Moving Along

I'm feeling kind of at loose ends at the moment - waiting for things to happen. They start happening next week! But right now, I'm filling time with chores.

The good news is, I've really been feeling a lot more energetic recently. I've motivated myself by scheduling things to happen, and I'm out there doing things to clear the decks so when they do (happen), I'll be able to take advantage. So chores and more chores it is - gardening and house, mostly. But I'm getting things done that have literally sat on a list for years. Trivial things, not major improvements, but things that I notice or that make a little difference in each day. So some feeling of satisfaction from that.

And more satisfaction from the fact I am clearly stronger than a year ago. It's obvious in my weight workouts. It's also showing up in the activity stats my watch collects. So far this year, my average steps are higher than the previous three years. That makes them the highest since my counted steps fell off a cliff at the end of 2022. (Why did they fall off a cliff? I went back and looked - I think I decided to let my knees determine how much I moved overall. The knee operation was in November 2023 - and I spent much of the year waiting for it.)

The less good news includes my knees - both of them - are hurting more than a little. Not so that I can't walk, just enough for me to feel them every time I climb stairs. But I've decided not to allow them to limit me so much. I'm squatting and lunging and stair climbing away. And walking and standing. My doctor has assured me that I will not damage the knees by using them, and I choose to believe him. And really, they usually feel at their worst when I start an activity, and feel no worse, or even better, as I move along.

More less good news is that my weight loss has slowed or stalled. I weigh every day I'm home, and the weight jumps around a lot each day: down .4 pounds, then up .8, then down .3, then down another .1, then up .2 .... Pop quiz: did I lose weight or not? Picking a trend out is not so easy - I have to use averages, step back and squint. Are any of the numbers the lowest I've seen this year? That's a positive sign! But then up 2.4 pounds the very next day! I won't stop the daily stepping on the scale, but I'm only rarely spending any time figuring out what that means for the trend.

I am spending that time right now, because I'm coming up on the time to order my next four weeks of meds. Is it time to increase the dosage? I'm definitely having more food thoughts, a change from a few weeks ago when I was more gliding along. So continuing to look at the weight data is important, but so is assessing how much effort I'm putting into managing my food. I liked when it seemed more easy and natural to make the right choices.

So I'll continue to monitor for the next few days. Unless I have a big whoosh of a loss in the next week (usually heralded by peeing my brains out), I'm going to request the next higher dosage. The good news is, that will give me two weeks to get used to that higher dosage (5.0) before I go away on vacation. The internet has many horror stories of side effects - I don't take them all seriously. But someone pointed out that this first step increase is the only time the dosage is literally doubled. Each additional increase is another 2.5 mg, but  it's a smaller percentage increase. 

To make me feel better, here is the big picture - my weight as an adult:

Each horizontal line is 10 pounds. The red line is where I stabilized before. 
The blue line is my goal weight in previous weight loss efforts.

 

I'm back down to the pre-intuitive-eating weight, before I decided "Fuck It, I'm just eating". Yay! And on this scale, you can't really tell that the slope has tapered off in the last month. So I really like this picture.

 

 

May Check-in

Me, in mixed white stripes on a sunny day.
It's important to have contrast, thus red shoes.
And for accessories, my black-and-white dog.

Today starts my 13th week on the weight loss meds. I started February 12. How am I doing? So far, so good! Things are going pretty well!

As of today, I've lost about 15 pounds. This is fuzzy, because I waffle on what my starting weight was. My weight is volatile on a daily basis. But since there is no official registry of my weight or weight loss, I have decided to measure from the single highest weight I have been this year, on January 24. That was right after my January vacation and about three weeks before I started the drug. But it's a choice that makes me feel good, because it shows today's numbers in the best light. And who am I accountable to for this? No-one, that is! So let's go with the feel-good choice!

Speaking of feelings, how do I feel overall? Pretty good, that's how! This is a big change from a couple of weeks ago. I got home from France having over-exerted myself and with a head cold, and felt crummy throughout the body a lot of the time. My internet buds tell me often the GLP-1 drugs lead to a decrease in arthritis swelling and pain, both for rheumatoid and osteo forms (I have osteo). But I felt crummy throughout my joints and muscles, all.

But that was two weeks ago! Now, I feel SO much better! What am I doing that might be helping this? 

- Prioritizing sleep. Rigorous go-to-bed times. On those occasions I'm awake in the middle of the night, tossing and turning, and I end up with less than six hours sleep, I take a nap. But that's happening less, the past couple of weeks. I've racked up some super slumber time.

- Prioritizing exercise. I've been doing a functional strength workout with a trainer twice a week for some time now, but I'm pushing myself harder and volunteering for heavier weights. And, significantly, I've added back a cardio component. I did this in February, then fell off the bandwagon in March and early April. On the trip, I was appalled at how out of shape I was for all the walking I did. So back onto a cardio machine four times a week now. It's for just 15 minutes right now, but I'm pushing my heart rate up high and keeping it there for most of the time. After three weeks of this, I'm able to keep up a much higher intensity for most of the ride. Nothing motivates me quite like actually seeing the improvement!

