Taking a GLP-1? Elevate Your Health with These Expert Nutrition Tips

If you’re reading this, you’re most likely taking or thinking about taking a GLP-1 medication. Perhaps you have a friend, family member, or co-worker who credits a GLP-1 for improving their health.

GLP-1 drugs have become incredibly popular and widely prescribed in recent years. In my experience, I have professionally counseled many patients taking GLP-1s and also have people in my personal life who’ve incorporated GLP-1s to help them reach their health goals.

If you’re new here, welcome! I’m Alison, a Registered Dietitian and creator of evidence-based educational resources dedicated to optimizing women’s health.

Research has found many benefits with GLP-1 medications, including weight loss, managing appetite, and improving blood sugar control. However, there have also been a handful of concerns impacting long-term nutrition, including loss of muscle mass, reduced metabolism, and weight regain.

The good news? There are steps you can take to minimize nutrition complications AND elevate your health while taking GLP-1 medications.

When you read this blog, you’ll learn:

·    What GLP-1 medications are and how they affect your body

·    The common health challenges with GLP-1s and strategies to address them

·    How to optimize your nutrition on GLP-1s, with a list of healthy and tasty dietitian-created recipes to try

Let’s start off with some quick facts about GLP-1 medications.

GLP-1s: What They Are and What You Need to Know

GLP-1s are a class of drugs called “glucagon-like peptide-1 receptor agonists”. They are medications designed to act like our body’s naturally produced hormones which affect your brain, GI tract, liver, and pancreas.

GLP-1 drugs work by slowing down food emptying from the stomach into the small intestine. With digestion taking longer, people taking GLP-1s usually feel more full for a longer period of time and/or notice a decrease in their appetite.

Well known brands of GLP-1s include:

·    Ozempic (generic = semaglutide)

·    Wegovy (generic = semaglutide)

·    Mounjaro (generic = tirzepatide)

·    Rybelsus (generic = semaglutide)

·    Trulicity (generic = dulaglutide)

·  Zepbound (generic = tirzepatide)

GLP-1s are usually administered via injection, which can occur daily or weekly depending on the medication and dosage you’ve been prescribed. One exception is Rybelsus, which is available in pill form.

You will need to meet certain criteria to be eligible for GLP-1s (and not all insurance plans will cover them) and they aren’t appropriate for some people, including:

·    People who are pregnant, nursing, or planning to become pregnant

·    Have a history of pancreatitis and/or thyroid cancer

·    Have multiple endocrine neoplasma (MEN) syndrome Type 2

·    Have active and/or history of eating disorders

·    Have allergies or sensitivities to GLP-1 medications

If you are prescribed a GLP-1, the length of treatment will be unique to you and your specific circumstances. Some people will be on GLP-1s for a long period of time (potentially life-long) so it is important to take your medication responsibly and adjust your lifestyle habits to support your health and nutrition long-term.

So what does the research say about the benefits of GLP-1s? Let’s dive in!

Benefits of GLP-1s

GLP-1 medications have been FDA-approved for weight loss and several GLP-1s are also approved for the treatment of Type 2 Diabetes. A 2021 review found that multiple types of GLP-1s effectively reduce blood sugar levels in patients with Type 2 Diabetes.

You also may have heard that GLP-1s reduce something called “food noise”. Some people report that the medication helps them not feel constant insatiable hunger, cravings for less nutritionally dense foods (such as fast food or sweet or salty packaged snacks), and/or preoccupied with thoughts of food in general. Quieting this inner chatter can help you feel more empowered to make positive lifestyle changes.

GLP-1 medications can be a good starting place towards managing health goals. However, it is important to have an in-depth conversation with your doctor about whether GLP-1s are right for you and if so the appropriate drug and dose for your specific situation.

If you’re taking or about to begin taking a GLP-1, let’s get into some of the challenges you may experience.

Challenges with GLP-1s

Though research on GLP-1s shows quite a bit of promise, much of it has focused on benefits (especially maintaining weight loss) in the short term. More studies are needed to determine if these medications are effective and safe for long-term use.

Additionally, GLP-1s are serious medications that impact multiple organs of the body and the process of adjusting to the drug can be difficult for some people, especially in the early stages of treatment.

