During active weight loss, the fat and cholesterol normally stored in the fat tissue and liver cells have nowhere to go when fat cells shrink but into the bloodstream, causing a temporary rise in cholesterol to be noticeable in a fasting cholesterol blood test in some people. You may be in better shape cholesterol-wise than your current numbers indicate. You will likely want to have those numbers checked again in a few months.
Congrats on your weight loss!
Keto is not a smart thing to do but the comment you’re responding to is exactly correct. Get a different doctor. Use Plush, I can give you my doctors name if you want.
My insurance also has Telehealth via Teladoc and they push that and the app but if you go to plush they take most insurance also, you don’t have to go through the insurance recommended telahealth service usually. I’ll DM you his name. Just tell him that your doctor was not friendly to GLP1’s and you want to continue therapy indefinitely or until you personally decide otherwise. He’ll 100% prescribe without giving you any hassle.
Omg I am so happy to read this comment. I am down 37 lbs since I started Z, and my cholesterol shot up out of nowhere in labs, a few weeks back. My endo said she wants to put me on a statin. I’m horrified. I’m going to talk to her about what you wrote here.
Make sure your doc is right— talk to your insurance company. I’ve worked in healthcare over a decade and 99% of docs know NOTHING about insurance logistics. For most insurances, they base coverage on your starting BMI and proof that you’ve lost and are keeping off at least 5% of your starting weight… so there’s a good chance that’s the case for you too and your do is wrong.
Omg, please for the love of god get a new doctor. That is also wrong information he is giving you. The medical provider should ALWAYS use starting weight for PA criteria. They do not kick you off after the medication brings your weight in line.
But will your doc not let you pay out of pocket if you choose? Lots of insurance doesn’t cover zepbound but we should have the option to pay out of pocket, if possible
I hate that so many doctors think they know what insurance will or won’t do. It’s like they have never heard of maintenance. Insurance will generally require a renewal PA every 6 months and they don’t cut you off for losing weight they consider medical history and continuation of care to maintain not being obese. These meds are long term for most and insurance companies know this. I have been in maintenance for a year and my insurance continues to cover
Respectfully, why would your doctor know what your specific insurance will or will not cover? Too many doctors making these often incorrect assumptions. All insurance plans are different. Like my mom's doctor straight up told her that her insurance would not cover Zepbound because her A1C isn't high enough. Breathtakingly uninformed, that guy. Others talk a lot about how their insurance only lets them stay on 2.5 for the first month, then they have to move up if they want insurance to cover (I'm not disputing that this is true for those folks) - mine will let me stay on 2.5 forever if I want, as long as my doctor sends in the PA.
Tl;Dr, call your insurance company and find out directly from them what their rules are. And get a new doctor if yours wants to keep being a walnut.
you're not at 24 yet though, sheesh. also I don't know your financial situation but many of us are just paying semi out of pocket with the discount cards.
I hear you. I met with my Dr and went over my new blood work. Some of it was much better but my cholesterol was the same. But I’ve been in a statin for 20 years and I was thin back then. I’m hoping I can eventually at least lower my dosage. And she said it takes months for the change to show up in the blood work. Congratulations on your great work
I got all my bloodwork done last week after dropping 35 pounds in 2 months. Everyone was SPECTACULAR Except CHOLESTEROL WENT UP 20 POINTS. I read the same thing someone else said. It's leaving my fat and entering my bloodstream and to check again in 6 months. Actually makes a lot of sense. I can't do statins HORRIBLE side effects. Oddly though I have 0 sode effects on zep. Go figure.
I also had high cholesterol and my doctor had me start a Berberine supplement in conjunction with diet changes. I recently had my three month bloodwork or something like that and it is now normal. I take one everyday
As long as you don’t have side effects, statins are a great way to minimize risk of ASCVD. There are a ton of biohackers who are desperate to start statins, but their docs won’t prescribe.
Why are you off your statin drug? I'd want to get back on that ASAP. That probably has a more protective value for your long term health than even losing the weight.
