Losing Weight On GLP-1...But Now My Body Doesn't Match! (Obesity Doctor FAQ)

Added: 2026-05-27

[00:00:00]I've noticed that most of the weight loss has occurred in the lower part of my body while my upper body has not slimmed down significantly or weight or clothing size. Hi, I'm Dr. Megan. I'm an obesity medicine physician and weight loss coach here to help you cut through the pseudo-science and confusion in weight care. My approach combines evidence-based medicine with real behavioral change, so you don't just take medications, you actually transform your health. Stick around for clear, medically based answers to your weight questions. Welcome to Frequently Asked Questions. Today's question is this uh person began using compounded tirzepatide.

[00:00:37]Um they started Well, first they started walking, low-calorie diet, lost 33 lb, then they started using compounded tirzepatide, lost an additional 28 lb.

[00:00:49]They're currently at 160, goal is 135.

[00:00:53]Um However, I've noticed that most of the weight loss has occurred in the lower part of my body while my upper body has not slimmed down significantly or weight or clothing size. I currently wear an extra large given that I still have 25 lb to lose. I would like to know whether it is likely that my upper body will begin to decrease in size and whether it is realistic for me to reach at least a medium size. Despite having a total lost a total of 63 lb, the change is not very noticeable, and which has already been observed by my family and friends. I would appreciate your guidance in uh regarding this concern.

[00:01:25]Okay, well, first of all, congratulations on all your hard work.

[00:01:28]It sounds like you were doing everything that you can to get yourself to be as healthy as you can be, and whether people notice or not, you know, and your body knows. So, I think you should give yourself a big gold star for that.

[00:01:41]Congratulations. Um Also, just as a caveat, I will say sizes are very, as you probably know, they're kind of all over the map, and a medium in one brand is going to be a small in one and a large in another and yadda yadda yadda. So, sizing, while I think it is helpful, I always love to use clothing how clothing fits as a good measure of how somebody's weight loss journey is going because I think it's a nice holistic measurement.

[00:02:13]Um but also uh you know, if you're going by clothing sizes themselves, um I would try to stick to one brand in particular just for some consistency, but there is some variability, of course. So, um anyway, congrats on all your hard work.

[00:02:33]Um and I would say, you know, this is sometimes a frustrating thing for people is that you can't really spot lose um weight. Now, there's a very tiny body of evidence that suggests maybe intermittent fasting helps with you know, visceral fat, that fat in deep in the abdomen, but that's not, you know, I I only tell people to intermittent fast if they naturally feel inclined to do so. I would never want a patient to do that just because. Um so but in general, you can't really spot lose fat, which is can be very frustrating for people. Um I always if people can switch to the FDA-approved version um of their tirzepatide or their semaglutide, I always prefer them to do that just because you just don't know what's in the compounded medications and not just in terms of safety, but also in terms of efficacy. So, would you be getting a stronger effect with the FDA-approved version? Um we don't know, so if people can, I that's always something for many reasons that I encourage them to do.

[00:03:43]Also, if people have a lot of weight around the middle and it's not moving, for these patients um I always think it's a good idea for them to check in with their physician because there are some medical conditions that can have can be more that can have more what we call truncal obesity or weight around the middle. So, Cushing's syndrome, hypothyroidism, things like that. So, I would definitely want a patient who is noticing that to check in with me so we can make sure that there's nothing else going on behind the scenes. And then finally, I when people are not happy with kind of where the weight is. I think it's helpful to get really specific about the weight. So, if it's um if it is it weight around the middle that you can pinch so we know it's more subcutaneous fat. Is it weight that you know, you feel like your your abdomen is kind of like a tight drum then there's not a lot of subcutaneous fat but it's feels deeper. It's kind of like filling out the stomach and then or the the trunk and then that's probably more visceral fat behind the abdominal wall.

[00:04:53]Um also for a lot of people for a lot of women, they carry weight in their breasts and that can be the last place that they're going to lose weight. And so, depending on where the weight is that is bothering somebody that they feel like is preventing them from getting to their healthiest BMI, something like a breast reduction may be also something that they want to look into as an option. So, where is the fat that's bothering you is very helpful in terms of regions and then what the options are available.

[00:05:24]These are great questions. If you have a question, you know, these questions come from the community. So, if you have a question, leave it in the comment section down below and I will add it to the list. If you are really struggling to get the most out of your GLP-1 medication, if you feel like you're really struggling in terms of how you're eating or how you're exercising, it's really just not working together to help you get the results that you want. I will leave my website information down below. Click on that link, schedule a consult with me. I will tell you how I help people all the time with this. I do this all day, every day. You cannot surprise me.

[00:06:01]Um, and I love to talk about it and I would love to help you if this is something that you are struggling with.

[00:06:06]So, um, I'll leave that info down below.

[00:06:09]Thank you so much for watching and please be well.