LIPOEDEMA WEIGHT LOSS AND GLP-1
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Episode 251:
Show Notes
This episode of The Real Health and Weight Loss Podcast features Kerri Batch, a Melbourne woman who shares her inspiring journey of losing nearly 50 kilograms over two years while managing lipoedema.
Kerri's Background and Challenges:
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Kerri has lipoedema, a condition that causes fat accumulation and fluid retention, making weight loss particularly challenging.
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During the pandemic, she experienced significant weight gain due to stress, burnout, and prioritising others' needs over her own.
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Her weight gain began to impact her mobility and job performance, prompting her to take action.
Steps Taken on Her Weight Loss Journey:
- Low-Carb Diet:
- Inspired by the podcast, Kerri adopted a low-carb (keto) diet, which is often recommended for managing lipoedema.
- She found it effective without obsessing over calorie counting or strict rules.
- Incremental Exercise:
- Kerri started with small steps, such as walking short distances, and gradually built up to walking 2.5 kilometres daily.
- She embraced the "power of small steps" philosophy, focusing on consistency rather than intensity.
- Lifestyle Changes:
- Reduced work hours to manage stress.
- Prioritised sleep by going to bed earlier and creating a morning routine to support her walks.
- Used tools like an Apple Watch to track progress and stay motivated.
- Additional Measures for Lipoedema:
- Incorporated compression therapy, a compression pump, and a vibration plate to manage pain and fluid retention.
- Medical Support:
- When weight loss slowed, she began using Wegovy (a GLP-1 receptor agonist) in August 2024. This medication helped suppress appetite and accelerate weight loss while maintaining other healthy habits.
Key Insights and Reflections:
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Focus on Behaviours Over Results: Kerri tracked habits like exercise duration rather than obsessing over the scale.
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Sustainability: Unlike previous diets, her approach feels sustainable long-term because it integrates enjoyable habits rather than rigid rules.
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Combination Approach: Success came from combining multiple strategies—diet, exercise, stress management, medical interventions—rather than relying on one "magic bullet."
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Mindset Shifts: She emphasised taking ownership of her health decisions and making small but consistent changes.
Impact of the Journey:
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Kerri reports improved mobility, reduced pain levels, better sleep quality, and increased energy.
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She feels confident that her current habits will help her maintain her progress even if she stops using medication in the future.
This episode underscores the importance of personalised, incremental approaches to health and weight loss while addressing unique challenges like lipoedema.
Episode 251:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:12) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:21) Good morning, my gorgeous friend. How are you today? It's Dr Lucy here on a beautiful Melbourne morning. And I have a special guest, another Melbournian, a real-life woman. And I would like to welcome to the podcast, Kerri. You will love her story. She's got lots and lots of pearls of wisdom because she has been on her own health and weight loss journey and has nearly cracked the 50 kilo mark of weight loss. And whilst you all know that we don't look at numbers on the scales as being the only measure of good health, what I think this does show is that she has put in some considerable effort to change some of the things she used to do. So, Kerri, I would love to hear your story, darling.
Kerri Batch (01:08) Thanks, Dr Lucy. It's really nice to be here. As you've just mentioned, I've lost a huge amount of weight over the last almost two years. And I have lipoedema. And so I've been struggling with weight gain and, you know, yo-yo dieting for a long time during the pandemic. And after the pandemic, I was, you know, working really hard and burnt out and putting everyone else's needs ahead of mine. And so my weight had just gone up and up and up, and I really felt like there wasn't really much I could do about it. It got to a pretty bad state. I was thinking, oh, I'm going to lose my job. I'm not going to be able to do my job anymore, even unless I deal with this. So I started going to a lymphoedema therapist, a physiotherapist named Helen Eason in Melbourne, who is fantastic.
Dr Lucy Burns (01:53) Ah, yeah.We love Helen.
