5 Critical Steps to Make Weight-Loss Results Last

Have you considered taking one of the popular weight-loss drugs like Ozempic, but you’re worried about weight regain once you stop taking the drug? Listen up! I’ve got some tips that will help you avoid some of the dreaded side effects and get the best results from using these medications.

While I always recommend a diet and lifestyle approach to weight loss, the bottom line is this: if you are weight-loss resistant, these solutions could give you the edge you need to finally move the needle. However, the last thing you want to do is lose precious metabolism-supporting muscle.

One of the downsides to using a drug like Ozempic is that it may prompt equal amounts of muscle and fat loss. Even though you see the number on the scale drop, your fat-to-muscle ratio may actually move in the wrong direction. Without adequate muscle on your body, you will have a lowered metabolism and a harder time keeping your body from storing fat once you stop taking the drug.

In this episode, I’m going to give you the exact strategies you need to put in place—whether or not you are using Ozempic—to increase your muscle mass, hold on to your skeletal muscle, and rev up your metabolism so that you can achieve lasting weight loss results and an ideal body composition for the long term.


00:01:28 – How semaglutide weight loss drugs work and side effects
00:02:08 – Muscle mass loss and your metabolism
00:06:40 – Using a DEXA scan to understand body composition
00:07:20 – Using a bioimpedance scale
00:08:05 – Using a tape measure to track fat loss
00:08:43 – How to use resistance training to hold on to muscle
00:10:16 – Using diet to achieve fat loss
00:13:15 – How the gut microbiome affects body composition
00:16:40 – Preventing dehydration with weight loss drugs
00:18:44 – Supplements that are helpful

Resources Mentioned in this episode

A body composition scale will help you track your muscle to fat ratio while you are losing weight.

I recommend the Carbon app to make sure your protein intake is optimal.

Staying hydrated while losing weight is critical, and I recommend restoring electrolyte levels with ElectroReplenish

Creatine monohydrate can be a game changer while building muscle mass.

Boost mitochondrial health and increase muscle strength with Timeline Mitopure

Support blood sugar balance with Designs for Health Berber-Evail.

