What I Eat in a Day on Ozempic, Keeping My PCOS and Autoimmune Condition in Mind

When Melanie Manar plans her meals, she has a few numbers in mind.

One is her goal for grams of protein per meal, especially for breakfast and lunch. Another is the range of calories she’s shooting for. And, finally, there’s 90: the number of pounds she’s lost over almost 2 years, and maintained for about 6 months, with the help of two weight-loss medications.

Switching between Ozempic and Mounjaro

Melanie, a 46-year-old health coach in Mission Viejo, California, started taking Ozempic (semaglutide) in November 2021. Then, she switched briefly to Mounjaro (tirzepatide), before going back to semaglutide. 

Ozempic and Mounjaro are both glucagon-like peptide-1 (GLP-1) receptor agonists that are injected under the skin once a week. But Mounjaro also works on another gut hormone, glucose-dependent insulinotropic polypeptide (GIP). The FDA approved both medications for blood sugar management in people with Type 2 diabetes. And studies have shown that they also help people lose weight.  

Melanie has health conditions that add to her need to plan meals carefully. She has polycystic ovarian syndrome (PCOS), a hormonal and metabolism abnormality that affects 1 in 10 women of childbearing age and can make it harder to lose weight. She also has an autoimmune disorder, Hashimoto’s disease, which can cause hypothyroidism (underactive thyroid) or, in rare cases, hyperthyroidism (overactive thyroid).

With Hashimoto’s, certain foods can induce flare-ups. “I've had to really figure out what I can eat and what I can't eat to keep the flare-ups at bay,” she says.

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She lost 70 lbs the first year 

Melanie lost 70 lbs during the first year of her weight-loss journey. The second year, she lost another 20 lbs while remaining on Ozempic, focusing on strength training and muscle building, and changing her eating habits.

Dieting, Melanie says, has never worked for her. She used to skip breakfast and eat a small lunch, but by dinnertime she felt hungry and needed a large meal. Now, she shoots for 600 to 900 calories for breakfast and has a bigger meal at lunch. Then, she has considerably less food for dinner and stops eating by 7PM. 

She has gained a following posting about her weight loss and eating habits on social media.

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Packing in protein from the start

Below, Melanie describes what her meals look like on a typical day. 

Breakfast 

Melanie’s day starts with a protein-packed breakfast. That often means having non-dairy Greek-style yogurt and adding in flaxseed to work toward her goal of 20 g to 30 g of fiber a day. She usually also adds in collagen protein powder. (Collagen has become a top-selling supplement thanks to some reports that it can improve hair and nails and improve skin elasticity.) And she puts protein-rich granola on top, which helps her reach her goal of about 50 g of protein for breakfast.

“With weight loss in general, you tend to see muscle loss, and you want to try and preserve as much muscle as possible,” she says. “I work out quite a bit and do strength training, so protein is very important to me. I really focus on protein and fiber.”

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Fiber can help counteract constipation as well, she says. Constipation is a well-known side effect of GLP-1 medications.

Lunch

For lunch, Melanie often makes a chopped salad with a generous amount of chicken or a protein bowl. She shoots for between 30 g and 40 g of protein and 400 to 600 calories in her lunches.

Dinner

Dinner is typically fish or chicken with vegetables and often a sweet potato. If Melanie wants a lighter dinner, she might make a protein shake, which she blends to ice-cream consistency.

Focusing on sustainability

Although Melanie has typical meals that she likes to make, she says that she's really focused on having a diet that she can sustain. That’s different from in the past, when she was always either dieting or not dieting. Now, she’s learned not to beat herself up when she eats a high-calorie, low-nutritional-value food. 

“You’re going to have days when you eat four pieces of pizza. It’s going to happen,” Melanie says. When it happens to her, she adds, she shrugs it off and focuses on what she’s eating the next day.

‘Not a magic pill’

Melanie likes to call herself “an elder in this [GLP-1] world” since she started taking the weight-loss medications more than 2 years ago before their popularity skyrocketed.

“Especially if you’re a little bit older — say 30 or older — I would say it’s a tool that will help you,” she says. “But it’s still on you to make the lifestyle changes.

“I had to throw everything at it. I have an autoimmune disease, I have PCOS, and I’m 46. I had to change my eating, my exercise, and I had to take the medication to lose just under 1 lb a week,” she adds, describing how, at one point, she was doing at least 10,000 steps a day, yoga once a week, and strength training three times a week.

That 1-lb-a-week loss is much different than the reports flooding social media, claiming that people lose close to 1 lb a day in some cases, Melanie notes. But she knows it’s a realistic, healthy goal.

“People say, ‘I’ve been on it 12 weeks and only lost 12 lbs.’ But that’s good,” she says. “If you’re losing a pound a week, that’s pretty healthy.”

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Written by:

Marcia Frellick

Marcia Frellick has been a journalist for more than 35 years. She started her career as an editor and became a freelance healthcare writer in 2008.

Edited by:

Tanya Bricking Leach

Tanya Bricking Leach is an award-winning journalist who has worked in both breaking news and hospital communications. She has been a writer and editor for more than 20 years.

Reviewed by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

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