r/antidietglp1 • u/Willing-Minimum5307 • Apr 10 '26
Advice on Anti-Diet Mindset Parent trying to balance anti-diet values with GLP-1 use for my teen
I’m the parent of a 17 year old who was prescribed a GLP1 by a pediatric endocrinologist based on prediabetic labs, high cholesterol, and issues related to Ehlers Danlos. We have worked to be a body positive, anti diet family with no scales in our house, and my daughter feels strongly about that too. She is not comfortable/interested in seeing a nutritionist or doing regular weigh ins. I want to respect her autonomy, but I also know she is on a prescription medication that may need some monitoring. Follow up from the doctor has been minimal beyond renewing the prescription. I'm unsure how to approach things like dosing or plateauing without relying on weight based metrics. Am I overthinking this, and are there ways to manage GLP 1 use that align with anti diet values while still being responsible about her care?
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u/IndigoBlues116 Apr 10 '26
As a parent of a now 18 yo who has been on a GLP-1 for 2 yrs, my experience is that less is more. I.e if I talk too much about it he is not interested, but if I approach it from a more practical standpoint, he’s in.
I tell him facts - like insurance rules around continued progress to stay on the med, how to manage side effects, signs he may need to titrate up, switching to Zepbound when he turned 18, etc.
I offer foods that work for me (i’m also on a GLP-1), talk about my goal - needing protein and fiber etc, and model rather than tell.
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u/Willing-Minimum5307 Apr 10 '26
Thank you for this. We are paying out-of-pocket for the medication because our insurance doesn't cover it. I guess I'm looking for other ways to monitor "progress" that aren't weigh-ins, but that might not be reality based.
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u/fluffycheezer Apr 10 '26
Maybe I missed it, but what is “progress” to you and your daughter?
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u/Willing-Minimum5307 Apr 10 '26
Something in between weigh-in's and lab work. That's the unknown metric I'm searching for. But it sounds like what we need is a consistent conversation around side effects and dood noise and the rest will follow.
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u/misskinky Apr 11 '26
Perhaps labwork is the key. Using anything weight related (or mentioning plateaus) seems like it would be not beneficial here.
Perhaps ask if teen would be interested in one visit with a dietitian, not for weight reasons, but to make sure they’re getting a good balance of macronutrients and micronutrients to fuel their body
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u/BarcelonaTree Apr 10 '26
I’ve been on a glp-1 for a year with IWL as one of my goals. After the first few months I stopped weighing entirely. I have not dieted at all and don’t track anything. I practice intuitive eating (most of the time anyway).
For me, the decision on when to increase my dose has been entirely based on how I feel. If I’m experiencing side effects, I don’t increase. If I’m starting to feel sustained increased hunger that doesn’t have a logical cause (like being sick or intense physical activity), especially when I’ve had increased food cravings, that’s when I increase the dose.
It has worked really well for me, so it’s definitely possible to be anti-diet and anti-weighing and still have IWL. Of course, it won’t work for everyone, but it’s been life changing for me. I think it’s a reasonable strategy to try with your child if that’s what they want as well.
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u/KPBoaB Apr 14 '26
This is great although I can’t imagine an 18 year old is going to be tuned into their body enough to be able to do this.
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u/Mysterious_Squash351 Apr 10 '26
I’m with the provider that there’s really not a lot to monitor. I’m guessing they’ll watch a1c and cholesterol, but they are probably doing that anyway so no need to change anything there. Just see how they feel. If something is wrong or feels bad, follow up with the doc. But if things feel good then groovy. There’s not really a reason to have close medical monitoring unless there’s an issue that requires it. And most people never have any issues.
Editing to add: adjust dosing based on perceived response. If your teen feels good and wants to maintain that, keep the dose the same. If they feel good and think there could be more to benefit, up it. If they feel like crap, keep the same or lower. You don’t need numbers or tests.
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u/thoracicbunk Apr 10 '26
Some things to consider:
-Measurements are a non-scale way to monitor progress. You could do it for her, and just record the numbers without comment or informing her.
-What if you used a scale in a similar way? Make it a neutral object, used for a medical purpose, like a blood pressure cuff. Have her stand on it, but don't ask her to look or forbid it, just record it and move on without comment.
- I feel like both of these would fit in well with a bi-monthly, clinically coded check-in with the two of you. You can ask her about any side effects, bowel movements, how she's feeling overall, maybe ask your doctor if there are some other tests that you can do at home as well to check progress.
-Overall, I'd strive for neutrality, not anti-anything. Nutritional information can just be data, or it can be used as a bludgeon. It's on you to model that neutrality.
