Deep Dive: GLP-1s || A Special Bonus Episode from More Personal

This is a bonus episode from my premium podcast, More Personal, where we lean into the personal side of personal development. In today's episode, I'm taking you on a deep dive into the world of GLP-1 medications. I'll share my personal journey from skepticism to understanding, exploring how these drugs are reshaping the conversation around weight, health, and body image.

Together we’ll uncover the complexities, benefits, and controversies of these medications. Get ready to challenge your perceptions and deepen your knowledge in this compelling first episode of our Deep Dive series on GLP-1s.

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TRANSCRIPT 

Monica Packer: Hi, I am Monica Packer with About Progress. What you are about to hear is a special preview of my private premium, always ad free podcast, more personal, where I lean into the personal side of personal development. I don't normally air an episode from more personal to the about progress feeds, so soon after airing get originally on more personal, but I'm doing that today.

One, because this is the deepest deep dive I've ever done. It required literal months of work, hours and hours of time from researching to reading, to interviewing people, to preparing the episode. And two, because it's a really hot topic right now, and it's GLP ones. I had really strong opinions when I began researching for this deep dive way back in the fall of 2024, but they changed throughout my research and they're still evolving.

As you'll hear in the episode this is the first of what is a two part episode series.

And even then, I only shared 30 minutes of this first episode as there's a whole other hour where I share interviews of two women and their experiences with GLP ones. And I just thought it would be best to keep that private on more personal for them. 

But the second episode, part two just aired this past week on more personal. So if you want access to the whole hour that's left of the preview, you will be hearing today as well as the full second episode, you can get both right away by signing up for the Supporters Club at the bestie or ride or die level.

Those levels are the ones that get access to more personal. you can do so at about progress.com/support. More personal is where we have a lot of fun. We also get to be more informal and even delve into topics that may be a little bit scarier to share on the public feed. Now, I'm gonna be honest, I'm doing that today in ways that are a little scary,

but I hope as you listen to this episode, you'll be able to hear that my goal with deep dives are always to learn primarily and then to share what I'm learning, not to preach my opinions, not to be 100% certain about my own.

And with that spirit, I share that episode with you today. Again, this is just the first episode of a two-part episode series. To get access to more personal sign up as a bestie or ride or die member of the Supporters Club at about progress.com/support,

one more quick thing. More personals always ad free, but since we are airing this on a Monday episode for the main feed about progress, there will be ads in this version. 

Welcome to More Personal, where we lean into the personal side of personal development. I'm Monica Packer, and today's feature is the Deep Dive we take on a deep but brief breakdown of a hot personal development topic, history persona, or something adjacent.

While this episode isn't meant to be a complete synopsis of what I'll cover today, it will definitely get you thinking and likely talking about what you're thinking. Let's set the scene of what we are diving deeply into today. I am a teenager at my local orthodontist, the one that most of the small town goes to waiting to be seen so my braces can be tightened. My home growing up didn't often carry celebrity or fashion magazines, so I am rifling through a few with a level of adolescent eagerness that would likely embarrass me. Now, page after page and image after image, I see beautiful, famous women known for their gorgeous hair, fine features, and tiny bodies.

In fact, they're also tiny, that you can see their bones clearly through their skin. Their sternums and clavicles jutting out like prizes to be coveted. Nobody had to say a thing. No article had to spell it out. No person had to look me in the eye and preach to me, but I got it. The message was loud and clear.

Frail is in. As a woman who lived through an American girlhood of heroin chic, I celebrated how the culture seemed to shift in my late twenties to thirties to one more of body positivity where we, as women, were allowed, encouraged, even to embrace different body types and push against the prescriptions of what the ideal woman looks like.

It was refreshing as it was healing of the younger me who took those magazine messages to heart. But it wasn't just the magazines and the celebrities that had pushed me to idolize thinness. It was a shared obsession from my family to my friends, to my faith, to seek smallness almost at any cost.

It was unavoidable to have been affected by it. Almost a foregone conclusion for any young woman from the eighties to early aughts to have disordered eating and body dysmorphia. The culture shift in my adulthood came at a pivotal moment for me. I was several years into my recovery from multiple eating disorders.

