GLP-1 Weight Loss Support Guide

By Britni Vincent, RD, LD
September 9, 2024

By now you’ve likely heard of GLP-1 and GLP-1 agonist medications as they are the big buzz in the weight loss world.

If you are thinking about trying one of these medications to promote weight loss, it’s important to understand how they work, the potential side effects and drawbacks of these medications.

And, if you are already taking a GLP-1 agonist medication, we're here to support you too!

There are lifestyle modifications you can make to potentially lessen side effects, prevent the excessive muscle loss that is often seen with these medications and to help prevent regaining all the weight lost when/if you go off the medication in the future.

Understanding GLP-1 Weight Loss Medications

GLP-1 agonist medications, such as Wegovy and Ozempic, are designed to mimic the effects of the GLP-1 hormone that your body makes.

GLP-1, which is short for glucagon-like peptide-1, is a peptide signaling hormone that is naturally produced primarily in your gut, but some is also produced in your brain. This is something that your body has and uses as part of its normal physiology.

GLP-1 is produced in small quantities throughout the day but increases while you eat.

GLP-1 helps to control appetite – it’s part of what tells you that you’re full and you can stop eating.

GLP-1 also helps insulin work more efficiently which aids in blood sugar regulation and improves insulin sensitivity.

GLP-1 agonist, the class of these medications, work by stimulating the GLP-1 receptors to mimic the same effect of GLP-1 in your body. While these medications can be highly effective, they are also associated with several side effects that can impact your quality of life.

GLP-1 Medication Side Effects:

The reason these drugs have so many side effects is it’s like mega dosing your body with this hormone. Your body would never produce this amount of GLP-1 naturally.

Side effects may be worse the couple days following the injection and when dosage is increased.

Not only is it the drugs themselves that can cause people to feel poorly, losing weight rapidly can sometimes result in feeling poorly. Toxins are stored in your fat cells and when you are losing fat rapidly your body is dumping out those toxins, which can affect the way you feel.

Can Your Nutrition Plans Help Manage Potential Side Effects of GLP-1 Medications?

Yes, nutrition can help manage many of the side effects of GLP 1 medications.

Although we have given you some tips in this article to get you started, if you are taking a GLP-1 medication we strongly recommend you work with a nutritionist to create a nutrition plan to support your weight loss efforts and mitigate side effects.

Some side effects of GLP-1 weight loss medications might include:

Digestive Symptoms: About 50% of users experience digestive symptoms such as nausea, vomiting, diarrhea and constipation.

Other Side Effects: Dizziness, abdominal pain, fatigue, headaches, mild tachycardia (fast heart rate), infections, headaches, and indigestion are also reported.

Severe Side Effects: More severe issues include gastroparesis (stomach paralysis), thickening of the bowels leading to bowel obstruction which could potentially require surgery, pancreatitis, thyroid tumors (seen in animal studies) and kidney issues.

Side Effect: Digestive Symptoms

Nausea is one of the most common side effects of the GLP-1 medications.

Individuals may have a significant reduction in appetite while taking these medications, increasing the likelihood of going too long without eating or just simply not eating enough.

Going too long without eating or not eating enough could lead to a dip in blood sugar. This dip in blood sugar can cause some people to feel nauseous, dizzy, get a headache, upset stomach, and feel tired amongst other potential symptoms.

There is a potential that not eating enough or going too long without eating could exacerbate some of the digestive side effects of the weight loss medications, especially nausea.

Tips for preventing digestive symptoms:

• It’s possible that small more frequent meals would work better for some individuals who have low appetite while taking these medications.

• I would also recommend eating breakfast soon after waking up to help reduce some of the nausea.

• Along with aiming to eat every 3-4 hours, eating a balance of real carbohydrates (think fruits, vegetables, and beans instead of bread, pasta and crackers), real protein (meat, fish, seafood, dairy and eggs) and real fat (olive oil, butter, olives, avocado, avocado oil, nuts and seeds) will keep your blood sugar stable and prevent those blood sugar dips mentioned earlier. Even on the Ozempic website, they recommend eating lower amounts of carbohydrates to see the best results.