- Taking a supplement and a longer-term anti-inflammatory. For my frequent body pains, I take tylenol. I can't take ibuprofen because it ruined my stomach. Tylenol helps quickly with pain, but does nothing to change the underlying condition. But let's not discount dealing with the pain! I also had in my medicine cabinet from my knee doctor a vial of a prescription anti-inflammatory, Celebrex. It doesn't act quickly, but over time it is supposed to be very good at treating inflammation. I've got a couple of months supply on hand for daily consumption. In addition my doctor recommended, in an off-hand way, taking a supplement I'd never heard of, Co Q10. I still don't know what it does or how it does it, but I'm taking it daily. Of course I've googled it, but evidence on supplements is scarce and shaky. But it doesn't seem to be hurting me, at least.

Sleep, exercise, and tylenol make me feel better right away, and the first two also have longer-lasting positive impacts. But I'm not sure I'd stick with them without the immediate impact. I've always had a hard time believing in the impact of vitamins, supplements, and long-term remedies. You have to take them on faith, faith in the science and studies. But tracing how I feel right now to these longer term remedies is tenuous at best.

So I feel good right now! Yay! But I am suspicious, and I don't trust that this will continue. But I'm continuing with both the supplement and the drug, as an experiment. It's an experiment with a flawed design, since I changed a few things at once. But just in case it's making a difference, I'll continue for now. 

They say that 15 pounds is about a clothing size. The truth is, I was in denial about how heavy I was for the past year - I assumed I'd lose the weight in a week a or two. So I had bought very few clothes for my large size, and instead wore clothes that strained a bit. So now, those clothes are fitting much better! 

My wardrobe in retirement consists mostly of clothes in which I can hike, garden or sail. I have in my closet wedding/fancy clothes, but not much of nicer but not dressy clothes. When we went casual at work many years ago, I was wary of specific prescriptions of what constituted suitable clothes. I suggested a test: if, when you got home, you were going to mow the lawn, change the oil on your car, whip up a huge batch of floury bread from scratch, or hike a few miles on the Appalachian Trail, and you didn't feel a need to change from your office attire first, then your office attire was incorrect. Those very slightly nicer clothes are the ones I've been digging out of my closet and trying on. The picture at the top is an example. I'm still not sure I'm suited for white clothes, because my impulse to just drop to my knees outside and start pulling weeds is somewhat incompatible. I don't want to look like a fashion plate, but I'm trying to not look like I'm about to hike when all I'm doing is meeting someone for lunch.

Pre-Trip Musings and Tidbits

I'm in a whirlwind of chores to get ready to leave for France. But in the midst of all of this activity, I'm also in my first little stall in weight loss, eight weeks in. It's not really a stall until it's lasted for way way longer than this. At this point, it's only been a week. But I'm concerned, wondering what is up. Is it that the meds aren't working, and I should up my dose? Or is it that I'm not eating and behaving appropriately? How is this going to affect my trip? 

I went on weight loss meds because I want to create an environment where I can be successful at losing weight and maintaining a lower weight without a huge amount of mental or physical effort to always be focused on eating the right things. (By physical effort, I mean the logistics of buying and preparing food. I know I will always need physical effort to be strong. Exercise till the day I die, baby.) The Weight Watchers app is a great tool to guide and track my food choices, but I don't want it to be my most used phone app every single day!

In the last three weeks I've had a birthday and an unusual-for-me number of social engagements involving food. I've relaxed and eaten what I want, in the quantities that feel right to me in the moment. I'm not meticulously pre-planning every day in advance to make sure I'm going to hit my targets. Instead, I'm more going with the flow, mostly going to my go-to foods I know help get me where I want, but swapping things out as the mood takes me. I thought, "I've got this nailed! Easy-peasy!" Based on recent scale evidence, maybe I shouldn't (yet) trust myself this way. 

I've found that in restaurants, my choices and my portions are different than they would have been before the meds. Those things that would have appealed to me in the past, carb and fat laden, (Alfredo pastas, I'm looking at you!) don't appeal quite as much. Fat especially is off-putting to me. But that is when I really stop and reflect before ordering, and when eating. If I charge ahead without much thought, old habits are right there. I go to the old staples on the menu, and then regret it.  Portions are easier. I fill up more quickly, and unless I'm really wolfing something down with no pause, I will stop well before I'm done. 

I read an article recently (I'm not taking the time to go back and search where, but probably in a newspaper, and probably now I think about it, the Wall Street Journal). The article was speculating on how the new weight loss drugs would impact the food industry. There is actually a lot of speculation about how supermarkets might need to change, but this article wasn't buying it. The author notes how use of the GLP-1 drugs is very much NOT evenly spread through the population. So, looking at the supermarket shopping carts of those on the drug, healthier foods will be spotted than in the average American shopping cart. But, the author asserts, that is likely because those currently on the drugs are those who already eat healthier than normal, are more affluent, more likely to shop at farmer's markets and less likely to buy fast food. But as the drugs become cheaper and more wide spread in their use, the demographics of those taking them will change. If the major effect of the drugs is to re-calibrate hunger and fullness (the author speculates), perhaps the type of foods in folks' shopping carts will not change much. After all, his final well-put thought is, "half a Big Mac is still a Big Mac, it's not an apple". It is too soon, he says, to change over our food system to different types of food. I don't know if he's right, but he has a major point on the demographics. And, on still going for a Big Mac, even if you can't finish it.