Ones all started with good intentions. Ones all secreted away into private while simultaneously being praised by the public for my incredible self-control and svelte physique. When at 28 years old, my newly acquired social media feeds began to feature women celebrating their curves, resisting the cultural norms that had so long bound us, I too celebrated.

I celebrated for the gift. It was to be more okay with myself, my body. And I also celebrated for a different world. I had longed to raise my daughter in one that cared more about what was inside a woman's brain than how her body looked.

Fast forward to 2021 when I heard the first whispers of a new drug called Ozempic, a GLP one medication. Originally catered to those with type two diabetes, but now being packaged under a new name and slated for weight loss, a tracked byproduct experienced by the original patients under Ozempic Care.

At first, I thought that it would be like the other weight loss pills and shots that have popped up throughout my lifetime, like Fenden, Metformin, Orlistat, among countless others. It would be declared safe and effective, swell in popularity, but then fall dramatically thanks to either ineffectiveness or major side effects, or both unapproved by the FDA and then pulled from the shelves.

I easily brushed it off and went on my body positivity way, but the whispers grew louder by 2023, it seemed like at least one podcast or news article in my daily lineup had Ozempic, wegovy, Manjaro, or Z bound in the title. Unlike my home growing up, I do regularly read celebrity magazines and sites, and I couldn't help but noticed that the movie stars, singers, and influencers were looking more and more like the bobblehead figures of my youth adult sized heads on pubescent bodies.

At the time, I myself was 36 and a half years old, 37 years old, and recovering from childbirth and doing the dance, every postpartum woman taps through of trying desperately to make peace with my now unrecognizable body and to instead seek to focus on my recovery and taking care of my newborn while my first four children basically replicated each experience in terms of weight gain before and then loss after birth.

Monica Packer: This one was different. And for no single reason I could point to beyond my now advanced maternal age. I did my best to be healthy, to move my body, to feed it nourishing foods, to not pay too much attention to how I looked and my clothes that were still tighter than they used to be. But I found it surprisingly jarring to be struggling so mightily with how my now bigger body impacted my self-worth.

And this after years and years of working so very hard on detaching those two things. While my first instinct was to dismiss the weight loss drugs when ads from her and other online prescription sites appeared constantly on videos from my favorite YouTube channels, I surprised myself one day with a thought.

I wonder how easy it would be to get that. I knew the answer was simple, stupid, easy. All I would have to do was fudge my weight and symptoms a bit, and I could trick any online service into giving me their form of a GLP one, even if I didn't technically qualify as overweight or obese. I. That thought stunned me, but not as much as the people in my life who were so clearly taking some form of GLP one from women at church who were suddenly, drastically slimmer to women in my extended family who looked like walking skeletons with boobs.

It was that last one in 2024 that broke my waves of frustration into a full fledged tsunami. I felt so very angry. I knew and loved one woman in my life in particular. I was personally familiar with the eating disorders of her youth and young adult years that had evolved to now decades of super clean eating and near constant exercise.

Monica Packer: Her body was always fit and toned. But never met her exacting skinny standards when I saw her after a month break. It was undeniable to me that she was on a GLP one. She carried the now classic signs completely hollowed out cheeks, almost no muscle tone.

The bobblehead, the wrist width upper arms. I knew in that moment that a GLP one had enabled her to be the anorexic she had always sought to be, but couldn't. It felt like watching someone slowly choose to die in front of my face. It was then that I sat down and wrote the first draft of this deep dive one matching the scathing rage.

I felt deep inside. Towards her and how she could do this to herself, but mostly to society, to wellness culture, and even to health professionals and pharmaceutical companies making a profit over yet another way to make women hate and hurt themselves. I shared a little preview to my Instagram stories of this potential deep dive, and I was immediately flooded with dms.

Stories and stories of women who are witnessing the living deaths of other women they loved, but also stories from women who were and are still on the drugs themselves, and how they carried a different perspective, one that challenged my initial hot take. The openness and courage of these women in sharing their sides made me pause.

