Oh, fer sure. We all know that one person who can eat whatever they want and never gain weight. Sucks to be in the camp where merely thinking about food puts on a pound or two. And yeah, genetics. High BP runs in both my partner’s and my family, and we’re both on the same BP meds now (how adorbz! 
), and it ain’t due to our lifestyle, that’s for sure. Damn genes! >shakes fist at sky<
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Gosh, I hope not. Is that founded on anything specific you’ve been reading? My MIL’s GP was looking at one of the new injectables - Munjaro, I think - to help with diabetes type ii control. My MIL has limited pancreatic function.
One of the possible side effects of Mounjaro is pancreatitis. There are quite a few others, some of which have caused lawsuits to be filed against the pharmaceutical companies producing them.
I agree with linguafood about diet being most important. Where exercise helps me is that when I go to grab something less healthy, I think, “well there goes all the good I did exercising this morning.” That does not stop me from enjoying a treat whenever I want but I eat less of it than I might otherwise. Like you, walking really helps my BP and makes me generally happier.
I don’t do “diets.” Everyone I know who has been on one ended up fatter once they stopped. From what I have read, science backs up my observation. It will be the same with Ozempic unless people commit to taking it for a lifetime. I don’t limit what I eat. It is fortunate for me that I naturally enjoy eating vegetables and fruit. I also like chips, fries, chocolate and wine. I’m no saint!
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Warning! Long boring description of personal experience ahead!
After Covid closed my gym, I went from weighing 216-220 (Bmi of 22-23 if memory serves) to 240 pounds and a Bmi of 30. Worse, after a lifetime of being active, lifting and cardio, i felt old and weak. Then my heart went into Afib when i was traveling for the winter and i spent 8 months mostly in Afib.
So i got home, spent 4 months on Metoprolol which rarely helped and caused me to sleep 14 hours a day. More weight gain.
Doc switched me to Fleqanaid and I went into a normal heart rhythm finally and started working out but i am so heavy my old workouts are causing injuries. Plus my workout intensity is poor. I almost never feel muscle burn the next morning, which is bad. Little weight loss.
When i get home from this winters travel my cardio doc is going to give me 3 months of Ozempic in the hope that i can lose enough weight to make my exercise routine effective enough after 3 months of weight loss so that i can stop taking Ozempic and keep losing weight.
Hopefully.
Maybe the weight loss drugs can work long term with prior planning on how you will effectively stop using them?
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It sounds like your doctor is suggesting you can lose x pounds through exercise.
Their opinion is probably the only one that matters, and I am not giving medical advice, but I am wondering if your doctor might think a consultation with a nutritionist might also be helpful.
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My “doctor” is actually a not so helpful Physicians Assistant. He pushed back when I was complaining about the side effects of Metoprolol and only gave in to a med change when I told him I had stopped taking the Metoprolol a week before, felt slightly better (and was sleeping only 9 hours a day rather than 14 previously) and would not take it again. But the PA has mentioned that Ozempa may help and my cardiologist seems to agree. My cardiologist quizzed me extensively on my workout history and seemed to agree with me that working out is important to my future health. He did not say it but I think the mental aspect of it may help a great deal too. Endorphins make a difference in a lot of ways.
My cardiologist has been my main support. My PA, not so much.
I had not thought of using a nutritionist, to be honest. I have started a 16:8 fasting pattern a week ago and a nutritionist would be a good source of info on its pros and cons. So far the fasting seems to have helped me take an inch off my stomach and half that off my waist. We will see. It is not the Mediterranean Diet, but it is a form of diet, of sorts.
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In my experience nutritionist spend a lot more time learning about this kind of thing than most physicians. There are exceptions; I once attended a three day conference in Napa with a bunch of them!.
Nutritionists also tend to schedule more time devoted to discussing things like that.
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Thank you for your thoughts on nutritionists! I will push to get an appointment w one and to see them as i go forward.
Neither Kaiser (past) or Blue Cross (current) have mentioned them over the years but i know they have them.
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Your welcome, but you should see what your doctor thinks. They may need to send a consultation request if you want it covered by your insurance.
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I pay out of pocket for a registered dietitian.
Some 3rd party insurance will cover dieticians in Canada.
I don’t know how it works in the States.
In Canada, anybody could call themselves a nutritionist. Some nutritionists charge as much as registered dietitians.
