old analog scale, so I explained what a difference it made when we bought a modern, digital scale (pictured) several years ago. The differences were like night and day. One, the nearly flat surface is easy to put both small and large things on. Two, the digital readout is accurate and so easy to read. Three, the "TARE" button makes it trivial to use a measuring cup, bowl, plastic container, etc., to hold food.



Here's an example I shared from food I was cooking that day. I was making pasta, so I placed a bowl atop the scale while the water was coming to a boil. Note the scale initially weighs the bowl.

In the old days you could adjust for the weight of the bowl either by doing mental arithmetic— something most people are weak at— or by turning a set knob somewhere around the back of the to reset the zero point with the bowl on it. The problem was, the knobs were generally finicky, and once you were done you had to set them back to zero again. Each reset required multiple adjustments of the knob to get it zeroed properly again.



With a digital scale, a simple touch of the TARE button zeroes the scale. Put your bowl or measuring cup on it, press tare, then add food.



Back in the old days, analog scales were such a pain I didn't bother to use them for pasta. I'd just estimate by eyeballing it. "Hmm that looks like about 4 oz.," and, "I'll add a bit more to be sure." Usually it was too much and I'd eat it anyway.

With accurate measurement so easy to do now I realized I don't even like 4 oz. of pasta (dry weight) for a meal. I've cut back to 3 oz., or even 2.5 oz. if I'm making a thick sauce. In the pic above I'm making 5 oz. because it's two portions— one for lunch today, one for lunch or dinner later in the week. Once the pasta's cooked I'll either eyeball it to split it in half, or pour the whole mass back into this bowl, weigh it, and part out half into a container for the fridge.

The best thing is these scales are so inexpensive. I think I paid somewhere around $20 several years ago, and it was unquestionably worth it. The same model today is on sale for under $10 at Amazon today!