Click Here To Read Transcript

Episode 552 YT Coming Off Ozempic for Weight Loss – STOP Weight Regain By Doing THIS
[00:00:00] I am JJ Virgin, PhD Dropout. Sorry, mom, turn four time New York Times bestselling author. Yes, I'm a certified nutrition specialist, fitness Hall of Famer, and I speak at health conferences and trainings around the globe. But I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as [00:00:25] many people as I can, and that's why I created the Well Beyond 40 podcast.
To synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode we'll talk about what's working in the world of wellness, from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right [00:00:50] now and have the energy to play full out at 100.
If you're considering or you're on one of the weight loss drugs like Rugo V or Azek, or Muja, this video is for you. I'm gonna outline what you need to do to avoid the rebound weight, regain and muscle mass loss. Oh. And [00:01:15] the dreaded ozempic face that you've heard about, these are these known side effects of these drugs.
Now, if you're wondering if these drugs are right for you, check out my video link below on what you need to know before you go on these drugs. So these drugs work by helping you tame your appetite and balance your blood sugar. That sounds great, right? And the bottom line is, if you are weight loss resistant, these drugs could give you that [00:01:40] edge that you need, however, The last thing you want to do is lose a lot of precious metabolism, supporting muscle, or gain the weight right back when you go off of them.
See, the drug costs a lot, but. Let's be honest, these side effects are gonna cost you way more than that in the long term. Now, fortunately, there's some specific simple diet and lifestyle strategies that you can do that [00:02:05] can minimize these effects. So first thing I wanna do is address the issue of muscle mass loss.
And why this is such a devastating blow to your metabolism, and then what you can do to minimize it. Now, I love Dr. Peter Atia, the Drive podcast, and he said that Ozempic may prompt equal muscle to fat loss. That means that even though you see the number on that scale, drop your fat [00:02:30] to muscle percentage is sky rocket.
In an Instagram story, he noted that some muscle losses, of course, always expected in weight loss patients, but drugs like Ozempic can exacerbate the issue. So here's the deal. Let's pull this whole thing apart. When you're losing weight, you're always going to lose a little fat-free mass. So your body, just so you understand this, your body is made up.
Fat [00:02:55] and fat-free mass. Fat-free mass is everything but fat. So fat-free mass is gonna be your bones, your organs, and your muscles, both your smooth and your skeletal muscles. It's also gonna be all the things that support all of that. So, When you lose fat, you'll never just lose fat because you also have some things that are just supporting the fat.
Remember, fat is alive, but that's only like 3%, [00:03:20] 3%. Like if you lost 10 pounds of fat, you would only lose like 0.3 of a pound. Of that supporting the fat. So what we wanna do is we're losing weight, is we wanna minimize the amount of fat-free mass we lose and we wanna really hold onto, or better yet, we wanna build skeletal muscle.
And here is why muscle. And these are said very carefully cause I want you to be able to remember them right. Muscle [00:03:45] is your metabolic spank. What does that mean? That means it's gonna hold everything in tighter, by the way, you know, if you're worried about I'm gonna lift weights and get bigger, it doesn't happen.
You lift weights, it holds everything in tighter muscle, requires more energy to be on your body because muscles constantly in this breaking down and building up, breaking beyond and building up. It's very energetic. So that is why it's metabolic spans. It's gonna give you a better [00:04:10] metabolic rate. That's how many calories you burn, right?
But it's also a sugar. This means that it gives a place for carbohydrates in the diet to go rather than get stored on your butt or your thighs or your belly as fat. And along with being a sugar spine, it is the first place that you can start to restore insulin sensitivity. When your body is better at hearing insulin, [00:04:35] then it's gonna have better blood sugar control.
One of the things that these weight loss drugs do is these weight loss drugs help you have better blood sugar control. So resistance training is one of the ways that we can do this. One of the things that can happen when you go on a diet is that you'll start to lose muscle, right? You'll lose muscle and you'll lose fat.
Here's why this is a problem, and I actually talk about [00:05:00] this in another YouTube video where I talk about weight rebound, and it was all based on a study that looked at the biggest losers six years. And the deal is, is if you lose muscle fat, you are gonna have this thing called metabolic adaption After the diet, this is where your resting metabolic rate is lower than it was before the diet.
This is always gonna happen. What you don't wanna have happen is have it be lower than it should. So we have a [00:05:25] predicted resting metabolic rate that should be based on our body composition. But what can happen here is if you lose more muscle, it'll be even lower than it should be, which means that it's gonna be a lot harder to maintain that weight because now you can eat even less calories.
And in fact, one study showed that people who had stopped using semaglutide gained back on average. Two-thirds of [00:05:50] the weight that they lost on that drug within one year. So think about this though, if all of a sudden you are losing fat and muscle and then gaining back mainly fat, can you see how that's really going to disrupt your.
