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Some of the best conversations start with listener questions, especially the ones that come from feeling stuck, confused, or wondering, 'is this normal?'

Today, I want to tackle two listener questions I received that I think a lot of you will relate to. 

One is about unexpected dryness while taking a GLP-1 medication. The other is a much bigger one: what to do when weight loss slows down after an initial drop, even though you feel like you're trying.

So, let's dive into the first question:

Question 1: Is Dryness Normal on GLP-1 Medications?

"I'm on Zepbound for five weeks. Is it normal to have dry lips and skin? I feel dry all the time inside and out, no matter how much water I'm having."

This isn't something I commonly see in my clinic. While everyone's experience is different, widespread dryness isn't a typical side effect I encounter with GLP-1 medications.

So what could be going on here? 

Before assuming it is medication-related, it is worth stepping back and looking at other factors that often get overlooked, especially if the medication has been stable for several weeks.

Things worth checking first:

• Seasonal changes, especially winter air, indoor heating, or air conditioning
  
• Skipping moisturiser or lip care compared to warmer months
  
• New detergents, soaps, or skincare products
  
• Changes in hormones, thyroid function, or other lab values

If dryness feels extreme, persistent, or new, this is a good reason to speak to your doctor and have basic labs reviewed. 

One skin-related side effect I do hear about occasionally is something called allodynia. This shows up as small, random patches of skin that are unusually sensitive or painful to touch. It is not ongoing dryness. It is more like a specific spot, maybe on your forearm or leg, that suddenly hurts when touched and then resolves on its own over a few days or a couple of weeks. We do not fully understand why this happens, and it is not linked to a specific deficiency or a clear timeline.

The key point is: if something feels off, do not brush it aside. Bring it to your medical team and get it checked.

Question 2: What Do I Do When Weight Loss Stalls?

This second question is one I get all the time, and it’s a bit more layered.

This listener had been on a GLP-1 medication for almost two years. Early on, the weight came off easily (about 50 pounds). Then things slowed down and over the past year, progress felt minimal. They increased protein, drank more water, but weren’t exercising and started wondering what was going wrong.

Here’s where I always want to start.

First: give yourself credit

Losing 50 pounds is a big deal. Full stop.

It’s easy to stay laser-focused on what’s still ahead and completely overlook how far you’ve already come. But that early progress matters. It tells us your body can respond. It also tells us this is not a failure, it’s a transition point.

Redefine what success looks like

If the only measure of success is the scale, everything starts to feel discouraging.

Instead, zoom out and ask:

• Are your labs improving?
  
• Is your sleep better than it used to be?
  
• Are you eating more protein or fewer ultra-processed foods?
  
• Do you have more energy or better stamina?

Those things count. Even when the scale feels stubborn.

Your body can be getting healthier even when weight loss slows. That matters more than most people realize.

BMI without body composition is not helpful

This is where a lot of people get stuck.

Many people assume they still have 20 to 25 pounds to lose because they are chasing an “average” weight based on BMI. The problem is that BMI tells you very little on its own.

Without knowing body fat versus muscle mass, you are flying blind.

Two people can weigh the same and have completely different health profiles. You might think you need to lose more weight when what your body actually needs is muscle, not less mass.

This is one of the reasons I work with body composition and other objective data inside the Body Intelligence Blueprint. When you can see how much fat, muscle, and lean mass you are actually carrying, the conversation shifts from “How much weight should I lose?” to “What does my body need next?”

That kind of clarity makes decision-making a lot easier and removes much of the guesswork.

Movement matters, but not for the reason you think

People often don’t like to hear this, but exercise is not a powerful weight loss tool on its own. 

That doesn’t mean it’s optional. This listener mentioned they were not exercising, but movement supports:

• Muscle preservation
  
• Metabolic health
  
• Stress regulation
  
• Emotional resilience
  
• Long-term maintenance
  

When people say, “I started exercising and then the weight moved,” what’s often happening is not calorie burn. It’s better stress processing, better sleep, better decision-making, and better consistency.

Humans are meant to move. Movement is one of the main ways we empty our stress bucket.

