GLP-1 weight-loss medications such as Ozempic and Zepbound are so potent they might make it appear that one can shed pounds without any effort at all.
However, experts warn against this misconception. Achieving sustainable weight loss and maintaining it requires lifestyle adjustments beyond just a weekly GLP-1 injection.
"Many patients experience a decline in muscle mass alongside fat reduction and also face gastrointestinal issues that may lead to discontinuing the medication," said senior researcher Dr. JoAnn Manson in a news release. Dr. Manson is the chief of preventive medicine at Brigham and Women's Hospital, Boston.
These concerns have prompted experts to develop specific dietary and exercise recommendations for individuals taking GLP-1 medications. These suggestions are outlined in an article published in JAMA Internal Medicine.
JAMA Internal Medicine"We advocate an approach that focuses on improving outcomes with GLP-1s by maintaining lean body mass, ensuring balanced nutrition, and managing symptoms that might otherwise lead to halting medication," Manson explained.
For example, research indicates that lean muscle mass constitutes 25–40% of the weight lost when using GLP-1 drugs, experts note.
"Commence each meal with 20 to 30 grams of protein from sources like fish, beans, chickpeas or tofu," the recommendations read. "Aspire to consume 1.0 to 1.5 grams of protein per kilogram of body weight daily if moderately active. If appetite is suppressed, employ protein shakes containing at least 20g of protein per serving."
The guidelines also recommend engaging in two to three half-hour strength training sessions weekly to preserve muscle mass.
GLP-1 drugs work by reducing appetite, which can affect appropriate nutritional intake for optimal bodily function, researchers emphasized.
"Maintain your energy levels with smaller meals and snacks (like fruits, small servings of nuts or unsweetened yogurt)," the guidelines suggest.
"Prefer complex carbohydrates that digest slowly such as sweet potatoes or oatmeal over refined grains (white bread, pastries) and sugary beverages which can lead to erratic blood sugar levels. Add healthy fats like olive oil or avocado for prolonged satiety."
Overall, experts recommend a well-balanced, nutrient-rich diet alongside GLP-1 medications to avoid calorie-restricted diets that could result in unhealthy weight loss and malnutrition from lacking essential nutrients.
To manage potential gastrointestinal (GI) side effects of GLP-1 drugs, the experts offer various recommendations:
- To alleviate nausea, refrain from fried or processed fatty foods. Opt for soothing whole-grain toast or cereal, a bit of fruit, or ginger tea instead.
- To counter heartburn caused by delayed stomach emptying due to the medication, consume smaller portions and avoid lying down for 2-3 hours after eating. Choose baking over deep-frying and steer clear of spicy ingredients like black pepper, chili or garlic.
- For constipation relief, increase consumption of fiber-rich foods such as oats, apples, vegetables, and nuts. Stay hydrated, and consider using over-the-counter laxatives if needed.
GLP-1 medications can also lead to dehydration, hence patients are urged to drink 8-12 cups of water daily. Consuming soups or water-rich foods like cucumbers and watermelon is beneficial as well.
For sustained weight loss, experts recommend adopting a regular exercise routine in addition to strength training. This includes building up to 150 minutes per week of moderate-intensity activities such as brisk walking, biking, or light gardening.
"Although GLP-1 medications are groundbreaking for obesity management, lasting success requires combining these drugs with personalized diet and physical activity plans," the authors write.
"A comprehensive strategy optimizes sustained weight loss while mitigating side effects, preserving muscle mass, and preventing nutritional deficiencies," they conclude.