After all, I am a woman with thin privilege while I've been up and down with the scale over my lifetime. And I've never had a model body outside of my anorexic days, and I'm not totally secure in how I look and see where the pockets of fat and things I don't like about myself are so very readily. And I've also battled multiple eating disorders from orthorexia to bingeing.

The truth is I've never naturally lived in a larger body. I've never had a hard time fitting into a seat on an airplane, nor spent years yo-yoing with one diet after another. A pattern that could ultimately stymie my metabolism to a near glacier pace. I've never been judged as lazy, thanks to my size, nor experience effects of extra weight on my health.

From infertility to lessened mobility, to PCOS, to pre and type two diabetes. While my initial rage writing felt cathartic, I knew logically it was the fear side of me coming out. And however justified and in some ways, accurate anger isn't and wasn't a great way to understand something, especially over a drug that isn't going anywhere anytime soon.

So I chose to do a better, deeper, more objective deep dive instead, and for myself, what are these drugs? Why do people use them and what effects are they having both on health and the culture at large? This is the deep dive I will begin to share with you today.

It departs from my past deep dives where I spend most of the time being more neutral, saving my own takeaways for the end. Instead, what you'll hear today is more personal. It's my own journey to try to understand and then to form opinions about GLP one drugs. I'll walk you through the same path I took from listening to people's experiences, to reading literal books on the topic, to interviewing medical and health professionals on their takes, and ultimately to share where I'm at now with the way I view these drugs.

Spoiler alert, it's complicated. Maybe it goes without saying, but there are triggers ahead. From eating disorders to words like obesity. So take care if those types of topics and even words are tricky for you. I make no promises that this deep dive series is extensive or exhaustive. That's what writing books and going to medical school are for, but it has and will be done in good faith and with a great deal of research that is well past Google searches or neighborly gossip sessions.

 This is a two episode series. While you'll hear from experts in the second episode, that will air later this month or next month. I am not one nor pretend to be so take what you hear from my deep dive and make your own.

Talk to your doctor. Get lots of education. Gather personal experiences from people you know who have used them, and then you can decide for yourself if GLP ones are the best invention of our time, or in some ways, the beginning of the end of who we are as humans. If you're like me, it will be something in between.

Part one, Oprah and the obesity epidemic  

I was disgusted by what I was seeing. Oprah advertising an hour long special on weight loss called shame, blame, and the weight loss revolution. I am a long time fan of Oprah Winfrey. Her decades of work have largely impacted my life for the better. But if there was one criticism I would have of her, it's her insecurity around her weight.

As a woman who is so evolved, intelligent and powerful, how could and can she still be hung up on a part of her that isn't who she actually is? So I was disappointed when she was honest about her GLP one use in 20 23, 1 of the few celebrities to be open about doing so By the way. And I was even more annoyed to see a full special, basically acting as an hour long advertisement of these drugs.

So I did not watch the special in real time, nor did I watch the three hour special that aired months later called Making the Shift. But as part of my own personal deep dive, I did, I watched both. And for the record, you can do so as well. You can watch the first special on Hulu and the three hour special on YouTube. Hi everybody. I wanted to do this special for the more than 100 million people in the United States.

And the over 1 billion people around the world who are living with obesity. Maybe that's you, or maybe it's somebody you love. And I do thank you all for joining us here. In my lifetime, I never dreamed that we would be talking about medicines that are providing hope for people like me who have struggled for years with being overweight or with obesity.

So I come to this conversation in the hope that we can start releasing the stigma and the shame and the judgment to stop shaming other people. For being overweight or how they choose to lose or not lose weight, and more importantly, to stop shaming ourselves. I have to say that I took on the shame that the world gave to me for 25 years making fun of my weight was national sport.

And I'll never forget a day in 1990, I saw myself on the cover of TV Guides Best and Worst Dress List. And I remember thinking at first, oh look, there I am on the cover. And then I read the headline that Mr. Blackwell, the taste maker of the time, called me Bumpy. Lumpy and downright dumpy. I was ridiculed on every late night talk show for 25 years and tabloid covers for 25 years.

Here are just a few of the thousands of headlines written about me, Oprah Fatter than ever. Oprah hits 246 pounds final showdown with Steadman censor into feeding frenzy, Oprah Warn Diet or die. So in an effort to combat all the shame. I starved myself for nearly five months and then wheeled out that wagon of fat that the internet will never let me forget.

