I Started a GLP-1 and I'm Ready to Talk About It

The controversy around these medications has been intense. I think we may be having the wrong conversation.

Sep 03, 2025

black and white measuring tape — Photo by Samuel Ramos on Unsplash

This post will discuss weight loss, body image, eating disorders, and obesity. Feel free to skip if that will be triggering for you, and please consult a medical professional before starting any medication regimen. And if you are here to heap shame upon me for using a medication, I’d kindly ask you to actually read the thing.

ETA (9/5/2025) - Fat shaming, harassment, and medical information will not be tolerated under any circumstances. If you have an opinion that is prescriptive (i.e. “these drugs are dangerous”), be prepared to back that up with evidence. And no, I don’t mean like RFK Jr. evidence. I mean like actual scientific studies and/or articles. My Substack is meant to hold a space for discussion and debate, but not for anti-science garbage. I will block at will.

As you can see from the title of this post, I started taking Zepbound. So, now I am on not one, but TWO medications (the other being Adderall) that people think they know everything about, but don’t. What can I say, I’m a controversial bitch.

For background, I was offered weight loss medication (Wegovy) by my doctor at my physical in October 2024. Despite having lost ten pounds of the forty I gained over the COVID pandemic, I was still considered obese.1

I had to think about it, which surprised me. If you had told me twenty years ago that I could take a medication that would make me lose weight, I would have jumped for joy. I am, after all, an X-ennial forged in the fires of heroin chic, Slim Fast, and Deal-a-Meal. But when I was faced with doing it, I felt really torn. Did I want to lose weight? Sure. Most of us do, and I have stopped feeling bad about that. I’m not a feminist failure because of it.

But my blood work was fine, save for borderline high cholesterol, which I have always had. I had cut down on drinking and sugar. I was exercising consistently. Other than my MCAS (more on that in a second), I was a relatively healthy woman. Not only that, my ADHD symptoms were finally under control. I felt stable for the first time in my life.

I had also been trying to deprogram myself from the Millennial Diet Culture that plagued women of my generation. I had a binge eating disorder for years, and had tried every diet under the sun. I have issues with “body positivity” (forcing emotions on people about their own bodies is toxic as hell IMO), but I was aiming for “body neutrality”. Developing a consistent yoga practice gave me a new relationship with my body, and I no longer owned a scale. I was no longer tracking calories or trying new diets. I nourished myself as I saw fit. My ADHD treatment helped enormously with the binge eating. I wrote about that journey a couple of years ago, so I will repost it here to save some time.

Insatiable

Kari Bentley-Quinn

November 2, 2023

Read full story

After a lot of thinking, I turned the Wegovy down. I didn’t want to throw a new medication in the mix. I didn’t want to risk destabilizing myself after finally feeling solid ground beneath me. I was also concerned about the side effects. I wasn’t worried that anything life threatening would happen, but I hate being nauseated more than just about anything, and I have a real phobia about vomiting. My doctor said we could revisit any time we wanted, and left it there.

It felt empowering to reject it. I felt like I had finally gotten to a place with my body I had always hoped I could be.

But, as usual, life had other plans for me.

After the election in the US, my old habits showed up to the party.

I wasn’t binge eating, certainly not like I used to, but I was making not-so-great choices. It was all I could do just to manage to do what was asked of me, let alone watch my diet. It felt like nothing mattered. The asshole in the Oval gets away with everything, why can’t I eat nachos and two mezcal Margaritas for dinner?

By the spring, I had started to reign my diet in. However, the stress had caused my MCAS to flare something wicked. When I have an MCAS flare, my body is wracked with inflammation for days. I experience joint pain, bloating, fatigue, gastrointestinal problems, hives, and flushing. I had also started having hot flashes, night sweats, and insomnia (thanks, perimenopause!). My Xolair injections were no longer working as well, and I refused to do another elimination diet. I went back to taking daily antihistamines, which causes —you guessed it—bloating and weight gain.

I knew I had gained back the ten pounds I had lost. I could tell because my face changes and my proportions are off2. I suspected that a lot of this was bloat from the inflammation and the antihistamines. I just refused to lose weight the “old fashioned way” again. I refused to deprive myself and be hungry all the time and work out like a demon, only to wind up gaining it back.

