I’m on a GLP-1—and It’s Not for Weight Loss

I’ve been afraid to write about this! #TransparentTuesday

Hi friend,

So—kinda big reveal time—I’ve been on a GLP-1 for a little while now. And I really want to tell you about it. 

I’ve been very worried about writing this, because I’m so aware that GLP-1s are incredibly polarizing, and that it could be upsetting, triggering, or potentially harmful for some readers to read about my experience. 

After all, GLP-1s are marketed (and heralded) as a sort of magical “weight loss drug,” and as a result they’ve been at the center of a lot of controversy in body positive spaces, with some highly visible anti-fatphobia advocates opting to embrace them, and others opting to critique, oppose, or even villainize them. 

The impassioned conversations I see happening about GLP-1s in my own field are so wildly diverse and contradictory that sometimes it gives me whiplash:

• These drugs are a miracle, they’ve given me my life back and I’ve never felt better!

• These drugs are just another tool of the patriarchy, designed to force women into obsessing over their bodies and shrinking themselves!

• They’re just morally neutral medications that help people manage their weight and mental health!

• They’re so dangerous, we don’t know the long term consequences!

• They’re so easy to abuse, people with eating disorders are using it to harm themselves!

• It’s a huge relief— this is the first time in my life I’ve ever felt safe and grounded when it comes to my relationship with food! 

• They interrupt the reward system in a way that decreases both desire and pleasure… it’s scary and upsetting to think about millions of women blunting their zest for life in order to lose weight!

And the thing is, all of these perspectives have merit.

These medications are miraculous for a lot of people, and often in ways that go way beyond weight loss. When people talk about quieting the “food noise,” sometimes they’re just saying they’re not as hungry, but the vast majority of the time (in my experience), they’re actually describing a massive improvement to their mental health with regard to obsessive thoughts and urges to engage in compulsive behaviors. 

It’s true that these medications help people lose weight by slowing down digestion and making them feel full sooner so that they eat less at each sitting, and this is the main way they’re marketed and discussed, as nothing more interesting than an “appetite suppressant.” 

But when I talk to people who are on these drugs for weight loss, the thing they all want to talk about is the freedom they feel. Freedom from the constant obsessions and negotiations about food, and the endless urges to eat—not from a place of hunger, pleasure, satisfaction, or joy, but from a place of emotional regulation or repression, coping, soothing, and numbing.

And as it turns out, whatever the hell these drugs are doing to the dopamine-centered reward system that helps decrease obsessive thoughts and compulsive urges around eating is also pretty damn effective for decreasing obsessive thoughts and compulsive urges for other stuff, too. 

Nicotine, for example. (Which brings me to my own reasons for starting a GLP-1.)

In a few days I will have been vape-free* for 8 months, after years of more or less chain vaping all day long (and most of the night). 

This is a weird fact for me to process, actually, because it both feels like no time has passed, and also like an entire friggin lifetime has passed since then. 

*Note: I’ve written about my decision to quit, and how unexpectedly brutal and difficult that journey was here, if you want to read about it!

I will say that if you find yourself judging me for choosing to go on a medication to help me quit vaping, I will either assume that you have never dealt with this kind of addiction before, or you are just… better and stronger than I am. 

(I’m being cheeky here, for the record, but I am in fact genuinely ok with you holding this narrative or judgement about me if you need to.)

Anyway, nicotine is unlike anything else I’ve ever experienced in terms of literal addiction. 

I’ve experienced chemical dependency before, and—like most of us—I’ve experienced plenty of other compulsive behaviors and habits that were difficult to quit, control, or cut back on, which I understood as being sort of “addiction adjacent.” 

But having now experienced nicotine addiction, I feel like everything I ever thought I knew about addiction, compulsivity, discipline, and even free will itself has been completely turned upside down. 

I am extremely proud of myself for quitting, and I absolutely did still have to call upon every iota of strength and self control inside myself to accomplish it, even with the help of a GLP-1. 

But I have never needed to work so hard to resist an urge before, or dealt with the constant wretched screaming in my head every second of every day, and the endless string of desperate mental negotiations chattering away, and making it impossible for me to ever feel settled or satisfied or safe.

I made the decision to start a GLP-1 pretty early in my quitting process. I had made it through the early “chemical withdrawal” part of the journey, and was shocked to discover that my obsessive cravings were still so loud, painful, and powerful.

I felt very strongly at the time that I only had one shot at success around this—that if I relapsed even once, a narrative would solidify that in this battle of the wills, nicotine was stronger than me. 

I felt sure that if that narrative was allowed to happen once, I would spend my entire life quitting and relapsing, over and over, just like everyone else I’ve ever known who has battled nicotine addiction. 

I wanted this to succeed so badly, I felt deep down in my bones that I absolutely needed to succeed on my first try, and I felt like I was in constant danger of breaking. So I did an absolute fuck-ton of research, and concluded that the best option for me, at that stage in the process, was to call upon the support of a GLP-1. 

