What's the 411 on GLP-1s?

You can hardly scroll through social media nowadays without hearing someone talk about GLP-1 medications (glucagon-like peptide-1) like Ozempic, Wegovy, Mounjaro, and Zepbound. These medications have been making headlines for their weight and diabetes management results. Some people have shared that it’s been a miracle; others warn to stay far away from them. As a registered dietitian, my role is to support your weight loss and diabetes management in a safe and realistic way. Whether you choose to lose weight holistically or use GLP-1 as a helpful tool for your weight loss journey-- you decide. MY mission is to help you understand how to nourish your body so that, whatever path you choose with your healthcare team, your health stays the priority and is protected.

While there’s a whole class of GLP-1 medications, injectable Semaglutide (Ozempic, Wegovy) and injectable Tirzepatide (Mounjaro, Zepbound) are the most popular and effective ones for weight and diabetes management—they’re the ones I’ll be focusing on, and I'll be calling them GLP-1s for the remainder of this blog post after the next paragraph. 🙂

These medications are taken as a once-weekly injection. Wegovy and Zepbound are FDA-approved specifically for weight management in individuals with obesity or those who are overweight with weight-related health concerns. Meanwhile, Ozempic and Mounjaro are FDA-approved for type 2 diabetes management but are frequently prescribed off-label for weight management.

If you’re looking to learn how to make the most of these medications, keep reading. We’re diving into the most important pieces you need to know: how they work, what to eat, side effects, and what to consider if you decide to take a GLP-1 and you've been diagnosed with PMOS (Polyendocrine Metabolic Ovarian Syndrome) or perimenopause/menopause.

How do GLP-1 medications work??

GLP-1 medications, also known as GLP-1 receptor agonists, work by mimicking a natural hormone in your body called GLP-1. GLP-1 is produced in your intestines and released into your bloodstream when you eat. It balances blood sugar by telling your pancreas to release insulin, reduces hunger by activating receptors in the brain that curb appetite, and helps you feel full by slowing digestion. So to summarize:

• They reduce hunger. By activating GLP-1 receptors in the brain, these medications lower appetite, reducing food intake.

• They increase fullness. They slow digestion, meaning food stays in your stomach longer. This extends feelings of fullness and prevents overeating.

• And they quiet “food noise” – Many people on these medications report a significant reduction in constant thoughts about food, often referred to as “food noise”.

Mind Over Matter When Building Healthy Habits

Building the right habits can help you get the most out of your GLP-1 and set you up for long-term success. But it’s important to consider one critical step:

• Ask yourself: what’s my relationship with food? - Your personal relationship with food plays a key role in your success with GLP-1s. Simply taking the medication and following a dietitian's guidelines is often not enough. In my experience, many of my clients on GLP-1s have been misguided or misinformed about how food is judged or labeled. It can cause a lot of disordered eating patterns and lead to a fear of certain foods. Having a dietitian who knows her way around the block when it comes to food labeling, finding your food tribe (vegetarian, vegan, flexitarian, etc.), and someone who recognizes all-or-nothing thinking, self-sabotaging, or hypercritical thinking and so many other thought distortions can help you navigate a healthier (not perfect!!) relationship with food. Having your PCP and a therapist on your side can greatly help you navigate this thing called life-- because let's be honest-- life be lifing! 😩 Having a healthcare team on your side is helpful, yet it's also important to work with what you have if access is limited.

You Don't Have To Carry It All On Your Own

If you're struggling with your relationship with food or your mental health,  I'm listing a few free resources below:

• Therapy for Black Girls

• The Mental Health Coalition Resources

• Thirteen Free Mental Health Resources

• National Alliance on Mental Illness (NAMI) GA

• 988 Suicide & Crisis Lifeline: Provides free, confidential support for emotional distress, mental health struggles, or substance use concerns. Call or text 988 anytime 988 Lifeline.

• Crisis Text Line: Text HOME to 741741 to connect with a volunteer crisis counselor via anonymous, 24/7 text messaging Crisis Text Line.

