Your Prescription Came With Instructions For The Medication. Not For The Food.

Here is something I see over and over in my practice.

A woman starts one of these medications. It works. For the first time in years, the weight actually moves.

And about three months in, something else starts happening.

The stairs feel different. Groceries feel heavier than they used to. She is sleeping fine and still tired at two in the afternoon.

She mentions it at her next appointment and gets told it is normal. Which is true. It is normal.

But normal is not the same as fine.

THE PATTERN

I am a Registered Dietitian. I have a master's in public health, I spent four and a half years in nutrition at a large company before this, and now I run a small clinical practice where most of my clients are women in their forties and fifties.

A growing number of them are on these medications.

And across all of them, the same three things show up. Almost every time.

Protein falls off first. Not on purpose. Protein is heavy, filling food, and it is the first thing to stop sounding good when your appetite drops.

Eating becomes unpredictable. Some days she forgets entirely. Some days two bites is enough. Some days food sounds fine right up until the plate is in front of her.

Energy goes. And that one gets blamed on everything. Her age. Her hormones. Her schedule. The medication.

Three things, and they all come from the same place.

THE MECHANISM

I call it the Hollow Loss.

The weight is coming off. That part is working. But when weight comes off fast and nothing is built in to support it, some of what leaves is not fat.

The scale says it is going well. The stairs say something else.

THE HONEST NUMBERS

Now, this is where most of what you will read online gets it wrong, and I would rather be straight with you than scare you.

You have probably seen the claim that a quarter of your weight loss is muscle.

That figure comes from a pooled analysis of 22 clinical trials. And it is real. But it measures lean mass, not muscle. Lean mass includes water, organs, and other tissue, and a good chunk of what drops early is simply water.

Here is the number that actually applies to a woman.

Modeling data cited in the 2025 clinical advisory on these medications puts muscle at roughly 10 to 15 percent of total weight lost in women, compared to 20 to 25 percent in men. And that is without any strength training at all.

So no. You are not wasting away. Anyone telling you that is selling fear.

What the research actually says is more useful than that.

How much lean mass someone loses is not fixed. It depends on how fast the weight is coming off, how deep the calorie drop is, how much protein is going in, and whether there is any resistance training happening.

The last two are the ones you control.

THE THING ALMOST NOBODY TELLS YOU

There is one line in that 2025 advisory that I wish every person on these medications got handed at the pharmacy.

It says that increased protein on its own is likely not enough to preserve muscle without a structured resistance training program.

Read that twice.

Because the entire internet is currently selling you the first half of that sentence.

Protein shakes. Protein bars. Protein everything. All of it useful. None of it sufficient.

And it works the other way too. You cannot hold onto tissue you are not feeding. Training without protein is just a deficit with extra steps.

You need both. And here is the good news: neither one has to be extreme.

THE GAP

So why is nobody explaining this?

Not because your doctor does not care. Because a prescription appointment is twelve minutes long and nutrition was never part of the training. That same 2025 advisory notes that around 90 percent of cardiologists get minimal or no nutrition education during fellowship. It is not a knock on them. It is just how medicine is built.

A 2025 study of 69 people using these medications found that only about half had been given any information on managing side effects, and only one in five had been referred to a dietitian.

Small study. But it matches what walks into my practice.

The medication got prescribed. The other half of it did not.

WHAT I BUILT

So I built the other half.

It is called Still Strong. It is a 30-day protocol, and it does three things.

It gives you one number. Your protein floor. Not a goal for good days. A floor you protect on the bad ones. Most protein advice is built for people who can eat, and you cannot always eat. So the number is built off your lean mass, not your scale weight, which matters because setting it off scale weight overshoots badly.

It gives you food that works with the appetite you have. Including a full shot day section: eight cold, low-volume meals for the days when nothing sounds good and you still have a floor to hit. Cold beats hot, because smell drives a lot of the nausea. Liquid beats solid, because drinking goes down when chewing will not.

It gives you the training half. Three sessions. Twenty minutes each. Sixty minutes a week, total. A chair, a wall, and a set of bands. The clinical guidance says at least three times a week, so three is what you get, because once a week is not a real dose and I am not going to pretend otherwise.