And that doesn’t mean you need to access a gym or need tons of equipment to get started.

Start with what’s realistic:

• Walking
  
• Wall push-ups
  
• Chair squats
  
• Short, no-equipment routines on YouTube

If you are doing nothing right now, five minutes a few times a week is enough to start. Over time, the goal is to move most days, in ways that feel sustainable.

Always rule out physiology first

If you are doing the basics consistently and things still are not changing, this is not a willpower problem. This is where checking in with your doctor matters.

Ask questions like:

• Has hunger or cravings increased?
  
• Have labs changed?
  
• Is your body responding differently than it used to?

There is a guiding principle in medicine I strongly believe in: everything is physiological until proven otherwise.

This is not a one-time fix and medication is not a finish line. Bodies change, and strategies have to change with them.

The long-term shift that actually matters

The real shift here isn't just about losing weight. It's about becoming a person who always figures things out and loves the journey along the way.

Don't wait until you reach some arbitrary goal weight to start living fully or feeling successful. Celebrate the wins now. Track what actually matters, move your body, and get the data you need to make informed decisions.

And most importantly, remember: this journey is about way more than a number on the scale.

Listen to the full listener Q&A episode which goes deeper into this, including how I evaluate a stall, why the scale can be misleading, and how to choose a next step that actually makes sense for your body.

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.   

 Welcome back to another episode of the podcast. How are you all doing? I am finally back in the groove. I'm back. It only took me three weeks to get fully into my regular routines and feeling like I'm actually making progress. You know what? That's not bad because I'm never someone that's like January 1st, new goal, new me. I'm always working on stuff year round, so anyway, I am. Excited to be feeling better. Right now, we're heading into the third week in 30 30, and friends, can I tell you, the group is incredible. The women that are in this round of 30, 30, the wins that they share what they're doing, I just cannot ask for better.

Women that are joining, and I've said this before, but I always have the largest fat loss times when I'm in an active 30, 30 round, I know I'm the one running it. But being in that environment where people are planning things and doing things and trialing things and they're staying in that energy, which keeps you in it as well.

It is so powerful. I'm almost mourning when that program, end of February is gonna be done because I'm thinking, oh my gosh, there's not the April round, which of course it made sense because I, again, I have the, the 30 30 retreat, the beyond the scale that retreat in Indianapolis in April. So that makes sense because I really like to.

Fully give attention to what I'm doing, but I'm realizing, gosh, do I love our community? I'm thinking I will look forward to September even more. So that's, that's the next one. Oh, and just a little bit of a, a, an and kind of forecasting on that. 'cause I'm, yes, I think this far in becomes in January, I think about September.

That round, I'm gonna do a few changes. I always, every round something changes I'm going to change it from six weeks to 12 weeks. Because what I've noticed is that the program is so quick, it flies by so quickly that sometimes you just need more weeks to work on things and to process things and to go through things.

I think that will be really helpful. Right now we have two calls. We have a Sunday morning. Planning reset. It's not too early. If you're Eastern, it's 11. But you know that depending on if you're PST, that can be a lot earlier. And then we have a Thursday evening group call, and what I notice with Thursday is everyone's tired, they're exhausted, and so I just figure, it would be.

Easier. If we did 12 weeks, we did three months, we're doing the Sunday calls that work for everyone, we're still gonna have a lot of those additional calls, but it just won't be so overwhelming per week where every single week there's two to three calls. 'cause it's just a lot for everybody. And so I think that that longer time.

Not having so much intensity. I think that's gonna be nice. Again, if you have any thoughts on that, let me know. I'm still in the planning stages of all of that, but I'm really looking forward to that.

Okay. So I wanna get, today, I'm gonna answer I think, two questions. I get a lot of questions that get submitted for the podcast. Just a reminder, the platform that I host my podcast on, they call it fan mail, where you can submit a question, I would never call it that, but if you submit a question, it is anonymous.

Unless you leave an email, we have no way to get back to you. I love getting the messages from all of you, and I try here and there to answer these questions on the podcast.