I wasn’t all that upset about the weight gain, to be honest. I was more upset about being sick again. I started to react to more foods. So, I took to the internet to see what the latest and greatest on MCAS was. Maybe there was a new treatment I didn’t know about.

In my search, I came across this study. A 56 year old woman with an extensive history of MCAS reported a complete abatement of her MCAS symptoms after using a GLP-1. I read more about the relationship between mast cells and obesity, and learned that adipose tissue (aka fat) increases the amount of mast cells in your body, leading your body to release more histamine, which increases inflammation and allergic reactions.

I went to my allergist with this information at my next appointment. I was told that, anecdotally, their patients on GLP-1s were seeing a reduction in symptoms. I then consulted my shrink, my therapist, and friends I knew who had taken these medications. They all told me that I had nothing to lose by trying it. What if it made things easier? What if I didn’t always have to do things the hard way?

I made an appointment with my GP to discuss it. She did say she would need my current weight (vs. a full in-person appointment to get weighed in front of strangers), so I bought a scale, as much as I hated to do so. Turns out I gained more than 12 pounds since November, which was not a surprise.

She told me that she would rather prescribe me Zepbound over Wegovy, since it was more effective and known to have fewer side effects, and had recently been approved by the FDA to treat obesity. Zepbound (which is also marketed as Monjauro for diabetics) contains not only a GLP-1 (found in Ozempic/Wegovy), but also something called GIP (glucose-dependent insulinotropic polypeptide). The role of GIP is not only to help blood sugar regulation, but to make the body more efficient in reducing fat and preventing fat accumulation, and helps reduce the side effects. There’s a lot more to it than that, but those are the Cliff’s Notes.

I couldn’t ignore how much more difficult it was now that I’m in my mid 40s to drag extra weight around. I exercise a fair amount. I do cycling (indoor and outdoor) at least 3 times a week, HIIT, weight training, and yoga. My joints are starting to take the brunt of it, and I could feel twinges in my knees where there weren’t any before.

This is where I am going to be really honest, because that’s what I do on this Substack.

The weight I gained over the pandemic was more than just normal life change weight. It is weight that reminds me of getting blackout drunk in my own house and eating entire bags of Doritos. It is weight that reminds me of listening to the agonal breathing of my dying mother-in-law in the next room. It is weight that reminds me of being terrified that everyone I love was going to die. It is weight that reminds me of how bad my ADHD got before my diagnosis, and how I was borderline suicidal (not because of my weight, but because my life felt unbearable). Every time I look in the mirror, I see the pain that got me here.

I don’t want to carry that weight anymore – in my soul OR in my body.

I agreed to give Zepbound a try.

The day I did my first injection of 2.5 mg3, I was shocked by how quickly it worked. Not only was I not hungry, there wasn’t even anything I wished I could eat. It was a little scary, because that is not how I operate. Eating anything was a struggle. My mouth wouldn’t chew as fast, even if I wanted to. It was an odd sensation. On top of that, I felt like I had a minor flu. Fatigue, aches, and all I wanted to do was sleep.

This caused some minor anhedonia, and a small amount of fear. Was I never going to want to eat ever again? Who am I if I’m not passionate about food and wine? What if this saps my ability to like anything? I spiraled a little. I even got a little bit dysregulated. But I reminded myself that any big change comes with some big feelings, and recognized that I needed to be patient.

As the week went on, it got better. We went out one night and I ordered sushi — one of my MCAS trigger foods — because it was the only thing that sounded good to me. I was loving anything cold, fresh, and protein packed. It was absolutely delicious. But when I was full, I just….stopped eating. I did not have an MCAS reaction to it, either. No hives, no canker sores, no joint pain, no waking up at 3 am with the dreaded histamine spike. Nothing. Normally, all Japanese food makes me flare no matter what, which is why I only eat it on special occasions after taking two Pepcid and a Xyzal.

After a couple of weeks, I gave these meds the biggest test yet: the Queens Night Market. This market has over 100 vendors, with every kind of food from any country you can imagine. Ordinarily, this would have given me anxiety. When presented with that much food and variety, I can easily go overboard. To my delight, I tried 4-5 different items, a couple of bites of each. Everything tasted amazing. And then I was….done. I also let myself get a hard seltzer, and wound up dumping out half of it. I just didn’t want the rest. WHAT IS THIS SORCERY?