And after losing 67 pounds on liquid diet, the next day y'all, the very next day, I started to gain it back. Feeling the shame of fighting a losing battle with weight is a story all too familiar. I know for many of you and also for my first guests, I want you to meet Amy. I lost 160 pounds and I posted a before and after photo on TikTok, and people seem to have connected with it.

You would not recognize the person I am now to the person I was a year ago. The hour long special begins with Oprah's own story on a lifetime of public shaming she endured for her weight. She then shares other stories of women and even a teenage girl who felt like their brains and bodies were wired differently than most.

Oprah details how GLP one drugs have helped her and so many like her to get their lives back because they got their brains back. Medical obesity experts appeared too, sharing why people biologically struggle with their weight in ways that defy convention and stereotype. Dr. W Scott Butch has been studying the disease of obesity for nearly two decades. For six years, he has been the director of obesity medicine in the Bariatric and Metabolic Institute at Cleveland Clinic. Your weight has been stable. It's come up a little bit here. But I think that's the difficulty.

Obesity D is a complex disease. There's many inputs from genetics to environment. The food environments change. We're not sleeping as much. Our microbiome is changing, maybe due to that changed process food. What we've learned through science is that the brain controls our body fat and our food intake and our metabolism.

So it regulates how much body fat we have in our body. And how big those fat cells are. Obesity is a dysfunction of that regulatory system that's supposed to control our body fat in a specific range. So when you lose weight, your body will intentionally slow your metabolism down. It'll intentionally make you more hungry.

All in an attempt to get back to where it used to be. The body is built to maintain our weight, our adipose tissue, our body fat, and some people are more prone to holding on to their fat. They have a higher weight set point. So people who are dieting are basically trying to restrict their caloric intake.

'cause that's what we've been told. Almost trying to hold their breath under water. And what do we see when that happens? We have to come up for air. Our body is gonna make us unable to continue to lose weight, and we will naturally go back to where we previously were. These experts also break down why these GLP one drugs work. Dr. Amanda Velazquez is an assistant professor of medicine in surgery and the director of obesity medicine at the Center for Weight Management and Metabolic Health at Cedar-Sinai Medical Center in Los Angeles.

There are seven medications that are FDA approved for weight management currently to treat individuals with obesity. There's the newer agents like GLP ones. These medications are a new era for the treatment of obesity. GLP one stands for glucagon-like peptide hormone. It is a hormone that every human has in their body, and it's produced by our gastrointestinal tract.

The hormone is working to communicate with our brain, our gut, and other parts of the human body that are important organs in weight regulation like the pancreas and fat cells. When someone takes a GLP one receptor agonist or a GLP one medication, it is essentially. Copying what our normal GLP one hormone does in our body, but doing it a little bit better.

What that means is it's working on the brain to help with reducing food noise. It's working directly on the gut to slow the digestion so that you're gonna be noticing that you're feeling satiety faster. Because right now we know from the science that individuals living with obesity, their GLP one is not working the way it should.

And so now we're enhancing that by taking the medication. And so it allows for it to basically do the lock and key situation where you have a hormone that is the key and the receptor, which is the lock, and allowing it to bind to different organs, to reprogram it. Essentially, we're seeing double the amount of weight loss you can achieve with this class of medications compared to what we've had in our toolbox for the last several decades.

In combination, of course, with a healthy lifestyle.

Watching that first hour long special had a different effect on me than I initially expected. I still felt angry about what these drugs are doing to unwind the still fresh progress made in allowing even the possibility that women don't need to all look the same. I also felt like the special glossed over

the potential severe side effects people are reporting having with these medications.

In addition to how these drugs can aid eating disorders like anorexia. Not to mention yak our culture back 30 years, but in some ways I felt an and coming up in my mind. These drugs reinforce that smaller is better, can be abused, carry the potential for major side effects are being prescribed by health professionals without proper oversight are potentially damaging the body positivity, movement, and shaping perceptions for all people, including young girls and obesity as a disease.

