If you are considering a weight loss medication, are already taking one, or want to wean off your weight loss medication, there are many things to consider. And for the purposes of this article I am talking about FDA approved GLP1 medications Wegovy (semaglutide), and Zepbound (tirzepatide).
How do these medications work?
Wegovy or semaglutide is a GLP-1 (glucagon-like peptide-1) and Zepbound or tirzepatide is a GLP-1 and GIP (glucose dependent insulinotropic peptide).
Our body naturally makes GLP-1 and GIP hormones to regulate things like blood sugar levels and appetite. Hormones in general are like messengers travelling to different parts of our body to help control different functions, kind of like text messages or signals that tell our cells to do something.
The GLP-1 and GIP hormones are produced in the intestines when we eat, especially when we eat carbohydrates and fat. These and other gut hormones help support digestion, nutrient absorption, hunger, fullness, and hydration.
The weight loss medications are made to make the same thing happen in our body that should normally happen to control hunger, fullness and cravings. But with the medication it’s a much stronger dose than our body gives – like taking an espresso shot dose compared to a cup of coffee dose. Plus, they last longer in our body and that’s why side effects can happen.
How do I know if it’s safe for me to take these weight loss medications?
If you are considering starting Wegovy or Zepbound, talk to your primary care provider first about whether this medication is right for YOU. There are certain situations and health conditions where it’s not a good idea to take these types of medication. You may also need some labs done if you haven’t had them checked in several months.
And if you are on medication already and want to wean off, make sure you work with your health care provider and have a good plan for weaning off or staying on a low dose. Each person’s situation is different and depends on your health goals.
What are the side effects?
Common side effects are nausea, vomiting, constipation, diarrhea and acid reflux, getting full faster or loss of appetite. This is due to the main action of these medications to slow down digestion. There are other possible side effects and not everyone gets side effects.
5 Important Nutrition Considerations While Taking GLP-1 Medication
- Digestion Changes. If you have any of the digestive problems mentioned above already, I would recommend trying to improve how your digestive system is working BEFORE you start the medication.
- Dosing should depend on your situation, not a preset schedule. Dose increases can also trigger or worsen side effects. Be sure to communicate side effects with your provider. Just because the usual dosing schedule is to increase each month does not mean it has to be done that way. If you are having bothersome side effects it’s best to stay on the lower dose longer until the side effects get better.
- Avoid becoming malnourished. Another reason to work with your provider and dietitian is to monitor for nutrient deficiencies such as vitamins and minerals. There are at least 11 different nutrients that your body could get low in when you drastically cut back on food intake. Your dietitian can help you decide what foods or supplements you might need.
- Don’t sacrifice health for weight loss. Muscle and bone loss are also a risk when you eat less and lose weight. Protein is very important but you need it throughout the day, not just all at one meal. Exercising your muscles is necessary to stay strong, among the many other reasons. And remember to focus on wellness, not just weight loss. It’s not about the scale, it’s about being healthier. When you start losing weight you will likely lose inches and feel your clothes fitting better before you see the scale move so stepping on the scale too often is not a good measure of success. And if you lose weight too fast you will lose even more muscle. Slow and steady wins the race when it comes to weight loss.
- You have to be well hydrated. Hydration is another super important factor. It’s not just about drinking a certain amount of water. Your body actually needs to be able to absorb that water. Then there’s the questions of what kind of water, artificial sweeteners and electrolytes. This is a very personalized nutrition area that your dietitian can help with as well.
Is there a special diet I need to follow when taking these medications?
There is no one specific diet but there are many food and nutrient considerations that need to be personalized for you. Despite what most people think a dietitian does, my job as a dietitian is to help you figure out what will work best for you and your life situation. That may include working on strategies for minimizing side effects, better digestion, energy level, inflammation, blood sugar, maintaining muscle, hydration, sleep, stress eating, meal ideas, or supplement needs.
Be smart when you take these medications and work with your health care team. These new weight loss medications have helped many achieve wellness goals but with side effects that may require adjustments in nutrition or dosing, it is important to follow up regularly with your provider and dietitian to ensure you get the best outcome possible.
