Can you become malnourished on a GLP-1?

GLP-1 medications can be a helpful tool for weight loss and improving how well your body turns food into energy.

With more people taking GLP-1 medications, their effects on appetite, eating habits and nutrition are becoming better understood.

GLP-1 medications can decrease appetite, help you feel full longer and quiet or eliminate cravings and thoughts about the next meal.

For many people, this can make eating feel very different than it did before. You may simply not feel as hungry, get full after a small amount of food or find that side effects such as nausea, vomiting or diarrhea make eating more difficult.

Staying nourished on a GLP-1

When you’re eating less, especially while losing weight quickly, it can be harder to get all the protein, vitamins, minerals and other nutrients your body needs.

Even when you’re not feeling physically hungry or thinking much about food, your body still needs regular fuel and nutrition.

If you’re eating very little, regularly skipping meals, or dealing with ongoing side effects, it’s important to pay attention to how well you’re nourishing your body. Over time, not getting enough food and nutrients can put you at risk for malnutrition.

The goal is to find ways to make the food you do eat count and make sure your body is getting the nutrition it needs while you’re taking your medication – not to leave you feeling weak, nauseated, dehydrated and unable to eat.

Common deficiencies and health risks while taking a GLP-1

Common nutrient deficiencies:

• Iron
• Vitamin B12
• Vitamin D
• Folate
• Potassium
• Magnesium
• Thiamin

Potential health concerns:

• Constipation or diarrhea
• Vomiting
• Nausea
• Anemia
• Muscle loss
• Dehydration

Malnutrition doesn’t always happen suddenly, and it may not be obvious at first. Paying attention to changes in your energy, skin, hair, muscles and overall health can help you know when to reach out for support.

Warning signs you may be malnourished

• Low energy
• Brittle nails
• Hair loss
• Flaky, itchy, dry skin
• Muscle cramping
• Unusual bruising
• Poor wound healing
• Unintentional muscle loss
• Getting sick more often

Talk to your healthcare providers, including a registered dietitian, about any side effects or health problems you’re having. They can help you minimize side effects and meet your nutritional needs.

Why is protein important while on GLP-1s?

Whenever you lose weight rapidly, you’re at risk of losing muscle mass. When taking a GLP-1 medication, it’s important to prioritize protein and strength training to help maintain and build muscle mass.

Muscle mass supports strength, mobility, metabolism and bone health. Preserving muscle during weight loss can help you stay active and maintain long-term health.

If you lose muscle mass, you’re likely to experience less strength, feel run-down and may find you need more time to recover after exercise.

Easy, high-protein foods well-tolerated on GLP-1s

• Greek yogurt
• Cottage cheese
• Eggs
• Low-fat cheese
• Tuna packs
• Edamame
• Beans/lentils
• Rotisserie chicken (skin taken off)
• High-protein oatmeal
• High-protein bean-based pastas
• Protein bars, powders or drinks that are low in sugar

What to eat first for meals while taking a GLP-1

If you’re getting full quickly, eat protein first, followed by fruits and vegetables, then carbohydrates with a focus on whole grains and other complex carbohydrates. To decrease feelings of being over-full or uncomfortable, it’s best not to eat and drink at the same time. Try sipping sugar-free liquids, such as water, between meals and snacks.

Smaller meals and snacks vs. three regular meals, while taking a GLP-1

Yes. If you eat too much in one meal, it might make you feel uncomfortable, possibly even nauseated and bloated. It could lead to vomiting. Try to eat the first meal soon after you get up in the morning, then eat again every three to four hours, with your last meal being at least an hour or two before going to bed.

It’s often helpful to set alarms or reminders to help with a consistent eating schedule versus relying on physical hunger cues.

Tips for success while taking a GLP-1 medication

To get the best results from weight loss medicines, it’s important to also make changes to your habits and lifestyle. Eating healthy, staying active and consistent self-care can help you reach and keep the weight that makes you feel your best. Important keys to success include:

• Eat a small, healthy snack or meal at least every three to four hours
• Get enough protein and fiber in your meals
• Drink enough water
• Exercise regularly, including both strength training and aerobic activity
• Practice eating mindfully
• Prioritize sleep

It’s possible to experience meaningful health benefits, including weight loss while also reducing your risk of malnutrition.

Anytime you’re trying to lose weight, don’t forget about the benefits you experience beyond what you see in the mirror or on the bathroom scale. Your blood glucose levels may no longer be in the prediabetes or diabetes range. Your blood pressure and resting heart rate may have gone down. You’re sleeping better. Celebrate these victories. They’re just as important, as dropping a couple sizes.