For some, to many people who are overweight, a disease like alcoholism, that is very misunderstood, if not outright dismissed. A disease that has impacted some people throughout their lives in ways that have only perpetuated the cycle of ineffective yo-yo dieting and further self-blaming and shaming to go with it.

The biggest and for me was this, I am incredibly wary of these drugs and who am I to say that Nobody should be using them ever before watching this special. I thought I knew what it was like to struggle with obsessing over food. For my young adolescent years, I tracked what I ate, starting out with good intentions to be healthy, but also falling for the culture's pressures at the time that healthy equated skinny.

The tracking and then the eventual restrictions of what I was taught were unhealthy foods, quickly became both compulsive and obsessive. Constant management of my food and my body lived rent-free in my head for my entire teenage years. When those patterns of disordered eating became full blown eating disorders in my early twenties, I felt like I could never, ever be removed from the constant fear and thinking around food.

My years of regimented eating reached a breaking point. My body, literally starving, needed food, and I thanks to having a body that can't throw up, couldn't purge in a typical way. So more exercise and more restriction, alternative bouts of uncontrollable eating, growing into patterns of thinking and behaving that controlled every moment of every day in ways that made me feel depressed, ashamed, desperate, and hopeless.

I thought about dying all the time and nearly gave into those thoughts in several terrifying moments. I am proud of myself every day for walking into my college counseling center and getting help. I was diagnosed with eating disorders, but in ways that even confused me. I thought I was a failed anorexic or bulimic, but my therapist kept using the words binge eating disorder among others.

This was something so unheard of at the time that even I wasn't totally convinced that it was in fact an eating disorder that maybe I simply lacked willpower, despite being lucky to have multiple therapists validate my binging at the disorder level. The shame lingered leading me to keep it a secret from every single person in my life.

Later, even my husband only vaguely understood that I was recovering from eating disorders, not knowing exactly which types I. Even when I began to be more open about my eating disorder history in my early thirties, it was still easiest to explain binge eating as non purging bulimia because people seemed to both better understand and validate it than the idea that someone who can't stop eating has an eating disorder.

I have long wondered if most people struggling with their weight are really eating disorder patients in disguise, not even knowing themselves, that their patterns of restriction and binging are more a disorder than lack of willpower. The internalized fat shaming, leading them to blame themselves more than their brains only increasing the patterns of behavior and eventual weight gain, and watching this special, that thought was validated.

For some too many obesity is actually a disease of the brain. So this sounds to me like I remember back in, you know, the late eighties, early nineties of the Oprah show, when we were talking about with experts, the idea of alcoholism being a disease. We had people saying mean things like just put the bottle down. There's no such thing as alcoholism being a disease.

Now, of course, we know differently. Alcoholism is a disease. For many people it is not a disease for everybody who is, uh, who drinks too much. And so I see this as the same that many people have. The disease of obesity, I. Everybody who is overweight does not have the disease of obesity. But if you have the disease of obesity, you're always gonna go back to that set point.

If you don't have it, then you can diet, lose weight, exercise, all of the things that we've heard over the years. Am I on the right track here? Absolutely. Are you all following this? Because if you're on track it, it means the rest of the world track, but there's a spectrum of obesity as well. It's not one disease.

It's many different subtypes of a disease. So it's complex, quite complex. And that's why it is so wrong to be shaming people because you don't understand the complex complexity of each person's situation. Yeah. And this, and I think as, as Amy said, this is just a reflection of someone's uneducated, uh, belief that this is just a self-inflicted condition.

As if people who wanna be, who have obesity, actually want to have obesity. It's looked at. These are weaker people who have no willpower. Yeah. Who can't cut it. That's right. And people who are thin can cut it. So let's talk about willpower. It's not a matter of willpower because as we just learned, people who perhaps are thin might never think about food the way people who have obesity. I was lucky to have remained healthy looking even at the peaks of my eating disorders. I wonder if I had many more decades of those behaviors and eventually lived in a larger body if I would've received the needed professional validation and help my patterns categorized under disordered eating.

Or would people and professionals alike have simply seen me and labeled me as lazy while my own disordered brain and body were eventually healed in ways that were painfully slow and took many years of work that were exhausting on every level. What if I hadn't been both validated and helped?

