Margaret Josephs isn't just looking great these days, she's feeling great too.
The Real Housewives of New Jersey star has dropped 22 lbs. over the past year, after beginning regular peptide and hormone replacement therapy with Jamie Gabel PA-C, a certified physician assistant at Advitam at the Shafer Clinic in New York City.
"It's been life-changing," Josephs, 55, tells PEOPLE of the process. "And it's not about being fat or skinny; it's about every aspect of my wellness coming together. I wanted to feel healthy and get my body to a place where I'm supposed to be. I feel so lucky to have found something that's really working for me."
"What can I say, the peptides are giving me a new pep," she jokes.
Peptides are chains of amino acids, which are the "building blocks" of proteins. Though the body naturally produces them, lab-made peptides mimic the natural ones, and when introduced into the body — via injection or in other ways, like through food and supplements — signal the body to bulk up the development of certain proteins.
There are thousands of peptides, each playing a different role in the human body. Collagen peptides help make collagen and elastin, proteins found in healthy skin. Creatine peptides help boost muscle growth or muscle repair. BPC-157 is said to help joint recovery.
Glucagon-like Peptide-1 (GLP-1) is utilized in the treatment of type 2 diabetes and obesity, as it signals the pancreas to increase the production of insulin, making the body more efficient at processing sugars. In recent months, Semaglutide — a GLP-1 receptor agonist sold under the brand names Ozempic, Wegovy and Rybelsus — has been trending on social media as some people in Hollywood circles have used it for weight loss, despite not having diabetes or clinical obesity.
"The list is long when it comes to peptides," Gabel tells PEOPLE. "Peptides can help with sleep problems, cognitive problems, memory issue, immune system weaknesses; depending on what needs repairing, there are pretty much peptides out there you can that can target different functions. And what's so attractive about them is that, it's not something super foreign. You're not taking some sort of chemical or something; this is something you're putting into your body that your body should recognize."
With so many options, people who are interested in trying peptides have a range of places to start.
That's where Gabel comes in. "Everybody does things different but we start from scratch here at Advitam," he says. "When a patient comes in, we do blood work, a full body composition analyzer and take a good medical history to figure out what's going on in their body. This is especially helpful when you talk about weight loss, because there could be things like GI issues, thyroid issues or metabolism troubles at play."
After that review, Gabel creates a customized plan for each of his patients.
"We don't just use a one-size fits all model," he explains. "It's about finding the right mix of peptides for our clients — and that can include weight loss, but also other things that work to improve somebody's brain, their gut, their skin, or their hormones."
Josephs says there were several health improvements she wanted to make, including weight loss.
"I was always thin, even after I had my son. But as I started getting older, I put on the pounds," she tells PEOPLE. "And it's not like I struggled with my weight; I didn't mind being a little extra voluptuous. I was always boobs and butt, right? That was not a big deal. I was happy with my body, my husband was happy with my body. And if I wanted to drop a few, I didn't have an issue.
"But prior to getting on the show, I was having a harder time dropping weight. I was perimenopausal, your hormones start to change. I had started gaining weight in different spots. It wasn't going well to the boobs and the butt; I was getting a little bit of a stomach. And by the time I got on the show, I was about 25 pounds heavier."
Seeing herself on TV over the years, Josephs worked to slim down. "I dropped a little bit a weight, maybe a few pounds. But it was very hard for me to maintain my weight," she says. "I'd be working out, eating healthy, running around all the time and nothing — and everybody knows I don't even drink alcohol, so that wasn't it. I just wasn't feeling my best self. I was feeling tired and sluggish. I struggled to find energy in the way I had in the past. I was dealing with some brain fog. Something wasn't right."
Then, reading one night, Josephs learned about peptides and Gabel's work.
"I said, 'Maybe this could be helpful for me?' " Josephs recalls. "I had broken my wrist months earlier and I still couldn't get my swelling down. And between that and my weight and my hormones, I figured it was worth a shot."
After testing her, Gabel put Josephs on a wellness program that included hormone replacement, peptides to maintain her muscle mass and strengthen her joints, and a GLP-1 mixture for weight loss. Josephs started the program last April and takes the peptides via injection in her stomach — one daily, another shot five days a week and a third, once a week.
A year later, she's down to where she was before. "I'm 126 pounds now, give or take a pound depending on the day," Josephs says. "And I haven't been that weight since I got married the first time in 1994."
"It was the right cocktail for me," she adds. "My swelling has gone down in my arm. My skin's gotten tighter. My bones stronger. I'm sleeping better, I have more energy. Not to get into the dirty details, but I'm very good sexually, thanks to the hormones. And I'm back to a weight that feels natural for me. So it's all been very positive for me. I feel great; more than anything, I feel great."
The peptide mixture can change over time. "Our patients come in once a month so we can monitor their progress," Gabel explains. "Peptides don't really know what you want them to do. They do multiple things. So sometimes, if something isn't working, we'll change it or adjust it. It's about finding an overall program that really works well for each person."
"It's really about longevity," notes Gabel. "It's not just coming here to get a quick fix. The way we do the program, it's about helping you achieve your goals over time."
There were side effects, as often is the case with anyone taking GLP-1s. "Not everyone's body reacts the same, but most of the side effects related to Semiglutide for example are gastrointestinal-related," Gabel says. "Nausea, constipation, those sorts of things."
Gabel suggests anyone interested in trying the peptides for themselves do their homework.
"Make sure you're going to someone that's vetted somehow; somebody you trust," he says. "That's really the best advice I can give. Because there's not a one-size-fits-all model to this. And it's a medication that's going into your body. You don't want to just order it on the Internet and expect that it's going to work for you. You need to talk to someone that's practicing good standards."
Josephs herself has no regrets, and has been recommending it to her friends. Her husband Joe has even gone on it. "I've never been so healthy," she says. "I went to my regular doctor, they were like, 'This is the best your blood work has ever looked! I got the top rate on my life insurance. It's really been incredible."
There's only one problem. "Joe is actually upset I have lost these 20 pounds,' she joked. "Joe loves to sleep with a meaty girl, and I had a breast reduction and now my boobs are tiny, my butt's tiny — I'm not his ideal body type anymore! Too bad, Joe!"
The Real Housewives of New Jersey airs Tuesdays (9 p.m. ET) on Bravo.
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