What diet should you follow if you are taking GLP-1 drugs?

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A new study has compiled optimal dietary recommendations to help people taking GLP-1 drugs for weight loss. Alba Vitta/Stocksy
  • Experts debate the best diets for people taking GLP-1 drugs to stay healthy while losing weight.
  • A new review has compiled optimal dietary recommendations available based on existing research.
  • The new guidelines may be useful for anyone looking to lose weight in a healthy way, but they are especially helpful for healthcare professionals who prescribe these medications.

GLP-1 drugs developed to treat diabetes are very effective in helping people lose weight. People who take these drugs can lose up to 15% of their starting weight within a year.

GLP-1 agonists mimic the glucagon-like peptide-1 hormone produced in the gastrointestinal tract. As a result, the brain experiences less hunger, the stomach feels fuller with less food, and food leaves the stomach more slowly. These drugs are based on the compounds semaglutide, tirzepatide, dulaglutide, or liraglutide.

Only two of these drugs, Wegovy and Zepbound, have approval received by the Food and Drug Administration (FDA) as a weight loss drug. Other GLP-1 drugs, such as Ozempic, Rybelsus, Saxenda, and Trulicity, are prescribed off-label for weight loss.

A new study presents dietary guidelines for people taking such medications to prevent nutritional deficiencies and work best for weight loss. The findings appear in Obesity.

The aim of the new research overview is to provide a centralised source of information, based on the best current research available.

According to the study authors, dietary advice can help doctors and patients taking GLP-1 drugs determine which foods they should and should not eat.

Because people taking these medications experience a decreased appetite (and therefore consume less food per day), there is a greater risk of developing nutritional deficiencies.

According to the study’s lead author, Lisa M. Neff, MD, executive director of Global Medical Affairs – Diabetes and Obesity at Eli Lilly and Company, there is currently limited evidence to support dietary recommendations for people treated with obesity medications (AOMs).

“For this reason, the dietary recommendations proposed in this review incorporate evidence from general public health, and VLCDs [very low calorie diets]”, Neff said Medical news today.

The GLP-1 drugs in this study are collectively referred to as AOMs.

“Our research provides targeted nutritional advice for patients developing AOMs, with an emphasis on healthy dietary patterns that allow for adequate intake of energy, macronutrients (protein, fat and carbohydrates), micronutrients, fiber and fluids,” Neff said.

Mir Ali, MD, a board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, said MNT The recommendations are more or less “the same kind of diet you would recommend to anyone trying to lose weight.”

Guidelines for a healthy, balanced diet to promote weight loss emphasize protein and vegetables, while limiting simple carbohydrates and sugar.

Neff said the information from the study will also help physicians successfully adjust a patient’s dosage for gastrointestinal side effects, such as:

“Dietary modifications may also be helpful. Patients may be advised to eat smaller, more frequent meals, stop eating before they feel full, and avoid foods and beverages that may worsen gastrointestinal symptoms, such as fatty foods, spicy foods, alcohol, and carbonated drinks.”

— Lisa M. Neff, MD, lead author of the study

The study confirms the importance of a healthy, balanced diet while using weight loss medication.

The information in the study is accessible to everyone, but will likely be most useful to professionals who work with people who use AOMs.

Weight loss drugs reduce hunger and food consumption, meaning “diet quality becomes even more important, as nutritional needs must be met within the context of reduced food consumption,” Neff noted.

According to Ali, the new dietary guidelines will help medical professionals direct their patients to foods that are not only healthiest, but also most conducive to weight loss.

“What are [patients] What should they be eating? What should they avoid? A lot of patients are not aware of these things. You have to tell them, ‘This is not going to help your weight loss if you eat these things because you’re getting too many simple carbohydrates.’ Your body is using that as fuel instead of burning fat as fuel. Our goal is to get your body into a mode where it’s burning fat, not just using the calories that you’re consuming as energy.”

— Mir Ali, MD, a board-certified bariatric surgeon

Michelle Routhenstein, RD, a preventive cardiology dietitian at EntirelyNourished, who was not involved in the study, said MNT Physicians treating people with GLP-1 should discuss the risk factors and symptoms associated with nutritional imbalances.

“Often, GLP-1 medications can suppress appetite too much, and without proper dietary advice, this can lead to muscle loss, nutritional deficiencies, constipation and dehydration,” said Routhenstein, who stressed the importance of consulting with a registered dietitian.

Ali agrees that diet patterns for weight loss are generally safer and more effective when followed under the guidance of a healthcare provider.

“If you have someone who gives you good dietary advice and you follow it regularly, it makes a big difference,” Ali said. “It’s easy to fall back into old habits and start eating the wrong things.”

Neff noted that counseling people being treated with AOMs can help health care professionals identify and treat pre-existing risk factors for malnutrition.[It can also] “We need to give patients goals for intake of important nutrients, including protein, dietary fiber, micronutrients and fluid,” Neff said.

“Ongoing monitoring during treatment may allow for early detection and management of any problems that arise, such as inadequate nutrient intake, gastrointestinal symptoms or mood disturbances,” she added. She added that future studies could further inform best practices for people taking AOMs.

“The availability of AOMs with greater efficacy and a generally favorable safety profile may enable more clinicians to take an active role in the management of their patients with obesity. This review provides practical nutritional recommendations and patient monitoring and management tips to empower clinicians and promote optimal health outcomes in patients treated with AOMs.”

— Lisa M. Neff, MD, lead author of the study

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