So I'm going to be in France, well known for taking food seriously. And excellently. And using butter and cream in everything. On the other hand, I'll be on a river boat where three meals a day are provided. Perhaps the boat cuisine will not that great. I'm not wishing for that, oh no, not at all, just speculating. (The internet reviews tell me it'll be great.) I certainly will not be seeking out the best restaurants in every port of call, though if on-board croissants aren't up to snuff, I will absolutely seek those out elsewhere! I intend to deny myself nothing during the trip, because food is definitely part of the experience. But maybe I'll be able to have a few elegant and savored bites, and be done.  I'm also taking along some dried edamame and garbanzo bean snacks for travel days, and if I feel like I'm not getting enough protein or fiber.

Already, weeks ago, I resigned myself to having a bit of a vacation bump-up in weight. My experience in the past is this always has happened, and generally I've gone back to my previous set point within a week of returning. But now, going into the vacation with a mini-stall, I'm worried. And, because I always borrow trouble plan ahead, I'm thinking about when I renew my Zepbound prescription for the next four weeks. That renewal is scheduled for the day I come back from the trip, and I had assumed I'd stay on my same low dose for another month. That was based on continuing to lose at that dose. I think I can delay requesting the renewal for a few days after I come back, but no matter what the scale says, I (currently) think I should just stay at this dosage through May. By then, I'll have significantly more evidence about how the drugs are affecting me and what it will take for consistent, continuing, weight loss. Time enough to bump up later, if needed.

In the meantime...

 

Most of these linen and cotton shirts were "hang to dry" anyway
But they definitely need ironing now!
The weird pink thing is a strawberry tower - 
check out the garden blog

I still haven't bothered to get my dryer repaired or replaced. Luckily, we've had some sunny weather, and the clothesline in the back yard works great. I don't hang my underwear out there, though! It's fairly private, but not completely. Everything takes longer to line dry, though, so I've had to plan way ahead on what I'm taking on the trip, and make sure it's clean, dry, and ready to go.

 

 

 

 

 

And in other news, my girl leaves for Oregon a couple of days after I go to France. I've offloaded a lot of my old camping equipment - and even outer-layer clothes - on her. She'll be living in an minimally furnished house with co-workers, and camping some of the time. I had a tent to give her, and emergency supplies I took from my own bug-out bag for her day pack: a multi-tool knife, a headlamp, a mylar blanket, a solar lantern, a water filter, a Bic lighter, and also rain gear I outgrew (sideways) and a beanie hat. We went together to REI where I had fun fitting her up with a compass, whistle, tiny first-aid kit, and new socks to go with her new hiking boots. I relate to this experience of hers through my memories of my undergraduate years, where I majored in field trips (though the degree says different). I had a summer in the Upper Peninsula of Michigan in an old logging camp, learning the same field skills that she will use. (She learned much of what she needs to know in Australia, and will be trained in specifics. But she will be alone in the woods before dawn most days.) I'm sorry I won't be there to wave good-bye to her as she sets off into the world to seek her fortune. I know she'll do fine, and I also hope she will enjoy it. I'm so grateful she has wanted to share her prep and planning with me! It's been fun!

Learning Things

At this point, I feel like making sure I'm successful on the GLP meds is my job. I'm thinking about it most of the time. I'm experimenting with foods, I'm checking in on my body, I'm getting up and moving around after I eat and the stomach is full. I'm reading everything I can find. Of course, making sure what I'm reading is from a reputable source is always an issue, especially since much of the information comes via social media or AI.

Weightless by Rocio Salas-Whalen

This book was recommended by a chat group on the WW app. It came out in December of last year, so it's quite up-to-date. I consider myself well informed about GLP meds, but I learned a lot from this book. I listened to it - 9 hours over the course of a week - as if it were a novel. I found it so useful that I've now ordered it to get a hard copy delivered. I love to listen to books, both fiction and non-fiction, but the listening format makes it very hard to go back and reference something. Even ebooks sometimes make it harder to look things up. I am a huge ebook and audio book fan, but if I'm going to be flipping back and forth through a book I prefer to have a hard copy in my hands.

The author has been a long term specialist in obesity medicine. This book is soup to nuts, from the history of obesity treatments and the development of GLP meds, to current options, what to expect, how to handle issues, and what to expect and options for handling maintenance. And like every self-improvement book you've ever read, individual stories:  "Carol was frustrated. She came to me because....".

She frames how to think about being on the meds as "creating a helpful environment for you to make the changes that will sustain you for the long term". In other words, the drugs don't do it, you do. And that takes work.

Here are some things that stuck out for me as I listened, that I want to go back and read more and study more. She is a fanatic on preserving muscle by eating protein and working out. She wants people to think of what we are doing is less about weight loss and more about "body recomposition". By this she means shifting the ratio of fat to muscle in our bodies. In her view, body composition analysis is how to determine if the process has been successful for you, not the scale readings. 