Other than fatigue, mood stuff, mild constipation, and a bit of dizziness, I haven’t had any of the bad side effects (yet). I have not even come close to vomiting, which is a huge relief, since I hate throwing up so much.

Instead of dwelling on negatives, I will focus on the positives:

I am down about 13 pounds, which is roughly 2 lbs a week. It looks like a hell of a lot more, since I am not bloated. It’s most noticeable in my legs and my face.
My MCAS symptoms are pretty much gone. I have not had to take antihistamines since after the first week. I am delighted by this.
Those perimenopause symptoms? Hot flashes? Night sweats? Brain fog? Not happening anymore.
I am sleeping better, my resting heart rate is lower, and I have energy in the morning.
Working out is easier because I am not fatigued and bloated all the time.
I have A glass of wine, maybe two on a weekend. I enjoy it, and then I am done.
I just look better. Not because I am smaller, but because I am not puffy from inflammation and exhausted from crap sleep.
My ADHD symptoms are a lot better, and my meds last longer. I feel more clear and focused than I have in a long time.

While I’m not mad at the weight loss, it’s the other things that are keeping me going. Not being sick all the time feels like being let out of prison.

There is a lot of debate about GLP-1 drugs, and not all of it is in good faith.

For the record, I do not entirely disagree with some of the arguments against GLP-1s. That doesn’t mean I agree with them, either. The issues are societal, legal, financial, cultural, and medical. In short: it’s complicated. But here I am hoping to find new ways to have a big conversation.

I’m just a girl, standing in front of the internet, begging for some nuance.

Here are the most common arguments against GLP-1s, and I will share with you what I have learned from my extensive reading (when I hyperfixate, I DO IT, okay?).

“GLP-1s will exacerbate disordered eating and body dysmorphia!”

This is a complicated debate, but from what I have read, I think it could potentially help people with eating disorders. All eating disorders have one huge thing in common — compulsive behavior. GLP-1s are being studied for treating compulsive behaviors.

According to the Stanford Report:

Early studies suggest that GLP-1s may be effective in treating opioid, alcohol, and nicotine addiction. In one small study of patients with opioid use disorder, a GLP-1 medication reduced their cravings for opioids by 40% over three weeks. Another study found that people with opioid or alcohol use disorder who took GLP-1s had a 40% lower rate of opioid overdose and a 50% lower rate of alcohol intoxication than people who weren’t on the medications.

I am in recovery from an eating disorder. On this medication, I eat to fuel myself, but I still eat for pleasure. I eat, I fully enjoy what I eat, and I stop when I have had enough. I don’t think about food all the time, certainly not the way I used to. I don’t start thinking about dinner right after I’ve finished lunch.

In short: I no longer obsess about food, which drove a huge part of my binging. The same goes for alcohol, which I have struggled with on and off for most of my adult life. I can still enjoy a glass of red wine with my dinner, and leave it there.

So, maybe it will make these things worse. But maybe, just maybe, it could make those things better.

“Taking a GLP-1 is cheating, and the best way to lose weight is to do it The Right Way”

Jesus tapdancing Christ, I think I hate this one the most.

This medication does NOT replace nutrition and exercise. If you don’t put in the work of making better choices, you’re not going to improve your overall health. You may lose weight at first just from eating less, but long term, you need to change your habits. This drug is a tool to help me do that, just like Adderall is a tool to help me manage my ADHD. Tools are not cures, nor do they mean you don’t have to put in some work.

But there’s something more important here.

These six weeks have shown me that the entire concept of “willpower” is BULLSHIT.

Under current models of weight loss/”wellness”, the only solution is becoming obsessive about everything you eat, and completely abstaining from things like alcohol. And then, unless you spend the rest of your natural life fighting with your brain not to pick up the bottle/Cheetos/what have you, you are a moral failure.4

It isn’t moral. It’s chemical. GLP-1’s are being studied for addiction treatment because not only do they regulate your appetite and your blood sugar, they also stimulate your brain to release more dopamine. You feel fuller after eating a smaller meal, but you also feel satisfied. Most of the drive to overeat comes from dysregulated blood sugar and/or dysregulated dopamine, both of which these drugs address.

