Ask a Dietitian: What should I be eating if I take GLP-1 Medications?

While nutrition is certainly an important part of taking GLP-1 medications, there is no one size fits all diet. These medications are prescribed for a variety of reasons, and needs vary between individuals.

But let’s back up a bit. What are GLP-1 medications? 

GLP-1 agonists are a category of medications used to treat type II diabetes and obesity. T These medications lower the patient’s serum glucose levels (also known as your “blood sugar”) and therefore help to manage metabolism. They do this through a few mechanisms, such as:

• Delayed gastric emptying: Slowing down the time it takes for food to pass from the stomach to the intestines.

• Enhancing insulin secretion: Insulin is the hormone that helps take the glucose we need from our blood into our cells.

• Inhibiting glucagon production if blood sugar is high: Glucagon is a hormone that increases the glucose in our blood by stimulating the liver to release its stored glucose. 

They can also aid weight loss by increasing satiety, impacting our feelings of hunger and fullness. Some patients have also reported a reduction in something called “food noise”, a term used to describe the feeling of ruminating or obsessing over food.  

What role does nutrition play in these medications?

In order to be effective for disease management, GLP-1 medications are used alongside lifestyle changes. This includes eating a varied, balanced diet that provides you with adequate calories and nutrients. Some people’s medical history will play a role in their diet, for instance, those with diabetes may need to follow a carbohydrate-controlled diet alongside their medication. Your care team, including your dietitian, is there to provide you with evidence-based, personalized guidance to manage your nutrition while taking GLP-1 medications.

Having an interdisciplinary approach to your care, working with both your doctor and dietitian, is important when managing your use of GLP-1 medications. GLP-1 medications can also have gastrointestinal side effects that may impact dietary intake, such as constipation, diarrhea, and nausea. To help reduce these side effects, your doctor may make adjustments to your dosage. There are also nutrition interventions that can be helpful, such as small frequent meals and proper hydration. 

Due to changes in the way you experience hunger and fullness on these medications, some people find it difficult to ensure they are eating enough food. When we don’t eat enough food, our body misses out on the energy and essential nutrients we need to keep us healthy. This can result in muscle loss and weakness, also known as sarcopenia. Over time, not getting adequate nutrition (also known as malnutrition) can result in not just muscle loss, but also hair loss, irritability, and weaker bones. 

Many dietitians have reported that their patients who take GLP-1 medications specifically struggle to meet their protein and overall nutrition needs. Some nutrition interventions dietitians use to help their patients meet their needs include:

• Prioritizing nutrient dense foods (lean protein sources, veggies, fruits, legumes, nuts, grains, seeds, etc.)

• Having small frequent meals 

• Focusing on low-volume, and calorie-dense foods can also help manage a poor appetite. 

Dietitians can also help patients define their intake goals more clearly based on the individual's needs, such as calculating protein and calorie intake goals. A good general recommendation is that 10%–35% of your daily calories should come from protein. Research is ongoing to develop nutritional guidelines for those on GLP-1 medications.

Notes on safety:

As for all medications- you should obtain a prescription from the doctor and fill the prescription at a state-licensed pharmacy. Do not use or purchase GLP-1 medications without talking to your doctor. Forms of GLP-1 medications that are not approved by the FDA can be risky.

There are lots of factors your health care providers will consider before prescribing a GLP-1 medication. This includes contraindications, which is any condition or circumstance that indicates a medication would not be appropriate. Most medications have contraindications. For example, patients with certain gastrointestinal diseases may not be able to take GLP-1 medications.

TLDR: There is no specific diet for GLP-1 agonist medications, however meeting nutrition needs is important as poor appetite and side effects like nausea can interfere with adequate intake. Your healthcare professionals can provide you with necessary individual, evidence-based guidance to manage your health and nutrition while taking these medications. Prioritizing nutrient-dense foods is important to meet nutritional needs. 

Words by Madeline Peck RDN, CDN, Huel nutrition team