Clinically, we have found that individuals who are taking these medications and eat real food in balance every 3-4 hours seem to have less of these side effects.

Side Effect: Weight Reduction Due to Muscle Loss

While weight loss is generally the goal of using weight loss drugs, losing too much lean body mass (muscle, bones, organs) is a concern for your health.

Most individuals on weight loss medications are not only losing fat but excessive amounts of muscle (1).

Significant muscle loss is seen with any rapid weight loss, not just from these medications. When you lose weight quickly your body has less time to rebuild and preserve muscle.

Excessive muscle loss will slow your metabolism, make weight management more difficult, and increase the likelihood you regain weight.

Excessive muscle loss can also affect your appearance, causing loose skin and a phenomenon known as "Ozempic face."

Muscle loss can also negatively affect your bone density, physical function and longevity. Studies have shown that low muscle mass is associated with outcomes such as higher surgical and post-operative complications, longer length of hospital stay, lower physical function, poorer quality of life and shorter survival (2).

Tips For Preventing Muscle Loss if You’re Taking a GLP-1 Medication

The more muscle you have, the better your metabolism is.

Muscle increases your resting metabolic rate, which is the energy expended just for your body to perform its basic daily functions.

Not only does more muscle mass equate to a better metabolism, but studies have shown that having more muscle is associated with longer longevity (3).

The recipe for maintaining and building muscle is eating protein + strength training.

• Focusing on a higher protein diet will help prevent you from losing too much muscle.
  
  We recommend aiming for 4-5 ounces (28-35 grams) of protein at meals and 2 ounces (14 grams) at snacks for women and 6-7 ounces (42-49 grams) at meals for men and 3 ounces (21 grams) at snacks. Note that these amounts are after the protein has been cooked.
  
  It can be difficult to get this much protein in when you don’t have much of an appetite. Smoothies can be a great option, because often it’s easier to drink something when you’re not very hungry. We have many delicious smoothie recipes on our website.

• The best protein comes from animal sources, because animal protein is more bioavailable to your body than plant-based protein sources.

  Some great sources of protein are: Meat (organic, grass-fed, free-range and pasture raised are best when you can), Eggs (organic pasture-raised is best), Fish and seafood (wild caught is best), Dairy (organic pasture-raised is best).

• Along with eating a protein forward diet, exercise, specifically strength training, is key to preventing excess muscle loss. This may mean just starting out with bodyweight exercises and as your strength increases moving to weights.

Risk of Weight Regain

For various reasons, including cost and side effects, people may decide to stop taking it. After stopping GLP-1 medications, many individuals regain the weight they lost, primarily as body fat. The current recommendation for most individuals is to stay on these medications indefinitely to maintain results.

One of the studies often cited when discussing the benefits of the GLP-1 agonist medications, Step 1, did an extension trial. The study included 327 participants. They monitored them for one year after stopping Semaglutide, Ozempic or Wegovy, and the lifestyle interventions included in the Step 1 trial.

After one year of stopping the weight loss medications, participants regained two-thirds of their prior weight loss and cardiometabolic improvements for preventing heart disease, like lowering high blood pressure, went back to baseline for most participants (4).

The weight that you regain is going to be body fat, so you’ll end up with more body fat than before you started the medication. This puts you in a worse health condition overall. It also means your metabolism will be lower, making it more difficult to lose weight again.

Tips for Reducing Weight Regain

If you make diet and lifestyle changes while being on GLP-1 agonist medications your risk of returning weight gain may be lower, because you now have a stronger foundation for your health.

• Eating real food

• Strength training

• Stress reduction

• Prioritizing sleep

• Eating adequate amounts of protein will also help prevent regaining the weight you lost.