• SAMHSA National Helpline: Call 1-800-662-HELP (4357) for 24/7 free and confidential treatment referrals and information services in English and Spanish National Helpline for Mental Health, Drug, Alcohol Issues | SAMHSA. 

Practice mindful eating

Paying full attention to the experience of eating and noticing flavors, textures, and how your body feels as you eat can help you tune into your hunger and fullness signals. This can improve your relationship with food and help you stay in tune with your body for long-term health. If you need a dietitian to help guide you through your relationship, schedule a free 10-min consultation with me by clicking on the button below.

What should you eat while taking a GLP-1 medication?

When taking GLP-1s, balanced nutrition plays a very important role. Eating better foods can help these medications work better by supporting weight management,  reducing side effects, and preventing nutrient deficiencies. 

Nutrition Matters

Prioritize protein

People taking GLP-1s  have higher protein needs than the average person.

Protein helps your body build and repair muscles, supports your energy needs, and keeps you feeling full. Increasing your protein intake helps maintain your muscles and prevent muscle loss during weight loss. Try incorporating protein-rich foods like chicken, beef, fish, eggs, high-protein yogurt, beans, lentils, tofu, and tempeh into every meal and snack. There is such a thing as eating TOO much protein. So have a chat with a dietitian to learn your personalized protein needs!

Focus on gut health 

This is vital. In addition to protein, I guide my clients to pay attention to these lifestyle tips: fiber, probiotics, and stress management.

Fiber supports digestion, keeps you feeling full longer, and can help with constipation - a common side effect of these medications. Aim to meet the basic guidelines for fiber (25 grams per day for women and 38 grams per day for men) and get a mix of both types of fiber: soluble and insoluble. Soluble fiber, found in oats, beans, lentils, and apples, slows digestion, lowers cholesterol, and stabilizes blood sugar. Insoluble fiber, found in whole grains, nuts, seeds, and broccoli, keeps digestion regular and prevents constipation.

Probiotics can help support your body’s natural production of GLP-1. Having a healthy gut supports hormone balance. It affects levels of insulin, estrogen, progesterone, and corticosterone. Examples of probiotic-rich foods include yogurt, pickles, pickled vegetables, kimchi, kefir, and kombucha.

Stress management-- Chronic stress can disrupt gut health. Practices like meditation, going for a walk, yoga, or simply spending time outside in the sun can help keep stress levels in check.

Be mindful of micronutrients

This isn’t talked about enough: GLP-1s slow stomach emptying, which can affect the absorption of certain micronutrients like calcium, iron, and vitamin D.

Calcium and Vitamin D support long-term bone health, which is especially important because those losing weight quickly can be at higher risk for losing bone mass.

To my perimenopause/menopause women: you may already be at risk for lower bone mass, so incorporating calcium-rich foods, vitamin D- rich foods, or possibly taking a supplement is critical. Include calcium-rich foods like dairy, leafy greens, and fortified plant-based alternatives, and vitamin D-rich foods like fatty fish and egg yolks in your meals and snacks.

Pair vitamin D-rich foods with healthy fats like avocado or olive oil for better absorption. Vitamin D, along with iron, also plays an important role in immune health. And iron also supports energy levels and prevents fatigue.

My PMOS girlies, take note! If you and your MD plan to start a GLP-1 regimen, make sure that you're getting enough iron-rich foods! Include iron-rich foods like red meat, lentils, chickpeas, and spinach in your meals and snacks. For better absorption, pair iron-rich foods with vitamin C (like oranges or bell peppers) and avoid consuming them at the same time as calcium-rich foods, tea, or coffee. The usual time frame between calcium- and iron-rich foods is to separate them by two hours

Common Side effects: Ozempic face, diarrhea, nausea, oh my!!

How can you maintain muscle while taking a GLP-1 medication?

