For many people, GLP-1 medications have been life-changing. By helping to reduce appetite, these medications make it easier to achieve weight loss and other health goals that may have felt out of reach for years. While many get excited that the scale is moving in the right direction, it can come with fatigue that makes exercise difficult, and uncertainty about what to eat on GLP-1 medications.
More than ever, experts are concerned about the critical gap in care for GLP-1 medication use for weight loss. Many people receive a prescription, but very little guidance on what to eat or how to prevent health-impacting muscle and bone loss. Nor are they offered strategies to deal with or avoid uncomfortable digestive issues.
GLP-1 medications are an incredibly powerful tool; simply eating less does not automatically translate to eating better.
This guide offers insights into ways to offer holistic support for GLP-1 weight loss, including simple lifestyle shifts that may help you feel your best.
Whether you’ve just started taking a GLP-1 medication or have been using one for months, understanding how to support your body and mind can help you feel stronger, healthier, and more confident throughout the process.
GLP-1 medications work wonders for suppressing appetite and reducing food cravings. However, when weight drops rapidly, a significant portion of that loss is from lean muscle – not fat. More than 25% of the weight loss on GLP-1 medications can be lean muscle mass.
Losing skeletal muscle can:
To counteract this, prioritizing high-quality protein at every meal is essential.
While scientists describe a high-protein diet as 0.8g/kg of body weight, recent recommendations are higher for those on a GLP-1 weight loss medication – up to 1.5g/kg of body weight.
A more helpful and practical number may be to try to eat 80 to 120 grams of protein per day. If you’re eating 4 times a day, each meal would need to include 20 grams of protein at a minimum.
As such, getting enough protein in can start to feel like a full-time job. To help, seek out high-quality sources of protein, such as fish, poultry, lean meat, dairy, egg whites, nuts, seeds, beans, legumes and soy.
Of note, ideally pair this higher protein intake with regular resistance training.
For many people, it’s liberating the way GLP-1 medications drastically quiet intrusive, constant thoughts about food (often called “food noise”). It can lead to positive changes like reduced emotional eating, fewer intense cravings, and less binge eating.
But there is a catch – you’re eating less – about 30 to 50% less. You now have to try to get all of your nutritional needs into fewer bites.
Your challenge now shifts from constantly fighting hunger to intentionally choosing foods that provide enough vitamins, minerals, and fibre.
When you are eating significantly smaller portions, every bite has to count. Research shows some alarming nutritional gaps among those using GLP-1 for weight loss. In a study that looked at the dietary intake of over 480,000 adults, the most common concern was low vitamin D levels, occurring in 7.5% of users by 6 months, and over 13% at 1 year.
According to studies, some of the nutrients people on GLP-1 medications tend not to get enough of include:
If fatigue is a challenge for you, a simple start would be to focus on foods or supplements that contain iron, vitamin D, and B vitamins – nutrients known to support energy metabolism.
Simple shifts in mindset and behaviour can support a successful weight loss journey on a GLP-1 medication. Known as behavioural nutrition support, the following strategies can help the journey of weight loss on GLP-1 medication:
Nausea, constipation, and changes in digestion are common hurdles, especially when first starting a medication or increasing a dose. This is because GLP-1 is a hormone that slows the digestive tract. This slowing is helpful in many ways for weight loss, as it extends the feelings of satiety, but it also means food sits in the digestive tract longer.
Instead of just pushing through the discomfort, there are some holistic nutrition strategies that support gut health and motility:
If you live a busy lifestyle, and sleep isn’t a top priority in your schedule, consider the importance of rest on your ability to cope with stress, emotions, and cravings. Studies show better sleep health is associated with greater weight and fat loss. Luckily, there are many strategies to support sleep, naturally.
The American Psychological Association has been taking note of the shift in mental health that can occur with the use of GLP-1 medications for weight loss.
While these medications can be a massive relief – lifting the heavy guilt of ‘failing’ at weight loss – they also bring a unique set of mental health challenges. They can intensify weight stigma and leave people feeling stuck in a no-win judgment trap:
Understanding and being aware of these pressures is important in supporting mental wellness during GLP-1 medication use for weight loss.
In addition, scientists have seen that there can be a decline in dopamine levels while on GLP-1 medications. (Significant amounts of dopamine is created in the gut, where the increase in GLP-1 is eliciting change.) Dopamine offers you a feeling of reward, a common feeling when you indulge in those cravings.
As such, in GLP-1 medication use, there can be a loss of drive. Since you’re no longer being stimulated by eating, consider other ways to offer your brain cells pleasure.
Try engaging in physical exercise, creative outlets or learning something new to trigger positive feelings. For example, cooking classes offer a chance to learn something new while developing healthier eating habits with long-term benefits.
Nutrition should never be an afterthought in GLP-1 care. As medical experts continue to call for formal nutrition guidelines for medication users, one thing is already crystal clear: medication alone is not enough.
Long-term success on GLP-1 medications for weight loss depends on:
Working with a holistic nutritionist can help bridge this gap by providing personalized support for the physical, nutritional, and behavioural changes that accompany your weight loss journey.
Become a Holistic Nutritionist – with flexible, online programs, you can start your journey to supporting others today.
Malnutrition in Obesity: Is It Possible? Obes Facts. 2022;15(1):19-25.