Whole metabolic rate because losing muscle and then gaining back fat means you're never gonna get that metabolic rate back up to where it was. So that is the really key, important thing here is we [00:06:15] wanna make sure as we're going through this, that we are holding onto our building muscle. Right. We are minimizing any of that muscle loss and you wanna make sure that you don't gain the weight back and especially you don't gain that weight back as fat because again, if you do that now you're worse off than before you went on the drug.
Okay? So, The question I hope that you're asking right now is, how do I avoid this? And I'm so glad that you asked this [00:06:40] because it doesn't have to be this way if you put the right diet and exercise parameters in place. But here's what it has to start with. It has to start with information. The first thing you're gonna want to do is ideally go get a DEXA scan.
Now a DEXA scan traditionally has been used for bone density, and we go in and find how your bones are doing right, but it can do so much more than that. A DEXA scan can actually go in and it can look at how much muscle you have, [00:07:05] how much skeletal muscle you have, where that skeletal muscle is like, are your arms and leg, E legs even.
It can also look at your visceral adipose tissue and your overall body fat. In the perfect world, you get a dxa. If you can't do that or for ongoing measurements, you're gonna wanna get a bioimpedance scale for home. And a bioimpedance scale sends a little wave up through your body so it can check the resistance to the wave to identify how much of your body is [00:07:30] fat free mass.
Versus fat. Now, these scales now can predict how much of that skeletal muscle and how much of the fat is actually the visceral adipose tissue. So ideally, get one of the scales that really breaks everything down for you. Now, the scale is predictive. It's not, it's not an absolute, right? The only way to know this for sure would be to do a cadaver dissection in that.
It kind of negates the whole purpose of this. However, if you're doing the same thing every day, it's going to give you really [00:07:55] good relative change, and that's what we're looking for. That's what you're gonna wanna monitor. So you're gonna wanna get a bioimpedance scale, and you're gonna want to use Aate measure around your waist and around your hips, because if you lose weight without losing your waist, you're making yourself worse, not better.
And I want you to vigilantly monitor your fat-free mass, and especially your skeletal muscle. Here's. We can only lose two pounds of fat a week basically, [00:08:20] and we have a little bit of fat-free mass supporting that. So realistically, we wanna really make sure that we are focused on holding onto and building muscle as we're losing fat, which might mean that your weight is changing much more slowly, but you're improving your body composition and that is everything.
Okay. So, One key part of this is that you're gonna need to do resistance training and minimally [00:08:45] you're gonna need to move each major body part. Two days a week three would be better. Let me walk you through those. So we have upper body pushing, upper body pulling, and hip and thigh hinging. So upper body pushing this involves your chest.
Your shoulders, front of your shoulders, top of your shoulders, your trapezius and your triceps, right? Pushing exercises, things [00:09:10] like a pushup, a chest press, an overhead press are simple things that you could do. And by the way, those are simple things that you could do at home. Yay. Next ones are upper body pulling.
That would be things like a pull up or a bent over row, things that involve your bicep, your lats, and the back of your shoulders, hip and thigh, hinging. Things like a squat, a step up, or a dead lift. [00:09:35] Now here's the thing. In order for you to build. You have to go to near failure. So the ideal range is gonna be somewhere in the eight to 15 rep range and doing multiple sets.
And I also explained this in another video, which we'll, we'll link to below, but if you can't lift heavy. If you're afraid of injuries, work with a trainer ideally. But what you can do is you can do longer sets, like 20 to [00:10:00] 30 repetitions, and then you could use blood flow restriction cuffs so that you still get that failure.
So there's always a way to do this, but it is mission critical to have that muscle to help maintain or build muscle and help with tidy and blood sugar. Let's talk about. So these drugs work to mimic what peptides produced in the gut do to help with satiety and blood sugar balance. Now we can do that with diet and [00:10:25] we need to focus on some gut microbiome rehab too, because these peptides are produced in the gut.
Your gut's all messed up. Gonna have trouble producing it. So first, let's talk about satiety and blood sugar. Now I like to say protein. And your ideal amount of protein is gonna be based on what your target body weight is. Basically, you're gonna want your daily range to be somewhere between [00:10:50] 0.7 to one gram per pound.
Target body weight, I put your minimum daily dose of protein at about a hundred grams and your minimum dose per meal at 30 grams. The reason I've done this is you want to get about three grams of leucine with your protein and most of these protein sources. Come with leucine, right? Especially high quality animal protein, but also pee and soy do [00:11:15] too.
So if you're not intolerant, and it's the leucine that's going to trigger muscle protein synthesis by triggering something called mTOR and muscle protein synthesis is what we need to go through to build that muscle. So with your protein, we're gonna want to choose lean, healthy sources. So that would be like, uh, a lean grass-fed, grass-finished filet Turkey, pastured chicken.
