Deborah Rustad Facebook ad: “This is why GLP-1 stops working for some women”

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I do the check-in weights at a weight loss clinic. About forty women a week on GLP-1. I can tell you which ones will stall around month four. And the handful who never do have one thing in common. I’m a medical assistant at a medical weight loss clinic. I’m not going to say which one, and I’m not going to use anybody’s real name, because these women trust me with a number every week and I’m not going to abuse that. But I need to say this somewhere, because I’m not allowed to say it at work. Here’s my job. You come in, I take you back, you step on the scale, I write the number down, I put you in a room. Then the provider comes in for her eight minutes. I do that about forty times a week, almost all women, almost all on semaglutide or tirzepatide. Which means I see the one thing your provider doesn’t. I see the whole year, on everybody, at the same time. And after about six months of doing this, I noticed the pattern nobody in the building talks about. Months one, two, three, the numbers fall. Beautifully. Eight pounds, then six, then five. The waiting room is a happy place. Women bring me photos of jeans. Then somewhere around month four, for what feels like more than half of them, the number stops. Not everyone. Not the same week. But often enough that I started being able to guess from the chart. Lost 25 in three months, now it’s been three visits of the same number, give or take a pound. I’d see the name on the schedule and think, this one’s about to get the speech. The speech goes like this. I hear it through the door forty times a week. “That’s completely normal. Almost everyone plateaus around month three. Your body’s adjusted. We’ll go up.” So they go up. And I book the follow-up. And a lot of the time, at the follow-up, the number still hasn’t moved and the woman looks greener, because the nausea on the new dose ate two weeks of her life. Then the second speech. “Twenty five pounds is a wonderful result. Some people just find their floor. This may be your body’s happy weight.” I have heard “happy weight” said to women who were plainly not happy. Women with 30 or 40 to go. Women who came in with a folder of food logs to prove they hadn’t gotten sloppy and never got to open it. And when they call the clinic crying, which they do, I’m the one who picks up. And I say what I’m trained to say. “The doctor says plateaus are normal. Keep logging. We’ll see you at your follow-up.” I said that for a year. Then, month five on my own shots, my number stopped. I’d started on the staff discount and lost 27 pounds in four months. I was one of the waiting room success stories. Then my husband’s dad moved in with us, with his oxygen and his opinions, and I was doing his meds at 6am and his dinner at 6pm and my own job in between. And somewhere in that stretch the food noise came back. Mid week. Days after my shot. Standing at the counter at 9pm eating his leftover mashed potatoes off the pot, on a medication that was supposed to make that impossible. Calm week, quiet head, maybe half a pound. Hard week with Dad, the noise ran straight over the medication and the scale froze solid. Like stress had a manual override on a $400 a month drug. I knew the speech was coming. I got it anyway, from the provider I work next to every day. “Completely normal. We’ll go up.” So we went up. Two weeks of nausea so bad I was eating maybe 900 calories and couldn’t look at chicken. Nothing, nothing, up one, nothing. Then labs. Thyroid, full panel, the works. Everything came back fine. And then, in the break room, from a woman I like, the second speech. “Donna, twenty seven pounds is a wonderful result. Some people find their floor. Maybe this is your happy weight.” Happy weight. I have 30 more pounds to lose. My knees know it. My blood pressure pills know it. And I had watched her say that exact sentence to two hundred women through a door. When I pushed, I got the version patients get. “Are you weighing everything?” I weigh other people for a living. “Calorie creep. It sneaks up on everyone.” Food scale, notebook, every bite. I’d handed out the notebooks. “You of all people should know plateaus are normal.” That was the office manager. And she was right. I of all people should know. That was the problem. I read the follow-up she’d booked for me on the schedule and went and stood in the supply closet, between the sharps containers, and cried where nobody could see me. And here’s the thing nobody tells you about the woman who stalls AFTER she’s lost some. Nobody feels sorry for her. Everyone thinks she should be grateful. “You look great! Aren’t you glad you did it?” My husband. My daughter. The provider I work next to. And I’d smile and think, I’m not done, and I have watched this happen to two hundred women, and not one person in this building can tell me why. And here’s the part nobody could explain. Not for me, not for any of them. My sleep got worse the higher my dose went. Not better. Worse. Shot night especially. I’d lie there wired, heart doing something I could feel, wide awake at 3am over nothing. My watch kept flagging it. Elevated heart rate, sleep score in the gutter. My body was screaming that something was wrong while every blood test said I was fine. And I’d heard that from patients too. “Is it normal that I’m sleeping worse?” I’d said, “I’ll mention it to the doctor.” Nobody ever did anything with it. One night at 1am I googled “semaglutide plateau permanent.” Turns out there’s a whole vocabulary for it. Set point. Metabolic adaptation. Long articles about how your