WHAT'S INSIDE

Here is the whole thing.

• ✅Your Protein Floor. Find your number three different ways, depending on whether you have a body scan, a smart scale, or neither. Plus how to split it across the day, which is the part that matters most after 45.
• ✅The protein reference chart. What 25 to 35 grams actually looks like across 19 common foods. This is the page people photograph and keep on their phone.
• ✅Shot Day. Eight cold, low-volume, high-protein meals for the hard days. Plus the playbooks for nausea, constipation, reflux, and the food-does-not-taste-right thing nobody warns you about.
• ✅The 4-week meal plan. Twenty-eight days, omnivore, built to land around 110 grams of protein a day. Built with room in it, because you are probably not going to finish every plate and the plan should account for that instead of making you feel like you failed.
• ✅The grocery list. Split into buy-once and buy-weekly, organized the way the store is laid out.
• ✅The 20-Minute Strength Protocol. Three sessions a week, four weeks of progression, no gym. Plus a 30-second baseline test so you can see the change in something other than the scale.
• ✅Filling the Gaps. The six supplements worth considering and the two you should not start without a blood test. Plus access to my Fullscript dispensary protocol, so you are not guessing at brands.
• ✅What to Ask Your Prescriber. A page to bring to your next appointment. The labs worth requesting and the questions worth asking, so twelve minutes goes further.

$27, one time. 30-day money back guarantee.

WHAT THIS IS NOT

It is not anti-medication. These drugs work better than almost anything we have ever had for this. If yours is working, that is good news and I am not going to complicate it.

It is not a weight loss plan. Your medication is handling that. Weight is a symptom, not the goal.

It is not medical advice. I am a dietitian. Food and training are mine. Your dose is between you and your prescriber, and there is not a single word in here telling you what to do with it.

WHY NOT JUST LOOK THIS UP FOR FREE?

Fair question, and I would rather answer it straight than pretend any of this is secret.

Every piece of it exists somewhere. The 2025 advisory is public. The protein research is public. There are thousands of free articles about eating on these medications, and some of them are good.

Here is what none of them do.

They do not give you one number. They give you ranges, caveats, and a comments section arguing about grams per kilogram. You still have to work out what that means for you, on a Tuesday, when you feel awful.

They do not agree with each other. Some are selling protein powder. Some are selling fear about muscle loss. Telling those apart means reading the underlying studies yourself, which is the thing you were trying to avoid.

They are written for people who can eat. Almost none of them account for an appetite that closes without warning, or for a day when two bites is enough.

They are fragments. A protein article here, a workout video there, a thread about nausea somewhere else. Assembling those into something that fits together is the actual work.

That is what the $27 buys. The number, the meals, the shot day plan, and the three sessions, already worked out and already fitted to each other.

You could do that assembly yourself. It would cost you a weekend and a lot of reading, and you would probably land close to where this already is.

THE SECOND THING WORTH KNOWING

One more, and then I will get out of the way.

You have probably read that people regain about two-thirds of the weight within a year of stopping. That comes from the semaglutide trial extension and it is accurate.

Here is the part that gets left out.

In that trial, the structured lifestyle support was withdrawn at the same time as the drug. Everything stopped at once. So what it actually shows is what happens when all the support disappears.

What happens when the nutrition and the training continue? That has not been tested in a controlled trial. Nobody knows yet, and anyone who tells you otherwise is going past the evidence.

What I will say is this. If your protein floor and your three sessions a week are habits by the time you taper, you are not starting from zero.

That is not a promise about the scale. It is just a better place to be standing.

Because if it falls apart the moment you stop, it was never really a plan.

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FAQ

$27, one time. 30-day money back guarantee.

P.S.

If you take nothing else from this page, take this.

The protein and the training are not two separate pieces of advice. The clinical guidance is explicit that protein on its own is likely not enough without resistance training. Most of what is being sold to women on these medications right now is only half of that.

You do not need my protocol to act on it. You could go do both starting tomorrow on your own.

But if you would rather have the number, the meals, the shot day plan, and the three sessions already worked out for you, that is what the $27 buys.

Either way, please do both.

Nate Bladecki, MPH, RD