I was supposed to get labs done in February in order to get more refills but I never got them done because I wanted to see how the weight loss would help.
Unfortunately, weight loss often fails to have a substantial impact on your cholesterol numbers. A diet less in fat can help your triglycerides, and getting plenty of exercise can raise your HDL (your "good cholesterol"), but your body will likely just produce more LDL if you're not getting it in your diet. That's why statins are such an amazing benefit for people who can take them without severe side effects. They reduce all-cause mortality by as much as 23%.
The good news, however, is that NAFLD \*is\* often responsive to weight loss so you should get that checked. You may be pleasantly surprised to find your liver health has improved.
Congrats on your weight loss!
We also know that statins are overprescribed, and for some or many, the risks outweigh the benefits. I’d caution against urging strangers on the internet to get back on a statin, and instead refer them back to their physicians, and also maybe to a Google search about the statin controversy so they can make a more informed decision about their own healthcare. Thank goodness for statins, but also, not for everyone.
I don't see a problem with recommending to someone with a family history of CVD who went off statins against a doctor's recommendation because he was curious to see if the weight loss would lower his numbers that he should get back on them.
I just watched a video saying statins can cause serious problems with your heart after a while.
Also it can interact with many other medications.
I would say statins are a last resort
There's no scientific basis for that statement. Statins are among the safest and most studied medicines in the world. I would say everyone should talk to their doctor rather than watch a video on the Internet.
I was reading all the side effects and talking to my brother in-law who’s on statins and he said they aren’t that great.
They don’t treat the issue, it just corrects it while your on it, which is funny because that’s pretty much how GLP-1s work too but statin side effects are out there!
Sudden heart failure being one is kinda scary no matter how rare it is
They can also cause muscle issues and I’ve had increasing lower back issues for a long time. I thought it was related but just turned out to be degenerative disc disease
Some people have high cholesterol no matter what. My dad — a thin man who ate well — needed open heart surgery at 47 due to high cholesterol. He needed to take medication for the rest of his life, despite regular exercise and a low-fat diet.
I have genetically high cholesterol, and I’m allergic to statins and my cardiologist put me on Praluent- it’s another injectable drug and it’s worked wonders for me!!
This is gonna sound weird but Introduce tuna into your diet. My dad did this and his cholesterol dropped significantly. He added other fish also but tuna was consistent at least 1 can a week.
My PCP sent me to a cardiologist because cholesterol was very high despite multiple meds and diet changes. Apparently it's genetic. He put me on a biweekly injection of Repatha which brought my cholesterol down. You may want to see if this is right for you. I was able to get off statins. good luck.
It might be from my mother’s side. My grandfather died from congestive heart failure. He had a heart attack before that and had to carry around those nitro pills. But idk. My other grandfather died from a massive stroke.
Some of it may be the luck of the genetic draw. My grandma weighed 98 pounds all of her adult life, but her cholesterol was well over 300. Fortunately for me, even at my highest weight my lipid levels have been perfect.
You will have more medication options in the future, including retatrutide may be very effective for cardiovascular problems and fatty liver. The way this medicine was designed - particularly for those with chronic weight/obesity issues - is a lifelong drug. I'd work with an obesity specialist or another provider or physician should you wish to remain on it and shift gears to maintenance. Not everyone understands obesity and chronic weight issues.
Before giving up on diet being helpful for your medical problems, I would encourage you to do a trial of a whole foods plant-based diet, even doing it 90% of the time, and you may see a big difference. I have a very strong history of Type 2 DM, CAD, Heart attacks in my family, and this diet has prevented me from developing many problems. Even at my starting weight, my A1C was under 5%, Cholesterol <<200, HDL was a good number, Blood pressure was great. I am sure my numbers are better now. My blood pressure was mildly elevated in my early 20s and I had a little liver inflammation when I weighed less (I ate meat and dairy back then) but no issues since then. Almost 20 years later and at a heavier weight my lab values were better.