[00:11:40] And if you're not intolerant, eggs and eggs, whites, if you're not intolerant, whey protein, um, if you are intolerant, bone broth protein, pea protein. So look for some great lean sources of these. And what I want you to. Is, I want you to start tracking this and you might say, oh, I can't eat that much protein.
Here's what's super awesome about protein. Yes, you can. Let's just start to add it in. It's three meals a day. Put it in between those three [00:12:05] and start to track it in, in that carbon app to make sure that you get the protein. So that app, again, I like is called Carbon. Check it out on the app store and start to input so you really make sure that you're getting what you need.
Cause remember what you measure and monitor, you improve. So we're checking your body composition. We're also gonna make sure that you get your macros right. Specifically, we're really looking at protein, but when we think about both blood sugar and satiety, let's talk about [00:12:30] how you can really help trigger that because we know that protein and fiber can really help stabilize blood.
Right. And we know that when you eat protein first and you also add fiber, especially from things like non-starchy vegetables and some healthy fat, maybe you put some extra virgin olive oil on that salad, right? That the protein and fiber slow down stomach, empty help you feel fuller longer, and the fat triggers or release of those [00:12:55] peptides in the small intestine to tell your brain that you are full.
And that's what we want our body to naturally. Super duper important. So I teach people, eat your protein first, then make sure that you are getting in your fiber first from non-starchy vegetables, and this is where you want to eat from the rainbow. And here is why. And you are doing this to feed your gut microbiome.
That is the key mission critical [00:13:20] thing. So you want different types of fibers, prebiotic fibers, resistance, starch. So you want different fibers and you want different colors cuz they represent different plant nutrients, different polyphenols. They all have different impacts on your gut microbiome, and we're rehabbing your gut microbiome here, so it works well so that as you start to taper off of these drugs, your own gut can start to produce what it needs to produce to tell you that you are full.
By the way, [00:13:45] what's super interesting about your gut microbiome, 70% of it is made up of these two bacteria bact and FCUs. Now, if you've. A bunch of ties. You will also be someone who is higher body fat if you've got a bunch of bsis, helps you burn fat. So your status, your gut microbiome is really important, not just for your immune system, not just for your nutrient absorption, not just for your mood, but also [00:14:10] helping with your body composition.
Super important. I also throw in. To do those five plus servings of non-starchy vegetables, a cup of raw, half cup of cooked, and then also two servings of fruit a day. And when I say fruit, it's fresh or frozen. It's not juiced. It's not dried, okay? It's not turned into a syrup. Those are all candy, just two pieces of fruit a day.
So that might be an apple. Blueberries, right? [00:14:35] Get your diversity in. It's really easy to get into a food rut with your veggies. Ask me how I. Okay. But I have been working through that, and so you want to try to get as many different things as possible. And this is where a little bit of frozen can work great too, because they've been frozen at the peak.
So you know, if you travel a lot, make sure you always keep some frozen veggies, frozen fruit at your house so that you've always got something. All right. Lots of diversity there. Super duper important. Now the [00:15:00] third thing here is healthy fats. If you're eating fish four times a week, which I hope you are right, you're going to get some healthy fats.
If you're making those smoothies, like I make smoothies and might throw in some fresher ground flax seed meal, a little avocado or a little coconut, you're getting some healthy fats in there. If you're making your vegetables, maybe you're using some extra virgin olive oil, maybe some gi, so likely you're probably getting a lot of the fat you already need and you won't need [00:15:25] much more.
But if you do use the whole fats first, things like avocados, nuts and seeds, but again, track all of this to make sure that you're getting what you need in. Since you won't really have much of an appetite. We gotta really make sure we're getting in that protein, we're getting in those vegetables. We're getting in those two fruits with a little bit of healthy fat.
And if you need to divide it over four meals, just make sure you're eating within a 10 to 12 hour. But track, track, [00:15:50] track. And if you have to do a green drink with some extra fiber in it, like throwing in, like doing a great green drink like my girlfriend, Dr. Anna Becca's, mighty Maka, and then throwing in some extra fiber or some cheer or flax beans, you can do that too if you can't quite get all those vegetables in.
We gotta get the greens, we gotta get the diversity, the polyphenols and the fiber in there to get that gut rehab going. Okay. And also, here's what's cool, all of that, the [00:16:15] protein, the fiber, and those phyto. Give you great detox support as well. So repairing this is gonna help you with your appetite and fat burning after you taper off again.
What I'm looking at here is really getting the things in place that we need to so that when you taper that you don't end up. With that weight regain. That is like my sole goal here. Now, one more thing that [00:16:40] happens with these drugs is dehydration. Now hydration is a huge, huge deal. First of all, we need to be hydrated to detoxify well, and by the way, you're losing body fat when you start to burn body fat.
Guess what? You are gonna need to detoxify Well, because toxin store in. And as your body starts to liberate fat, if your body [00:17:05] can't detoxify well, those toxins are now running around. In your system that is not good. What do you need to detoxify? Well, you need number one protein because it's what carries toxins outta the body.