So let's go over to today. The first one is, I'm on Zap Bound for five weeks. Is it normal to have dry lips and skin? I feel dry all the time inside and out, no matter how much water I'm having. Is this normal? So my first response, again, not giving medical advice, but just what I see in my clinic. I do not see this, so this is not something that I commonly see dry skin, I think about.

Is there anything that changed that season for you?, I'm here in the Midwest. A lot of people, they're not using air humidifiers, they're not moisturizing, they're not doing things differently in the winter compared to the summertime. Now, I do see that you live in Florida, so I had to eliminate that.

But I would first look for things like that. I would be seeing your doctor making sure that labs are okay. I would be looking for new detergents. What, what can be contributing, to the skin symptoms that are occurring. Now, the other thing that I wanna say here is. While I don't see that, what I do see at times or something called allodynia, which is you have random patches in your skin that are very sensitive to touch and they tend to come on randomly and they go away anywhere from a few days to a week or two.

So it'll be, for example, like I've had it on the, back of my, forearm, this little patch where it was like, ooh. It's just like, if you touch it, it really hurts, but it goes away after a period. And we don't know what causes that because we don't have it linked to a deficiency.

It's not like it occurs right when you start it, it's not a certain set time period. So those sensitive nerve areas, I do hear that. But again, always talk to your doctor because there are some things that are more important than others, so we wanna make sure we're not missing that. The allodynia, those sensitive nerve patches, I do hear that the skin having those, that that increased pain sensation, but that goes away, but I'm not hearing it with dry skin.

The next question here, this is really a multi parter and I'm gonna try to summarize this, but I have a lot to say on this. So this person is saying they love the podcast. They're wondering for looking for some advice. They've been on a GLP one for almost two years. They're on manjaro, which again thinks

same thing. Zep Tirzepatide 15 milligram. And they'll admit, they say they didn't put in all a lot of effort initially, but the weight just seemed to fall off. They lost about 50 in that period, but then the past year they've struggled. They say it didn't move at all. And then they say, well, to be honest, my weight has gone down, but my size hasn't changed as I would've liked. They're trying things like increasing protein and drinking water. Exer and they're not exercising, and then they're saying, well, I think I have another 20, 25 before I reach an average weight. They're giving me stats on being 57 years old, height, weight, all that kind of stuff. And they're asking for thoughts on this what could help at a, a stall, things like that.

Okay. Here's the thing. Let's start with some basics. Number one, you need to have gratitude for how far you've come. If you've lost 50 pounds, that is a massive amount of weight. It's massive. And I know that we all always are only focused on the thing that then is still coming in the future.

But I would do the math on what percentage that is for you, the 50. Also, we need to redefine success in not just the scale moving, but other things happening as well. Are labs improving? Is your sleep improving? What other areas are you more active? What other things are happening in your life that we can quantify as a success?

And the reason we need to look for this, it's that you getting in more protein and hydration, that is something improving. Your body's getting healthier because of that. Likely when you're getting in more protein and hydration, things like that, maybe your ultra processed food went down. I want you to start to be a little bit more expansive as far as what you're seeing with success.

The other thing I wanna know is how do you know that you have another 2025 pounds to go, you say, then I would be a quote unquote average weight. I'm assuming that you mean by that mid-range normal BMI and BMI is just trash. If you don't have a body composition where you know, pounds of body fat, pounds of skeletal muscle.

I can't do anything with that, it's kind of like, I don't even know if you have more weight to lose. I know nothing. You are flying blind when you don't know this stuff. So I would look into that and then see that you are actually not only tracking things that matter more than just the net number on the scale.

But also that you are get a little bit more diverse as far as what you're thinking. Right off out the bat, whenever someone is maintaining, let's say that your weight really hadn't moved in several months and you're doing all the things, what I look for is what's the lowest hanging fruit of something that we can change.

You said yourself, Hey, I'm not exercising, and I could start to do that. I would say, yeah. Let's jump on that. So we know from the data that exercise does not lead to a bunch of weight loss. Now, a lot of you're gonna say, but Matea, the minute I started to exercise, I started losing weight.