What if, thanks to the lack of support, my compulsive patterns of brain and body worsened and alongside them, the blame and shame of myself, that's what I felt like I was seeing in this special. While I wasn't suddenly all gung ho for GLP ones being the answer, I found myself more open to finding out if it could be for some people.

I also realized that my initial hell fire and damnation reaction to these weight loss drugs was skipping over the fact that overweight to obese women, especially, are placed in an impossible position. Society's standards of smallness have in many ways led to us being bigger than ever, but women who experience that are damned if they do, damned if they don't.

They are judged for their size, but also judged if they get medicated help in restoring their health. Either way, they are shamed for not having enough willpower. This exhaustion was further validated by Oprah's three hour follow up special called Making the Shift, where she speaks to a whole variety of women for body positivity, experts to celebrities, to doctors, to women in the audience about what it looks and feels like to be a woman in this modern age.

And always, always defined by the way we look. Each woman had a different take and a different solution. But the bigger answer was true for all. Maybe just maybe we as women can stop the infighting over what any woman chooses to do in response to a lifetime of pressure to be small. Whether that's to boldly claim more space, being loud and proud of living in a bigger body.

Or to take on measures drug aided or not to have an easier life in a smaller frame. I too realized that I couldn't judge any woman for doing what she needed to do to survive. To solidify that, I knew I had to talk to real women who were willingly choosing the latter to use GLP ones to take back their brains and their bodies.

Part two, two real women and their experiences with GLP ones. 

We are all likely familiar with the negative side effects people have experienced on GLP one drugs, GI issues, constant nausea, the significant loss to muscle mass, and even bone composition. I think of my friends elderly mother who had to be taken to the ER due to drug aided malnutrition. I also think of the ER doctor you will hear from in the next episode of the series.

Who has seen Pancreas's permanently destroyed thanks to these drugs? We all know of the people who don't need these medications that are abusing them from influencers who just wanted to lose the last of their baby weight and now look like 11 year olds, two literal 11 year olds being hospitalized for drug aided anorexia.

But what about the women who quantifiably need these drugs, who have been well informed and properly cared for with medical supervision, and have overall been happy with their experience and grateful for these medications? Thanks to my single side preview of my initial rage writing session on Ozempic, I had the opportunity to connect with two women in particular who were ready and willing to share their perspective with me and with all of you./  

This is where the preview of my first episode in the two part episode series is coming to an end, and I really think you need to listen to this full episode. These two women were so brave and willing to share about their own experiences and listening to their stories of both why they got onto the drugs and how they've helped them, and also how it's not so.

Black and white for them either. That's what really began to shape how I currently feel about GLP ones, and it made me step away from my fear bound certainty I had and to be more open about it, but still very cautious. I. And in the second episode,

That just came out last week.

 , you will be hearing me interview three professionals on this, in addition to sharing my where I'm at now.

Thoughts and those professionals include an ER doctor, a nutritionist slash dietician, and a dietician slash therapist who works with eating disorder recovery patients. And they have different opinions each one of them, but they also have a lot more research that. Of course back up where they're at with it.

And, uh, I think it's gonna be really informative. Not only for me, of course, but hopefully for you. Again, this is all in the spirit of just sharing about something that is really common. These drugs aren't going anywhere, and I'm sure you are grappling over your own thoughts on them. And you have people in your life who are taking them, and perhaps you are concerning it yourself.

And, uh. Getting the full episode of Part One and the Full Part Two episode , you'll get a clearer and deeper picture on what's going on , as well as my own thoughts too. So join the Supporters Club at the bestie or Ride or die levels to get access by going to about progress.com/support.

And as a reminder, the Supporters Club is what keeps about progress's Lights on this work would not be possible without it. The supporters make my work here with about progress free and available for all. So I encourage you to become one. Now's a great time. Go to about progress.com/support and remember, you can always support the show for free.

Simply share this episode with someone who you know would need it. Leave a rating and review. Make sure you subscribed. And really importantly, right now, if you can go and subscribe on YouTube and watch our videos there of the episodes, that would be really helpful right now. Thank you so much for listening.

Now go and do something with what you learned. Today.