She writes about resistance and weight training, which I'm on top of. But she sets really high targets for the daily protein intake - for everybody, all ages and sexes, an absolute bare minimum of 100 grams of protein a day. This is significantly higher than the 83 gram minimum WW sets for me. I am close to that WW minimum almost every day, but raising it to 100 grams will be really hard. She is a big fan of whey protein powder, which I'm not ready to embrace. She suggests the best way to make the protein target is to add whey powder to everything, from your morning coffee (not gonna happen) to sprinkling on other meals, and also a shake/smoothie. (I'm not sure why I'm so reluctant to try the whey powder - I think besides my aversion to frankenfoods I'm afraid of aftertastes. But maybe I should experiment. At Whole Foods, I found an entire section full of different kinds of whey powder. So maybe? But not in my sacred morning black coffee!)

She also asserts that our bodies generally don't absorb more than 30 grams of protein at a single meal, and so making the 100 gram target would require three hefty meals and a hefty snack, or some pattern of spreading it out through the day. I have a long history of not feeling hungry in the morning, and working out first thing on an empty stomach. But if I'm going to get all the right eating in, I need to start early. I have to eat smaller meals, and I want to finish big eating a few hours before bedtime. So I've tried grabbing a lowfat cottage cheese (19 grams protein) directly I get up. I've tried to restrict myself to only a couple of (plant-based) protein shakes a week, so far after working out, because they are definitely a frankenfood (ultra-processed). But they are very convenient, from 20-30 grams of protein, and fairly palatable. I have been adding some ground flaxseed to meals where it is easily disguised - tasteless to me, not gummy like chia seeds, but some impact on texture and looks. I cook my rice and pasta in bone broth. My latest try - using my girl's vegan hack for parmesan - nutritional yeast, found next to whey protein in the supplements aisle. (I read the label for plant-based "parmesan" in the vegan case at the store - 0 grams protein and 0 grams fiber. Must be made from petroleum?) Results are not yet assessed on the nutritional yeast.

The one disturbing (to me) thread throughout the book is how the author assumes losing weight is everyone's goal. (Though only with preserving muscle, not skinny only.)  If she talks about body positivity, inclusiveness, and health at every size (HAES), I missed it or it didn't stick with me (another reason to have a hard copy to look at). Intuitive eating didn't work for me, but I've spent years coming to terms with how I look and feel. I don't hate my body now. I am quite healthy, and don't have co-morbidities from my obesity. But still, HAES is about being as healthy as you can in the body you have now. There are health impacts from obesity, and losing weight fixes many of them. But there are even more social impacts, and I hate that that is true and I think it's wrong. But still, I would like to look better in nice clothes. 

I've thought about this, and the fact that no everyone who wants it actually has access to the drugs is not a reason for me to not take them. My not doing this, as an individual action, helps no-one. The fact not everyone wants to, or can, take them is also not a reason for me to stay away. I support those who are happy with the way things are, or choose a different path for whatever reason. But I'm still doing it.

Check-In - How are things?

TL;DR: I'm fine

I've finished three complete weeks on my GLP meds. So far, my side effects are only gas and some often present minor queasiness. I treat that with ginger hard candies. I also am often cold and when I'm not moving, huddling under blankets. I'm tracking my food meticulously through the WW app (interestingly, it gets easier the more you track, because it offers up choices you have used before). I am now doing a pre-plan in the morning, to make sure it's going to reach my protein and fiber targets. It's a bit like a jigsaw puzzle - do I need to fit a different piece into lunch because it's not adding up? It's surprisingly difficult!

I lost some weight very quickly, so quickly it started to make me nervous. WW discourages looking at calories but I was shocked to see a couple of days were less than 1,000 calories! No bueno! I was eating to hunger, but I don't want my body to shut down into starvation mode. Now, I'm eating more by the clock. But still, I plan out my day with plenty of food, and then find I can't finish everything on my plate. Mostly, I put it aside and try to come back in an hour or two. Overall, I'm back to eating much more normal totals for the day. Generally I'm having two hefty snacks, one in the afternoon and one later in evening. The snacks may be leftovers, or they may be dried and salted beans (edamame or garbanzos, this week) or Wasa rye crisp with flavored nut butter, and fruit - mandarins and apples.

I need to rely on convenience foods or foods I will prepare in bulk for leftovers - I'm not cooking three meals a day for myself. My girl recommended a brand of bottled protein shake loaded with protein and fiber both - Koia - and I'll have one of those for breakfast after working out. I do have to have something afterwards, because while it's good, it does still have a bit of an aftertaste. My favorite brand of canned tuna, Wild Planet, makes a couple of tinned ready-to-eat salads, tuna and beans, loaded with protein and fiber. I have a good selection of lentil and bean canned soups, ready to heat up. I often add some shredded rotisserie chicken to them, to make sure I'm getting to the protein numbers. The craving for sweets has seriously diminished. I have usually just a single square of chocolate in the evening, and feel satisfied with that.

I did my first prescription renewal; it was pro-forma. I'm staying on the same dose for another 4 weeks at least.  I requested the refill via app, updated some vitals stats, later that day my clinician approved it, and sent it to the pharmacy. They acknowledged receipt still on that first day. Three working days later, (the outside of how long  they said it should take), I got a text telling me to pay. I did that immediately, and got a status update it had shipped and should be delivered the next day. But UPS didn't come through, the package took a detour, and it showed up a day later. With the weekend, it took exactly one week - I requested on Wednesday and it showed up on  the next Wednesday. I can't count on the one-week delivery, I think - I'll continue requesting the renewal around the time of my third dose, so I'll have two weeks for approval and delivery.

