Holistic Good Health: Your GLP-1 Questions Answered By Telezen MD

As regular 10almonds readers will know, weight loss alone does not equate to good health, and GLP-1 drugs, when used, are best combined with a holistic approach to ensure full wellness.

We recently asked 10almonds readers to submit questions to be answered by Telezen MD, a fully-licensed US telehealth platform designed for people who want more than symptom management when pursuing online weight loss treatment.

Here’s what they said:

1. Do GLP-1s cause muscle loss? How can you prevent muscle loss, and how do you calculate how much protein you need daily?

Any significant weight loss can include some loss of lean mass, which is why we believe preserving muscle should be part of the plan from the beginning.

At Telezen MD, our general protein target is 0.7 to 1 gram of protein per pound of goal body weight per day, individualized when appropriate.

For example, if your goal weight is 150 pounds, that would mean approximately 105 to 150 grams of protein per day.

We recommend prioritizing protein first at every meal and spreading it throughout the day rather than trying to consume most of it at dinner.

Good options include eggs, Greek yogurt, cottage cheese, chicken, turkey, fish and lean meats. When appetite is very low, a protein shake containing approximately 20 to 30 grams of protein can make reaching your daily target much easier.

We also teach a simple 1-to-10 rule for packaged foods. If you’re counting something as a meaningful protein source, look for approximately 1 gram of protein for every 10 calories. For example, a 150-calorie food marketed as “high protein” would ideally provide around 15 grams of protein.

Protein is only part of the equation. Your muscles also need a reason to stay. We recommend resistance training approximately 2 to 3 times per week, when medically appropriate.

For appropriate patients, creatine monohydrate, commonly 3 to 5 grams daily, may also complement adequate protein and resistance training.

The goal isn’t simply to weigh less. It’s to lose unwanted body fat while doing everything reasonable to preserve strength and lean mass.

This is one reason our GLP-1 Nutrition Protocol™ is included with Telezen MD’s GLP-1 program. It teaches patients how to nourish their bodies while their appetite is reduced rather than simply telling them to “eat less.”

If you’re wondering whether this would be best for you, take a tour of the options, here

2. What kind of food should I be eating while on a GLP-1 and after I stop the shots so I don’t gain the weight back?

When you’re eating substantially less food, the quality of what you eat becomes more important, not less.

We focus on several fundamentals.

Protein: Start meals with protein and work toward your individualized daily target.

Fiber: A practical target for many adults is approximately 25 to 30+ grams per day, increasing gradually. Good sources include vegetables, berries, beans, lentils, chia, flax, avocado and whole grains.

Quality carbohydrates: Foods such as potatoes, oats, rice, quinoa, beans, fruit and whole grains can absolutely be part of a healthy GLP-1 nutrition plan.

Healthy fats: Olive oil, avocado, nuts, seeds and fatty fish.

Hydration and electrolytes: This is a big one for us. At Telezen MD, we recommend electrolytes as part of the hydration routine for our GLP-1 patients, when medically appropriate.

Reduced appetite can sometimes mean people eat and drink less overall. Nausea, vomiting or diarrhea can further increase fluid and electrolyte losses. We encourage patients to hydrate consistently throughout the day rather than waiting until they feel depleted.

People with kidney disease, heart conditions, high blood pressure or medications that affect sodium or potassium should discuss their individual electrolyte and fluid requirements with their clinician.

We also don’t want appetite suppression to become an excuse to chronically under-eat. If a full meal feels overwhelming, smaller nutrient-dense meals or foods like Greek yogurt, cottage cheese, eggs, chicken, fish or a protein shake can make it easier to meet nutritional needs.

Our GLP-1 Nutrition Protocol™ goes much deeper into this, covering protein, meal structure, fiber, hydration, practical meal templates and strategies for eating properly throughout treatment.

How does your diet stack up? You can get a good perspective on it by answering these questions 🙂

3. I’ve been on a GLP-1 and my weight loss has stalled. Why am I not losing, and should I keep increasing my dose?

Not necessarily.

Weight loss isn’t perfectly linear, and a week or two without movement on the scale doesn’t automatically mean the medication has stopped working.

Water retention, sodium intake, constipation, hormonal changes, sleep, carbohydrate intake and even when you weigh yourself can affect the number on the scale.

Instead of reacting to individual weigh-ins, look at the trend over several weeks. Also consider waist measurements, how your clothes fit, appetite, food noise and strength.