Kerri Batch (01:54) Yeah. And such an amazing cheer squad for me. She's been really amazing, and she put me onto the Real Life Medicine podcast. So I started listening to that religiously. I listened to, you know, from Episode 1 all the way through to about Episode 50, I think, and I was totally hooked straight away and figured that, well, I can try low carb for a week or two. It's not going to do any harm. One of the standard or the current popular treatments for lymphoedema is a keto diet, which is basically just a super low carb diet. So I tried that, and I really didn't do anything else. I wasn't counting anything. I wasn't adding up anything. I wasn't too stressed about it. But the weight just started coming off, which was amazing, given that everything else I tried was a real struggle. So I kept on with that, and because of what the podcast was telling me, I realised I needed to do some exercise as well. I started thinking, well, maybe that's actually possible. If I start losing weight, it'll be a bit easier to walk around. So I made some pretty radical changes. So I stepped down from a fairly senior role in my workplace. I went down to a 0.8 job, so I had a day off a week. I started taking care of my sleep. I started walking for half an hour every day. Well, eventually it got to half an hour every day. It started out with me putting on my runners and walking to the park and then home again. I wasn't getting very far, but at least I was getting some kind of routine in. So after about a week of doing that, then I'd venture into the park and walk to the first seat in the park and then sit there for a while and then come home again. And eventually I'm up to now half an hour, sometimes a little bit longer for a rigorous walk. So from being worried about a fire evacuation at work and whether I'd be able to evacuate quickly enough to walking for two and a half kilometres a day over about a year of effort, that has been pretty amazing. And I've lost a lot of weight along with that.
Dr Lucy Burns (03:58) Yeah, I love that. And what I love is that you've really looked at like one of our theories is the power of small steps. So it's not like you said, right, well, you know, I need to exercise, therefore I've got to do 45 minutes every day or I'll do nothing. You started with small and built up.
Kerri Batch (04:18) Yes, absolutely. Yeah, small was all I could manage. And I figured, well, it's something I can do. I'll try it. I didn't really hold out much hope, but it was effective and it became easier and easier every day.
Dr Lucy Burns (04:30) Yeah, yeah, yeah. And I think that's the key. It has to start small. Otherwise we give up. It feels too hard. It's like climbing a mountain when you're just looking at the top, you know, whereas really it's about just doing that one step at a time. A little bit is better than nothing, and then you can build on that little bit. So I love that.
Kerri Batch (04:48) Yeah, and that climbing a mountain thing is absolutely true because now looking back, it's been a bit over 18 months, I think. I started in April 23, and I'm amazed to be able to say I've lost as much weight as I have now. I never thought that would be possible, but here I am. I just did, you know, a little bit each day, and I made sure I did it every single day no matter what, and it's made a huge difference.
Dr Lucy Burns (05:12) Yeah, I love that. But, yes, you're right. At the start if you go, oh, my God, I've got to lose 50 kilos, people go, oh, that's so hard. I'm never going to do it. It's going to take forever. And it does. It does take a long time. It's not like it's going to happen, you know, in a week.
Kerri Batch (05:25) Yeah, and even if you could, like, that's not going to be a good way to do it anyway. I'm really conscious of trying to make sure that I'm not overdoing it. You know, I'm being sensible. I'm not getting too obsessed with this.
Dr Lucy Burns (05:36) Yeah. So what sort of mind tricks, I guess, do you use? You know, do you ever have times where it feels like, oh, my God, this is taking forever or how do I keep going with this? Like what sort of self-talk do you do?
Kerri Batch (05:50) One of the things that has really helped is making sure that I've made it as easy as possible to get up in the morning to go for a walk because I do with any excuse I would give up. So I started, you know, I'd shower at night so I didn't need to worry about that in the morning. I'd have all my clothes laid out next to my bed so as soon as I opened my eyes they'd be there. I was making sure I got to bed earlier so that I wasn't fighting off still being tired when the alarm went off in the morning. That made a big difference. I'm pretty competitive so I've been, you know, tracking everything on my Apple Watch and making sure that I'm, you know, exceeding yesterday's goals or at least meeting the targets has been a really good mind trick for me. I've also tried to avoid, as you said earlier on, I haven't been paying too much attention to the scales. Like I'm only letting myself be weighed about once every six weeks so it's not about am I a kilo lighter than I was a week ago. It's just about making sure I'm moving and doing the right things and I'm feeling good and I'm enjoying the fact that, you know, I've got to do lots more clothes shopping. That's been fun. And I think it's about listening to my body really which I think I've learnt from the podcast. You know, I'm a rule follower and I've done all of the other diets in the past where you, you know, count points or count calories or whatever but this feels much more empowering, that idea that the podcast talks about all the time about you are the boss of you. You know, I'm making these decisions. It's not me following a set of strict rules that someone else has imposed on me. That's helped a lot too.
