Jessica Grim, Nurse Practitioner

Jessica Grim, Nurse Practitioner Board-certified Nurse Practitioner with over 26 years of medical experience. Video and in person visits available.

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https://www.saguarobeautyandwellness.com

04/22/2026

Why do online weight loss companies and providers without enough education on weight loss medications encourage you to increase your dose when you hit a plateau?

For the online companies, it makes them more money.

For providers, they just assume more = better.

Social media has convinced people that feeling hungry or hearing food noise again is the medication not working.

This is actually not usually the case. It’s a good way to spend a lot of money though.

I notice people become fearful of eating, being hungry, and food noise when on a GLP1. They then want to increase the dose.

That’s only the correct answer about 50% of the time. This is where my education in obesity medicine is very helpful.

* If you aren’t eating enough, your body will fight for survival and make you hungry even with the medication.

* If you are breaking down muscle instead of fat, your body will give you the signal and demand more calories in. Listen to what it’s saying. This can be either an exercise, calorie, or food quality issue.

* plateaus are important. It is normal. You will lose more and lose less different weeks. That’s normal and ok.

* now come in real close, you need to hear this: While on this mediation it is vital to address your fears and emotions around food and food noise. If you are menopausal and have been dealing with that biological food noise, let’s talk about it. Food is love in our culture, let’s talk about it. This is a layer of weight loss.

If you're using a GLP-1, one of the biggest mistakes I see is this: People start eating less…but they don't start eating...
04/20/2026

If you're using a GLP-1, one of the biggest mistakes I see is this:

People start eating less…
but they don't start eating better.

And that's where things quietly go sideways.

Because GLP-1s change appetite but not physiology at the cellular level.

They help you eat less.
But what you eat still determines everything that happens next.

Let's zoom out for a second.

Every time you eat, you're not just consuming calories—you're sending information.

Each meal sends signals that interact with hormones, metabolism, and the microbes living in your gut.

Over time, those signals shape inflammation levels, energy production, and the cellular repair systems that influence how you age.

So when food intake drops on a GLP-1, the quality of that food matters even more.

Because now, every bite has to work harder for you. The shift that changes everything
GLP-1s are a tool.

But they're not the driver of long-term health.
Food is.

If you use this phase to upgrade the quality of your inputs,
you're not just losing weight—you're improving:
→ metabolic flexibility
→ muscle preservation
→ gut health
→ long-term aging trajectory

That's the difference between short-term results and true longevity.

Want to lose weight fast and be ready for summer?!That’s not my program unfortunately, but I do think that exact message...
04/18/2026

Want to lose weight fast and be ready for summer?!

That’s not my program unfortunately, but I do think that exact message has been sensationalized by influencers paid by clicks and views. The #1 factor I have to address with every single one of my weight loss patient is: we actually do NOT want to drop weight fast.

Here is where I talk myself out of a job 😆 but I want to point some things out. Why? Because you have options and only you know what is right for you. You deserve support. I was raised in poverty and spent much of my early adulthood in poverty, so saving you money is important to me.

4-8 lbs per months on average is the goal weight loss for the average person looking to lose less than 50 lbs. This is adjusted based on each individual’s unique life, including age, job, activity level, health/chronic conditions, and what has been and needs to be adjusted - or whether or not someone even wants to adjust something.

Head to head, tirzepatide outperforms semaglutide. However, semaglutide is still a great medication.

Cost needs to be considered. In my last post I point out statistics and cost of the weight loss GLP tablets. My question to you is this: if a medication costs $299+ per month and has a high chance of helping you lose 1.5-4lbs a month, peaking after 14 months, are you willing to spend the money or do you think your money is best spent using other options?

There are really great gyms, clubs, classes (fitness and nutrition), personal trainers, nutritionists, meal prep and delivery services. Take that budget and consider if there are other options that may fit your life better, yield possibly the same or better results, and save you money.

There are also other medications that can help with weight loss. I prescribe them all. Currently GLP1 medications are the most effective and the ones I’m asking about the most, which is why I talk about them a lot on here. There are other tablet and injectables though that are less expensive, down to $30/month. They may not have as good statistics as the GLP1s, but not everyone needs a big weight loss number or is appropriate for that medication.