I have a couple acquaintances who called themselves nutritionists after some sort of short online program.
What disturbed me the most was medical advice one was selling to my friend about menopause. The nutritionist is a former middle management bank employee who decided at 48 to give up her bank job, and make a living through yoga instructing, crafting greeting cards and selling herself as a nutritionist to women heading into menopause. There are so many changes beyond one’s control due to the change in hormones and age . It is disappointing to see a peer try to make money off that by selling anti-aging BS to women who consider her a friend, but I guess it’s a successful business plan. 
Registered dietitians are regulated.
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Events happen in life where one might have a temporary change in lifestyle that results in weight gain. Once I get out of a healthy eating and exercising routine it is hard to get back to it even though I know how much better I will feel once I do so. I know for me even 10 extra pounds makes my body hurt and less able to perform some physical movement without discomfort. I could see how taking Ozempic for a few months could help jumpstart weight loss and help one get back to their former healthy routines. I hope it works out for you.
ETA: I have no expertise in weight loss or medicine. Anything I write is just coming from my opinion and should not be taken very seriously. Except for my hope that it works out for you.
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The NYT had a fairly depressing article on just how difficult it is to NOT gain the weight back one has lost. It’s almost like our bodies are programmed to hold on to any weight for dear life, continuously working against our vanity. #asshats
Here’s the paragraph in its full, sad glory:
Why doesn’t the weight stay off?
When you lose weight, your body responds by increasing your appetite and reducing the number of calories you burn, Dr. Hall said.
He and others have estimated that for every two pounds of weight you lose, your metabolism slows by about 25 calories per day, and your appetite increases by about 95 calories per day. So in other words, if you lose 20 pounds, your body will burn roughly 250 calories less each day while craving about 950 calories more.
To maintain your weight loss through dieting over time, you’ll have to continue eating less while resisting a rising appetite and slower metabolism, which is “increasingly difficult,” Dr. Schur said.
The drive to eat more is so strong because our brains “sense that our energy stores are being depleted,” she added, and “that’s a threat to our survival.”
The new weight loss drugs prevent weight regain in part by reducing normal appetite signals, Dr. Collazo-Clavell said. But when people stop taking the drugs, the weight returns, probably for the same reasons described above.
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The focus shouldn’t be on weight, or losing just weight for sake of losing weight.
The focus should be on body composition and more specifically muscle mass.
Retaining muscle mass as we age is far more important than just losing weight, although the more muscle one has the more likely they are to be metabolically healthier and “not overweight”. Because pound for pound muscle is more metabolically expensive than fat tissue, i.e., muscle burns more calories at rest than an equal amount of fat.
A 120 lb person with 25% body fat will be less metabolically healthy than 120 lb person with 15% body fat.
Focus on building and maintaining muscle mass and the rest will more easily fall into place, i.e., weight loss and/or weight control.
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That’s a great point, and I didn’t realize it varies by state.
Here’s what Kaiser says..
Here’s what Sutter says.
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Thankfully, the nonsense of BMI as a reliable indicator of anything has long been debunked.
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A 120 lb female, depending on her height to some degree, with 15 percent body fat is likely anorexic. She would be unhealthy or metabolically unhealthy.
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Or an extreme athlete. Or she’s shorter than 5".
At 15% body fat:
“You will be lean, feminine, yet athletic, and will often see the outline of your abdominal structure.”
Is this from the last century? 
I mean… if having a six-pack is one’s idea of health. But ya gotta be feminine, ladies!
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15 percent body fat is going to lead health issues for most women. The women under 5 foot 3 who have 15 percent body fat would likely way 100 lbs.
Of course, there are skinny people who have higher body fat and relatively no muscle mass, as well as muscular people who carry a lot of fat on top of their significant amount of muscle.
I have one friend who is 5 foot 2, who has never exercised, who eats a lot of prepared food and poutine, but eats like a bird.
When she got married 20 years ago, I weighed 150 and she weighed 100.
She dropped 5 or 6 pounds after the wedding, so she has weighed 90-96 lbs over the past 20 years.
Me, I have gained a lot more than 6 lbs since 2004,and I’ve kept exercising.
She claims the only time she has weighed more than 100 lbs was when she was carrying her twins.
Lol.
I was measured by a BodPod this week. I’m a little touchy about the whole body fat thing.