Before assuming you need more medication, go back to the fundamentals:

Are you meeting your protein target?

Are you getting approximately 25 to 30+ grams of fiber?

Are you staying adequately hydrated and using electrolytes appropriately?

Are you resistance training and moving throughout the day?

Are you eating enough nutrient-dense food to meet your body’s needs despite reduced appetite?

Are constipation or other GI issues affecting the scale?

Most importantly, don’t increase your dose on your own.

We tell our patients: the goal isn’t the highest dose. It’s the effective dose.

If you’ve experienced little or no response over an appropriate period, or you’ve been stalled for several months, that’s the time for your prescriber to review your treatment, nutrition, dose, adherence and other factors that could be affecting progress.

4. My hair started falling out after starting a GLP-1. Will it grow back? What can I do to stop the hair loss?

Hair shedding can occur during significant or rapid weight loss and has also been reported during GLP-1 treatment.

One potential contributor is telogen effluvium, a temporary form of shedding that can occur after physiological stress, including significant weight loss. Reduced calorie, protein and micronutrient intake may also contribute.

That’s why one of the first things we look at is the nutritional foundation.

Make sure you’re consistently getting enough protein and overall nutrition.

Depending on the individual, a clinician may also consider whether there are deficiencies or other issues involving iron/ferritin, vitamin B12, vitamin D, zinc or thyroid function.

We don’t recommend blindly taking high doses of iron, zinc or other supplements without knowing whether you actually need them.

If shedding is related to telogen effluvium, it is often temporary once the underlying trigger resolves, but hair grows slowly, so improvement isn’t immediate.

Significant or persistent hair loss should be evaluated by a healthcare professional because not all hair loss occurring during treatment is necessarily caused by the medication or weight loss.

5. Are GLP-1 medications dangerous? Is there anything to be scared about when using Zepbound or similar medications?

GLP-1-based medications have been extensively studied, but like any prescription medication, they have potential risks, side effects and contraindications and aren’t appropriate for everyone.

Common side effects are gastrointestinal and can include nausea, vomiting, diarrhea, constipation and abdominal discomfort.

More serious adverse events can occur, which is why proper medical screening and physician oversight matter.

What protects patients isn’t pretending a medication has zero risk. It’s using it responsibly. That means reviewing medical history and current medications before treatment, using appropriate dosing and titration, staying adequately nourished and hydrated, communicating significant side effects and not changing the dose or frequency without the prescribing clinician.

Severe or persistent abdominal pain, repeated vomiting, inability to keep fluids down, significant dehydration or other concerning symptoms should be evaluated promptly.

Questions involving kidney disease, previous gastrointestinal surgery, significant liver abnormalities, a recent ruptured appendix or other complex medical conditions require individualized physician assessment rather than a general yes-or-no answer.

If you’re wondering whether it might be appropriate for you, the best place to start is with this overview 😎

6. I get extremely nauseated and have vomited to the point that I’m bedridden. Is there another option other than terminating the prescription?

Severe nausea and vomiting that leaves you unable to function normally is not something you should simply push through.

Contact your prescribing provider promptly.

Your clinician may need to evaluate your current dose, titration schedule, hydration, nutrition, other medications or whether another medical issue could be contributing.

There may be options between continuing exactly as you are and stopping treatment entirely, but that decision should be made with your clinician.

For milder nausea, smaller meals, eating slowly, stopping when comfortably full and avoiding very large or high-fat meals may help.

Hydration and electrolytes are especially important when vomiting or diarrhea occurs because you’re losing both fluids and electrolytes.

But if you’re repeatedly vomiting, can’t keep fluids down, feel significantly dehydrated or have severe or persistent abdominal pain, don’t try to solve it with electrolytes alone. Seek medical care.

7. I get a quarter-sized rash that itches for 3 to 4 days after my injection. How can I minimize injection-site reactions?

Localized injection-site reactions can occur.

Rotate injection sites consistently, follow the injection instructions for your specific medication, avoid injecting into irritated, bruised, scarred or damaged skin, and make sure you’re using proper injection technique.

If the reaction happens repeatedly, becomes larger, lasts longer or gets progressively worse, discuss it with your healthcare provider rather than simply continuing to inject through it.

Generalized hives, facial or throat swelling, difficulty breathing or other symptoms of a serious allergic reaction require urgent medical attention.

8. Can you take a GLP-1 every other day?

For commonly used injectable semaglutide and tirzepatide, standard administration is once weekly.