40% of Americans are obese, and up to 70% are overweight. There is something bigger at play than “calories in, calories out” or how many minutes you log on the treadmill. It could be environmental, it could be genetic, it could be what is in our food supply, it could be our lifestyle, it could be a lot of things.

Either way, it isn’t our fault, nor is it within our control. Stop talking about the “right way”. There is no “right way” when our actual biology is working against us, not only when it comes to our weight, but our overall mental and physical health.

“These drugs are brand new, not studied enough, and we don’t know the long-term implications.”

This is mostly false. While long term studies on the newer classes of these drugs (like Ozempic, etc) are still pending, the idea that these drugs are “brand new” and “not studied” is a myth.

GLP-1 was first discovered within the intestines in 1986 – nearly 40 years ago – as not just a byproduct of the digestive system, but as an active hormone. In 1987, scientists discovered that GLP-1 could stimulate insulin release, and only when blood sugar levels were high. This began more than a decade of research and development.

Most people are not aware of this, but GLP-1s have been on the market for more than twenty years now. The first GLP-1 approved by the FDA for treatment of Type 2 diabetes was called Byetta (exenatide), and that was in 2005. The first GLP-1 specifically for weight loss was called Saxenda, which was approved by the FDA in 2014. The newer drugs we see today are improvements on these original formulations.

So, no, these medications did not come out of nowhere. They are not inherently unsafe, and in some cases have been used for decades. In some cases, they are used as preventative care. These medications may prevent Alzheimers. There are preliminary studies saying that it can prevent some cancers, including breast cancer. It reduces the risk of heart disease, high blood pressure, and liver disease. If you suffer from MCAS, as I do, a study was released in July that showed that 89% of participants experienced a reduction in their symptoms.

That’s a hell of a lot more than a “weight loss” drug.

“Telemedicine companies and companies like Weight Watchers are irresponsibly prescribing this medication.”

Again, yes and no.

While I do not have an issue with the concept of telemedicine — I think it’s made health care more accessible, not less — I DO have an issue with the fact that there is no mental health support included when you get these medications. I was surprised by some of the Big Feelings that came up, and I have a regular therapist and a psychiatrist.5

With some telemedicine companies, there is an option to buy the medication from compounding pharmacies and measure out your own injections. This can lead to accidental overdose (you really don’t want to do that), and you can’t guarantee these compounded medications don’t have ingredients that the patient can’t tolerate.

I will always argue for more access, more affordability, more support and more education when it comes to any medical treatment. Unfortunately, given who is currently in charge of the nation’s health, I am not sure these problems will be resolved. Certainly not any time soon.

Proceed with caution, and realize that the way capitalism functions in this country, people are going to find ways to profit off of something popular.

“Don’t you remember Phen-Phen??!?! Diet pills? Those weren’t safe either!”

Diet pills are made with caffeine and/or amphetamines. GLP-1s are not remotely the same class of drug.

NEXT.

“The side effects are terrible!!”

In some cases, they can be. It depends on a lot of variables – the dosage, the starting weight of the patient, pre-existing conditions, and what you put in your body. If you do your first injection and then eat fried food, well, plan to spend some time in the bathroom.

The most talked about reports of adverse effects are coming from accidental overdose. As I mentioned, getting the medication in vials and/or from compounding pharmacies means that a patient with relatively little medical experience is expected to measure dose, and inject correctly. This has led to some very unpleasant experiences, but not fatal ones. While no one wants to spend any time in the ER with severe nausea and vomiting, or spend a few days in the hospital getting flushed out with an IV, an accidental overdose is not the fault of the drug.

There are some reports of things like gallstones, pancreatitis, etc. More often than not, this is because of pre-existing conditions, losing weight too fast (which is why you need a doctor to monitor your progress), drinking too much alcohol, etc.

There are some people who cannot tolerate these medications. If the side effects are too severe, any doctor worth their salt will lower the dosage or take the patient off entirely. If you take this outside of medical supervision, that is at your own risk. For what it’s worth, my side effects have been minimal. Some people have none at all.

