Beyond Ozempic: Nutrition and Dietary Considerations While taking GLP-1 Drugs.

GLP-1R receptor agonist drugs have hit the market as a game-changing means towards better weight and, ultimately, better health. These drugs have been in existence for quite some time, but only now appear to have taken the head seat at the weight-loss table. Though these drugs work well on their own, they may work better when paired with the right lifestyle changes. Here are the foods and supplements to consider if you take a version of these drugs.

What are GLP-1 agonist drugs?

GLP-1R agonists like liraglutide or tripeptide activate the GLP-1 (and other) receptors that are spread throughout the body. Their main mechanism is to delay gastric emptying (taking longer for food to pass from the stomach to the small intestine), lowering blood sugar, and regulating insulin. When these drugs are taken, an individual will most likely feel fuller much quicker and have a reduced appetite. 

What dietary considerations should be made for individuals taking these drugs?

Diet is critical to maintaining muscle, as well as reducing the risk of malnutrition during weight loss. It will also affect your efforts to keep weight off when you stop taking drugs.

1. Small, frequent meals: Due to delayed gastric emptying and lack of hunger, you may notice that the amount of food you consume at any one time is limited. Instead of three meals and a few snacks a day, more frequent eating may be the preferred method to optimize adequate nutrients throughout the day.
2. When you do eat – make it count: Since your total calories throughout the day may be significantly reduced, you’ll have less opportunity to get the nutrient density your body needs. I recommend a “bang for your nutritional buck” approach over an “eat whatever you want” approach. Focus on what you drink as well: One animal study indicates that being on GLP-1 drugs may inhibit fluid intake and may increase the risk of dehydration – so focusing on adequate hydration through water, teas, and even high-hydration foods (think citrus and watermelon) will be essential.
3. Protein: Protein provides amino acids important for the health of every cell in the body ad also plays a role in muscle synthesis, assisting growth and maintenance. Since GLP-1 drugs cause weight loss, which may, in some cases, be rapid, the risk of muscle loss goes along with it. Studies show that a loss of muscle mass has been associated with a reduced ability to maintain weight loss, as well as accelerated biological aging. Aim to add in protein in some capacity each time you eat.
4. Fat and Complex Carbohydrates: With all the attention on protein, it may be easy to overlook fat and complex carbohydrates. Healthy fats and adequate fiber can help make the GLP-1 experience easier. Fiber may help ease constipation or diarrhea and enhance a better microbiome. Healthy fats may help enhance your health span (the years you enjoy good health) and longevity.

What role do supplements play?

Supplements may be an easy way to restore some of the nutrients you may be missing and combating any nutrient deficiencies from eating less. Some supplements I recommend to my patients include:

• Creatine HCL: Creatine is a compound derived from amino acids. When supplementing, Creatine HCl is the more preferred form since it has better absorption with less gastric side effects than with other forms. Studies link creatine to enhancement in energy levels (through the production of ATP, which is a primary action of creatine), maintenance and growth of muscle mass, and enhancement of brain health. Creatine supplementation has been a critical factor in my patients’ recommendations for maintaining muscle while on GLP-1 drugs, and this will be important in maintaining weight loss if they come off the medication. 

• B complex: B vitamins are common in foods that may be missed or not eaten frequently enough while on GLP-1 agnostic drugs. A B complex supplement may help obtain all the B vitamins essential for good health. Folic acid, for example, is an important vitamin shown to help reduce neural tube defects in pregnant women. Some reports indicate there may be an increase in pregnancy while on a GLP-1 agonist drug (however, studies are needed to confirm this).

• Vitamin D: Vitamin D is poorly absorbed via food in the diet. A supplement is often recommended to offset the risk of deficiency (which has been associated with everything from poor bone health to increased mortality. Speak with your healthcare provider to determine the adequate dose to meet your health goals and current D levels.

• Pro/prebiotics: Probiotics and prebiotics may help to enhance optimal gut health, which is an important focus while on GLP-1 agonist drugs due to reduced fiber intake. 

GLP-1 agonist drugs have been shown to benefit many aspects of health, and hundreds of studies are underway that may reveal even more benefits. Focusing on diet, adequate sleep, and exercise (especially resistance training) will be necessary for success while on these drugs and once/if you discontinue taking them.