body “defends” a weight. I read all of it with my heart pounding and thought, so that’s it. That’s what I’ve been watching. Everybody’s body just decides. I drafted a message asking to drop to a maintenance dose. What was the point of paying, even discounted, to hold steady. It sat in my phone. Unsent. But here’s what I had that none of those women had. I had the whole board. Because there were exceptions. A handful. Women in month six, seven, eight, whose number never stopped. No speech. No dose bump. They’d come in and I’d write it down and think, what is it about you? So I started asking. At check-in, quietly. “Can I ask you something off the record? What are you doing that everybody else isn’t?” The first one shrugged. The second one said something about sleep. The third one, I’ll call her Rita, put her purse down on the scale by accident, laughed, and said, “You’re going to be mad.” “Why would I be mad?” “Because it’s something my other doctor made me start before my first shot here. It costs about $30. And I assumed you all knew, because she acted like it was standard.” Her other doctor. A functional medicine doctor across town. And when I asked the fourth exception, she named the same doctor. Before Rita’s first injection, that doctor told her something Rita had written down in her phone. She showed me at the scale. “Every woman I put on these medications starts magnesium first. Because the shot is about to create the exact deficiency that stops it from working. And it doesn’t stop it on day one. It stops it the week the reserves run out.” I read it twice. Magnesium? I TAKE magnesium. Every night. Since week two. For, let’s say, the reason every woman on these shots ends up taking it. We tell patients to. The bottle from the drugstore was on my nightstand. “What kind?” The drugstore kind. I had no idea there were kinds. We’d been telling women to take it for a year and nobody in the building knew there were kinds. “That’s the problem. Wrong form. Let her explain it the way she explained it to me. Because it explains your whole waiting room.” So here it is, the way Rita gave it to me, standing at my scale. Your stress response works like a thermostat. Turns up under pressure, turns back down after. Magnesium is the fuel that lets it turn back down. When you’re depleted, the thermostat sticks on high, and your body reads that as an emergency. An emergency means storage mode. Hold onto everything. Release nothing. The shot quiets your appetite. It does nothing about storage mode. So you can take your foot off the gas all you want. Stress is still standing on the brake. Now here’s the part about the plateau. The part I’d been watching for a year without a name for it. Almost all of your magnesium comes from food. Most women over 50 are already running low. Stress burns it, medications drain it, even the soil our food grows in has less than it used to. Then you start a GLP-1, and suddenly you’re eating half of what you ate before. The drug is doing its job perfectly. But half the food means half the magnesium. “Nobody’s empty on day one,” Rita said. “You’ve been eating normally your whole life. Then for three or four months you eat half as much. Every week there’s less coming in.” “And right around when you’ve been doing that for months, life happens.” A father-in-law. A divorce. A move. A mother into memory care. I could have named twenty. “That’s what my doctor watches for. Not some magic week on the calendar. The longer you’re eating that little, the easier it is for a gap to catch up with you.” And then the provider goes up a dose. Less food. Worse nausea. Eating even less than before. I stood at my scale and watched a year of charts rearrange themselves in my head. The three-month drop. The month-four stall. The dose bump that made it worse. The sleep. All of it. In two hundred women. And it was never about which ones were sloppy. I pushed back. Obviously. I work in a clinic. “We run labs on everybody. Everybody comes back normal.” “You check everything that comes back normal. A standard test measures the magnesium in your blood. Almost all of it lives inside your cells, and no routine panel looks there. You can be starving at the cellular level and pass every test. Nobody checked mine either. Nobody checks anyone’s.” Everything we tested was fine. The thing that wouldn’t have been fine, nobody tested. We had a word for it instead. Plateau. And a word is where the investigating stops. “This sounds like the cortisol girls on Instagram,” I said. “The moon face videos. If a supplement fixed stress we’d all be taking it.” “I said the exact same thing to her,” Rita said. “And she said, I’m not selling you a cortisol detox. Your medication changed how much you eat. When you eat that little, you replace what’s missing or your body fights the drug. That’s not a trend. That’s arithmetic.” “But I’ve been taking magnesium this whole time.” “Wrong form. The type in the bottle you have never made it to where it matters.” She took a light blue bag out of her purse. SPNutrition. Magnesium bisglycinate gummies. “This is the kind my doctor specifically told me to take. Bisglycinate. Not just whatever bottle says magnesium on the front. Absorption is up to 90%.” And the gummy is the other half. Because you chew it, it breaks down like food unlike a pill, so your body treats it like food. These shots slow your stomach way down, so that matters more than it sounds. And on the higher dose, my stomach was barely moving at all. Two gummies before bed. That was the whole protocol. That was the thing I was going to be mad about. A year of charts. Two hundred speeches through a door. And the difference between Rita’s chart and everybody else’s was a $30 bag her other doctor treats as standard care. I still half didn’t believe her, so I went home and researched for three hours. The studies on magnesium and the stress response. The nutrient gaps that show up when people eat this little. The clinical trial data on the group that loses early and then stalls. It all checked out. I’d scrolled past this stuff for a year assuming it was scammy. Some of it is. The arithmetic isn’t. I ordered that night. 