 I'm already thinking ahead on how to handle my next trip. I'm going to France! Did I tell you guys that? In five weeks! As it turns out, my trip departs on a Thursday, injection day, so that's easily dealt with at home. I return 8 days later, Friday afternoon. I'm really thinking I don't want to travel with my syringe and vial, worrying about refrigeration, sharps disposal, etc., and I should just postpone my shot until I get home. Then, I can either do the following dose back on my Thursday schedule or else switch to Fridays. I read that adjusting by a day is generally ok - it's 3-4 days that get complicated. 

 

So to address the big question, how's my weight? It's fine. Using start day to today, I've lost 3.5 pounds in three weeks. The past few days, the loss has stalled, but it's way too soon to worry about that. It makes sense my body will adjust after the big woosh at the beginning. I would like to lose around a pound a week max, so I'm on track for that. I'm working with my trainer to lift heavier than before (I just got new 25 lb dumbbells, woohoo, moving up from the 20s!) and I'm hoping my focus on protein and that will keep me strong.

My smart scale purports to track fat vs. muscle besides weight, but these readings are notoriously inaccurate. Still, looking at the trend, it thinks I'm losing a mix of fat and muscle, but losing the fat at twice the rate of muscle. I was heartened to read an article in the NYTimes this week that says while every weight loss will lead to some reduced muscle, there is no evidence that using the GLP meds leads to more muscle loss than any other form of weight reduction. 

I kept up my cardio on my inside machines throughout February on days I don't lift. I intend to keep to that. But I rarely left the house in February for walks due to weather, and I've got to get back into that before my next trip. 

But so far, so good! 

How's it going?

 

Picture yesterday.
I have a "start day" photo, but it's so
unflattering - not so much in the body,
but in my expression. I forget to smile!

This is week two of the weight loss meds. Today is Friday, and injection day is Thursday. I have found that this blog is very useful to me as a journal and a reference, keeping me honest in my memories. It's so easy for a memory to become a story, and as it does so, it morphs and changes. That's not all bad, but it's good to also have a reality check on the past. And so I think it's worth capturing what's going on with me even when I feel like the answer is "not much".

The first week on the meds was fine. I had a great deal of trepidation, but all I have felt is minor versions of classic side effects. My stomach feels full quickly, and remains that way for a while. I'm gassy (and I was gassy before, too!) and sometimes those burps seem to carry some acid with them. I am often cold - no more am I embracing the weather in full Scandi style. Instead, I'm huddling in layers, under electric blankets, and not going out as much as I was before. (My tiktok girlies tell me this is a common symptom.) My sleep varies, with several periods of being wakeful in the middle of the night, other mornings the wakefulness starts at 5, and I just get up. (One night I peed FIVE times, leading me to adjust my hydration schedule!) Don't know if this sleep disruption is a symptom, as this sometimes happened anyway. I'm consistently getting to bed earlier, which helps.

Wednesday, the day before injection day, I was truly hungry for the first time. And for the first time that week I went over my daily points. (My WW reset points week is injection day.) Weekly points had been accumulating, from leftovers and activity, so there was plenty of buffer in the budget. I am focused on the protein and fiber numbers, and it is truly an effort to get there. I just added "calories" to the summary stats WW posts for each day, and I find most days have been below their suggested minimum of 1200. I don't want my body to go into starvation mode, start digesting my own muscles, and become hyper-efficient, requiring heroic efforts to lose any weight. I've been at least close to the targets every day, but I'm now planning to add an evening snack every day I seem to be falling short. My work is to have an inventory of snacks that move me in the right direction, not ice cream or Trader Joe's treats.

The injection paraphernalia I have to assemble for
the actual injection. I had the instructions out for this,
the second injection, not trusting to memory. 

I'm trying to undo years of a habitual after-eating flop to the couch and instead get up and move around after eating, which is really helpful in reducing any discomfort. I'm also trying to slow down my eating, and I'm breaking meals into smaller pieces - stopping partway through a meal, but coming back to the leftovers after an hour or two. I'm eating, but I'm on a major campaign to preserve or even build muscle through this, and so eating enough is really important to me. For the first time, I'm really using the WW app to plan in advance in detail. I try in the morning to build a day that will reach the four-way optimization of enough protein, fiber, and calories, while staying below the total points.

I've talked to my trainer about the WL meds, and she's on board with upping the weights and really going for improvement, not just maintenance, to fight muscle loss. I've had great workouts, and right after the workout I'm drinking a protein shake. They are excellent sources of protein and fiber, and I've found a brand that is fine. It tastes good, and I'm able to eat a tangerine or something afterwards to do away with a not-terrific aftertaste. I'm also sticking to my 15 minutes of cardio on the days I don't lift weights (so 2x weight training, 4x cardio, one day off). I was exhilarated yesterday on the Nordic Trak, and again today on the stationary bike, to find it had gotten much much easier.  The purpose of the cardio is to improve my cardio-vascular fitness, and the last two days were the highest I've gotten my heart rate up in a long time. I'm trying to hit the cardio commitment for the entire month of February and I've tied the purchase of some fun new tech to achieving that. When I talked about a newer, higher commitment for March, my trainer wisely suggested seeing if I'm still improving with the 15 minutes - and I am. So we'll see how it goes.

