For those of you who have been to my clinic, you know that I am a stickler about making sure we have calorie restriction.... to a point. This afterall, is how we loose weight: burning more calories than we take in. I strongly believe that GLP-1 receptor agonists are a helpful tool to control hunger while we learn better portion control and healthier food options. BUT, you can restrict calories to a point that it is ultimately unhealthy. For some clients, GLP-1ra can be so powerful, that they allow the patient to go all day without feeling hungry. Ultimately, this is a sign that the dose is too high and should be adjusted! Too much calorie restriction can result in nutritional deficits that destroy the organs and cause illness or death. Lets look at clinical anorexia for example, I have seen patients with anorexia restrict calories to 300-900 calories per day. But sustaining the diet at this level of intake over time is absolutely asking for trouble. We recognize this easily among a patient population with an eating disorder. BUT- do we recognize the same issue when the caloric restriction is the result of too much medication?? Creating an caloric intake and state of anorexia in a person desiring weight loss, is no more healthy than the eating disorder itself. Any provider offering weight loss services, should be doing more than prescribing a GLP-1 receptor agonist. If they are not monitoring for sign of excessive caloric restriction (and some don't) they could be putting patients at risk

If you are a patient undergoing treatment for weight loss, be honest and forthcoming with your provider about your appetite and your caloric intake. If they are not monitoring this for safety- find a resource that will! Be patient, SLOW AND SUSTAINABLE is the goal!