A client of ours took some time off from training here and returned after several years away.
When she came back, she mentioned that she had been on a GLP-1 to help with fat loss.
I asked her how everything was going on the medication.
“It’s been life changing.” she said.
And she added: “Now I know how skinny people feel.”
“What do you mean by that?” I asked.
“It never dawned on me until I got on the medication, that I didn’t need to finish my plate.”
I’ve never forgotten that conversation.
I’ve been in a smaller body all of my life.
Some people think it’s because I never eat “junk food” but that’s not true.
Some people think it’s because I spend a lot of time working out or counting every calorie that goes into my mouth but neither of those is true.
There’s a term that been coming up more frequently over the last several years that I want to highlight and that term is “dysregulated appetite.”
And the easiest way for me to explain it is to think of it like a signal.
For someone who has struggled with their weight for most of their life, they may eat a meal that “should” satisfy them and allow the gut to send a signal to the brain that the body is satiated and eating can cease.
But the signal isn’t clear.
It’s distorted or delayed or compounded with other sensations in the body so that this person continues eating even though they “should” be reducing their portions to help with fat loss.
In my case, and I’ll only speak for my lived experience, those satiety signals are often very clear.
For example, yesterday I went out to lunch with my mother and my oldest son, Jackson.
I wasn’t overly hungry but I also didn’t want a heavy meal like burgers and fries or pasta.
So I ordered a flatbread pepperoni pizza that came off the appetizer menu.
When it arrived, it was sliced into 8 pieces, and according to the menu, each slice was approximately 130 calories.
I made it about halfway through and I already knew I wasn’t going to be able to finish it.
Sure enough, I left two slices behind, which my son was more than happy to finish for me.
That signal, in my case, was letting me know that if I kept up the eating, I would go quickly from satisfied to uncomfortably full.
And this is pretty normal for me.
I wasn’t saving those extra pieces because I was concerned about calories. I was saving them because I really don’t like feeling uncomfortably full.
But for someone whose signal is less clear, they keep eating not directly because of discipline or willpower (although they play a role), rather the signal isn’t firing loudly enough to get them to stop.
Fullness means something different to them.
Satisfaction from a meal means something different to them.
Stress, trauma, grief, personal relationship to food, and our relationship to our body image all play a role in how we respond to our appetite.
And in the case of my returning client, and the many people who’ve had similar results on a GLP-1, the medications can make living with a dysregulated appetite much easier.
No, the medications may not “teach” someone how to reverse the dysregulations but they can make other health promoting actions a lot easier in consideration of the big picture.
(Photo courtesy of Emanuel Ekstrom)