Dr Lucy Burns (07:22) Yeah, yeah. And you know what else I love there is that you're tracking but what you're tracking is your behaviours. You're tracking how many times you've gone for a walk or how many, you know, I don't know if you're tracking sleep and things like that but there when we focus on the process, the results just come. Whereas for a lot of people they focus on the results and the result, you know, in their mind is the number on the scales. So they spend all this time obsessing over that whereas in fact if they actually took some of that away from the scales and turned it into, well, instead of tracking my weight every day or hopping on the scale six times a day, what if I tracked what time I go to bed or how many times I go for a walk or how long I go for a walk for or, you know, what time I stop eating in the evenings. If you focus on those things, then the rest comes along.
Kerri Batch (08:15) Yeah, that's right. Things like how many minutes of exercise have I done in a day with a focus early on. Now I'm looking much more at the pace I'm walking at, you know, how many seconds does it take me to walk a kilometre and I can see how that's improved over time. I've got all these other stats on the health app on the Apple Watch about my walking symmetry and my step length and all of those kinds of things and they've all improved, I mean slowly, but, you know, as I reach one goal I would start looking at some of the other metrics and, yeah, following their behaviours has made a huge difference.
Dr Lucy Burns (08:51) Oh, I love that. I love that. It's wonderful. So you, you know, made a decision, time to do something, mobility was getting impaired, worried about your job or getting, as you said, getting out of the building safely should there be a fire and then you've gone, right, I'm going to do low carb, I'm going to do some movement. As part of doing movement it sounds like you've started going to bed earlier anyway and making sure you had enough sleep so you weren't too tired to do your movement. You reduced some of your stress by changing your work role somewhat and having time off. So, you know, they're your four S's basically of your sustenance, your strength, your stress and sleep and they helped you come a really long way by the sounds of things. And then it sounds like you needed a little bit more help. Can you tell us a little bit about that?
Kerri Batch (09:41) Yes. So I lost about, I think it was about 28 kilos on the low carb and the walking, but I'm preparing for surgery later this year and there was a weight target that the surgeon had given me and I was a bit worried I wasn't going to meet that target. The weight loss was still happening but it slowed down and so I was worried about the timeline I was working to. I think if it hadn't been for the surgery I would have just kept doing what I was doing, but I had a deadline. So on August 24, I started taking Wegovy and that accelerated, well accelerated, returned the weight loss to what I had early on. So that's helped me lose the last 20 kilos and that's been really good. However, I was a bit worried about the effects and, you know, whether it was a sensible thing to do. So I've done lots of reading and research and I knew that I didn't want to just put all of the eggs in that basket, so to speak, and, you know, stop doing all of the other things. So I've been reading a lot about the importance of protein and strength training and so on when you're taking any of these weight loss medications. So I've really focused on those things as well so that I see Wegovy as just one of the many things I'm doing to look after my health and improve my metabolic health and my weight.
Dr Lucy Burns (11:01) Yeah, absolutely. And I think that, you know, there are lots of people and we see this, women or blokes as well, who do low carb and they lose a significant amount of weight and then it plateaus out. And then, you know, they kind of keep thinking, what else can I do, what can I change? And for a lot of them there's not much more they can change. So we know that the injectable weight loss medications, the GLP-1s, act on some of our metabolic hormones. So, again, as you know, because we love saying this, that weight loss is all about hormones. It really is a hormonal process and it's metabolic hormones and metabolic hormones are influenced by a number of our lifestyle factors. But for some people having that extra tool in their shed, it's not cheating. Like people think it's cheating. It's not. It's just using something else that is going to help you.