You need those greens and plants because those help you free up the toxins as well, and you need the fiber and then you need water as well. I tell people, a, you wanna have [00:17:30] at least half your body weight in water. A day in ounces, half your body weight. And by the way, it doesn't just have to be water. It can be green tea, it can be some black coffee, but at least half your body weight.
If you're sweating a lot, working out a lot, you'll want a little bit more. But here's why this is important beyond just detox support and beyond. Now that we know that these drugs. Can impact and only only, you're not hungry, you're not thirsty. We already don't have a good thirst mechanism, so we gotta really focus track [00:17:55] your water just like you're tracking your macros.
But here's the thing, if you are mildly dehydrated, number one, it's gonna slow down your metabolism. And then also, It actually makes you store fat. Here's the wild thing that happens when you're mildly dehydrated. Besides what it does with raising cortisol and lowering metabolism, cuz just, you know, when you drink water, you actually boost your metabolism a little bit.
But what happens when we're mildly dehydrated is [00:18:20] our body actually starts to make fructose from our glucose and stored as fat. That's the last thing you wanna have. When you're in this situation, so make sure that you stay hydrated, make a commitment on that. And what I've been doing is using is recommending doing some electrolytes as well.
So I have a drink called Electro Replenish that I love and I would say one serving of that a day. Now let's talk about some other [00:18:45] supplements that can really help here as well. So you need a good found. Supplement a daily multivitamin, mineral antioxidant, essential fatty acid formula to make sure you're coving all your bases since your calories are going down.
Right? We get our nutrients first from food, and then we supplement with supplements to make sure we're optimized. So I have a daily essential packets, one of those a day. Here's another thing that I want you to take. Creatine monohydrate, super [00:19:10] important here. So creatine monohydrate can help you. They've done studies in two different areas.
Used to be like you only heard, Body builders, but so much interesting research is now coming out to help people avoid sarcopenia that is losing muscle as we age. This is what we wanna avoid here, sarcopenia. So creatine, the general dosing. And by the way, if you're more plant-based, you definitely need this.
If [00:19:35] you're a woman, you definitely need it. We're like 70 to 80% less creatine than men, but the general dosing is three to five grams. Bigger person, five grams, little a person, three grams. Now what you need to do is take it every single day because you have to keep your tissue saturated. To get to tissue saturation, you'll wanna take five grams four times a day for five to seven days, cuz that will help you get to that tissue saturation.
And [00:20:00] then you just maintain it by taking it every day. So that's creatine, monohydrate. Another one that I love is Mito Pure from Timeline Nutrition. This is called Lyth A. They've done a ton of research on this. This is something that we should make from our gut microbiome, but only about 30 to 40% of us do that, and that's, we have a really well-functioning gut microbiome too, but that's a genetic thing.
If we can make the oli from different [00:20:25] foods like pomegranate, I take it every day. It's shown in a study like what it does is it helps our muscles clean out the gunk so that we can become stronger. And in fact, a study showed a 21% increase in muscle strength in just six weeks using Mi Toure. So I will also put the link to that down below.
Now another one that I love, and this one we may wanna look [00:20:50] at as you're coming off of it, but this is the A product called Bur. And the one I like is from Designs for Health. It's called Burber Avail, but Burberine can lower the blood sugar response to a meal. So hopefully as you're going through this medication, it's actually improving because you're doing the resistance training and you've got your diet dialed, you're improving your insulin sensitivity.
But if you do see that you have any issues with your blood sugar, burberine for the when, also some apple cider [00:21:15] vinegar, and this is a great time to use a continuous glucose monitor to help you really see what's. On. So I really like having all of this in place now because here's the deal. What we are doing is getting your body ready so that you'll be primed and you'll know exactly what to do as you taper off the medication.
Right? So you gotta be tracking your macros. You gotta track your body composition so that when you [00:21:40] do come off of this, you maintain and continue to improve on your results. Again, I look at these drugs and I go, if you've been weight loss resistance, if you're just stuck, if you're insulin resistant, nothing's moving.
This could give you the edge you want, but I wanna make darn sure that you don't get worse from it because of these rebound effects. Now measuring and monitoring your macros, Works best when you have [00:22:05] a solid strength building plan. So if you're over 40 and you wanna make the most of your gym time, you're gonna wanna learn how to optimize your body composition.
So watch this next video where I discuss exactly how to do that. Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great, and more importantly that you're built to last. And check me out on [00:22:30] Instagram, Facebook. And my website, jj virgin.com.
And make sure to follow my podcast so you don't miss a single [email protected]. See you next time.

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