Reply to Wagovy and similar - how long? how much food?

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[quote=Anonymous][quote=Anonymous]OP here

Thank you for input.

I do want him to change his ways - eat less fatty meats and fatty foods in general, more vegetables -

no one can stay on it forever and when he eventually goes off - all the weight will be right back. [/quote]

You’re right of course. But, that’s a tough line to walk with an adult, and especially a spouse.  My spouse supports me by cooking healthy food I can eat (winter is a lot of low sodium tomato or chicken brother based soups, with chicken or turkey (or ground chicken/turkey), veggies, and/ or beans. Chicken broth with ground turkey, cannellini beans and kale this week.  A Tbsp or so of fresh shaved Parmesan and yummy.  Summer was smoothies and salads with protein). He also is great about sticking to restaurants where there are some items on the menu I know I can eat.  Mostly— we do get tacos one Friday night a month. But, as long as I listen to my body and keep the portions small, I’m fine. And, by mentioning every couple of weeks that— “wow.  Your legs are getting really toned.  I can tell you’ve been working out.”  And “I feel like I’m holding a completely different person” and “that shirt is really loose on you. I think you’ve lost another size,” I feel seen and supported.

If I was getting the side eye every time I took a bite of less healthy food, it would just piss me off— and not top me from eating it.  Plus, he had 20 pounds to lose and some not great labs. So, he went to my weight loss center with me to work with a dietician on that, without using meds.

I will say that I still struggled with appetite and cravings on the .25 and .5 doses. By 1.0, if I was eating more than a couple for bites of some of your husband’s “cheat foods,” my GI system made sure I regretted it. And sweet and salty highly processed food just stopped tasting good.  So, his ability to eat those foods or their appeal may still wane. People expect magic on the first 2 doses, but they are more meant to get your system used to the meds and are less effective than higher doses. They also do tend to wear off midweek.

If he’s doing insurance, they will want to see a certain percentage of weight loss in the first 5-6 months to renew the PA.  So, his MD should be telling him after 3 months that if he doesn’t pick up the weight loss, he will “fail” the medication. And more and more insurances require proof of “lifestyle changes”. — seeing a dietician, taking a fitness class, joining a gym, Fitbit steps— something.  So either he will get it together or not.

If you are paying out of pocket and aren’t wealthy enough for that money to be a drop in the bucket, I think it’s reasonable to have a discussion where you say “we’re sacrificing elsewhere to afford this medication. I’m glad to do that for your health, but, we cannot afford this medication forever.  So, I’m asking you to ….”  Don’t say stop eating junk. He may not understand that he needs a lot of protein, but I’m sure he knows chips and gummy bears aren’t on any diet plan.  Instead, ask him to go to a licensed dietitian every month at first, then every 2-3 (should be covered by insurance and most will ask him to start log food) and/or start an exercise program. Focus on maximizing the benefits of an expensive med, and not he is eating foods he shouldn’t.  Those are reasonable asks if you are shelling out hundreds of dollars for the medication.

And, if you can, be like my amazing DH.   Go with him to the dietician at first— because most of us can use a tweak to our diet, even if we aren’t overweight. And cook/ buy food that comply with his diet plan (if he wants dips, he needs to go buy them).  Exercise with him sometimes. And make sure he knows that you notice that his pants of loose or that he is building muscle or that he needs a smaller shirt.

Marriage can be tricky. Losing weight can be emotionally charged. I know I respond better to positive reinforcement than negative comments. Then again, because I know this, I’ve set it up so I’m accountable to someone besides DH, so he isn’t in the position of being the nagger.  If I’m losing to much muscle or cheating on meals, my MD or dietician calls me on it.  So DH doesn’t have too.

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