Cost Considerations

These weight loss medications can be expensive, with costs often as high as $1700 per month.

Many of the weight loss medications are not covered by insurance, leading to significant out-of-pocket costs, especially if long-term use is required.

How To Naturally Increase Your Body's GLP-1

GLP-1 has a lot of benefits so the idea of increasing your own production makes a lot of sense. Increasing your own GLP-1 will help reduce your cravings, control appetite and balance your blood sugar.

As I mentioned earlier, GLP-1 is something that is naturally made in your own body, specifically in your gut and your brain.

These are natural ways to boost your own body’s production of GLP-1:

Protein:

Eating protein rich foods has been found to increase the secretion of GLP-1 in the gut.

Protein itself increases satiety and aids in blood sugar balance. Clinically, we see that individuals who get enough protein throughout the day have far fewer cravings.

Fiber:

After you eat fiber the bacteria in your gut ferments the fiber, stimulating GLP-1 production. Not only does fiber boost GLP-1 production, but it also increases satiety, keeping you fuller longer.

Fiber rich foods include vegetables, nuts, seeds, avocadoes, beans, and fruit. Raspberries, blackberries, jicama, kale, peas, beans, chia seeds and avocado are all particularly high in fiber.

Eat Food In Order:

Take it a step further and eat your vegetables first, protein and fat second, and starches and sugars (fruit) last. This isn’t always realistic to do, but when it works for you, it’s a good practice to follow.

One study showed that by following this meal order your GLP-1 production can increase up to 38% percent and stay elevated longer (5). Another benefit from eating in this food order is that the blood sugar effect from the starch or sugar will be reduced.

Akkermansia:

Akkermnsia is a specific kind of bacteria in your gut and a new probiotic on the block so you may have heard a bit about it.

It has been found to increase GLP-1 production in the gut. Not only does it increase GLP-1 production, but it has been shown to aid in weight loss and lower blood sugar levels.

One study found that participants who took an Akkermansia supplement on average lost 5 pounds over 3 months without any other changes - as well as improved fasting insulin by 30% (6).

HiPhenolic:

HiPhenolic is a new professional grade supplement made by Ortho Molecular. It helps with weight loss through various mechanisms, which includes increasing GLP-1 production. Similar to Ozempic, HiPhenolic helps to reduce appetite and increase satiety. Along with that, it can help to support lower blood pressure to healthy levels.

One of the ingredients, Metabolaid®, increases GLP-1 production. In an eight week, double-blind, placebo-controlled trial of overweight individuals, those who received 500 mg of Metabolaid® daily (a blend of hibiscus and lemon verbena extract) had a statistically significant increase in the satiety hormone GLP-1 compared to the placebo group (7).

HiPhenolic also contains green coffee bean extract, which has also been shown to help people lose weight (8). These ingredients work synergistically to increase energy sensor AMPK. AMPK increases cellular metabolism, helping glucose uptake thereby reducing insulin resistance. For those that are caffeine sensitive, this product doesn’t contain caffeine. 

Bitter Foods:

Bitter foods including coffee, yerba mate tea, bitter greens, and lemon have been found to increase GLP-1 production.

Yerba mate is something you may have never heard of. It is a type of tea that’s popular in Latin and South America. Like black and green tea, it does contain caffeine. It has been found to increase levels of GLP-1 and increase leptin levels. Both of these mechanisms help to increase satiety and decrease appetite.

GLP-1 Weight Loss Support from Nutritional Weight and Wellness

If you are taking GLP-1 medications for diabetes or weight management, you are likely seeking the best ways to support your health journey.

At Nutritional Weight and Wellness, we believe in the power of real food nutrition to complement your medical treatments and help you achieve sustainable health and wellness.

Our Real Food Approach

At Nutritional Weight and Wellness, we advocate for a real food approach to nutrition. This means focusing on whole, unprocessed foods that nourish your body and provide essential nutrients.