Taking a weekly medication every other day isn’t a standard dosing schedule.

Patients shouldn’t change the dose or frequency on their own in an attempt to get faster results or reduce side effects.

If the prescribed schedule isn’t working for you, that’s a conversation to have with your prescribing clinician.

9. Do GLP-1 supplements like Bioma work? Are they safe?

Supplements marketed as “GLP-1 boosters” are not the same thing as prescription GLP-1 medications such as semaglutide or tirzepatide.

A supplement containing probiotics, fiber or plant extracts may have nutritional or digestive effects depending on its ingredients, but that doesn’t mean it reproduces the pharmacologic effects or clinical weight-loss results of prescription GLP-1 medications.

We would be cautious about any supplement marketed as though it is a “natural Ozempic” or an equivalent replacement for prescription treatment.

Always tell your provider which supplements you’re taking. “Natural” doesn’t automatically mean appropriate or interaction-free.

10. How long do you stay on a GLP-1? Do you have to take it forever to maintain your weight?

There isn’t one answer that applies to everyone, but the research makes one thing very clear: what happens after weight loss deserves just as much attention as losing the weight in the first place.

Weight regain after discontinuing GLP-1-based treatment is common.

In the STEP 1 extension, participants who stopped semaglutide regained approximately two-thirds of their prior weight loss within one year. More recent tirzepatide research tells a similar story. In a follow-up analysis of SURMOUNT-4, 82.5% of participants who discontinued tirzepatide regained at least 25% of the weight they had lost within one year.

This doesn’t mean everyone will regain all of their weight, and it doesn’t mean every patient needs to remain on the same medication or dose forever.

It does mean that maintenance needs to be part of the plan from the beginning.

GLP-1 medications can reduce hunger, increase satiety and quiet food noise. While the medication is providing that support, we believe it’s incredibly important to use that window to build the habits and behaviors you’ll need long term.

That includes prioritizing protein, strength training, eating balanced meals, building appropriate portions and meal structure, staying active, maintaining hydration and electrolyte habits, improving sleep, addressing emotional eating, identifying triggers and old patterns around food, and learning strategies for managing hunger and food noise if they return.

That’s exactly why Telezen MD includes Lose It for Life™ with our GLP-1 program.

Medication can help change appetite, but it doesn’t automatically change the habits, behaviors and patterns that existed before treatment. We want patients working on those things while they’re losing weight, not waiting until the medication is gone.

For patients who reach their goal weight but aren’t ready to discontinue treatment completely, Telezen MD also offers a physician-guided GLP-1 microdosing maintenance program.

Our microdosing program uses a fixed lower-dose approach intended for weight maintenance and habit support rather than the stronger appetite suppression and active weight-loss goals of traditional treatment.

Whether continued standard treatment, maintenance treatment or discontinuation is appropriate should be determined individually with the prescribing clinician.

The goal shouldn’t simply be “How fast can I lose the weight?”

It should also be “What am I building while I lose it so I have the best possible foundation to maintain it?”

For help figuring out the best goals for you, take Telezen’s (free) personalization quiz here 🙂

11. What should I do about saggy skin on my upper arms and face? Do I need collagen?

Some loss of skin elasticity can occur after significant weight loss, particularly when weight comes off very quickly.

That’s one reason we generally favor gradual, steady weight loss rather than trying to lose as much as possible as quickly as possible.

For many people, a general target of approximately 1 to 2 pounds per week is considered a gradual rate of weight loss, although the appropriate rate should always be individualized.

A more gradual approach gives the body and skin more time to adapt to changes in body size, but it can’t guarantee that loose skin will be prevented.

Age, genetics, how much weight you lose, how long you carried the weight and your skin’s natural elasticity all play a role.

We focus on the fundamentals:

• Lose weight gradually rather than chasing the fastest possible result.
• Prioritize adequate protein to support lean mass and overall nutrition.
• Resistance train to preserve or build the muscle underneath the skin.
• Stay consistently hydrated, including electrolytes when appropriate.
• Avoid extreme calorie restriction that makes it difficult to meet your nutritional needs.

Collagen supplements may provide modest benefits for certain measures of skin health, but they’re not a guaranteed solution for significant loose skin and shouldn’t replace adequate total protein.

For substantial facial or body skin laxity after weight loss, a dermatologist or other qualified clinician can discuss additional treatment options.