To be clear, the research on the efficacy of GLP-1s around addiction is still so absolutely brand new that while the studies are currently underway, it can still only be described as “promising,” so I don’t mean to make it sound like I was making the obvious responsible choice. 

The truth is that I was absolutely taking a wild and desperate gamble. The research and anecdotal evidence was promising enough for me, but make no mistake: this was a Hail Mary. It was also unsustainably expensive, and came with a wide variety of risks. 

This might sound silly to many people, but the GLP-1 risk I was most worried about was weight loss. 

This concern came from the fact that I really am genuinely weight and body neutral, so being smaller didn’t hold any appeal, and I absolutely did not want to deal with the (inevitable) negative side-effects of under-eating. Plus I really didn’t want my audience to see me losing weight and feel betrayed or triggered for no reason. 

Mostly though, I just knew that if the medication caused any kind of significant or ongoing weight loss, I wouldn’t be able to stay on it. And if it could actually help me with my quitting goal, then I really, really needed to be able to stay on it. 

So I got started. I went through telehealth, and started on the tiniest little microdose that they put people on at first to avoid side effects. That first month I didn’t feel anything. No relief from cravings, no side effects, nothing. I was still white-knuckling my way through every hour  (every minute) without vaping, so the next month I went up to a slightly bigger dose. 

About halfway through that second month, I felt the very first little bit of distance from the endless screaming cravings, and I wept in gratitude. 

It kept going from there. The higher dose that I landed on was still low—less than half of the normal recommended “weight loss” dose—but it offered me significant relief from my cravings and the mental “noise” about nicotine. 

After a few months there, I started to feel safe again. I started to trust myself. I started to see myself as a person who simply does not use nicotine. 

I will be forever grateful to this medication for helping me get there. 

And since I mentioned it before, I do want to speak to the question many of you will probably have, which is: “did you lose weight?” 

My answer is that I don’t weigh myself so I can’t be sure, but I don’t think so. 

I gained some weight immediately when I first quit vaping, in part because of the predictable metabolic changes, but also because I was basically coping and bribing myself with candy all day long. 

When the meds kicked in, I stopped needing the candy bribes, and my eating habits went back to more or less how I used to eat before vaping…so it would be disingenuous to say there was no impact on my weight. I suspect there probably was an impact, but I experienced that impact as sort of helping me return to normal. 

That said, I do know my measurements (hip and waist) are the same as they were in February, because I have a tape measure to help me buy clothes online, and I recently bought a pair of jeans that required me to measure. Hence why I say I don’t think so.

Anyway, I could write forever about the details of my journey, including the dosage, type, side effects, quirks, and benefits… and if you want me to do that please leave me a comment and let me know! 

Because I actually have so much that I would love to write about and share with regard to these medications, including how they impact our ability to listen to our bodies (both for better and for worse), and what a massive impact they can have on that constant deep-down feeling of existential neediness or dissatisfaction. 

But I feel wary of sharing too many of these details because I want to be careful about not making this story sound like I’m giving advice!

Again: I’m absolutely not suggesting that anyone else do what I did, and I’m not “promoting” GLP-1s. 

I’m simply sharing my story, and while my experience on these meds happens to have been a positive one, everyone’s experiences with these medications will be completely unique to them, and there are tons of risks involved that need to be considered between you and your doctor. 

And to be clear, I also do have a lot of concerns and critiques about GLP-1s in general. 

• I’m so unbelievably angry about the way they’re being marketed, discussed, and prescribed, because given the potential magic they can work around things like addiction, it pisses me off so bad that we’re only thinking about their potential for weight loss, and the way their marketing is encouraging weight stigma. 

• I’m very concerned about the use and abuse of these medications among people with a history of eating disorders and body dysmorphia… and also about the way they can actually trigger eating disorders and body dysmorphia in people who don’t even have that kind of history! 

• I’m worried about the existential impact of so many people (and especially women) chemically suppressing their experience of desire and/or pleasure. 

• I’m positive that a bunch of women are going to end up dead due to abusing these medications along-side a disordered desire for thinness. 

• I’m furious about the exorbitant cost, and the way billionaires and big pharma are getting rich off them. 

So yeah, there’s a lot there about GLP-1s that we could talk about and critique. 

But I am forever applying a “morally neutral” lens to everything—including our bodies and our choices—and I have absolutely no judgement about people who do (or don’t) opt to take these drugs, for any number of reasons. 

That said, my experience has been positive, complicated, and fascinating… and I would love to write more about it.

What do you think? What did reading all this bring up for you, and what’s your relationship to these drugs? Are you on them, curious about them, scared of them, or something else entirely? 

I’m dying to know, so please hit reply and tell me what you think and feel.

This is a massive, complex, important topic for us as a culture right now… but it’s also such a personal and individual experience for each person inside it!

Big hug,

Jessi

PS. If you are thinking about trying to quit nicotine and want some support please let me know. It’s so unbelievably difficult that I offer pay-what-you-can support around it, and I’d love to help.