Key notes (and these are important):

• Weight loss with both drugs is gradual: noticeable by 4–12 weeks, with most occurring in the first 6–12 months, then plateauing.

• Individual results vary based on starting weight, adherence, diet, exercise, genetics, and side effects (mostly gastrointestinal, like nausea).

• Zepbound (dual GIP/GLP-1 agonist) consistently shows greater average and categorical weight loss than Wegovy (GLP-1 only) in both head-to-head and separate trials.

• These are mean results from clinical trials; real-world outcomes can differ. Neither is a “magic pill” - lifestyle changes are essential, and weight regain often occurs if treatment stops and healthy lifestyle, emotional, and diet adjustments weren’t successfully made while on the medication. If you have an underlying condition or are on a daily mediation that causes weight gain, then it’s likely you will need to cycle or continue on a low dose of something like a GLP1 long term.

04/16/2026

I have two openings for lip filler and two spots left for Botox this Saturday! Shoot me a message or call/text at 503-559-9505 to claim a spot and receive $50 off!

Ketoconazole shampoo is great to have on hand. You can buy it at any local store.Did you know that using this shampoo 1-...
04/16/2026

Ketoconazole shampoo is great to have on hand. You can buy it at any local store.

Did you know that using this shampoo 1-2 times per week can help reduce hair loss? It is an anti-inflammatory and antifungal, with properties that reduce hair loss especially for women in midlife and menopause because of hormone shifts. There are studies that show it improves hair density, size, and proportion when cycled in with your hair care especially with hormone driven hair loss.

It can also help reduce flaking skin on your face! For men who experience flaking, especially under facial fair, washing their face and beard with ketoconazole shampoo controls that flaky skin.

On April 1st a new weight loss pill, Foundayo, was approved by the FDA. It’s made by Eli Lilly, the maker of Mounjaro an...
04/14/2026

On April 1st a new weight loss pill, Foundayo, was approved by the FDA. It’s made by Eli Lilly, the maker of Mounjaro and Zepbound (both tirzepatide). It is a synthetic GLP1 peptide pill taken once daily. Because it is synthetic, it can be taken any time of the day and with or without food but still yield expected results.

It was made to directly compete with Wegovy, which is semaglutide and available in injectable and tablet form made by Novo Nordisk. It is the GLP1 peptide, and due to this needs to be taken on an empty stomach at least 30 minutes before food (but preferably 2 hours before food).

Both require titrating up to the weight loss dose, so you can expect taking a daily tablet and increasing the dose every month for about four months before making it to the weight loss dose that you will take ongoing.

Both start around $149/month but the upper doses and weight loss dose is $299/month. This is cash pay prices. If you have commercial insurance (non-Medicare and Medicaid/OHP) you can sometimes qualify for a discount. This can be applied for on the manufacturer website for both drugs.

Compounded does cost less on both. I prescribe both brand name and compounded, a decision made by my clients after we discuss their medical and personal needs.

Overall, expect to lose less on Foundayo. The Wegovy pill does pretty well and is comparable to the injection statistics for weight loss. The side effect profile is pretty much the same for both, so I think the most reasonable choice for Foundayo over Wegovy would be just for convenience.

I just want to point out statistics show people lost 11-13% of their body weight on these medications over 64-72 weeks. For the ease of an example, let’s say a 220lb person would lose 12% after 68 weeks, which is 26.4 lbs. That’s about 0.4 lbs a week, or 1.5 lbs a month.

04/14/2026

Dr. Mary Claire Haver is a board certified OB/GYN and a wealth of knowledge.

Breaking news in Perimenopause and Menopause: the International Federation of of Gynecology and Obstetrics (FIGO) just r...
04/12/2026

Breaking news in Perimenopause and Menopause: the International Federation of of Gynecology and Obstetrics (FIGO) just released their recommendations for first line treatment of mental health in perimenopause and menopause - and it’s hormone replacement therapy. Specifically, transdermal estrogen (patch, cream, etc). In the U.S., first line treatment is antidepressants/anti-anxiety medications, but this study and recommendation will help to start the shift of how providers practice and support women.

68% of women experience symptoms of depression and anxiety in perimenopause. This isn’t a character flaw; it’s biology. This is because estrogen and progesterone directly stimulate our happy and calm neurochemicals, so the loss during this transition of hormones directly impacts these neurotransmitters.

