On July 18, 2025, the conversation around weight management took a significant turn with the advent of GLP-1 medications like Ozempic and Wegovy. These groundbreaking drugs have been hailed for their ability to assist individuals in losing weight. However, if you are among the approximately 1 in 8 Americans who have tried these medications, including newer options such as Zepbound and Mounjaro, it's crucial to be aware of potential risks, including nutrient deficiencies, muscle loss, and bone loss. To counteract these risks, incorporating a balanced diet and regular exercise is essential.
Dr. JoAnn E. Manson, a professor of medicine at Harvard Medical School, emphasizes that while GLP-1 medications are revolutionary for obesity management, lifestyle choices play a vital role in achieving the best outcomes. Patients who pay attention to their protein intake, consume a healthy diet, stay well-hydrated, and engage in regular muscle-strengthening exercises tend to experience better results. To support these efforts, new guidelines published in JAMA Internal Medicine provide systematic tools for implementing lifestyle interventions alongside GLP-1 medications.
One notable side effect of weight loss through GLP-1 medications is the loss of muscle and lean body mass, which can average around 25%. Dr. Manson warns that this muscle loss can lead to bone loss over time, particularly in older adults or those leading sedentary lifestyles. To combat this, it is recommended to consume plenty of protein. Aim for 1 to 1.5 grams of protein per kilogram of body weight daily, or approximately 20 to 30 grams per meal. This intake is slightly higher than the standard recommendation of 15 to 30 grams per meal for adults.
In addition to diet, exercise is crucial. Start with a self-assessment of your current fitness level and gradually work towards 150 minutes of cardio each week, along with two to three 30-minute strength training sessions. Following the CDC's recommended activity level will help you maintain muscle mass during your weight loss journey. If you have a prescription from your doctor for personal training as part of a medically necessary treatment plan, insurance may cover it. Additionally, inquire whether your healthcare provider offers a formal weight management program that could qualify for reimbursement.
Managing the right eating strategy is essential to mitigate potential digestive side effects associated with GLP-1 medications, such as constipation, nausea, and heartburn. Dr. Klein suggests adopting smaller, more frequent meals while reducing fat and salt intake. Chewing slowly can also help, as it reduces the bulk leaving your stomach, allowing your gut to manage the slower-than-usual food movement into your intestines.
Hydration is another key component. Since GLP-1 medications can suppress thirst, it’s vital to stay hydrated to keep your digestive system functioning properly. The guidelines recommend consuming eight to twelve glasses of water daily, along with hydrating foods like soups and water-rich fruits and vegetables such as cucumbers and watermelon. It’s advisable to limit dehydrating beverages containing alcohol and caffeine.
According to Dr. Jody Dushay, a co-author of the guidelines and assistant professor at Harvard Medical School, GLP-1 medications are designed for long-term use. After achieving a weight loss plateau at the highest tolerated dose, patients may enter a weight maintenance phase. This could involve lowering the dose, maintaining the same dose but extending the time between injections, or, less commonly, trying a break from the medication.
Keeping weight off can be challenging, but research suggests that the key to success lies in consistency. Weight regain varies from person to person and is influenced by numerous factors. Dr. Dushay highlights that an ongoing commitment to a healthy lifestyle is paramount for long-term weight maintenance.