Kerri Batch (12:04) Yeah. And I think the way it helped me the most obviously, like the way I'm conscious of it helping was that it turned off all the food noise, all of the difficulty about, you know, I want to eat some rice or I want some pasta or I want some chocolate. It turned all of that off and so it made it much easier to stick to the low carb lifestyle. However, it's done a whole lot of other things for my body which I'm kind of fascinated by. Like my sense of smell is suddenly much more acute. It's bizarre but interesting. Interesting. Yes. And I think that, well, I'm assuming that all of the insulin resistance and all of those things that it's working on a hormonal level are working as well. Otherwise, the weight loss wouldn't be what seems at least at the moment to be quite healthy for me. Like I feel great. I feel like I've got lots of energy. I don't feel like I'm doing anything dangerous. You know, I'm monitoring. I've stayed at a fairly low dose so I haven't gone up to all of the increases of dosage that are recommended by the manufacturer. So I feel like I've got it low enough to be working to supplement all of the other things I'm doing.
Dr Lucy Burns (13:09) Yeah, absolutely. And, in fact, you just highlighted another one of our favourite points which is we want people to use the lowest effective dose. You're right, the manufacturers would like you to use the highest dose because then they get to sell more of their product. But we are big fans of the lowest effective dose, and in order to get the lowest effective dose, the best way to achieve that is to optimise your lifestyle factors as well. So you're right, I mean, Wegovy is not going to make you go for a walk, but for some people it can be, well, they lose a little bit of weight and maybe they start off with Wegovy, Semaglutide, or Tirzepatide, which is Mounjaro. Maybe they start off with that, they then lose a bit of weight, and then they go, oh, actually, I'm now confident or comfortable enough to go for a walk. I think the danger is when people just do that one thing, they just take the medication, they don't change anything else. So they don't get the health benefits of movement. They don't get the health benefits of more sleep. They don't get the health benefits of good nutrition, vitamins, minerals. They don't actually get any of that. So, yeah, they get weight loss, but they don't actually gain health. So I love what you've done because you've gained health.
Kerri Batch (14:36) Yeah, it does feel that way, and I've read a lot of stuff, I've seen a lot of stuff in the media about all the people who lose weight with Wegovy or Ozempic or any of the other GLP-1s who then pile weight on again as soon as they stop. But I know that's not going to happen to me because I'm still going to do the walking, I'm still going to stay low carb, I'm still going to be looking after my sleep. All of those things are going to keep me in good shape, much better shape than I've ever been in before.
Dr Lucy Burns (15:01) Yeah, you've been doing this for two years. So when people go, oh, my God, it's going to take so long, yeah, it is going to take a long time, but actually living takes a long time. Health takes a long time. It's not something you do once and then it's done. It's about developing those habits that you can then do for a long time.
Kerri Batch (15:21) Yeah, that's right. I've lost a bunch of weight in two other previous times using other well-known diets, but it was like holding my breath. I couldn't sustain it for the rest of my life. You know, I was really disciplined and I was focused and I did all the right things, I followed all the rules and it worked. But as soon as I tried to, you know, relax a little bit and just, you know, live my life, it all fell apart again, whereas what I'm doing now feels really sustainable. I think, I hope that I can keep doing this for, you know, decades because it's, I mean, it's sometimes hard to get up in the morning and go for the walk, but it's not anywhere near as hard as the other things I've tried previously.
Dr Lucy Burns (16:00) Yeah, and it's also not anywhere near as hard as the trajectory you were heading on.
Kerri Batch (16:06) Yeah, absolutely. I heard a saying, which I think is pretty well known, about choose your hard. It's either hard now or it's hard later, and I got the feeling that it was going to get really hard really quick unless I started doing something radical while I still had a chance, you know, before I kind of really fell off the cliff of ill health.
Dr Lucy Burns (16:24) Yeah. Another question I had for you, I hear anecdotally people who are on the GLP-1s who have lipoedema. So, again, lovely listener. If you haven't heard us talk about lipoedema in the past, it's a condition that affects, you know, our body fat. So it actually affects the connective tissue between the fat cells and that connective tissue becomes quite leaky and accumulates a lot of fluid around it and then gets scarring and nodules and it's inflammatory and it's quite painful and it doesn't usually respond to something like straight-out calorie reduction, which is what dieting used to be. It was just all about just reduce your calories, doesn't matter about anything else. But what I'm hearing is people are finding that their pain in particular improves with the GLP-1s. I don't know whether you had a lot of pain with your lipoedema or what you've noticed with it. Have you noticed anything specific?