My job is to follow science but apply common sense, then teach you about the most up to date information I have available to me so you can make an informed decision about your health. This news supports what many of us hormone specialists were already thinking and enables us to have these conversations with our peers and clients to help them choose what is best for them. I know it will for me!

https://pubmed.ncbi.nlm.nih.gov/41902367/?utm_source=FeedFetcher&utm_medium=rss&utm_campaign=pubmed-2&utm_content=1JUQiFFHYgOnKzn2_dFOjAskQR-ZHKjL_M_hdypdsXWLRe753w&fc=20221008043540&ff=20260402033410&v=2.19.0.post6+133c1fe

04/10/2026

I was shocked when I came to the realization that women have not been fairly studied in medicine. I didn’t come to this realization because I am a feminist or because I was having symptoms. The facts are there, and once my eyes were open I had to face those facts then decide what I can do about it.

I am a data and research driven provider. One my peers, a nationally OBGYN MD, started looking closely at studies over the last 40-50 years and realized they were not assessing results for women vs men. We were being treated as tiny men, biological equals, when we are not.

Once these studies started to be reassessed, it became clear that some significant research and treatments benefited men, but not women. A great example? Aspirin for cardiac health. Clear benefit for men, minimal benefit for women once the study results were divided by gender and reassessed.

Women are 4 times more likely to have an autoimmune disease. We are more likely to live 20% of our lives in poorer health than our age matched male counterparts according to the McKenzie Institute. Women are more likely to develop dementia.

Daily I answer DM questions and have consults with female clients to come to me feeling like they aren’t being heard and are having unacceptable symptoms. Once we get the action part of the conversation or I start asking specific questions about their symptoms and medications, where a difference can be made and they can advocate for a life they deserve to live with their primary medical team (advice I give for free in my consult), they go radio silent. This happens regularly. I wonder, have they been gaslit to the point that they can’t even accept that they might actually get help? Have we been convinced this sometimes miserable life transition or high symptoms are just “a part of life” to suffer through? You tell me why women panic and cut off communication when help is a fingertip away.

I want better for all of us.

Testosterone facts:- this is the first hormone that starts to decline as a woman heads into perimenopause and most notab...
04/08/2026

Testosterone facts:

- this is the first hormone that starts to decline as a woman heads into perimenopause and most notably causes fatigue, brain fog, and muscle mass/strength loss.

- whereas women begin to lose it significantly around midlife, men lose it slowly and consistently from about their mid-30s on. They notice less energy, loss of muscle, and often subtle signs of depression, irritability, and anxiety.

- men actually have had a steady 1% loss of testosterone over the years in the general population on top of natural aging loss, meaning a 45 year old man in 1989 had 15-25% more testosterone than a 45 year old man in 2025.

- testosterone replacement can make a big difference in how people feel. Replacement is through topical creams, gels, and injection into the muscle.

04/05/2026

It’s not just how much you move. It’s how HARD you move.

A new study in the European Heart Journal looked at ~100,000 people (over 50% women) and asked a simple question:

👉 If two people move the same amount… does intensity matter?

Answer: YES. A lot.

People who did more vigorous activity (the kind that makes you out of breath):

✨ ↓ 63% lower risk of dementia
✨ ↓ 60% lower risk of type 2 diabetes
✨ ↓ 46% lower risk of death

And here’s the kicker:

👉 You don’t need hours.

Even 15–20 minutes PER WEEK of higher-intensity effort made a difference

Getting breathless. Basically.

Jiehua Wei, Minxue Shen, Shenxin Li, Yi Xiao, Dan Luo, Gerson Ferrari, D**g Hoon Lee, Leandro F M Rezende, Jason M R Gill, Matthew N Ahmadi, Emmanuel Stamatakis, Xiang Chen, Volume vs intensity of physical activity and risk of cardiovascular and non-cardiovascular chronic diseases, European Heart Journal, 2026;, ehag168, https://doi.org/10.1093/eurheartj/ehag168

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Stayton, OR
97383

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Friday 9am - 5pm
Saturday 9am - 5pm
Sunday 9am - 5pm

Website

https://www.saguarobeautyandwellness.com/

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