“When I saw the termination notice come in, it was kind of nerve-wracking.” James Digilio is 62 years old. He couldn’t pay for his health insurance after costs skyrocketed. “I was paying, last year, $57-a-month premium. And then it jumped up this year to $1,690 a month. When I first saw it, I was surprised. I thought this was a mistake.” Millions of people like James saw their insurance premiums soar in January after the Senate deadlocked on competing proposals, leaving the expanded tax subsidies to expire. James relies on medication to manage his blood pressure, cholesterol and diabetes. Since losing his insurance, he started rationing his medication. “I was concerned about the medications, not knowing how I was going to refill them. I figure if I could stretch it out and not take them for a week or so, then that’s another week I could tack on that I could still stretch it out to.” James works at a pizza restaurant, making $14 an hour washing dishes and delivering food — that brings in, on average, $1,200 a month plus tips. He says that the $1,690 health insurance payment would eat up all the income from his job. “It would have been very hard to manage to pay that much premium for health insurance.” He takes care of his sister, who is currently unemployed. In January, to cover their expenses, James took out his Social Security retirement benefits early. If he had paid for his new health insurance premium on top of the other expenses, that would have left him nearly $1,400 in debt at the end of each month. For years, Florida has been leading the nation in Affordable Care Act enrollment. One in five residents are enrolled in an A.C.A. plan, compared to one in 15 nationwide, and 98 percent of Florida’s enrollees relied on federal financial assistance to pay for a plan. Now, many are facing a future without health insurance. More than a million people nationwide have dropped their coverage since the A.C.A. subsidies expired. Today, with only a week and a half of medication left, James is visiting a free clinic nearby to see if they have the medications he needs. “OK, if you just take a seat and I’ll tell the nurse you’re here.” “Jimmy’s case is not unique. All of our new patients who had insurance and now do not have insurance have all seen tremendous increase in their monthly premiums to the point that they can’t afford them any longer.” Terri Belletto runs this volunteer-based clinic in Bunnell, a city in northeast Florida. It relies on private donations and grants for its funding. She says her clinic has seen a surge in patients over the past three months. “This is the largest increase in patients that we’ve seen in the 12 years that I’ve been here. If we’re not in crisis mode in health care in the United States, we’re almost there.” “So was it two months from now, you said?” For James, a measure of relief. Today, the clinic refilled over a month of medication for free. The clinic may have met his immediate health care needs, but what worries James is where to go for anything more serious and how he’d pay for it. “If I had affordable health care, my life would be easier. It would be more relaxed and I could not have to be stressed about the insurance and hopefully also medications.”

GLP-1 drugs (glucagon-like peptide-1s) have exploded in popularity in recent years – initially as a way to control diabetes and then as tools for weight loss.

Growing research suggests that these drugs – which include semaglutide and tirzepatide – potentially have benefits beyond weight loss, with stronger evidence for cardiovascular and kidney health.

Even so, experts caution that these medications are not foolproof — and using them the wrong way can undermine results or even create new health problems.

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Dr. Meena T. Malhotra, MD, a functional medicine doctor and weight-loss specialist in a suburb of Chicago, confirmed that she has seen myriad health improvements in patients taking GLP-1s – particularly those with diabetes who were “very sick.”

“We observed that this sick population was doing better than the diabetics who were on other diabetes medicines,” she shared with Fox News Digital, noting that she observed improvements in brain health, memory, heart health, circulation, and liver and kidney function. “We realized there was more to the drug than just sugar control and weight loss.”

Malhotra said she believes many people can safely microdose GLP-1s, but she cautions against the following common mistakes.

Mistake No. 1: Taking GLP-1s before making lifestyle changes

Anyone considering GLP-1s should first focus on adopting a healthy lifestyle, Malhotra emphasized – a view widely shared by endocrinologists and obesity medicine specialists.

GLP-1 medications work by slowing gastric emptying, reducing appetite and improving insulin signaling. People with preexisting GI symptoms may be more prone to discomfort or intolerance, though responses vary, and formal evidence is limited.