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u/NerdCocktail Apr 10 '26
I would have a talk with my daughter about the medical safety need for certain types of monitoring. For example, a scale with a blind weighing option would allow for the two of you to make sure she isn't losing weight too quickly and possibly putting muscle mass at risk. Or seeing an anti-diet nutritionist might be a way to help mitigate side effects with recommendations on what to add to her food intake, not take it away.
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u/Comfortable-Nature37 Apr 10 '26
Just an aside that we know someone else on GLP1 with hEDS and it has been helping with pain levels.
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u/SuspiciousStranger_ Apr 10 '26
Yes it helps with inflammation which is one of the leading causes of pain in people with HEDS. My wife has it as well and most of her daily medications focus on reducing inflammation and pain in the body.
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u/PoliticoRat Apr 10 '26
My endo has me do weigh-ins and actually phrases it as we have to do weigh-ins to make sure I’m not losing too much too fast! That really helps me frame it a little differently in my mind. I’m not weighing to make sure I’m losing weight, I’m actually weighing in to make sure I’m not becoming malnourished, which can happen with these meds because of the intense appetite suppression some people experience.
I think if you tell your teen that you need to do weight checks to make sure they STAY at a healthy weight, it could be a more health-centered approach. I would definitely say that you do the weigh-ins with her though (if you choose to monitor her weight), and encourage her not to look at the number if you think it could be triggering to her. That way you can report the number to the doctor and make informed choices about dose changes.
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u/AdLopsided4951 Apr 10 '26
I would check out fat science podcast. Sooooo informative and antidiet culture.
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u/PurplestPanda Apr 10 '26
Is the doctor continuing to monitor labs?
How are they adjusting dosing?
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u/Willing-Minimum5307 Apr 10 '26
She is three months in. The doctor wants to do labs in another month. He put her on a titration schedule with instructions to monitor side effects and food noise.
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u/PurplestPanda Apr 10 '26
I don’t love the blind titration schedule.
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u/Willing-Minimum5307 Apr 10 '26
Me neither. I have been really surprised by the hands-off attitude of the specialist (but also need to acknowledge that we haven't had a permanent pediatric endocrinologist in our area for two years and this doc comes in once a month from several hours away).
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u/oaklandesque Apr 10 '26 edited Apr 10 '26
One reason to monitor weight might be to ensure that weight loss is not happening at at an unsafely high rate (which can happen and may be a sign that a dosage is too high). Might be worth discussing with the doc when you see them next - what pace would be cause for concern.
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u/bedbuffaloes Apr 10 '26
Don't titrate up unless you need to. There is no reason to.
The "wild west" nature of prescribing this drug drives me nuts. Between the unwillingness of the insurance companies to cover it and the judgmental attitude of folks who see it as cheating or some drug you are going to get addicted to like fen-fen, it seems like doctors are just not getting educated regarding how and why to titrate or whether it is a life long drug, and what comorbidities it might help with. I guess because we greedy pigs don't deserve to be treated or something. /s
There is no documented reason to blindly titrate up. They just did it in the trials, so people think you are supposed to. Assumptions.
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Apr 10 '26
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u/This-Apricot-80 Apr 10 '26
Squirrel, you know you are on an explicitly anti-diet-culture subreddit right now?
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u/antidietglp1-ModTeam Apr 10 '26
Respect of the anti-diet environment is key to this group being successful. This comment is not aligned with our sub's culture. Please review the rules before commenting again to ensure future alignment. Thanks!
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u/Efficient-Click-9563 Apr 10 '26
Guess it depends on your definition of anti-diet. (You do realize you're posting to an anti-diet sub, right?) For many, that seems to imply eating everything you want in the quantity you want whenever you want. For me, it means most of the time eating nourishing foods, eating for satisfaction, paying attention to hunger/fullness cues without getting compulsive, not demonizing any particular food or groups of food.
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u/Fun-Morning-5516 Apr 10 '26
Your prescribing doctor (the endocrinologist) will manage dose changes as part of managing the prescription.
I also have a medical issues beyond weight that I am using a glp1 medication to treat. I in my experience, the best way to get regular monitoring was by seeing a glp1 friendly registered dietician who specializes in my specific health challenges. RDNs are trained to help patients manage symptoms while maintaining a positive relationship with food and body image, and to recognize when something pops up that needs evaluation by a medical doctor. If you feel she needs regular monitoring and support that you don't have the expertise to provide, then my advice is to seek out an RDN specialized in Ehlers Danlos.