Challenges associated with GLP-1s include:

Side Effects

Everyone reacts to GLP-1 medications differently and side effects (particularly affecting the GI) are common. These include:

·    Nausea

·    Vomiting

·    Stomach pain

·    Headache, fatigue, and/or dizziness

·    Constipation or diarrhea

·    Heartburn, indigestion, and/or GERD

·    Bloating, belching, and/or flatulence

·    Low blood sugar (particularly in those with Type 2 Diabetes)

·    Changes in mood

·    Potential interactions with other medications

You may also experience negative effects from consuming certain types of foods and beverages, such as spicy, fried, or sweet foods/drinks.

For some people, side effects are more intense shortly after starting the medication but lessen over time, and can be well managed with the right strategies. Here are some steps you can take to deal with unpleasant side effects:

-Eat slowly, stop when full, consume smaller portions, and avoid being too physically active immediately after eating.

-For nausea, avoid strong smells and eat crackers, mint, or a ginger-based food/drink about 30 minutes after taking the GLP-1.

-To reduce vomiting, stay hydrated by drinking plenty of water and eat smaller, more frequent meals rather than 3 large meals. It may help to start the day with a small breakfast and then eat small meals every 3-4 hours while drinking adequate fluids.

-To reduce diarrhea, stay hydrated by drinking plenty of water, avoid dairy products, high fiber foods, and foods and drinks high in sugar until symptoms subside.

-On the flip side, if dealing with constipation, increase fiber consumption and drink plenty of fluids. 

Loss of Muscle Mass

You may lose more weight on GLP-1 medications, but studies have found that much of this weight loss is often muscle. This isn’t something you want, because you need muscle to protect your bones and maintain your everyday functions (like being able to lift yourself up and move around without assistance) as you age.

To combat muscle loss, it is important to exercise regularly while taking GLP-1s. Incorporating strength training at least 2-3 times per week will promote the growth and maintenance of your muscles.

Reduced Metabolism and Weight Regain

It may be exciting to lose a substantial amount of weight quickly while on GLP-1s, but this often comes with a lowered metabolism. This means that the amount of energy (calories) that your body needs from food goes down, so you don’t need as much food to maintain your weight. 

Often when people go off the GLP-1 drugs and eat more than they had been, it becomes very easy to gain weight back.

Eating smaller, nutritious meals and snacks throughout the day can help manage your metabolic rate and give you the tools to keep your weight stable after reaching your goals. You can also opt for protein shakes to get enough daily nutrients if that works better with your appetite.

Though there are risks with GLP-1 treatment, there are also ways to reduce and prevent nutrition and health challenges even when your eating habits have changed. Let’s take a closer look at the nutrients to focus on while taking GLP-1s.

Nutrients to Prioritize on GLP-1s

Typically, when you’re on a GLP-1 you’re eating quite a bit less than you’re used to. This may not be a concern if you’re getting enough macronutrients (like carbs, protein, and fats) and micronutrients (like vitamins and minerals) each day, but if not, it is easy to become deficient in these.

Nutrient deficiencies can lead to major problems down the road, including malnutrition and increased risks for falls and fractures (yikes!).

Here are the nutrients I recommend you prioritize while taking a GLP-1:

Lean Protein

Protein is the key to growing and maintaining your muscle mass. It is recommended to spread out your protein intake throughout the day.

A recently published article in JAMA recommends having 20-30 grams of protein at each meal from lean sources such as fish, poultry, yogurt, beans, or lentils.

If your appetite is substantially decreased or you have difficulty tolerating these foods, you can also get protein from liquid shakes.

Calcium

It’s important not to forget about the health of your bones as you work towards your health goals with GLP-1s. Getting adequate calcium in your diet from foods such as dairy, canned fish, soy, and fortified orange juice helps strengthen bones, prevent bone loss, and reduce risk for conditions like osteoporosis.

The National Institute of Health recommends that adults age 19-50 get 1,000 mg of calcium daily, while women age 51+ and adults 71+ should get 1,2000 mg of calcium daily.

Vitamin D

It’s easy to become deficient in Vitamin D when your dietary habits change on GLP-1s. However, this vitamin is necessary for the body to absorb calcium and it also helps promote optimal muscle function.