Kerri Batch (17:26) There's so many contributing factors it's hard to really pinpoint anything to a specific cause, but certainly my overall pain is reduced. So I did get quite a bit of pain. I don't think it was, you know, awful. It certainly wasn't all the time, but, you know, the number of times that I think about, oh, maybe I'll take a painkiller now is way lower than it used to be. I'm able to sleep better because there's less pain at night. So, yeah, it has definitely helped. It hasn't removed the pain, but it's helped a lot, yeah.
Dr Lucy Burns (17:55) Yeah, yeah. And look, I think, you know, in general, women with lipoedema will often feel better on a lower carbohydrate diet, whether that's ketogenic or just lower carbs because, again, carbohydrates retain fluid, you know, within our muscles. We've already got, you know, women with lipoedema already have a fluid issue, so we want to be able to reduce that fluid load. So even doing that can make them feel better initially. But, yeah, I've heard, again, for some women that the GLP-1s in particular just reduce the heaviness that they feel in their legs. And, again, that makes it easier to move.
Kerri Batch (18:37) Yeah. And I've done lots of other things in that same time period to manage the lipoedema as well. So I've been wearing compression and I've been using a compression pump. I've just started using a vibration plate. All of those things are supposed to help with lipoedema pain and fluid retention. So, like I said, you know, it's hard to know which thing really has made the difference, but I think, like the weight loss, it's been a combination of doing all of the things as well as I can has come together as being a really nice formula for me.
Dr Lucy Burns (19:06) Yeah, yeah, absolutely. And I think, you know, to finish off, you're absolutely right. There's no one magic bullet. There's no one thing. It's doing all the things and you don't have to do all the things in one go. But if you can build on your portfolio of, you know, weight loss tricks, then you will find over time focusing on the good food, good sleep, stress management, some movement, some strength training, some social connection, plus or minus medication. And for women with lipoedema, the other conservative things, as you mentioned, compression, MLD, vibration, whatever it is that works for you, doing all of those things, you've got to kind of do them all.
Kerri Batch (19:52) Yeah. Like I can say now I've got a long list of things I've been doing, but like you said, I didn't start doing all of them at once. That would have been impossible. I just started with putting on my runners and walking to the park and switching my diet over to a low carb thing. And then, you know, over time I've just gradually added more and more in and I've got some more things to try this year. As I feel stronger and more confident about what I can manage, I can try new things. I love that.
Dr Lucy Burns (20:16) I love that. Well, Kerri, you have been amazing. Like, you know, again, I think just for people out there, it feels like such a long way to go. But honestly, the journey is the journey and it's life and what you're actually doing is not such a long haul. What you're doing along the way is gaining skills and confidence and basically we're doing this for life. So don't think about how far you've got to go. You're going to do it all the time anyway. And what I always say to people is, you know, honestly, the thing you do to lose the weight is the thing you do to maintain it. So it has to be something that is manageable, that you like doing, that you tweak, that you curate all the time and find your path.
Kerri Batch (21:03) Yeah, and like I said earlier, yeah, I can absolutely keep doing all of these things. I mean, hopefully I can stop taking the Wegovy. I'm not really wanting to be on that for life. But, you know, the walking and reduced stress and sleep, it's just leading to a more enjoyable life anyway.
Dr Lucy Burns (21:17) Yeah, absolutely, absolutely. I love that, Kerri. Well, thank you so much for being a guest on our podcast. And, lovelies, you know, just think about, you know, whenever you don't want to get out of bed in the morning, just think, oh, well, Kerri will be up. She'll be walking. I better go. I will.
Kerri Batch (21:32) That's true.
Dr Lucy Burns (21:35) Awesome. All right, lovely friend. I will see you again next week. Thanks for listening. Bye for now.
Dr Lucy Burns (21:45) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