Here's what's happening. When you're exercising, number one, you're keeping things like your skeletal muscle, right? You, your heart health is improving. There's so many things that are happening. But what is very important when you are moving is that you become more creative with your thinking.

You have more emotional resilience usually because you're processing things. There is a lot mentally and emotionally that is occurring when you exercise. So you need to do this because I don't know how you are emptying your stress bucket without moving as humans, we are made to move. If we can't move because of disability or other reasons, that is a whole different story.

But if we are physically capable, I want you moving. And so I would look at what's the version where I don't have to go out and buy any equipment, any bands, join a gym. I don't need to do any of that today. What is possible for me? So most people, if you're able to, can you walk back and forth a few times?

Can you do some wall pushups? You can find a bunch of videos on YouTube or TikTok where there's no equipment, beginner exercises, and you start there and you start to build on that. At the end of the day, I'd love you moving most days of the week. If you look at the sports medicines, society recommendations are gonna say 30 minutes, at least five times a week.

It's not enough. It's not enough. Now I want to get you moving in general. If you're doing nothing, let's start with five minutes, a few times a week, but eventually. I want you moving every single day. And I don't care if it's walking, we need you intentionally moving, and I need some strength training happening.

I would definitely be bringing that in and redefining what success is. And if things are truly not moving and you feel like I'm getting this protein, I'm, I've decreased ultra processed food, I'm getting in my fiber, you're doing all these things, hydrating, sleep, stress down, all that kind of stuff.

Then I would talk to your doctor because are your urges and cravings up? Is your hunger up what physiologically is going on? I was listening to a podcast the other day, a lot of the time, the podcast that I listen to, they talk about childhood obesity. This mother was saying, my child emotionally eats and they're making everything sound like the child is picking that, what they're doing.

And then the doctor said, well, maybe, maybe not. You know what it made me think of everything is organic until proven otherwise. So that's a, a concept in medicine where I am always gonna look for the physiological reasons before I sit there and tell you it's a mental health issue.

Always. Same thing with this scenario.

Instead of taking this on that my body can't lose the weight or I'm not making progress as quickly, things like that. Have you been, has it been checked out recently? This is not a one and done. This is not, oh, I went, I got on the med and now magically everything's supposed to happen. It's amazing that first part worked out for you, but now might be the part where you need to maybe get labs done again.

You need to have different strategies, different things need to happen. That's okay, this is part of the journey you for life are gonna have to be changing things and figuring it out. And I love the fact that coming in the future, we have medications that are targeting many different pathways. That's really encouraging because I know that there are many different reasons why people are struggling with this and it's gonna be really great to be able to get a little bit more customized with that and have more options.

But right now, I would start with, I'm gonna become a person who always figures this out and loves the journey. I'm not gonna be waiting to the end. That is really what I wanted to talk about today. Something that I have not talked about before is that some of you sometimes are wanting to work with me, but you don't live in Indiana or Illinois, so you can't be my patient. But you want to go over a body composition report, you wanna talk to me about nutrition, things like that.

I have a one-to-one program. I just have a few spots at a time, but it's called the Body Intelligence Blueprint. And this is a three month period where you work with me. Before ever even seeing me. You're gonna get your genome mind mental health map done a body composition.

A two week nutrition log. So you're gonna have a bunch of data, and then we're gonna meet once a month for three months, and we're gonna go over strategies for you. This is not medical advice that's occurring in those visits, but there's a lot of education that can occur and some of you are really wanting that, so I wanted to just let you know about that.

I will put the link to that down below. When the spots are gone, we just turn it to wait list. So don't worry if, if when you get on it says, Hey, this is a wait list. We won't let someone sign up unless I'm right away able to work with you.

Someone that contacted me recently and joined that one-on-one, they said, well, can you see me right now? And the answer if you are able to register is yes. But if it goes to wait list, no, not at that moment, because I'm not gonna take you into a program if I couldn't see you in a week or two, right? I just wanted to put that out there. If that's something that you're looking for, we'll have the link down in the show notes. I hope you have an amazing rest of the week and we'll talk soon.