The goal with GLP-1 treatment shouldn’t be to lose weight as fast as possible. It should be to lose weight in a way that supports muscle, nutrition and long-term health.

12. If I’m not diabetic, will a GLP-1 make my blood sugar too low?

GLP-1-based medications affect glucose regulation, but clinically significant hypoglycemia is generally a greater concern when they’re combined with certain other glucose-lowering medications, particularly insulin or sulfonylureas.

That’s one reason your provider needs to know all medications you’re taking, even if the GLP-1 is being prescribed for weight management rather than diabetes.

If you experience symptoms that could represent low blood sugar, discuss them with your clinician rather than assuming they’re a normal part of treatment.

13. Is it worth taking a GLP-1 if I only need to lose 20 pounds?

The number on the scale isn’t the only measure of whether weight loss is meaningful.

For someone with overweight or obesity, even a relatively modest reduction in body weight can be associated with improvements in certain metabolic and cardiovascular risk factors.

We also look beyond pounds lost at things like waist circumference, blood pressure, blood sugar, lipids, strength, mobility, energy and overall quality of life.

Whether a GLP-1 is appropriate for someone who wants to lose 20 pounds is a separate medical question.

It depends on whether that individual meets treatment criteria, their health history and whether their clinician determines that the potential benefits outweigh the risks.

For help deciding whether GLP-1 medications would be appropriate for your personal goal, take Telezen’s (free) personalization quiz here 🙂

14. I have one kidney or kidney disease. Is Mounjaro/Zepbound safe for me?

This is one of the questions where a general newsletter answer could be misleading.

Having one kidney isn’t the same thing as having impaired kidney function, and chronic kidney disease varies substantially in severity.

Your clinician needs to consider kidney function, other medical conditions, medications, hydration status and your complete health history.

One particularly important issue is dehydration. Significant vomiting or diarrhea can lead to fluid depletion, which can place additional stress on the kidneys.

Someone with one kidney, stage 3 kidney disease or abnormal kidney or liver labs should have their individual medical history reviewed by a qualified clinician before starting or changing treatment.

The same applies to the reader questions involving a LINX device, previous gastrointestinal surgery, a recent ruptured appendix and other complex medical histories.

Those are exactly the situations where individualized physician evaluation matters.

It’s not a bad idea to start with an overview like this one!

A final thought for readers

One of the biggest gaps we see in GLP-1 care is what happens after the prescription is written.

There are many places where a patient can get access to medication. But medication access and comprehensive weight-management support are not the same thing.

Losing weight is only one piece of the puzzle.

• What are you eating when your appetite is dramatically reduced?
• Are you getting enough protein to help preserve muscle?
• Are you getting enough fiber, fluids and electrolytes?
• Are you strength training and moving your body?
• Are there nutritional gaps that need to be addressed?
• Are you sleeping enough?
• Are you changing the habits and behaviors that contributed to weight gain in the first place?

And perhaps most importantly: What are you building while you’re losing the weight that will help you maintain your results later?

These are the areas where we believe patients need far more education and support.

A GLP-1 can help reduce hunger, increase satiety and quiet food noise. But it can’t strength train for you. It can’t choose your food. It can’t make you sleep. And it can’t automatically change years of habits, emotional eating, triggers or behavioral patterns.

That’s why we built Telezen MD around more than the prescription.

Physician-guided GLP-1 treatment provides the medical component.

The GLP-1 Nutrition Protocol™ gives patients practical tools around protein, meal structure, fiber, hydration, electrolytes, supplementation and preserving muscle while losing weight.

Lose It for Life™ focuses on the behavioral side, helping patients work on the habits, triggers and patterns around food that medication alone cannot change.

We also emphasize the fundamentals that are easy to overlook: sleep, daily movement, resistance training, hydration and building routines that can continue long after active weight loss.

For appropriate patients who have reached their goal and want continued support with maintenance, Telezen MD also offers a physician-guided GLP-1 microdosing maintenance program.

We don’t believe success should be measured only by how many pounds someone loses.

The bigger goal is to use the period when the medication is helping to build the nutrition, muscle, behaviors and lifestyle that support better health and long-term weight management.

Note: aside from the preamble and this indented note, all answers here were written by Telezen MD, not 10almonds staff. We (10almonds staff) wholeheartedly agree with them on the importance of tackling health holistically; it’s just also important that we make clear this sponsored article was written by a company that specializes in providing GLP-1 treatments. If you’re curious about them, you might want to try an online visit here.

Take care!