Q&A: too much protein?; posture and bone health; are GLP-1s forever?; hypertension versus high blood pressure
May is here! 🌸
ICYMI 👉
Today’s LIVE Q&A is about SLEEP 💤 🛌! Join me HERE TODAY at 5/2 at 3 pm ET!
Paid subscribers can submit their questions for me to answer live, right here!
In this week’s reader-submitted Q&A, we’re tackling these questions:
Is it possible to eat too much protein?
How can I improve my posture and strengthen my bones as I age?
Is it safe to stay on a GLP-1 forever?
When should I worry about high blood pressure?
📣 Send me your questions for future Q&As! Click here to write me. ✍️
The following subscriber questions have been lightly edited for length and clarity.
QUESTION #1: TOO MUCH PROTEIN?
Is it possible to eat too much protein? I’ve started adding protein shakes and bars but now I’m wondering—can you overdo it?
- Jake
Jake,
Great question—and one I hear more and more as people (rightly!) begin to pay attention to the role of protein in energy, muscle maintenance, metabolism, and overall well-being.
The short answer: yes, it is technically possible to eat too much protein—but for most people, the concern isn’t “too much” protein. It’s not enough, especially as we age.
Here’s some context. Most healthy adults need about 0.7 to 1.0 grams of protein per kilogram of body weight per day (that’s about 0.36 to 0.45 grams per pound). For a 150-pound person, that’s somewhere in the range of 55 to 70 grams of protein daily—more if you’re physically active, recovering from illness or surgery, or trying to maintain or build muscle in midlife and beyond.
If you’re adding a shake or a protein bar or two to your day, you’re probably not “overdoing it.” In fact, you might be landing closer to where your body wants to be—especially if your previous intake was light on protein (which is very common, especially among women).
That said, excessive protein (well beyond your needs, over time) can stress the kidneys in people with preexisting kidney disease and may crowd out other important nutrients like fiber. So it’s less about the total grams and more about balance—and listening to your body. If you’re suddenly relying on bars and shakes for most meals or feeling bloated, constipated, or sluggish, it might be worth dialing it back and focusing on whole food sources of protein (like fish, eggs, beans, tofu, or lean meat) and pairing them with fiber and healthy fats.
Protein is essential—not just for muscles but for mood, metabolism, immune health, and more. You don’t need to fear it. Just aim for a steady, balanced intake throughout the day and check in with how you feel. That’s usually the best data of all.
QUESTION #2: IMPROVING POSTURE AND STRENGTHENING BONES
I’m 68 and active, but I’ve noticed I’m getting shorter and my balance isn’t what it used to be. I haven’t fallen, but I’m nervous. Is this just aging, or should I be doing something specific to prevent things like my bones and posture from getting worse?
- Carl
Carl,
This is a terrific question. I will point out that you’re already ahead of the curve by noticing these changes before something like a fall or fracture forces the issue. That’s exactly the right time to ask what more you can do. Because while aging is a fact, decline is not inevitable.
Getting shorter and feeling less steady are often early signs of musculoskeletal changes—most commonly, a combination of decreased bone density (osteopenia or osteoporosis) and loss of muscle mass (a.k.a. sarcopenia). The good news? Both are modifiable. There is a lot we can do to keep your frame strong and upright, even well into your 60s, 70s, and beyond.
Strength training is one of the most powerful—and underused—tools in medicine. It doesn’t have to be intense or time-consuming. Just 20–30 minutes twice a week can meaningfully improve balance, bone strength, posture, metabolism, and even bladder control (yes, really). After just four to six weeks, many people notice less back pain, better stability, and a stronger sense of confidence in their body.
You don’t need to live in the gym. A few dumbbells at home, resistance bands, or even a yoga practice can engage key muscle groups. And walking—especially with a weighted vest or backpack—can help build strength in the hips and spine. I like to think of this as “stacking” benefits: movement that helps your bones, muscles, mood, and balance all at once.
It’s also worth asking your doctor about a bone density scan (DEXA), especially if you’ve never had one. Knowing your baseline can help guide decisions about supplements, medications, or physical therapy. Speaking of which: if you’ve never seen a physical therapist for balance and posture, it’s like taking your car in for an alignment before the wheels fall off. Prevention is always better than patching things up later.