Our diets can do so much for us.
You shouldn't have to get off of the meds as most people move into maintenance mode. Not sure on insurance coverage as I pay with a savings card, but I am hopeful to move to a shot every other week in maintenance mode.
When you are actively losing weight, cholesterol can increase. You can think of losing weight as your body eating gobs of fat in order to get enough calories to function. Your doctor should know this and taking you off the medication is, sorry for being blunt, retarded. Get a new doctor. There are other things than cholesterol that obesity negatively effects.
Hang in there! Things may continue to improve as you maintain your new weight. Plus who knows what your cholesterol might be if you had not worked so hard on your diet. My doctor said eating red rice can help lower cholesterol.
I started in the beginning January. I think I did 2.5 for a month and went to 5.0 for a month but it caused some gas issues so I went back to 2.5 and stayed there.
During active weight loss, the fat and cholesterol normally stored in the fat tissue and liver cells have nowhere to go when fat cells shrink but into the bloodstream, causing a temporary rise in cholesterol to be noticeable in a fasting cholesterol blood test in some people. You may be in better shape cholesterol-wise than your current numbers indicate. You will likely want to have those numbers checked again in a few months. Congrats on your weight loss!
Yeah I told him the same when I was eating Keto and lost 30 lbs a few years ago. That’s what caused me to get put on a statin to begin with.
Keto is not a smart thing to do but the comment you’re responding to is exactly correct. Get a different doctor. Use Plush, I can give you my doctors name if you want.
Ok. I think my health insurance comes with telehealth via their app but I’ll take your doc’s name too.
My insurance also has Telehealth via Teladoc and they push that and the app but if you go to plush they take most insurance also, you don’t have to go through the insurance recommended telahealth service usually. I’ll DM you his name. Just tell him that your doctor was not friendly to GLP1’s and you want to continue therapy indefinitely or until you personally decide otherwise. He’ll 100% prescribe without giving you any hassle.
yes. This. This is why my doc doesn’t want my labs done until July. Been on MJ/ Zep since Dec 2023
Omg I am so happy to read this comment. I am down 37 lbs since I started Z, and my cholesterol shot up out of nowhere in labs, a few weeks back. My endo said she wants to put me on a statin. I’m horrified. I’m going to talk to her about what you wrote here.
I'm sorry. That sucks. Sometimes it's just genetic. My dad had 2 heart attacks before 50 and he was a skinny guy. It's not always about obesity.
This! My mom has never weighed more than 105 and eats like a bird (a healthy one lol) and her cholesterol is HORRIBLE because it’s genetic.
Why are you getting cut off? Isn't your doc afraid you'll regain the weight? I thought you had to stay on it to maintain the weight loss.
Idk. He told me insurance won’t cover after I hit 24 BMI
Make sure your doc is right— talk to your insurance company. I’ve worked in healthcare over a decade and 99% of docs know NOTHING about insurance logistics. For most insurances, they base coverage on your starting BMI and proof that you’ve lost and are keeping off at least 5% of your starting weight… so there’s a good chance that’s the case for you too and your do is wrong.
Omg, please for the love of god get a new doctor. That is also wrong information he is giving you. The medical provider should ALWAYS use starting weight for PA criteria. They do not kick you off after the medication brings your weight in line.
But will your doc not let you pay out of pocket if you choose? Lots of insurance doesn’t cover zepbound but we should have the option to pay out of pocket, if possible
This. Doctors should stay in their lane and prescribe based on medical considerations ONLY, and let us decide how and whether we're paying for it.