What has happened to my weight, by day 9 of the meds? I believe I have ranted before about how I think about my weight:  it is not really the number that appears at any one moment on the scale, but an average based on the trend. Variation around that trend is caused by water, and other transitory factors. And certainly the weight has been as volatile as ever this week. Here is the picture:

My weight in 2026- turn phone to landscape
The small green dots are daily scale readings. The dark blue line is the weekly average of those.
The big red dot is the first day of injection. 
The orange fuzzy lines are the 5-pound range I've been in since midway through 2022. 

 My weight was at the top end of my range since the beginning of the year (including my mid-January vacation). My daily scale readings have certainly gone down since the first injection. This is not uncommon, in my first week of trying to lose weight. But I won't really consider I'm well on my way to actually losing weight until I consistently see numbers below the bottom orange line - out of the past few years' range. 

But it certainly is nice to see the trend line going down!

 

 

February Tidbits

Brand recommended by my girl.
Tasty, and very little aftertaste

I don't think I'm in the mood today to write a long and meaningful or at least witty essay on anything - too scattered. So some notes.

• I did my first injection yesterday. TL;DR: mostly a non-event. I planned to exercise first, then eat, then inject. Somehow, while getting ready to inject, I suddenly realized how very important it was to clean my coffee pot - I've had it a while and never cleaned it. So I had to find the on-line users manual, make up a citric acid solution, and run through the iterative process to get the mineral scale out of it, and then to rinse it clean. (Pro-tip on coffee pot cleaning - citric acid is just as effective as white vinegar and much easier to rinse out afterwards.) Finally I assembled everything for the injection at the dining room table: glass vial from the fridge, syringe and sharps box from high up in my bedroom closet. Then, I remembered a tiktok that said to leave the vial out of the fridge for a while to let it warm up before injecting it. So another chore got done instead. Finally finally, I opened the syringe package, filled the syringe from the vial, and injected into my belly. Couldn't really feel it, as everyone says. Totally a non-event.
• How did I feel? Yesterday, I felt a bit queasy from time to time, and had some ginger. I have even more gas than usual. Nothing big. Yes, stomach seemed a bit full, and getting up and moving around was helpful.
• Speaking of exercise, I'm trying very hard to do 15 minutes of cardio every single day. Cardio hard enough to raise my heart rate significantly. Today marks two weeks of doing it, every day I don't do weight training with my trainer. This was a recommendation from my primary care doctor last year, and my neurologist confirmed that 15 minutes a day seems to be sweet spot for migraines - less exercise leads to more attacks, more exercise is good for your body but seems to have no impact on migraines. If I get through February with doing this every day, I'll treat myself to something.

• 

  Clockwise from top right: 
  Mussels, Steak, Chicken, Butter, Andouille 
  Sausage, Hot Dogs, Ravioli

  
  I joined a butcher's club! There is a butcher shop in Takoma Park, Soko Butchers, with fabulous local food. They have a monthly box - I got the smallest available. And you get what you get. I thought of an Athena Scalzi-style long post all about it, but never mind, here's a quick recap
• Mussels! Kind of ironic after my rant about fish in the house, but I cooked and ate them last night, and cleaned up and got the garbage out. High protein!
• Tenderloin steak - aka filet mignon. Tonight or tomorrow, going with the sear-and-then-roast approach. (My boys did that (in my kitchen) before Christmas, and started a fire and filled the place with smoke for over an hour. But it tasted good!) 
• Airline chicken. Who knew that was a thing?  I've got a plan for the air fryer.
• Hotdogs and sausages, I love them.
  Local VERY tasty butter, may last a while given how I'm trying to eat
• Heart-shaped ravioli 
• So I'll be cooking for bit.  

•  Today, I definitely feel bloated, full in the abdomen. If I was wearing a belt instead of elastic waist pants, I'd be loosening it. After early morning exercise, I had a protein shake instead of oatmeal for breakfast, followed a while later by tangerines to get the taste out of my mouth. It's sunny and not too cold, so I need to convince myself that 15 minutes of exercise before breakfast is not a reason to sit around the rest of the day.

Weight-loss Meds Eve

That's a little bit optimistic. My meds are going to be delivered, probably Wednesday or Thursday. I'm tracking via UPS. Hopefully no more snowstorms to upset the schedule!

 I'm all ready for this. I've been preparing since late last year. I waited until after I got back from my big vacation to set this in motion, and it's taken a little bit longer than I had hoped. But they're on their way.

I've done a ton of research on this. I'm doing this via Weight Watchers, based on the experience of my pathfinder and an on-line look at reviews for other places. I've read pretty much everything on the WW site, met on-line with their doctor, and got approved. I spent time on social media and with ChatGPT (surprisingly useful for very specific questions). So I have a plan, which will of course be modified as soon as I get some practical experience. In the meantime, I'm staying away from anymore online input. I've got what I need to get started. 

