Approximately 16 million American adults are currently using GLP-1 medications, which represent a significant advancement in the fight against obesity and the management of conditions like Type 2 diabetes. These medications, including semaglutide (marketed as Ozempic and Wegovy) and tirzepatide (known as Zepbound), have garnered attention for their effectiveness in aiding weight loss. However, health professionals are cautioning against the misconception that these drugs alone are a panacea for achieving a healthier lifestyle.
Despite the effectiveness of GLP-1 medications, experts emphasize that diet and exercise remain crucial components of any weight management strategy. Dr. JoAnn Manson, chief of the division of preventive medicine at Brigham and Women’s Hospital in Boston, highlights the necessity of maintaining a balanced approach. "If you’re not paying attention to protein intake, hydration, and regular physical activity — particularly resistance training — you risk poor nutritional status and substantial muscle loss," she warns.
GLP-1 drugs function by mimicking a natural hormone that regulates hunger and blood sugar levels. These injections help reduce cravings, slow down digestion, and prolong feelings of fullness. However, they can also lead to gastrointestinal side effects such as nausea and vomiting, which can deter some individuals from continuing their use. Dr. Manson suggests that with some relatively straightforward behavioral changes, these side effects can be managed effectively, allowing patients to benefit from the medication.
Dr. Manson, along with her co-authors, recently published two insightful articles in JAMA Internal Medicine aimed at both clinicians and patients. Here are five essential tips for those taking GLP-1 medications:
1. Be Aware of Muscle LossWhile GLP-1 medications can assist users in losing between 15% to 21% of their body weight, Dr. Manson notes that a significant portion — up to one-fourth — may include lean body mass and muscle. This highlights the importance of incorporating strength training and adequate protein intake.
2. Prioritize Protein in Your MealsStarting each meal with 20 to 30 grams of protein can be beneficial. Sources of protein can include chicken, fish, beans, chickpeas, and tofu. Dr. Manson recommends aiming for about 1 to 1.5 grams of protein per kilogram of body weight daily. If appetite is an issue, protein shakes can serve as a convenient supplement.
3. Incorporate Resistance TrainingTo counteract potential muscle loss, engaging in resistance training two to three times a week is advisable. This can be achieved through bands, weights, or body-weight exercises. Aim for a total of 60 to 90 minutes of resistance training along with 150 minutes of aerobic activities, such as brisk walking, each week.
4. Stay HydratedProper hydration is essential, particularly to alleviate dehydration and constipation associated with GLP-1 medications. Dr. Manson recommends drinking between 8 to 12 glasses of water daily. Additionally, consuming water-rich foods like cucumbers and watermelon can help maintain hydration levels. It's also advisable to limit alcohol, caffeine, and sugary or artificially sweetened beverages.
5. Avoid Lying Down After MealsTo reduce the risk of heartburn, it's best to avoid lying down for two to three hours post-meal. Incorporating fiber into your diet can assist with constipation, while avoiding high-fat or fried foods can help manage feelings of nausea.
Dr. Andres J. Acosta, an associate professor of medicine at the Mayo Clinic, notes that many patients hold a misconception that simply taking the medication will lead to weight loss without further effort. Clinical trials of these medications included comprehensive lifestyle interventions, emphasizing the necessity of a calorie-reduced diet and exercise.
"This perception — just take the shot and don’t do anything else — is misguided," states Acosta. "Patients won’t achieve the outcomes seen in clinical trials if they do not adopt a holistic approach to weight management." He stresses the importance of a healthy diet rich in protein and adequate hydration, while also setting realistic expectations from the outset.
Additionally, Dr. Elizabeth Mietlicki-Baase of the University of Buffalo emphasizes the need to explore strategies to prevent weight regain after discontinuing GLP-1 medications, a topic that remains under research.
In summary, while GLP-1 medications represent a significant tool in the fight against obesity and Type 2 diabetes, they are not a standalone solution. A balanced approach that includes a nutritious diet, regular exercise, and lifestyle adjustments is crucial for achieving sustainable weight loss and improved health outcomes.
