Nutrition while taking GLP-1 medications for weight loss

Celebrities like Oprah Winfrey are making headlines with their weight loss assisted by a class of prescription medications known as GLP-1s. After a series of approvals from the Food and Drug Administration, providers are prescribing these medications, which have been on the market for about 20 years to treat diabetes, for weight loss.

The medications work by mimicking the action of GLP-1, a naturally occurring hormone that stimulates insulin secretion. Weight loss on these medications is largely attributed to how they help control sugar levels, regulate appetite and slow the passage of food from the stomach to the small intestine. This combination helps promote weight loss and reduce the risk of cardiovascular events.

Reframing obesity as a treatable disease

Sentara Comprehensive Weight Loss Solutions registered dietitian Dina Yusufov highlights the changing perspective around obesity within the medical community.

"We are recognizing obesity as a disease, not a personal failing," Yusufov explains. "By reframing our approach, we remove the shame and stigma often attached to weight struggles. That changes the focus to providing the continuous support, medication and tools needed for change – just as we do for other chronic conditions."

Newer weight loss drugs, including GLP-1 medications, are part of a "toolbox" of solutions available to people with obesity as they seek to improve their health. For long-term weight loss, people need ongoing medical support to combine the best options for their unique needs, Yusufov says.

Support is key

As many people who have struggled with weight understand, there is no magic pill, including GLP-1 medications.

"I believe support is extremely important when you take these medications," Yusufov says.

"Our program provides individual support that empowers patients to make sustainable lifestyle changes."

Yusufov looks at each person's background, where they struggle and their life stressors. She helps patients address those factors and adopt healthier eating habits. When supporting patients taking GLP-1 medications, Yusufov also monitors other health measurements such as their A1C level, hydration status and energy level. The A1C test measures your average blood sugar levels over the past three months to give information on prediabetes or diabetes management.

Dosage adjustments are also made individually. Yusufov encourages patients not to compare themselves to others, particularly regarding dosage and weight loss.

How long each person needs to be on the medication also varies and should be discussed with their provider.

"Real nutritional changes are not an overnight change," emphasizes. "This should not be considered the easy way out for long-term success. These medications are a tool – they help you get started improving your nutrition habits and identifying where you need to make lifestyle adjustments."

Nutrition recommendations

While taking GLP-1 medication, it's crucial to focus on a balanced diet that supports overall health and complements the effects of the medication. Here are some key recommendations from Yusufov:

1. Prioritize protein: Including lean sources of protein in your meals can help promote satiety, regulate blood sugar levels and support muscle health. Choose protein-rich foods like poultry, fish, tofu, beans, lentils and Greek yogurt.
2. Eat small meals frequently/emphasize whole foods: Base your meals around whole, unprocessed foods such as lean proteins, vegetables, whole grains, fruits and healthy fats. These foods are nutrient-dense and provide essential vitamins, minerals, fiber and antioxidants. Yusufov also recommends eating smaller meals more often. For many, this means "learning" to eat breakfast, which she says many people are used to skipping. Yusufov says that skipping breakfast leads to increased hunger throughout the day.
3. Portion control: Yusufov teaches the "plate method" of eating – a simple way to plan portions without counting calories, calculating or measuring. This method consists of filling half your plate with non-starchy vegetables, one-quarter of the plate with protein foods and the last quarter of the plate with carbohydrate foods. Yusufov also suggests combining protein sources with fiber, which helps promote a feeling of fullness. Eat protein first, non-starchy, fibrous vegetables second and starchy foods last.
4. Get enough fiber: Fiber is important for all healthy eating plans, particularly when taking GLP-1 medications. Constipation can be a common side effect of GLP-1 medications, and ensuring an adequate intake of fiber can help alleviate this symptom and promote overall gastrointestinal comfort. Yusufov recommends getting 25-35 grams of fiber per day. She also recommends getting as much fiber as possible from foods, but a powder-based fiber supplement may be helpful if additional fiber is needed.
5. Stay hydrated: This is an important element in any weight loss plan, especially when taking GLP-1s, as it can help with constipation, a common side effect of this medication. Yusufov recommends drinking between 48 to 64 ounces of water daily.

Managing side effects

Another reason Yusufov believes clinical support is essential for people taking GLP-1 medications for weight loss is to help support patients through common side effects such as constipation and nausea/vomiting. Water helps soften the stool, and for nausea, sipping herbal sugar-free teas, like ginger or spearmint, can help alleviate symptoms.

"Your provider or dietitian can help prevent and address common side effects with strategies including hydration, physical activity and dosage adjustments as needed," she says.

She also encourages patients to report these concerns promptly and keep an open line of communication with their healthcare providers throughout their weight loss journey.

Long term success

Yusufov emphasizes the importance of making dietary and lifestyle changes while on GLP-1 medication as a crucial step toward long-term success. By choosing healthier foods and adopting positive habits while on the medication, people build a strong foundation for lasting change.

"Recognize that improving nutritional habits takes time. It's not an overnight change," she says.

Learn more about weight loss treatments at Sentara Comprehensive Weight Loss Solutions.