A couple of notes about what's happening and my plans:

I'm getting Zepbound (tirzepatide) vials direct from the supplier, Lilly. Bit of a story, but the cost for vials from which I fill a syringe is half or less than getting pens. I've watched a ton of videos, from Lilly and others, about how to do it. I bought a sharps container for disposal, and read the regulations for my state. I'll have the Lilly video in front of me the first time I do it. I'll refill the scrip on-line, based on my experience at delivery timeframes.

I'm not too worried about what sites on my body to use, I'll rotate. I've thought a lot more about time of day and day of week for the weekly injection. While you can adjust the day after you start, it's better to stick with the same day, and it seems even the same time of day. That means I don't start as soon as they are in hand, but where and when I think I'll end up for a schedule. And apparently, a reason to focus on the schedule from the start is the med's effect on body and mind is greatest shortly after the injection, and it wears off during the week. There are also greatest chances for side effects early on in the weekly cycle.

One of the major concerns about these meds for old people such as myself is muscle loss. I already do the recommended weight training level of twice a week. But there are recommendations about timing of injection and exercise. For example, don't exercise directly after an injection (duh). More interestingly, the recommendation seems to be to do weight training on days 2-4 of the weekly cycle (injection day is day 0). Since my standing convenient weight training appointments are Monday and Wednesday mornings, I think I'll be injecting Fridays or Saturdays. (In contrast to some folks, since I'm retired and have retired friends, weekends are not often very different than weekdays as far as eating and social events go, so that's less of a consideration.) My initial shipment should be here by this Friday.

The intensity of the weight session recommended is interesting: sets of 8-10 reps (calibrate the weight so that is appropriately challenging), if exhausted, reduce sets not weight. Keep the intensity up to keep those muscle fibers feeling like they are needed! This fits with my trainer's philosophy, and we agreed a few weeks back to try to up the overall intensity and progression.

Recommendations for cardio for seniors on weight loss meds are weaker. There is the standard "150 minutes a week" recommendations, but most sources say if you need to choose between cardio and weight training, choose weight training every time. And cardio should be lighter in intensity. No marathon training or blowing through VO2 max. I've just upped my intentional cardio to try to use each of my machines every day I'm not weight training. I'm trying to do 15 minutes every single day, and once I've got that as a baseline, I'll up the minutes. But I'm trying to build the consistency habit first. And it's only 15 minutes! I should always have time for that. In contrast, when I rely on a walk as my main cardio, I have to set aside much more time. I have available to me from the Apple watch "time in heart rate zones" and I'm trying to build up time in a higher zone. 

There are also recommendations, sometimes conflicting from different sources, about timing of eating with weight training sessions. Apparently it affects how efficiently a body metabolizes the protein eaten. After discussion with my long time trainer (who just finished a certification course for fitness for seniors and who has a slew of other training and certifications) I'm going to plan to eat something high protein right after we finish a session. I never eat beforehand now, and my early training timeslot wouldn't lend itself to finishing a meal a couple of hours before our session. They also say don't do a cardio session after a "long fast" (eg overnight). I think my little fifteen minute session isn't a huge concern, even with some intensity, but I will definitely plan to eat shortly afterwards. This will have to intentional. My current habits sometimes have me eating more like a brunch, sometimes exercising, then spending time grooming and dressing, then looking at my ipad, then finally getting around to preparing something to eat. One thing I think I'll try to keep on hand is low fat cottage cheese - a little container has 18 grams of protein and just enough carb to provide some short term fuel.

I haven't settled on a time of day for injections yet. One school of thought is that evenings allow sleeping through any nausea. Others say the injection at night prevents them from getting a full night's sleep. I'm curious about how this will make me feel, so I'm inclined towards a day time injection, at least to start, so I can actually pay attention to what is happening to me.

 I'm laying in supplies of easy-peasy high protein and high fiber foods. I've been using the Weight Watchers' app for a few months and I fully intend to continue using it.  I already had a big supply of ginger candies and teas for nausea - used for preventing or dealing with sea sickness, so that's in place. I've been experimenting with bottled protein shakes. I go down the supermarket aisle with my phone out, snapping barcodes with my Weight Watchers' app. It's easier to use the WW points as a shorthand for how useful the bottle is, rather than analyzing the nutrition label myself. One bottle I bought I sampled was a chocolaty flavor, and the first sip surprised me with how good it was. But then, the very bad aftertaste remained in my mouth for a long time - until I ate something else. I poured the rest of the bottle down the drain. Yuck! That's why I need to experiment.

My experience with the WW app has definitely geared me already towards protein and fiber, and my habits have adapted. There is a "GLP" switch in the app which I'll flip soon, I'm not sure what it does, but I'm guessing it emphasizes the protein and fibre more than it does point totals.  Dehydration is apparently a concern, but not so much for me. I don't track it, because I am the water queen, always with a glass or bottle next to me. I will maybe use a refillable measured bottle for a while to make sure I don't slump in this. I connected my watch to the WW app for the purpose of getting more points for activity, but I didn't connect any of the other areas like sleep. I don't see that changing.

 Food shopping tomorrow and Wednesday, different stores. Then, the adventure begins! 

