In the past I would have shrugged this off as just another weight-loss trend. But as the universe would have it, GLP-1s becoming so mainstream perfectly aligned with me entering perimenopause—and facing a demoralizing stalemate with my weight. At annual physicals from my teens through 30s, I fell exactly in the middle of the “healthy weight for height” green zone on the doctor’s wall chart. Maintaining my size wasn’t effortless, but it wasn’t too hard either. I love to work out, enjoy vegetables and fish, and am not big into red meat or fast food. Whenever my jeans started to feel snug, I could fit in some extra runs and cut back on snacking, eating sweets, and going out for dinners and drinks.
At least that used to be the case. My mom warned me that in her 40s, she all but stopped being able to lose weight. I nodded along, but my inner obnoxious teenager (who only Mom can summon) was secretly smug and skeptical. Surely, she’d never worked out as much as I do, and weight lifting wasn’t even a thing most women did when she was my age. I’d managed to fit back into my prepregnancy clothes after having three kids. Middle age wouldn’t claim my taut midsection; I wouldn’t let it.
Yet here I am, eating my words. My mom was right. Over the past few years, as my hormones have gone rogue, so has my weight. And nothing—I mean nothing—will move the needle back down. From my tried-and-true tactics (getting 10,000 daily steps, running, doing Pilates, not snacking after dinner) to emerging advice (lifting heavier weights, eating all the protein), each fresh burst of motivation only leaves me more deflated. Occasionally, I’ll make subtle progress, only to have a stressful week or brief holiday indulgence undo it all—plus a few pounds. For the first time ever, my weight now teeters at the tippy, tippy top of that green zone. I miss my defined waist, and my closet is bursting with clothes that now fit completely wrong.
In this vulnerable place I’ve let the social media ads and photos of ever-slimmer acquaintances creep into my consciousness. I began to wonder where people who are not taking GLP-1s for medical reasons get them. Are they trusting for-profit telehealth providers? Is there a better way? Should I ask my primary care doctor for her thoughts? Would she laugh or, worse, scold me? I decided I was only comfortable starting a potential medication journey in her office. But first, I needed to know what I was even asking for.
The Wild West of off-label GLP-1 use
I started by going straight to the source: peers in a similar life phase who’ve used GLP-1s to lose 10 or 15 pounds. I figured they’d be reluctant to spill the tea, but when I posted on Facebook, promising to alter people’s names for anonymity, the DMs started pinging in at a rapid pace. It turns out that, yes, as you may have suspected, lots of people are using GLP-1s. I learned that there seem to be two main ways people who don’t meet the FDA criteria are getting the drugs.