60 day money back guarantee. After four months of paying to hold steady, $35 was not the risk in my life. Day one, nothing. I want to be honest about that. End of week one, I was falling asleep faster. The forty minutes of ceiling staring shrank to ten. Week two is when it happened. I slept through the night. Straight through, no 3am, first time since Dad moved in. Even shot night. My watch noticed before I did. And that Friday, I stepped on my own scale at work before anyone was in, and the number moved. Two pounds. In one week. After seventeen weeks of nothing. And here’s the part I need to be precise about, because I know exactly how a chart gets read. Nothing about my medication changed. Same drug. Same dose. The exact dose that had given me nausea and nothing for two months. Same food scale. Same notebook. The medication didn’t suddenly start working again. It never stopped working. My body finally had the fuel to stop fighting it. Weeks three and four, steady. A pound, sometimes two, most weeks. The way it had been in month one. A hard week hit with Dad and, for the first time, the food noise stayed quiet through it. That’s when I actually believed it. Week six, the jeans I’d bought in month three buttoned again. Down 39 as I write this. My chart looks like Rita’s now. For four months I thought I’d hit my floor. My happy weight. The number my body decided on. The thing I’d told two hundred women on the phone was normal. I hadn’t hit anything. I’d run out of fuel. And every dose increase and every “push through” dug the hole deeper, because eating half the food means getting half the magnesium, and I’d been on the shots long enough to empty the tank. And not one person in a white coat thought to look for it. I want to be fair. They’re not bad providers. It’s just not what they’re trained to look for. They’re trained to adjust the dose. So they adjust the dose. Here’s the part that bothers me most. I still work there. I still do the check-in weights. I still hear the speech through the door, forty times a week. And I am not allowed to recommend anything to a patient, so when a woman calls crying at month four, I still say what I’m told to say. So I’m writing this instead. For the women I couldn’t say it to. I still take my injection every Sunday night. Same drug, same dose, nothing changed. I still have stress. Dad’s still in the back bedroom with his oxygen and his opinions. I just stopped running on empty. Every night before bed, two gummies. Thirty seconds to chew. My magnesium replenishes, my body comes off high alert, and the medication I was already paying for finally gets to finish the job it started. That should be standard care for every woman starting these injections. Rita’s other doctor treats it that way. My clinic has never said a word about it, and I’ve stopped expecting them to. If you lost beautifully for the first few months and then it just... stopped. If you got the speech, and then the dose bump, and then the second speech. If you called your clinic crying and someone like me told you plateaus are normal. If you brought a folder of food logs to prove you hadn’t gotten sloppy and never got to open it. If you already take magnesium, the drugstore kind, every single night, because the clinic told you to, and your scale hasn’t moved. If your sleep got worse the higher your dose went, and you’re lying there at 3am wondering if this is all your body is ever going to give you... I’m not saying you definitely have a magnesium deficiency. I’m a medical assistant, not a doctor, and I’ll say that as many times as I need to. But I’ve watched a year of charts stall at the same place, and I’ve watched the exceptions, and I spent four months and a lot of money asking a higher dose to do a job my body didn’t have the fuel to finish. SPNutrition is a small company. They make their gummies in limited batches using pure magnesium bisglycinate, the specific form Rita’s doctor put her on from the beginning. Right now they’re running a sale. I checked the site this morning and ordered a second bag for my sister-in-law, who starts her injections next month at a different clinic. I told her she is not starting a single day without it. I can’t say that to a patient. I can say it to her. To be honest, I panicked a little when I saw the sale banner, because every time they run one of these, they sell out fast. They have a 60 day money back guarantee too. Two full months. That’s longer than it took me to feel the difference. If nothing changes, you get every penny back, no questions asked. But if it works? If by the end of week one you’re falling asleep without the ceiling staring? If by week two the 3am wake ups stop and your number moves for the first time in months? You’ll wish you’d started it the same day as your first shot. I know I do. And I wish I’d asked Rita a year earlier. Anyway, I’m linking an article below that explains the magnesium link better than I can. Just take 2 minutes to read it. 👇 https://spnutrition-us.com/pages/adv1

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This is why GLP-1 stops working for some women

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