'I'm an A-list trainer, and there's one thing nobody is saying about weight-loss drugs.'

As a clinical nutritionist and personal trainer to many of Hollywood's A-listers, I thought I'd seen it all and heard it all.

It's been almost eight years since Mel Gibson sought me out because "nothing worked" and he was "tired and fed up with not fitting in the mirror any more". Since then, I've had the pleasure of being on set with him and whoever else he's working with to make sure everyone is eating well, staying healthy and getting some time to exercise while they're filming. Or, as I like to put it, I get to smack donuts out of their hands and put yoghurt and berries in them instead.

Watch: Speaking of celebrities, here's Naomi Watts on Mamamia's No Filter with Mia Freedman. Post continues below.

In my time working with celebs (who are still, at the end of the day, just people like us but with just a few more resources than most of us), I have seen many a fad diet rise and fall and trends come and go — but one has remained steady and doesn't look like it's going to be disappearing any time soon. So much so, that I even gave it its own nickname: 'The Hollywood Hungry Look'. And reading this, you can probably visualise the exact look I'm talking about.

You might think I'm talking about women only here, but unfortunately it's the fellas too. The belief that being skinny is tied to their self-worth is almost unshakeable — so when the GLP-1 craze hit the market a few years ago, it's little wonder that it took off like the proverbial rocket in Hollywood (and just for the record, Mel Gibson has never used any weight loss medication at all).  

I do get it though. With so much emphasis being placed on how someone famous looks every time they step out of the door and all the trolling, hurtful comments and judgy remarks, I can't actually blame these people for wanting to use everything available to them to avoid all the snark, even at a cost of around US$1500 per month for off-label use. I can't even imagine the drain on a person's mental health that level of public judgement would cause.  

But then along comes the next set of judgement… the comments that they're 'too thin.'

'She has Ozempic face.'

'She's lost a few pounds, she must be on a GLP-1.'

'He cheated.'

How exhausting.  

Kelly Clarkson said that she found it interesting that people assumed she was miserable and depressed about her weight when she started using a GLP-1, when actually the fact was that her blood work reached a point where she didn't have much choice but to enlist some help.  

I think Whoopi Goldberg hit the nail on the head when she said "it's hard for anybody to know what a 'normal' weight would be. Everyone has something to say but nobody said, 'Hey, how are you doing?', because it involves so many other things."

Louder, Whoopi!  

Hollywood has definitely glammed up the 'effortlessly thin' aesthetic, that's for sure.  But the thing is, taking a GLP-1 is anything but effortless, it can be quite brutal. And I must admit, I started off being very judgy when GLP-1's first came to light, even uttering the word 'lazy' once or twice myself… until I saw the REAL side of things. 

My online alter-ego, let's just call her 'Sheryl', entered the Facebook GLP-1 chat groups and what I (she) saw in there was horrifying.  

In fact, just last week, one poor anonymous group member wrote: "OMG I just ate two pieces of KFC, and I'm terrified I'm going to put weight back on". 

Cue the comments of 'skip your next meal' to 'drink heaps of water and walk for two hours on a treadmill' to even 'if you don't sh*t yourself from eating that take some laxatives to help things along a bit'.

Wow.  

The questions — and answers for that matter — in these chat forums were diabolical.  It would seem that there's a groundswell of men and women worldwide who are just told, 'Here, inject this and you'll get skinny' and then left to their own devices — not taught anything about nutrition, health, exercise and how to manage any of those things while they're on a seriously powerful medication.

Not to mention the fact that while these people are eating almost nothing and existing on fresh air alone, it's not just fat they're losing.  It's muscle. And when a person's body loses muscle their metabolism hits the floor — meaning that when they do start eating 'normally' again, they don't have the metabolic rate to back it up and — you guessed it — the body will store it all as fat. 

Oprah Winfrey said that she only takes her GLP-1 'now and then' on an as-needed basis to stop her yo-yo dieting… but Oprah honey, isn't that a yo-yo diet in itself??  

I started off judgemental at the people taking it — and now I'm royally pi**ed off at the people who prescribe it. Even American Comedian Tracy Morgan said he "learned how to out-eat Ozempic" and has now gained 20 kilos while still on the medication.

We need to do better at this.  

There's a raft of clear benefits from taking GLP-1's. But abuse them or deploy guesswork tactics and you have all sorts of problems.

Maybe they do exist, but I haven't yet come across any chat groups asking what they should be eating or doing after a pace-maker insertion or after a cardiac ablation, or what dose of beta-blockers everyone else is on and do you think I should go up a dose?

These GLP-1 medications are unique, in that they can have significant, life-altering side effects if not used correctly and yet they can be accessed quite easily.

I've also heard the horror stories of hospitalisation with everything from heart palpitations to hyperglycaemia, hyperemesis and renal dysfunction. And yep, some people who have used the medication correctly and under careful guidance will still experience problems — just like any medication, it comes with inherent risks that some will respond to. But the majority of people who experience the 'big bad' side effects do so out of innocent or wilful ignorance, and that's just terrible.

So what's the solution?

First and foremost, education. I would like to see that GLP-1 medication comes with some sort of counselling or education attached. Something that, while people are experiencing the relief of their 'food noise' disappearing, they can use the time wisely to learn how to make great food choices, develop a healthy and sustainable relationship with food and put themselves in a position of improved health – both physically and mentally.  

I have been working in the health space long enough to not be naïve about the aesthetic side of confidence. Although I focus more on health outcomes, I don't pretend it doesn't exist — many of us just want the image we see in the mirror to match the image we have of ourselves in our mind and be complimented when others see us. I get it. And yes, for some people, willpower just ain't going to cut it — it's almost like telling a depressed person to just 'be happy' when their mind isn't wired that way. 

It's the same for people who can't stop thinking about food, have insulin or leptin resistance or maybe have some unresolved trauma. A GLP-1 has become the equivalent of an anti-depressant to these people, and whether they remain on them long-term or short-term is between them and their treating doctor.

My mission, though, is to help people understand that a GLP-1 is a tool to deploy while you take the time to improve your health and wellbeing yourself — the two of you need to work together, not separately.  After all, you wouldn't take antibiotics for an infected wound and then neglect the cleaning and care of said wound, would you? Same, same.

If you want more from celebrity nutritionist and personal trainer Samantha Jackson, follow her on Instagram or check out her e-book on GLP-1 medication.

Feature image: Supplied.