As I was writing the initial draft of this article, Serena Williams announced that she was using a GLP-1, and celebrated her 30 pound weight loss. There was a lot of ink spilled on this, so I’ll link to

Mikala Jamison

’s fantastic response instead of recapping any of it, except to say that I generally do not care for the views of the actress who was once on a TV show starring Ted Danson.

Body Type

Here's a Serena Williams GLP-1 thing, goddammit

Body Type is a place for helpful guides to feeling better in and about your body + body culture essays like this one with over 82,000 views. If you throw me 96 cents a week for an annual subscription, you’ll get access to everything. Thanks…

2 months ago · 80 likes · 9 comments · Mikala Jamison

The reaction to all of this ranged from “reasonable” to “batshit”. The idea that an elite athlete would be frustrated over not being able to lose weight — weight that affects their literal job — is not weird and should not be controversial.

Moreover, this insistence that she was “shrinking herself” to be “skinny” is distorted. Who the hell could look at Serena and call her “skinny”??? Is she fit as hell? Yes. But she is not a “skinny” woman. No one with that much muscle can be called “skinny”, FFS. Even if I lose all the weight I gained, I will never be “skinny”. It’s not how I am built. Also, maybe we shouldn’t be using “skinny” as a pejorative, if we’re truly not into body shaming.

But this isn’t about “skinny” or “fat”. It’s about us.

After 30 years of battling with society’s opinion of fat people, body shaming, and surviving the era of low-rise jeans, I have some complicated feelings around weight and body image. I am sure that this brings up complicated feelings in a lot of us, for a variety of valid reasons, especially if you live in a larger body. And that is completely understandable.

But your feelings are not facts. And your feelings should not control health care for other people, nor should it prevent you from seeking medical treatment if you need it. If you aren’t happy where you are, or your health is suffering, I do not want you to think that any of your advocacy means less because you decide to take this medication.

I come back to one of the OG tenets of feminism:

OUR BODIES, OUR CHOICE.

I beg of you, do not sacrifice bodily autonomy at the altar of outrage. That is exactly what our current administration wants us to do. They already banned abortion in multiple states (based mostly on icky feelings), they have decimated care for transgender people (also based mostly on icky feelings) and now they are trying to ban mRNA vaccines. Who’s to say that they won’t try it with these medications, as well? The more we conflate our emotions with science, the more we legitimize their views.

It is okay to have mixed feelings. It is valid to wonder if this complicates the body acceptance we have been working towards. It is reasonable to worry about safety and efficacy. It is understandable to be concerned about things like Skinny Tok and advertising.

It is not okay to shame, blame, and insist that people using these medications have no handle on what is and isn’t good for their own body.

A few days ago, I had a lovely dinner with a dear friend of mine, one I was nervous to tell about my medication adventure. She had expressed some Strong Feelings about GLP-1s in a conversation we had earlier in the year. My weight loss is noticeable, though, so there was no avoiding it.

In between bites of a truffle pasta we split at our favorite Italian place (so delicious!!), she said, “I know a lot more people on these meds now. My cousin, who works in a hospital, is also on it. I realized that my problems with it were just my own shit about my weight and my body”.

This is why we are friends. I’m a big fan of people who can admit they were projecting or revise a strongly held opinion. I think the world would be a better place if we did more of that.

It was a beautiful night, the conversation was flowing, the weather was perfect, and I was truly enjoying myself. I had no anxiety about what I was eating or drinking. I wasn’t thinking about the calories in the pasta, or if I would order too much wine, or if I overdid it on the bread. My body was making all those decisions for me.

And the best part — I knew I was probably not going to have an MCAS flare. I didn’t realize that I was carrying another kind of weight that comes with a chronic illness — which is constant hyper-vigilance and fear around everything you eat.

I may have to stay on these medications for the rest of my life, and I’m fine with that. I feel better than I have in a very long time. I offer this not as an endorsement of medication, but as a vote of confidence that people (especially women!) should be trusted to make decisions about their own body.

I deserve to feel better. And so do you.

I support whatever choice you make to get there. I’d only ask that you do the same.

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