By choosing nutrient-dense foods, you can support your body's natural processes and enhance the effectiveness of your GLP-1 weight loss medications, making your investment in these medications more worthwhile.

How We Can Support You

Personalized Nutrition Guidance:

Our team of expert dietitians provides personalized nutrition plans tailored to your unique needs and health goals.

We consider your medical history, lifestyle, and preferences to create a plan that works for you.

Schedule A Nutrition Consultation

Balanced Meal Planning:

We teach you how to create balanced meals that include the right mix of proteins, fats, and carbohydrates.

This helps stabilize blood sugar levels, support weight management, and reduce the risk of muscle loss.

Schedule A Nutrition Consultation

Digestive Health:

Proper digestion is essential for nutrient absorption and overall health.

Our guidance includes tips on improving digestive health, which can help alleviate some of the digestive symptoms associated with GLP-1 medications.

Schedule A Nutrition Consultation

Hormone Balance:

Balanced hormones play a vital role in managing weight and blood sugar levels.

Our approach includes strategies to support hormone balance through nutrition, helping you feel your best. 

Schedule A Nutrition Consultation

 

Additional Weight Loss Resources:

• Best Weight Loss Program: Nutrition 4 Weight Loss
• Do Weight Loss Pills Work?
• Does Support Really Help With Weight Loss?

 

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REFERENCES: 

1.      Ida, S., Kaneko, R., Imataka, K., Okubo, K., Shirakura, Y., Azuma, K., Fujiwara, R., Murata, K. (2021), Effects of Antidiabetic Drugs on Muscle Mass in Type 2 Diabetes Mellitus. Current Diabetes Reviews, 17(3):293-303. doi: 10.2174/1573399816666200705210006. 

2.      Prado, C.M., Purcell, S. A., Alish, C., Pereira, S.L., Deutz, N.E., Heyland, D.K., Goodpaster, B.H., Tappenden, K.A., Heymsfield, S.R. (2018), Implications of low muscle mass across the continuum of care: a narrative review. Annals of Medicine, 50(8):675-693. doi: 10.1080/07853890.2018.1511918 

3.      Srikanthan, P, Karlamangla, A.S. (2014), Muscle mass index as a predictor of longevity in older adults. The American Journal of Medicine, 127(6), 547-553. https://doi.org/10.1016/j.amjmed.2014.02.007 

4.      Wilding, J. P., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The step 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564. https://doi.org/10.1111/dom.14725 

5.      Shukla, A.P., Andono, J., Touhamy, S.H., Casper, A. Illiescu, R.G., Mauer, E., Zhu, Y.S., Ludwig, D.S., Aronne, L.J.(2017), Carbohydrate-last meal patturn lowers postprandial glucose and insulin excursions in type 2 diabetes. BMJ Open Diabetes Research and Care, 5(1): e000440 doi:10.1136/bmjdrc-2017-000440 

6.      Depommier, C., Everard, A., Druart, C., Plovier, H., Van Hul, M., Vieira-Silva, S., Falony, G., Raes J., Maiter D., Delzenne, N.M., de Barsy, M., Loumaye, A., Hermans, M.P., Thissen, JP, de Vos, W.M., Cani PD. (2019). Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study. Nature Medicine. 25(7):1096-1103. doi: 10.1038/s41591-019-0495-2. 

7. Boix-Castejón, M., Herranz-López, M., Pérez Gago, A., et al. Hibiscus and lemon verbena polyphenols modulate appetite-related biomarkers in overweight subjects: a randomized controlled trial. Food Funct.2018;9(6):3173-3184. doi:10.1039/c8fo00367j 

8. Haidari, F., Samadi, M., Mohammadshahi, M., Jalali, M.T., Engali, K.A. Energy restriction combined with green coffee bean extract affects serum adipocytokines and the body composition in obese women. Asia Pac J Clin Nutr.2017;26(6):1048-1054. doi: 10.6133/apjcn.022017.03. PMID: 28917230.