Six Questions I Get Asked All the Time

I have spent 25 years answering nutrition questions one person at a time. The questions repeat. That is not a complaint, it is the reason I built something.

The inconvenient truth is that everyone needs to personalize their nutrition for their body and their weight health. Most practitioners are not trained to personalize weight health, and I am working hard to change that. Even when they are trained, most people cannot access those practitioners because of cost or location, or their question comes up a month before their next appointment. So people ask the internet, or Claude, Gemini, and Chat. I get it. You want help when the question occurs, not on the day your appointment happens to be scheduled.

The internet answers immediately, confidently, and usually “correctly.”

Correct is not the same as better for you, as in what your body needs for weight health.

That distinction, personalizing weight health, is the thing I have built a career on, and it is easiest to see in the questions themselves.

Today I am sharing the questions I get asked most often, along with my onix’s response. It is guidance, not treatment, and it works alongside your doctor rather than instead of your doctor.

Better, not perfect. Always.

Answers edited for brevity.

1. “I was losing weight on a GLP-1. Now the weight loss has stalled. I can’t eat any less than I already am.”

Ashley’s onix: It’s definitely frustrating when weight loss stalls, especially on a GLP-1. Think of your body as an operating system. While GLP-1 medications are a valuable tool, they’re not a standalone solution.

Optimal digestion and hydration, what I call the “crust” of your weight health pizza, are absolutely critical for these hormones to work effectively. If your body isn’t breaking down, absorbing, and eliminating nutrients well, it can’t fully utilize what it’s getting, even with medication.

When fat cells shrink, the body liberates toxins it has stored. If your body isn’t able to process and remove these toxins efficiently, it can signal an alarm, and fat loss might stall.

My next step for you would be to run a quick digestive assessment and then a hydration experiment.

2. “I’m supposed to get 150 grams of protein a day. I’m not that hungry.”

Ashley’s onix: Protein matters for building and repairing muscle, which is crucial for weight health and satiety. However, just increasing protein without optimizing digestion and ensuring your body can actually use it can sometimes slow fat loss and even contribute to muscle and bone loss.

I focus on optimizing the better amount of protein for your unique body, from diverse sources and at the right intervals, rather than just hitting a high daily number.

My takeaway is to consider not just the quantity of protein, but also its quality, variety, and how well your body can break it down and absorb it.

3. “I started a GLP-1 and now I’m constipated. I added fiber and protein like everything said to. It got worse.”

Ashley’s onix: Starting a GLP-1 medication can slow gastric emptying, which is why constipation is a common side effect. Adding more fiber when motility is already slow can often make things worse by compounding the sluggishness, not better.

What your body needs is motility support first, like addressing hydration and specific types of fiber spread throughout your day, not just adding a large fiber load all at once. Magnesium citrate, mid-section movement, and deep breathing can be helpful strategies.

I’d love to know what a typical day of eating and drinking looks like for you, including any supplements you’re taking, so I can offer more tailored guidance. What are your goals, and what made you decide to start a GLP-1 now?

4. “I know I need more fiber. I know which foods have it. I still don’t do it.”

Ashley’s onix: It’s one thing to know what to do when it comes to fiber, and another to actually do it consistently. Getting a variety of fibers (soluble, insoluble, and prebiotic) is crucial for everything from steady blood sugar and healthy cholesterol to a thriving gut microbiome and regular motility.

Instead of aiming for a single daily fiber number, I find it more effective to think about at least 7 grams of fiber per pit stop, ensuring your body can effectively use what you’re giving it throughout the day.

To make this delicious and doable, try adding just one more fiber-rich food to one pit stop each day, maybe some avocado with your eggs, or a sprinkle of seeds on your salad. This is all about “Better Not Perfect” experiments.

5. “I’m worried about my bone health. I have osteoporosis, and my doctor has told me to increase my calcium, and that I might need to take medication. But I read about all those side effects and I’m concerned about that.”

Ashley’s onix: It’s completely understandable to be concerned about both osteoporosis and the potential side effects of medication, as your bone health profoundly impacts your overall vitality. When we focus only on calcium, we often miss crucial signals about what your bones truly need to thrive.

Your bones are constantly sending signals, and when we only focus on calcium, we often miss the bigger picture of what they truly need to be strong. Calcium is just one piece of a much larger puzzle.

Here’s how I approach bone health from a personalized lens. Your bones need nutrients, including amino acids from protein, minerals, and more, so focusing on calcium alone won’t help your bones build or break down less often. And even with calcium, taking it in isn’t the same as the bone getting it and being able to use it. Bone health, like all weight health, begins with digestive health. Your body needs to deliver the nutrients your bones need to build, and that’s the role of digestion. Your digestive tract also houses a hormone called GIP, which some people have heard of because it is in the GLP-1 medication known as tirzepatide. This hormone travels from the gut to turn on activity in bone-building cells (osteoblasts), working there with another hormone, estrogen. So hormone health is another piece of the puzzle, and a final piece is inflammation. If you have unresolved inflammation, your bone health will suffer.

The good news is that we can assess what is likely contributing to your osteoporosis with data. Labs like CTX and P1NP, along with markers of inflammation like hsCRP and ferritin, a digestive assessment, and micronutrient levels can all help us understand the better intervention for you. If a medication turns out to be the right tool, we work on a plan that reduces its negative impact on the rest of your health.

Would you like to do this together? I recommend starting where I always start, with a digestive assessment. Want to jump in?

6. “Should I eat on waking or fast for a few hours?”

Ashley’s onix: The timing of your first pit stop is crucial because it sets the metabolic tone for your day, influencing blood sugar stability and energy.

From my perspective, not feeling hungry on waking often signals underlying issues like suboptimal digestion or poor sleep, rather than permission to delay eating.

I recommend an experiment: have your first pit stop within two to three hours of waking (this can be adjusted based on medications) to properly fuel your body’s operating system. Focus that pit stop on being nutrient-balanced and easily digestible, then move for at least 7 minutes after you take in that nutrition. I’d assess the results of this experiment in terms of energy and satiety, and over two weeks or a month, how your weight composition responds.

Want to try the experiment? If so, tell me what you usually have when you break your fast, along with anything you take or do before you break it. And let’s agree on how long you want to run the experiment and how you’ll measure your results. We don’t measure weight composition changes any sooner than two weeks, but I like to use four to six weeks.

Go beyond average. Keep asking questions.

Ashley Koff, RD is a registered dietitian with over 25 years of experience, founder of The Better Nutrition Program, and the best-selling author of Your Best Shot: The Personalized System for Optimal Weight Health—GLP-1 Shot or Not. Her expertise is available as a founding expert on Onix.