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Before beginning the medication, Malhotra recommends improving basic nutritional habits, such as increasing intake of whole, minimally processed foods, and prioritizing protein and fiber to support satiety and gut health.

Even small improvements can lead to early weight loss, reduced fluid retention and improvements in insulin sensitivity, doctors agree. 

Once GLP-1 medications are started, these lifestyle modifications may reduce the necessary dose amount, result in fewer side effects and help preserve lean muscle mass.

Mistake No. 2: Starting without proper medical evaluation 

The growing trend of obtaining GLP-1 medications online without proper medical oversight can pose serious health risks, Malhotra warned.

“Nobody examines the patient – they just fill out a form and the medicine shows up at their door,” she said.

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Patients should see a medical provider for a thorough exam and blood work before starting the drugs, the doctor emphasized.

“If something is off, it needs to be addressed,” she said. “Whether it’s a thyroid issue, a heart condition or another factor slowing your metabolism, any underlying problems should be fixed first.”

During treatment, Malhotra recommends that her patients come in once a month to make sure they are losing fat and not lean muscle mass. “That’s very important, because if you lose lean mass, your body is not getting healthier,” she said.

This ongoing monitoring also helps to ensure that the patient is following a balanced diet, getting adequate protein and adhering to strength training. “There’s more to it than just giving yourself a shot,” Malhotra added.

Mistake No. 3: Not getting enough protein

One of the biggest mistakes people make when taking GLP-1s is cutting calories but not getting sufficient protein, according to Malhotra.

“If you are decreasing the calories but not fixing the nutritional foundation, you will lose lean mass,” the doctor said. “But if you’re eating a balanced diet with adequate protein and doing strength training with a smaller dose of the drug, you will get better results and your health will improve.”

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Most people need about 0.5 to 0.8 grams of protein per pound of body weight each day to maintain muscle and support overall health, according to medical experts. For a 200-pound person, that would equate to roughly 100 to 160 grams of protein daily.

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Higher amounts may be needed for those who are physically active or trying to build strength. “The amount of protein you need will depend on the frequency and intensity of your workouts,” Malhotra said. 

Mistake No. 4: Increasing doses too quickly

Another common mistake is rushing the process and increasing GLP-1 doses too quickly in hopes of faster results, according to the doctor.

“You may start to see results within the first week or month, but some people do need a higher dose over time,” she said. “The key is to be patient and increase it gradually — typically month by month.”

If a patient doesn’t see results after the first injection, that doesn’t mean the dose should be doubled right away, according to Malhotra. 

“That’s a recipe for problems, including side effects like pancreatitis,” she said. “Your body needs time to adjust and adapt.”

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“You can go up if you hit a plateau or if it’s not helping, but we usually wait a month to increase the dose.”

While many expect “instant gratification,” health is about balance, Malhotra added. “It won’t take 20 years, but give it two months, I think that’s fair.”

A general rule of thumb, according to the doctor, is “don’t start too soon, don’t stop too soon.”

Mistake No. 5: Not managing side effects properly

GLP-1 side effects can often be prevented by building a strong foundation of health and keeping everything in balance, according to Malhotra. 

“That said, some people will still have side effects, and there are ways to manage them,” she said.

“If you are decreasing the calories but not fixing the nutritional foundation, you will lose lean mass.”

The doctor recommends eating smaller, more frequent meals instead of large portions — ideally about the size of your fist. 

It’s also important to keep fat intake low, she advised – GLP-1 medications already slow stomach emptying and fat can slow it even further, which may worsen nausea.

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For nausea and constipation, simple strategies can go a long way, according to the doctor. Some patients find ginger helpful for nausea, she said, though it is not a substitute for medical guidance.

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Incorporating more liquids, such as shakes, soups and broths, can be easier on the stomach, she suggested. Prunes and other fiber-rich foods can help support digestion and prevent constipation.

“These little lifestyle hacks can help a lot with managing the side effects, instead of stopping and then finding that your weight is yo-yoing,” Malhotra said.

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