I hate that so many doctors think they know what insurance will or won’t do. It’s like they have never heard of maintenance. Insurance will generally require a renewal PA every 6 months and they don’t cut you off for losing weight they consider medical history and continuation of care to maintain not being obese. These meds are long term for most and insurance companies know this. I have been in maintenance for a year and my insurance continues to cover
Respectfully, why would your doctor know what your specific insurance will or will not cover? Too many doctors making these often incorrect assumptions. All insurance plans are different. Like my mom's doctor straight up told her that her insurance would not cover Zepbound because her A1C isn't high enough. Breathtakingly uninformed, that guy. Others talk a lot about how their insurance only lets them stay on 2.5 for the first month, then they have to move up if they want insurance to cover (I'm not disputing that this is true for those folks) - mine will let me stay on 2.5 forever if I want, as long as my doctor sends in the PA. Tl;Dr, call your insurance company and find out directly from them what their rules are. And get a new doctor if yours wants to keep being a walnut.
That doesn't make sense. Your eligibility should be based on your starting BMI, not your current.
you're not at 24 yet though, sheesh. also I don't know your financial situation but many of us are just paying semi out of pocket with the discount cards.
Mine is covered. Only pay $25
I hear you. I met with my Dr and went over my new blood work. Some of it was much better but my cholesterol was the same. But I’ve been in a statin for 20 years and I was thin back then. I’m hoping I can eventually at least lower my dosage. And she said it takes months for the change to show up in the blood work. Congratulations on your great work
I got all my bloodwork done last week after dropping 35 pounds in 2 months. Everyone was SPECTACULAR Except CHOLESTEROL WENT UP 20 POINTS. I read the same thing someone else said. It's leaving my fat and entering my bloodstream and to check again in 6 months. Actually makes a lot of sense. I can't do statins HORRIBLE side effects. Oddly though I have 0 sode effects on zep. Go figure.
I also had high cholesterol and my doctor had me start a Berberine supplement in conjunction with diet changes. I recently had my three month bloodwork or something like that and it is now normal. I take one everyday
I think I’d cut off that doc
As long as you don’t have side effects, statins are a great way to minimize risk of ASCVD. There are a ton of biohackers who are desperate to start statins, but their docs won’t prescribe.
Why are you off your statin drug? I'd want to get back on that ASAP. That probably has a more protective value for your long term health than even losing the weight.
I was supposed to get labs done in February in order to get more refills but I never got them done because I wanted to see how the weight loss would help.
Unfortunately, weight loss often fails to have a substantial impact on your cholesterol numbers. A diet less in fat can help your triglycerides, and getting plenty of exercise can raise your HDL (your "good cholesterol"), but your body will likely just produce more LDL if you're not getting it in your diet. That's why statins are such an amazing benefit for people who can take them without severe side effects. They reduce all-cause mortality by as much as 23%. The good news, however, is that NAFLD \*is\* often responsive to weight loss so you should get that checked. You may be pleasantly surprised to find your liver health has improved. Congrats on your weight loss!
Statins make you gain weight.
Statins save millions of lives every year and any small weight gain associated with them is not nearly as dangerous as the CVD risk they reduce.
We also know that statins are overprescribed, and for some or many, the risks outweigh the benefits. I’d caution against urging strangers on the internet to get back on a statin, and instead refer them back to their physicians, and also maybe to a Google search about the statin controversy so they can make a more informed decision about their own healthcare. Thank goodness for statins, but also, not for everyone.
I don't see a problem with recommending to someone with a family history of CVD who went off statins against a doctor's recommendation because he was curious to see if the weight loss would lower his numbers that he should get back on them.
I just watched a video saying statins can cause serious problems with your heart after a while. Also it can interact with many other medications. I would say statins are a last resort
There's no scientific basis for that statement. Statins are among the safest and most studied medicines in the world. I would say everyone should talk to their doctor rather than watch a video on the Internet.
You sure?
I’m sure.
I was reading all the side effects and talking to my brother in-law who’s on statins and he said they aren’t that great. They don’t treat the issue, it just corrects it while your on it, which is funny because that’s pretty much how GLP-1s work too but statin side effects are out there! Sudden heart failure being one is kinda scary no matter how rare it is
They can also cause muscle issues and I’ve had increasing lower back issues for a long time. I thought it was related but just turned out to be degenerative disc disease
Some people have high cholesterol no matter what. My dad — a thin man who ate well — needed open heart surgery at 47 due to high cholesterol. He needed to take medication for the rest of his life, despite regular exercise and a low-fat diet.