Musings on Food, With Reference to Weight Watchers

My girl got me this gift pack for Christmas. 
Cinnamon almond butter is to die for, vibrant on apples
Habanero honey is pleasantly warm and sweet on crackers
Wild expresso is unusual, and growing on me
I'm saving the chocolate for a treat.

I've been doing the Weight Watchers food tracking app since November, with time off during the holidays and my vacation. I felt extremely disordered and at sea about what to eat, thinking about it constantly. At first, tracking felt really good - it gamified planning out the food, it was unique and fun. And not terribly burdensome. Now, it's still not really burdensome, but I wouldn't describe it as fun. And, I'm not using it as a hard constraint. I often go over my daily and even weekly points. At the beginning, I never did. Now, I am trying to be brutally honest in the tracking, even when it's blowing the budget out of the water. Knowledge is power.

With more experience, I've got a better handle on what drives their calculation of points. And, of course, I've got some bones to pick with the way they do it. And questions about using the app to capture the right amounts.

WW wants me to eat a lot of protein and fiber. The way they want me to do it is with lean meats, fruits and vegetables, and fibrous proteins like beans. They penalize all fat enormously. They likewise penalize carbs without fiber. They are ambivalent about whole grains, it seems. Sometimes, they seem to strike an ideological stance which seems to be to be totally arbitrary - and I hate arbitrary. Exhibit one is potatoes versus brown rice:

	Brown Rice	Potatoes
Calories	216	135
Fat	2 g	0
Fiber	4 g	2 g
Protein	5 g	2 g
Points	5	0

 Potatoes are a vegetable and thus by definition is given a free ride, zero points. Rice is a grain, and thus its points are calculated based on its calories and macro-nutrients. It's got fat, to go with its higher fiber and protein, and so its points are nearly 20% of the daily allowance of points! The differential in points seems overblown and arbitrary.

Meat is another area I find a little difficult to understand. Basically, lean meat is supposed to be zero points. Very clearly, chicken with no skin is zero points. But venturing into other meats quickly is a quagmire. When looking up beef or lamb, there are entries in the app for "fat trimmed" cuts with zero points, but other entries looking nearly identical that give a lot of points to the same size portion. I like to choose the zero points version, but I wonder how realistic that is? A lot of meat has a lot of fat throughout, not just in obvious pockets that can be cut out. Going forward, I can't live on chicken alone, so I'd like to sort that out. When I was successful in weight loss in the past, I ate a lot of grilled or broiled meat to go with my vegetables and no carbs. (BTW, I recently had occasion to look up my blood work lab history. During the height of my Atkins-like eating my cholesterol, glucose, etc., was excellent! Take that, you low fat high carb conventional wisdom-spouting nutrition "experts" of the past! (Ooops, sorry, apparently I have some unresolved issues over my history as a dieter.))

Most fish is also zero points. I love to eat fish, but I hate to cook it. I hate handling raw fish, and I hate cleaning up the mess and getting the garbage outside quickly before it starts to stink, which is almost immediately. Maybe I can overcome my aversion? Canned tuna is one thing I can handle, frozen peeled shrimp as well, freezer to pan with no time to stink. I've cooked salmon fillets as well, so easy, but I have to get the garbage out and the dishes done very quickly afterwards.

Meanwhile, my eating is slowly evolving. I've never been a big fruit person, but raw fruit is a zero point bargain. Oranges and mandarins and apples are part of my routine. I'm still enjoying nut butters with my apples, or spread on my rye crisp crackers. Dried bean snack foods can be satisfying when I'm jonesing for salty crunch. Buying rotisserie chickens has made getting proteins easier. I used to feel guilty about the short cut, thinking it was stupid to pay for something I could so easily make. But I'm definitely opting for convenience over frugality right now, in an effort to steer my food in the right direction. I often don't want to spend time cooking, and so I continue to search out convenience foods. Canned lentil or bean soups, sometimes supplemented with either more veggies or chicken. Frozen veggies - broccoli or green beans, can be tossed into a pot by the handful, to bulk it up.  Frozen dinners - most of the entrees I have relied on in the past come with a shit ton of points. But I go down the freezer aisle in the store with my phone open to the WW app, clicking on labels. It turns out, some brands have smaller portions, which means fewer points. I've been buying them and trying them - ok for taste, jury still out on if they are satisfying. When I cook, I try to package up leftovers into portions quickly, freezing some. I can eat the same dinner for 2-3 days in a row, and then I'm bored and want to move on. 

I still have days and foods I want that overwhelm my good intentions. I have to just plain not buy ice cream for the time being. I have been known, however, to get in my car and go to the store just for that. I'm saving chocolate nut butters for my next big craving session, to see if they will work on an apple or rye crisp to satisfy. 

 No surprise, my weight bounced back up to the top of my current range after the holidays and my vacation. It's been almost two weeks home, and no significant loss seen. I am the ultimate pear-shaped woman and I'm tired of having jackets falling off my shoulders but barely closing around my hips. I don't want to have to buy new pants in a yet larger size. So I'm pursuing weight loss meds. But like my pathfinder friend, I think learning to manage my food using the (somewhat arbitrary) WW points system is a viable way forward, meds or not. We'll see.