Tina’s Transformation

Tina is a bright and earnest medical technician who is devoted to our patients and her coworkers here at the Duboc CardioWellness Clinic (CWC). She has been with working with us for five years and is a beloved member of our team. Tina comes from a family of large people, and even as an active teenager playing soccer for hours a day, she had difficult time keeping her weight under control. Her mother took to various doctors, but they could find no medical or hormonal reason for the weight gain. Tina struggled to lose the extra pounds around her midsection, no matter how hard she tried with diet and exercise. When her weight ballooned to 262 pounds in her 20s, she developed prediabetes and polycystic ovarian syndrome (PCOS). Her physician started her on metformin, which lowered the blood sugar and helped regulate her cycles but didn’t budge the weight.

Then about a year ago our CWC nurse practioner Tammy Ibanez started Tina on a GLP-1 agonist; at first this was Mounjaro (also approved for weight loss as Zepbound), then Ozempic; currently she is on Wegovy. In our CWC we use these four meds interchangeably, depending on which one is best covered by the patient’s insurance. Tina noticed mild and transient nausea when she first started the once-weekly self-injections, but this resolved when Tammy discontinued Tina’s metformin. Now she occasionally has mild constipation, which she treats with a stool softener pill and psyllium (Metamucil), a fiber supplement. She immediately noticed that her appetite was not as voracious, and it was easier to make healthy choices and avoid sweets and junk food.

One year later, at 187 pounds, Tina is 75 pounds lighter and still trending down. At 5’ 8” tall, her BMI went from 40—morbidly obese—to 28—mildly overweight. More importantly, nearly all the weight came off her mid-section and abdomen; her waist shrank from 50 inches to 38 inches. Tina beams when she tells me about her off-the-chart high energy levels. Even after working 10 hours, she comes home and is ready to go out with friends or get some exercise. She never feels like needs a nap anymore and spends much less time watching TV. Her lab values are dramatically improved as well, with no more prediabetes or PCOS.

Nothing succeeds like success. As the weight has come off, she has been more and more motivated to eat right, get her sleep, and be physically active; her mood is consistently vibrant and happy. Increasingly, Tina is hearing compliments from her friends and family about the sparkle in her eyes, her energetic and cheerful demeanor, her fit-looking physique, and her beautiful skin. I too have noticed that when I start my patients on these new once-weekly injectable GLP agonist drugs, they don’t just lose weight, they also become healthier—not only in appearance but also when we look deeper with blood tests, imaging studies, etc. The fat in their liver melts away, which reduces inflammation throughout the system. Their sleep and blood pressure improve, and their lab values are better across the board.

Tina is increasing her intake of healthy protein foods and doing strength training three times per week to maintain her muscle tissue while still losing fat tissue. All of us should be doing weightlifting twice a week for at least 20 minutes per session to maintain strong bones and muscles, but this is especially important for anyone on these GLP-1 drugs, which tend to reduce muscle and bone mass along with the excess fat tissue.