You don’t need to overhaul your life. Insert small changes into your routine—carry groceries in both hands, take the stairs, do a few squats while brushing your teeth. Even “exercise snacks” (short bursts of movement throughout the day) count.
In short: this is aging, yes—but it’s the kind you get to participate in, not just watch happen. You have more agency than you might think, and your body is very much still listening to what you give it.
Your future skeleton will thank you.
QUESTION #3: STAYING ON A GLP-1 FOREVER
Is it safe—or realistic—to be on a GLP-1 medication forever? How do you help patients think about long-term plans?
- Betsy
Dear Betsy,
This is a thoughtful—and increasingly relevant—question as more people begin using GLP-1 medications like Ozempic, Wegovy, or Zepbound for type 2 diabetes, obesity, or metabolic health.
Let me start with this: GLP-1s are real medications. They’re not quick fixes or lifestyle replacements or “willpower in a pen.” They’re tools—powerful ones—with clear clinical benefits for the right patients. But like any tool, they work best when used intentionally, in context, and with ongoing care and conversation.
To your question about being on them “forever”: It depends.
For some people—those with chronic, progressive conditions like type 2 diabetes or longstanding obesity—GLP-1s may be used indefinitely, much like a statin for high cholesterol or an SSRI for depression. That doesn’t mean it’s a crutch; it means managing a medical condition with a tool that works. These drugs not only help with weight loss and blood sugar control—they’re also showing promise in reducing cardiovascular risk, liver disease progression, and even sleep apnea severity. For some patients, the benefits of staying on them long-term clearly outweigh the risks.
But for others, GLP-1s may be a temporary bridge. These meds can create space—less food noise, more satiety, better energy—for people to make sustainable lifestyle changes. Once those changes are firmly in place, some people can taper off the medication and maintain their progress with continued support around nutrition, movement, stress, and sleep.
The most important thing is that we don’t treat GLP-1s as an all-or-nothing proposition. The goal isn’t to be on or off forever. The goal is to feel better, metabolically and emotionally, and to make a long-term plan that reflects your values, your biology, and your life.
As I often tell patients: there is no gold star for managing a chronic condition without medication. There’s only your body, your quality of life, and the tools that help you move through the world with more ease and agency. If a GLP-1 is one of those tools, there’s no shame in using it wisely—for a season, or for the long haul.
QUESTION #4: HYPERTENSION OR HIGH BLOOD PRESSURE
I've never had high blood pressure, but my doctor flagged it at my last physical. I’d had coffee, was late, and super stressed. How do I know if it’s real or just a blip?
- Dale
Dale,
It’s entirely possible that your elevated blood pressure reading was just a blip. Stress, running late, white coat anxiety, even a cup of coffee or needing to urinate—these can all temporarily raise blood pressure. So a single high reading at a physical doesn’t automatically mean you have hypertension, but it is a signal to pay attention.
To know whether it’s a true issue or just situational, your doctor may recommend home monitoring or a series of repeat readings taken under calm, consistent conditions. Measuring your blood pressure at home, at the same time each day (preferably in the morning, before coffee or exercise), can give a more accurate picture of your baseline numbers. Many people are surprised to see how much their readings fluctuate based on mood, meals, and timing.
If your readings are consistently elevated—systolic (top number) above 130 or diastolic (bottom number) above 80—then your doctor may want to explore next steps. But if it was a one-time spike, no immediate action may be needed beyond keeping an eye on it and checking again in a low-stress setting.
Even if it was just a blip, it can be a good opportunity to take stock of lifestyle factors that support healthy blood pressure—like reducing sodium, managing stress, getting enough sleep, and staying active. Sometimes the best medicine is simply information, and catching a possible trend early gives you room to respond before it becomes a problem. I hope that helps!
My big picture advice? Don’t give up. There are options. And it’s not in your head—it’s in your very real, very wise, very lived-in body that deserves comfort and care.
Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.
ICYMI, check out my recent Q&As on:
Thoughtful answers, thank you.
In my experience, doctors readily dismiss high blood pressure readings as due to the white coat syndrome, as you mention. But, if a patient’s BP gets higher when seeing a doctor, isn’t that relevant? Other experiences as well may raise a patient’s BP. Are those reactions factored in when assessing BP levels, to get a fuller picture? Or are readings at home, sitting quietly, all that matter?
Many thanks.