The Skinny on “Skinny Shots”:

What GLP-1 Drugs Mean for Fertility, Hormones & Long-Term Health

A straw broke my camel’s back. 

I haven’t shared a hot take in a while, but after seeing yet another postpartum transformation story on social media that skipped over the use of GLP-1 medication, I couldn’t stay quiet.

Before I go further, I want to be clear: I have clients who are working intelligently with GLP-1s and finding immense success. This is not about shame. Used responsibly, these drugs can be powerful tools. What I will ca

ll out is irresponsibility—because when social media spreads misinformation, it fuels insecurity, especially among postpartum women who are already vulnerable.

The content I saw today came from a woman who had a dramatic weight change after baby—confirmed to be supported by GLP-1 use—yet she attributed her results to light dumbbell workouts and “peptides.” She even offered to sell her programming so other women could achieve the same results (without any credentials). 

What I can’t ignore is the irresponsibility of presenting a medication-driven transformation as something anyone could achieve with light workouts and supplements.

This is unrealistic—and it leaves women feeling like they’re failing when they can’t replicate an unnaturally rapid transformation.

If you’re frustrated with resistance to weight changes after baby—or at any stage—and you’ve watched someone drop 30 pounds in a short time, it’s not that you’re doing something wrong. The truth is this: the only way to achieve extreme, rapid weight loss is through extreme measures. That usually means medication that bypasses natural metabolic processes, or extreme restriction and training carried out with unrelenting consistency.

Neither of those approaches lasts.

In the name of science, here’s the TL;DR. 

GLP-1–based meds (Ozempic®/Wegovy® = semaglutide; Mounjaro®/Zepbound® = tirzepatide) can drive meaningful weight loss, but there are real considerations for women in their reproductive years: pregnancy planning/washout windows, interactions with oral birth control (tirzepatide), lean-mass losses without smart training/protein, GI and gallbladder risks, and high rates of weight regain after stopping. These aren’t “bad” drugs—but they’re not a casual wellness hack either.

What the research actually says.

They work—while you’re on them. In large randomized trials, weekly semaglutide 2.4 mg led to ~15% average weight loss; tirzepatide can be similar or higher. Cardiovascular risk reduction has been shown for semaglutide in people with established CVD. But these are treatments, not cures: benefits depend on continued use. 

After stopping, regain is common.

In the STEP-1 extension, people who discontinued semaglutide regained ~2/3 of the weight they had lost within one year, and cardiometabolic gains eroded. Translation: if you plan to use it briefly and “lock in” losses, the odds aren’t in your favor. 

Fertility & pregnancy planning matter. The semaglutide label instructs women to stop at least 2 months before a planned pregnancy (long washout). Data in early pregnancy are limited; labels caution potential fetal risk based on animal data. Tirzepatide’s label is similar regarding pregnancy avoidance. These are not recommended during pregnancy or breastfeeding. 

One big gotcha for birth control (tirzepatide). Tirzepatide delays gastric emptying and reduces oral contraceptive exposure, enough that the FDA-approved label advises using a backup or non-oral method for 4 weeks after starting and after each dose increase. Semaglutide hasn’t shown the same OCP effect. If you’re on the pill, this detail matters. 

PCOS nuance (not all “bad” for fertility). In women with obesity and PCOS, GLP-1 therapy (alongside lifestyle changes) can improve weight, insulin resistance and cycle regularity—factors tied to fertility. But that doesn’t erase the pregnancy/washout and contraception issues above, or the need to protect lean mass. 

The client I mentioned earlier is managing PCOS symptoms and experiencing remarkable, sustainable changes—because her GLP-1 therapy is paired with the foundational work: strength training, adequate protein, and lifestyle support.

Know the risks and proceed accordingly.

GI effects & gastroparesis spectrum. Nausea, vomiting, constipation are common; the semaglutide label cautions against use in severe gastroparesis and warns about pulmonary aspiration risk with anesthesia (because of delayed gastric emptying). Observational data signal increased diagnoses of gastroparesis vs. comparators. 

Gallbladder disease. A meta-analysis found associations with a higher risk of gallbladder/biliary disease (e.g., gallstones). Labels also warn about acute gallbladder disease.

Ileus/intestinal obstruction (rare). The FDA added ileus to Ozempic’s label in 2023; risk is rare but serious.

Muscle loss. ~25–40% of the weight lost can be lean mass unless you protect it (adequate protein + progressive resistance training). Losing muscle can lower metabolic rate, impair performance, and isn’t ideal for hormone health.

If you’re considering one, here’s how to protect your health & hormones.

1. Get crystal-clear on timing. If pregnancy is on your horizon, map a safe plan (including washout) before you start. If you use tirzepatide and take the pill, use backup contraception for 4 weeks after starting and after each dose increase. 

2. Guard your muscle. Program 2–4 days/week of progressive lifting + adequate daily protein while on therapy to minimize lean-mass loss. 

3. Screen for GI/gallbladder history and discuss anesthesia plans (labels now flag aspiration risk with GLP-1s during procedures). 

FDA Access Data

4. Plan for maintenance. Because regain is common after stopping, build a long-term food, training, sleep, and stress strategy ahead of any taper. 

And finally, the real CLUB take.

Medications can be powerful when medically indicated and paired with the right strategy. But for many women in their 20s–40s, the realities of pregnancy planning, contraception logistics, and muscle preservation shift the equation.

If your primary goals are hormone health, fertility, and sustainable weight, the first line of defense should still be: protein, fiber, resistance training, restorative sleep, and stress management. If a GLP-1 is still on the table, we design it around your cycle and your life—not the other way around.

Share the science with the women you love. The club was built on truth, research, and helping women not only optimize their health but also repair their relationship with food and movement. Social media may be pushing us backward—but by spreading light, encouragement, and evidence, we can move the conversation forward.

At least I hope we can.

Can’t wait to see you in the Club.

SOURCES

The Science

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La Merrill, M., Emond, C., Kim, M. J., Antignac, J. P., Le Bizec, B., Clément, K., Birnbaum, L. S., Barouki, R., & Clément, E. “Toxicological Function of Adipose Tissue: Focus on Persistent Organic Pollutants.” Environmental Health Perspectives, vol. 121, no. 2, 2013, pp. 162–169. PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC3569688/

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Neeland, I. J., Marso, S. P., Ayers, C., Lewis, K., Li, W., Xu, J., Kanevsky, E., & Lingvay, I. “Effects of Semaglutide on Lean Body Mass in Adults with Overweight or Obesity: The STEP 1 Trial.” Diabetes, Obesity and Metabolism, vol. 26, no. 3, 2024, pp. 638–647. Wiley Online Library, https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.15728

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Tysoe, O., et al. “Body Composition Changes with GLP-1 Receptor Agonists.” Nature Reviews Endocrinology, 2025, https://www.nature.com/articles/s41574-025-01140-w

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“Study Suggests Weight-Loss Surgery May Release Toxic Compounds from Fat into the Bloodstream.” Johns Hopkins Bloomberg School of Public Health, 2019, https://publichealth.jhu.edu/2019/study-suggests-weight-loss-surgery-may-release-toxic-compounds-from-fat-into-the-bloodstream

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“USC Study Shows Persistent Organic Pollutants Are Associated with Higher Blood Pressure in Teenagers after Weight Loss Surgery.” Keck School of Medicine of USC, 2025, https://keck.usc.edu/news/usc-study-shows-persistent-organic-pollutants-are-associated-with-higher-blood-pressure-in-teenagers-after-weight-loss-surgery/

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