Beyond Weight Loss: GLP-1 RA Nutritional Considerations

As more patients use glucagon-like peptide-1 receptor agonists (GLP-1 RA) for weight loss, additional counseling beyond the medication may be needed – particularly since reduced appetite and food intake can lead to muscle loss and nutrient deficiencies. Be ready to guide patients on optimizing nutrition and incorporating physical activity.

So how much protein do patients need? To preserve muscle, guide patients toward boosting their intake. As a rule of thumb, consider 1-1.2 g/kg/day for sedentary adults and a higher target such as 1.5 g/kg/day for physically active adults. Help patients meet these goals by telling them to spread intake across three meals to minimize gastrointestinal discomfort, and prioritize high-quality whole food sources like chicken, fish, eggs, dairy over protein shakes or bars loaded with added sugars and fats. And remind patients to eat their protein first at each meal - before they feel full.

What additional dietary advice should you offer? Encourage patients to "eat the rainbow." Variety delivers different benefits - leafy greens provide B vitamins and vitamins A, C, E, and K, whereas red and orange produce supplies vitamins A and C. Don't forget that legumes offer protein, fiber, iron, magnesium, and B vitamins. And emphasize choosing whole foods over refined options, as processing strips away essential nutrients and fiber.

Special populations need additional consideration. For example, older and postmenopausal adults may benefit from vitamin D and calcium supplementation while adjusting to a new diet and reduced appetite while on a GLP-1 RA. Continue to recommend 800 IU of vitamin D daily for patients 71 years and older, and women 51 years of age or older need 1,200 mg of calcium daily.

What about physical activity? Encourage at least 150 minutes of moderate activity (brisk walking) or 75 minutes of vigorous activity (jogging) weekly, plus muscle-strengthening exercises twice per week. Consistency and gradual progression are key. For example, for less active patients, recommend starting low and going slow. Remind them that any movement is progress – even small steps count.

Overall, GLP-1 RAs are powerful tools for weight loss, but success depends on more than the medication alone. Adequate protein intake, diverse nutrient-rich foods, and regular physical activity are essential to preserve muscle mass, prevent deficiencies, and maintain results. Proactive nutritional and lifestyle counseling can make a large impact.

Be sure to explore our interactive CE course and GLP-1 toolkit for additional tips and strategies for nutrition and lifestyle considerations to support patients using GLP- 1 RAs.