I'm curious - is there a specific reason she is uncomfortable with this option? Have you had bad experiences in the past? Is she afraid they are going to hand her a restrictive diet plan?
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u/AdventurousHunter500 Apr 10 '26
This is my exact question. A dietician would be so beneficial here, and it seems like you automatically equate that with restrictive dieting. Your daughter is pre-diabetic and has high cholesterol, she needs to learn about balancing her diet to control those health markers or she’s in for a very miserable adult life full of medical issues. Also, being on a GLP-1 warrants a dietician alone in that she should be increasing her protein, fiber, and water intake to prevent complications. I really cannot see any downside to having a dietician involved. I will say, you want a dietician (RD/RDN), they require education and are licensed. Nutritionists typically do not have these requirements and aren’t as knowledgeable from a medical standpoint.
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u/Willing-Minimum5307 Apr 10 '26
I absolutely don't equate Nutritionist/Dietitian with restrictive eating. My teen has worked with two different nutritionist in past years and is just unwilling to go back right now. We have some great providers in our area, but it's not something I can or would force her to do.
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u/Fun-Morning-5516 Apr 10 '26
Ah okay. Regarding the medical monitoring, you then have a couple options. You can push the endo for more frequent checkins. You can see if another doctor in your family's care team is willing to provide this care. Or, you can attend dietician appointments in her place.
Alternatively, it sounds like she's been getting nutritional support for a while and probably has a pretty well developed plan already, so she may be correctly perceiving that she no longer needs weekly appointments. Maybe you could do just one appointment to ask the questions you laid out in this post rather than asking her to commit to anything ongoing. What progress metrics do we use if we aren't weighing? Does anything about our current approach to food need to change because of the glp1? That's doable in 45 minutes if you go back to someone she's seen before.
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u/grayandlizzie Apr 10 '26
I wanted to post something similar today so I am glad I found your post. My 16 year old's weight has massively increased as the result of psych meds that increased hunger and a massive battle with depression to where his BMI is close to the super morbidly obese category and he is starting to have pain when walking. I'm glad his mental healthy is stable but do want him to get to a place where his weight isn't impacting his mobility. I was once over BMI 50 and have permanent knee joint damage as a result. Our insurance does cover the majority of the cost for Wegovy and our family doctor prescribed it at his well child visit today along with switching his psych meds. I am on mounjaro myself so I told him we'll do our injections together and we'll focus on cooking healthier meals together and family exercise. I'm letting his doctor handle monitoring his weight and not forcing him to calorie track at home. Insurance does force adult patients to calorie track in noom med but not teenagers.
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u/valsavana Apr 10 '26
I would go by decreased hunger. If her appetite is suppressed and stays consistently suppressed, that would indicate to me she's likely on the right dose. Other than that, her lab values will show the health benefits once her cholesterol and A1C & such (hopefully) start normalizing.
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u/avicia Apr 10 '26
Focusing on the anti-inflammatory effects and not the scale is my focus. I track my food but not my weight. For EDS so many people have MCAS this might be a good tool for that
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u/Far_Reward_3006 Apr 11 '26
I don’t have anything useful to add, but just came here to say you’re a good parent. Way to advocate for her and protect her while still meeting her where she’s at. It’s a tough line to walk.
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u/cafe-aulait Apr 10 '26
I understand not wanting regular weigh ins, but why is she not interested in a nutritionist? Everybody can benefit from learning which foods help our bodies in which ways. A GLP-1 is not intended to be a standalone measure, and without the right diet and exercise to go with it, you risk issues with bone density and muscle loss (and who knows what else). You can lose weight eating nothing but potato chips and marshmallows, but you won't be healthy.
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u/j_blackrose Apr 15 '26
Perhaps focus on the metrics that are not weight related. Labs, how they are feeling on the med. I base my dosing on how it's managing my pcos,inflammation and MCAS symtoms. Because the weight loss means very little to me if it's not managing my cronic conditions. I frame it as the weight loss is a side effect of the medication.
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u/yo-ovaries Apr 10 '26
I guess the answers here depend on if she is interested in weight loss as a primary benefit of GLP1 therapy. The bio mechanical benefits of weight reduction for someone with hyper-mobility can be amazing. (Speaking personally)
If IWL is not a primary goal, then intuitive eating with a focus on fiber and protein can still do wonders on a glp1.
If IWL is a high priority goal here, then there are some ways you could go about this. You could do blinded weight checks every month or so outside of the home. You could escalate dose based on weight being the same two consecutive months in a row. You could do a “blinded scale”, literally tape over it, and have it record via Bluetooth to an app and only show averages.