GLP-1 weight loss drugs have reached their peak – and for good reason.
GLP-1 stands for glucagon-like peptide-1. These include brand names you may recognize such as Ozempic, Wegovy, Mounjaro and Zepbound. GLP-1s were originally developed to help people with type 2 diabetes control their blood sugar levels. However, they are now approved as an anti-obesity drug, and many people with obesity have found that they can lose more weight with a GLP-1 than with diet and exercise alone. In fact, GLP-1 users often lose up to 15% to 21% of their original body weight within a year.
As more women consider using GLP-1 for weight loss, it is important to remember that these medications should be part of a comprehensive treatment plan that also includes healthy diet and exercise.
“GLP-1s are very effective in weight loss, but diet and physical activity are still important,” said JoAnn E. Manson, MD, professor of medicine at Harvard Medical School and chief of the division of preventive medicine at Brigham and Women’s Hospital. “It’s not enough to just take these medications – you want to eat a healthy diet and minimize certain side effects that may arise from taking these medications.”
Approximately 25% of a patient’s weight loss from GLP-1 is muscle mass or muscle mass. People who think they are only losing adipose tissue (the fat mass that increases the risk of further health problems) may not realize that by losing muscle mass, they could also be creating new health risks. Losing too much muscle mass can lead to bone loss and osteoporosis. And this can pose an even greater risk for postmenopausal women, who are already at higher risk for these conditions due to hormonal changes.
“This loss of muscle mass really highlights the importance of lifestyle factors for healthy weight loss,” Manson said.
Another side effect of GLP-1 is decreased appetite. While this is often seen as a positive outcome for users who say they no longer feel the desire to overeat, reduced food intake can lead to nutrient deficiencies when patients do not consume nutrient-dense foods. Gastrointestinal upset is another side effect of GLP-1 that can reduce users’ food intake, as patients may eat less or their bodies may be unable to absorb nutrients due to vomiting. Another risk is that a gastrointestinal disorder could cause GLP-1 users to stop taking the medication, causing them to gain back the weight they lost.
Holistic treatment and care for obesity
If weight loss medications, including GLP-1, are prescribed, they should be part of a comprehensive care plan. As with any health condition, people should work with their healthcare provider (HCP) to develop a plan that addresses their individual needs.
In addition to medication, the most effective obesity treatment plans include dietary changes and an emphasis on exercise and other physical activities. Mental or behavioral health support should also be addressed, from counseling and support groups to discussions about managing stress and emotional/disordered eating habits. In any obesity treatment plan, it is also important to consider social determinants of health. These are non-medical factors such as where people live and work that affect their health and access to medical care.
Maximizing the benefits and managing the side effects of GLP-1
When GLP-1 is prescribed, it may be helpful to start with a small dose and increase slowly to minimize gastrointestinal side effects and help patients manage them if they do occur.
“Following some of these guidelines can help patients who are trying to avoid the reflux symptoms they may be experiencing,” Manson said. “We want to help patients maintain GLP-1 levels and avoid premature births [stopping] of these medications.”
To improve outcomes for patients using GLP-1 medications, healthcare professionals can begin developing a treatment plan after a basic nutritional assessment and screening and learn about the patient’s current dietary habits. Manson recommends that patients taking GLP-1 medications consume 1 to 1.5 grams of protein per kilogram of their body weight to help maintain muscle mass. While plant or animal proteins are the preferred choice for protein, protein shakes can be used when patients are struggling with decreased appetite or gastrointestinal issues.
Eight to twelve glasses of water or other liquids should also be consumed daily to compensate for dehydration caused by GLP-1. Manson recommends that half of the plate at every meal should be fruits and vegetables.
Regular physical activity is also important. Although any type of activity is worthwhile, resistance and strength training are important to prevent loss of muscle mass and muscle mass.
Doctors and patients can follow the MEAL plan to maximize the weight loss benefits of GLP-1. The MEAL plan is:
MPreserve muscles
• Consume 20-30g of protein (fish, poultry, yogurt, beans) per meal
• Use protein shakes if GLP-1 severely reduces appetite
EProvide energy and balance
• Eat snacks (nuts, fruit, yogurt) between meals
• Eat slow-digesting foods (oatmeal, sweet potatoes) and healthy fats (olive oil, avocado).
AThere are no side effects of GLP-1
• Increase fiber intake and stay hydrated to prevent constipation
• Reduce fried foods; Eat whole grains and try ginger for nausea
• Reduce spicy foods; Stay upright after eating to avoid heartburn
LFluid for hydration needs
• Drink 8-12 cups of water daily; eat hydrating foods (soups, cucumbers, melons)
For physical activity, 150 minutes of aerobic exercise per week (e.g. brisk walking) and 30 minutes of strength training with weights or resistance bands two to three times per week are recommended.
Manson said that while these dietary guidelines are what medical professionals would give to most patients regardless of taking weight loss medications, they may be particularly important for GLP-1 users. Combining GLP-1 with overall healthy diet, activity, and lifestyle changes can reduce the likelihood of weight gain while promoting healthy long-term habits to maintain weight loss.
This educational resource was created with the support of the Obesity Care Advocacy Network, a member of the HealthyWomen Corporate Advisory Council. HealthyWomen is a member of the Obesity Care Advocacy Network.
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