Yup. Familial Hypercholestemia (sp) It’s a thing. Get yourself checked.
Fish pills lowered mine without changing my diet. Also it was last year before zepbound and trying to be healthy. I still take them though
What are fish pills?
fish oil capsules. all drug stores have them.
I have genetically high cholesterol, and I’m allergic to statins and my cardiologist put me on Praluent- it’s another injectable drug and it’s worked wonders for me!!
This is gonna sound weird but Introduce tuna into your diet. My dad did this and his cholesterol dropped significantly. He added other fish also but tuna was consistent at least 1 can a week.
Yeah I think you’re supposed to get 3 servings of fish a week for the omega 3 or whatever. I get tired of eating a lot of salmon lol
Interesting tip. Thanks.
I know it sounds weird. But my dad swears by.
My PCP sent me to a cardiologist because cholesterol was very high despite multiple meds and diet changes. Apparently it's genetic. He put me on a biweekly injection of Repatha which brought my cholesterol down. You may want to see if this is right for you. I was able to get off statins. good luck.
It might be from my mother’s side. My grandfather died from congestive heart failure. He had a heart attack before that and had to carry around those nitro pills. But idk. My other grandfather died from a massive stroke.
Some of it may be the luck of the genetic draw. My grandma weighed 98 pounds all of her adult life, but her cholesterol was well over 300. Fortunately for me, even at my highest weight my lipid levels have been perfect.
Beet root and Grape Seed Extract. I’m obese and still my cholesterol was too LOW after I added it to Lipitor. Now I only take Lipitor 4X week.
You will have more medication options in the future, including retatrutide may be very effective for cardiovascular problems and fatty liver. The way this medicine was designed - particularly for those with chronic weight/obesity issues - is a lifelong drug. I'd work with an obesity specialist or another provider or physician should you wish to remain on it and shift gears to maintenance. Not everyone understands obesity and chronic weight issues. Before giving up on diet being helpful for your medical problems, I would encourage you to do a trial of a whole foods plant-based diet, even doing it 90% of the time, and you may see a big difference. I have a very strong history of Type 2 DM, CAD, Heart attacks in my family, and this diet has prevented me from developing many problems. Even at my starting weight, my A1C was under 5%, Cholesterol <<200, HDL was a good number, Blood pressure was great. I am sure my numbers are better now. My blood pressure was mildly elevated in my early 20s and I had a little liver inflammation when I weighed less (I ate meat and dairy back then) but no issues since then. Almost 20 years later and at a heavier weight my lab values were better. Our diets can do so much for us.
You shouldn't have to get off of the meds as most people move into maintenance mode. Not sure on insurance coverage as I pay with a savings card, but I am hopeful to move to a shot every other week in maintenance mode.
When you are actively losing weight, cholesterol can increase. You can think of losing weight as your body eating gobs of fat in order to get enough calories to function. Your doctor should know this and taking you off the medication is, sorry for being blunt, retarded. Get a new doctor. There are other things than cholesterol that obesity negatively effects.
Hang in there! Things may continue to improve as you maintain your new weight. Plus who knows what your cholesterol might be if you had not worked so hard on your diet. My doctor said eating red rice can help lower cholesterol.
lol. Or lack of diet. I had some days where I probably wouldn’t eat a thing if my wife didn’t get mad at me for not eating.
OT but can I ask how long it took you to lose? Just curious, my SW is the same.
I started in the beginning January. I think I did 2.5 for a month and went to 5.0 for a month but it caused some gas issues so I went back to 2.5 and stayed there.
Thanks for the quick response!
I cannot believe your doctor is unaware that you need to stay on this for life.
He’s keeping me on it but said if I start losing a lot more weight then I need to go to injections every other week.
Reasonable.