How to eat well whilst taking GLP-1s

Giving your body what it needs

Firstly, let's talk about malnutrition. This is where your body is not getting the nutrients it needs and, as a result, it is not able to function as well. Whilst one of the main reasons you may be taking GLP-1s is to lose weight, it's really important you do this in a healthy way to mitigate some of the risks of weight loss. Let's dive into the different ways you can do this.

Preserving muscle mass

Protein is involved in maintaining and building muscle mass, wound healing, and helping you feel satiated after a meal. During weight loss, you will not just lose fat tissue but also muscle. In order to minimise this muscle loss, a higher intake of protein is recommended.

• For adults not losing weight, the protein recommendation is 0.8g/kg/day.
• For adults losing weight, 1.2–1.6g/kg/day is recommended.

What does this look like? If you are 70kg, this is 84g–112g spread evenly throughout the day.

Bone health

Vitamin D and calcium both contribute to good bone health, which is more at risk when you are rapidly losing weight. It's important you are meeting your daily requirements of these to try to protect your bone density whilst losing weight. For more at-risk individuals, a supplement may be appropriate.

• Vitamin D: 10µg / 400IU for adults
• Calcium: 700mg for most adults

Resistance training is also very important for maintaining and building muscle mass throughout your treatment, and it helps build and maintain bone density.

• Aim to strength train 2–3× a week
• You can start anywhere! Even if it is using cans of baked beans whilst sitting down

Gut health

Fibre intake is important in gut health. It is recommended adults consume 30g of fibre a day, however only 4% of adults in the UK actually meet this. Whilst eating less, it can be even more challenging to meet this recommendation. Eating enough fibre can also help relieve some of the gastrointestinal side effects of taking a GLP-1, making it even more important.

Micronutrients

Some important micronutrients to make sure you are meeting are vitamin D, iron, calcium, magnesium, zinc, and vitamins A, D, E, K, B1, B12 and C. Micronutrient deficiency can cause symptoms of extreme fatigue, hair loss, skin irritation, poor wound healing and bruising.

Managing the side effects of GLP-1s

• Nausea and vomiting
  • Smaller but more frequent meals (5–6 meals a day)
  • Aim for lower fat meals
  • Herbal tea like ginger or peppermint may soothe nausea
  • Dry crackers when nauseous
  • If you are vomiting, an oral rehydration solution may be appropriate
• Feeling full very quickly
  • Again, try smaller but more frequent meals (5–6 meals a day)
  • When eating a meal, eat the protein and fibre-rich foods first. This helps ensure you are meeting protein and fibre requirements, even if you are unable to finish your meal
• Constipation
  • Try to gradually increase your fibre by around 3–5g per week
  • Stay hydrated with at least 2 litres of fluid per day (this includes coffee, teas and squash)
• Diarrhoea
  • Try to avoid greasy, high fat foods
  • Consider reducing your fibre down if appropriate
• Heartburn and reflux — this can be caused by delayed gastric emptying
  • Avoid caffeine, alcohol and fizzy drinks
  • Eat slowly, with the little and often approach
  • Keeping a food and symptom diary can help identify foods which give you symptoms, so you can look to avoid them in future
• Loss of interest around food
  • Choose nutritious foods which are more palatable, such as smoothies, soups and protein drinks with fruit and vegetables blended in
  • Unsweetened dairy foods may be more appetising, such as yoghurt, cottage cheese and milk
  • Setting alarm reminders for meal and snack times

A lot of these gastrointestinal side effects can happen when starting the medication and increasing doses. The symptoms can subside as you adjust to the new dose, so it may be about temporarily managing them until your body adapts.

How a dietitian can support you

Dietitians are really great at:

• Motivating you throughout your weight loss journey, through the highs, lows and plateaus
• Educating and supporting you to make healthy habit changes for the long term
• Realistic aims and goal setting
• Providing practical nutritional strategies to help you reach your goals
• Monitoring possible nutritional deficiencies and side effects whilst taking GLP-1s
• And don't forget celebrating your wins — the best part!

In summary

If you are planning to take a GLP-1, please talk to an appropriate healthcare professional to ensure any nutrient deficiencies and side effects are addressed. Adequate nutritional intake is key to supporting your health long term whilst taking GLP-1s.