Use of GLP-1
medications is becoming common to treat obesity. Recent reports show that 6% of
the US adult population is using GLP-1 therapy and 12% are currently using it
or have in the past (Reference 1). It has quickly become clear that GLP-1
patients have nutrition and exercise needs that are not being met.
A joint advisory
from several nutrition and obesity societies was recently published in the American
Journal Of Clinical Nutrition. (Reference 2).
The Study
This joint advisory was comprehensive and very well put together. Here
are some of the most important take home messages:
-Research is showing that GLP-1 users cut their calories so severely that
nutrient deficiencies often develop. The most likely deficiencies are iron,
calcium, magnesium, zinc, Vitamins A, D, E, K, B1, B12 and C.
-Such a dramatic reduction in calories (up to 40%) results in very rapid
weight loss which contributes to muscle and bone loss. One trial cited in the
advisory showed that 40% of weight lost by GLP-1 users was lean body mass.
-Another interesting finding is that 67% of patients stop using the
medication after 1 year and 85% after 2 years. This is a problem because it
looks like lost weight comes back on quickly after stopping this medication.
Conclusions And Recommendations
For many people, the GLP-1’s have been a godsend. However, as with any
medication, it must be taken properly. In many cases, doctors are just
prescribing this medication and letting people go out into the world and
basically starve themselves. This has been a disaster.
Here are a few very important take home messages for those taking GLP-1’s:
-Don’t starve yourself. Be sure to track your calories. Women should not
be eating less than 1,200 calories per day. Men should not be eating less than
1,500 calories per day.
-Many GLP-1 users have the idea that because they are losing weight, they
can eat whatever they want, just less of it. This is not the case. Because
calories are so restricted, you have to ensure that the dramatically reduced
amount of food you are eating is packed with nutrients. Otherwise, you will
risk nutrient deficiencies.
-It is crucial to lift weights when you are on these medications. This is
essential to preserve muscle and bone during the weight loss process.
-Lastly, prepare for life without these medications. Although people are
supposed to stay on these meds for life, 85% stop taking them after 2 years.
This is for a variety of reasons, including cost, side effects or decreased
efficacy. Make sure you are preparing a diet, cardio and strength program to
keep lost weight off if the medication is discontinued.
References
1) A. Montero, G. Sparks, M. Presiado et al. KFF Health Tracking Poll May 2024: The
public’s use and views of GLP-1 drugs, Kaiser Family Foundation (KFF), 2021.
2) Mozaffarian D, Agarwal M, Aggarwal M et al. Nutrition priorities to
support GLP-1 therapy for obesity: A joint advisory. American Journal of
Clinical Nutrition 2025: 122:344-67