Vitamin D is in protein-rich foods like salmon, tuna, eggs, and fortified milk, and can also be found in fortified non-dairy milks and wild mushrooms. The daily recommendation for Vitamin D is 600-800 International Units (IU). Supplementation may be necessary to ensure you get enough of this important nutrient, speak with your medical provider (and test your blood level annually) to ensure the dosage that is right for you.

Fiber

It is common to experience constipation while taking a GLP-1, and this risk often goes up when your food intake goes down (because this can mean your overall fiber intake isn’t adequate to provide benefits to your GI tract). Choose foods high in fiber, such as fruits, vegetables, legumes, and whole grains and drink plenty of water to support healthy bowel movements and overall balance of the gut.

You should aim to get 25-30 grams of fiber per day from carbohydrate food sources. If you’re experiencing other GI side effects like diarrhea, or are eating far less than the recommended 25-30 grams, it is best to introduce fiber-rich foods gradually.

Now that you’re familiar with the nutrients to focus on while taking GLP-1s, let’s look at some recipes to help you elevate your health!

5 GLP-1 Friendly Recipes

There are many ways to get the nutrition you need to reduce your risk of health challenges on GLP-1s. These recipes (created by Registered Dietitians!) offer an important balance of nutrients like lean protein, fiber, calcium, and Vitamin D while being lower in volume to not feel overwhelming to eat. The list features both plant-based and omnivorous options, with substitutions to make vegetarian or vegan if desired.

First on the list- a wholesome and tasty breakfast!

1) Greek Yogurt Parfait

This straightforward recipe from Registered Dietitian Kristi Ruth contains just four ingredients and is great for on the go. It’s also packed with 28 grams of protein per serving (you can even increase the protein content by adding more yogurt, using Skyr yogurt, or increasing the peanut butter powder) as well as other important nutrients like fiber and calcium.

Get the recipe here.

2) Huevos Divorciados

Double the sauces (and the fun!) with this protein-fueled meal of eggs and black beans. Created by EatingWell’s senior nutrition and news editor, this delicious Mexican recipe is part of a nutritionally balanced and culturally diverse eating plan for people taking GLP-1 medications.

Get the recipe here.

3) Black Lentil Salad

This plant-powered recipe from RD Jenny Shea Rawn boosts protein AND fiber-rich lentils with nutrient-dense yet light veggies like English cucumber and celery. It can be enjoyed right away or after chilling for a few hours, and is easily made vegan (such as substituting vegan feta) if you prefer.

Get the recipe here.

4) Tuna Corn Salad

This yummy offering from RD Jenny is a great way to get your calcium, Vitamin D, and protein from tuna while enjoying fresh and zesty flavors. The best part? It all comes together in just 10 minutes!

Get the recipe here.

5) Air Fryer Pesto Salmon

Another great recipe from RD Kristi! All you need are frozen salmon fillets and either a homemade or store-bought pesto sauce for this protein fix, but you can also pair it with sides like salad, roasted veggies, rice, or pasta.

Get the recipe here.

The Takeaway: Elevating Your Health on GLP-1s

GLP-1 medications can help you reach and maintain a healthy weight, keep your blood sugars stable, and even improve your quality of life. However, there is an increased risk of reduced metabolism and muscle loss while on GLP-1s and it is common to gain weight back after you stop taking them.

Though you will likely feel less hungry while taking GLP-1s, it is important to get enough quality nutrients like lean protein, calcium, Vitamin D, and fiber to maintain muscle mass, a balanced metabolism, and optimal physical function. Think of your GLP-1 medication as one part of a healthy living lifestyle, in addition to physical activity, adequate sleep, and dedicated time with your loved ones.

The dietitian-crafted recipes in this blog are great ways to help you meet your nutritional needs as you endeavor through your GLP-1 journey. You can enjoy them as is or make any modifications that best suit your tastebuds and your lifestyle.

SDNutritionWriter is here to help with your women’s health nutrition journey! Stay up to date with our blog and be sure to check out our resources to support your nutrition goals.

Talk to your medical provider and give a thorough health history to determine the appropriate GLP-1 treatment for you. When taking a GLP-1, do so exactly as directed and contact your provider immediately if you experience any adverse effects while administering or taking the medication.

Special thanks to Registered Dietitians Kristi Ruth and Jenny Shea Rawn for their contributions to this piece.