This is important not just for people who are taking GLP-1s, but also for my PMOS girlies and perimenopause/menopausal women! If you’re using GLP-1s for weight management, you may be at risk of losing muscle along with fat. There have been increasing reports from individuals who have what is called "ozempic face," or they see significant skin sagging in their arms and legs. If you're losing weight too quickly or not eating enough. Remember, you need to eat! I have good news for you, though. You can protect your muscles by eating enough protein and regularly doing resistance exercises.

Eating enough protein and incorporating resistance training 2-3 times each week can make a big difference. Whether that's lifting weights, using resistance bands, or doing bodyweight exercises at home, maintaining muscle is as vital as losing fat. But before starting any new exercise routine, consult your healthcare provider.

Handling nausea and diarrhea

Some people experience nausea or diarrhea when they first start the medication or increase the dosage. Here are some tips to try to handle both:

• Eat small, frequent meals

• Stay hydrated – Sip small amounts of water throughout the day to prevent dehydration, which can worsen nausea.

• Replenish Fluids – Drink 8–10 glasses of water daily and include electrolytes (broths, sports drinks) to replace lost minerals.

• Eat protein-rich snacks

• Try ginger and peppermint – Ginger (fresh, chews, or tea) and peppermint (tea, candies) can help with nausea.

• Try cold or room-temperature foods

  
  

Final Thoughts

GLP-1 medications can be helpful.

But medication isn't a replacement for caring for YOUR body.

Whether you're taking one, considering one, or simply trying to understand them better, remember that sustainable health isn't built through one medication or one meal. It's built through the choices you make over time—Choose progress over perfection; balance over rigidness, grace over shame.

Do you need help making lifestyle changes that can lead to sustainable weight loss with or without a GLP-1 medication? As a registered dietitian, I’d love to help.

Every person's health journey is different, and there's no one-size-fits-all approach to nutrition and health. Whether you're taking a GLP-1 medication, managing PMOS, navigating perimenopause or menopause, or simply looking to build a healthier relationship with food, I'd love to help you create a realistic plan that fits your lifestyle and health goals.

Let's work together to help you care for You.

Schedule Your Free Consult Here

Disclaimer: The content provided in this blog only applies to FDA-approved injectable Semaglutide and Tirzepatide medications (Wegovy, Ozempic, Zepbound, and Mounjaro). It does not apply to other weight loss medications or compounded versions of Semaglutide or Tirzepatide. Consult with your physician for medication management.

1. Aronne, L.J., Sattar, N., & Horn, D.B. (2024). Continued treatment with Tirzepatide for maintenance of weight reduction in adults with obesity. JAMA, 331(1), 38-48. https://doi.org/10.1001/jama.2023.24945.

2. Blum, D. (2023, June 21). People on drugs like Ozempic say their “food noise” has disappeared. The New York Times. Retrieved November 13, 2024, from https://www.nytimes.com/2023/06/21/well/eat/ozempic-food-noise.html

3. Bodnaruc, A.M., Prud’homme, D., Blanchet, R., & Giroux, I. (2016). Nutritional modulation of endogenous glucagon-like peptide-1 secretion: A review. Nutrition & Metabolism, 13, 92. https://doi.org/10.1186/s12986-016-0153-3.

4. Campos-Nonato, I., Hernandez, L., & Barquera, S. (2017). Effect of a high-protein diet versus standard-protein diet on weight loss and biomarkers of metabolic syndrome: a randomized clinical trial. Obesity Facts, 10(3), 238-251. https://doi.org/10.1159/000471485.

5. National Institutes of Health. (2024, July 24). Calcium fact sheet for health professionals. Retrieved November 13, 2024, from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/ National Institutes of Health. (2024, October 9). Iron fact sheet for health professionals. Retrieved November 13, 2024, from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/ National Institutes of Health. (2024, July 26). Vitamin D fact sheet for health professionals. Retrieved November 13, 2024, from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

6. Mahapatra, M.K., Karuppasamy, M., & Sahoo, B.M. (2022). Semaglutide, a glucagon-like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Reviews in Endocrine and Metabolic Disorders, 23(3), 521-539. https://doi.org/10.1007/s11154-021-09699-1.