GLP-1 Medications: Dos & Don’ts by Lori Skurbe, RD

GLP-1 receptor agonists, such as Ozempic, Wegovy, Mounjaro, and Zepbound, are medications used to help regulate blood sugar and support weight management. While they can be effective, nutrition, hydration, and lifestyle choices play a key role in maximizing their benefits. Here’s what to do—and what to avoid—when taking GLP-1s.

 Do:

• Eat protein focused meals – Make at least 25% of your plate lean protein such as skinless poultry, fish, seafood, reduced-fat or nonfat milk, yogurt, cheese, eggs, beans, lentils, tofu, and lean meat. Check with your Registered Dietitian (RD) to determine how much protein you need daily. Try to eat the protein first. Protein helps satisfy hunger and, when combined with exercise, supports muscle maintenance and growth. Inadequate protein and lack of exercise can lead to muscle loss, which can cause frailty and a lower metabolic rate. 
• Include fiber-rich foods – Make half of your plate non-starchy vegetables, such as asparagus, broccoli, cauliflower, green beans, peppers, salad greens, leafy greens, tomatoes, and cucumbers. These are high in fiber and low in calories. Fiber is important for overall health, and can help relieve constipation, a common side effect of GLP-1 medications.
• Balance your plate with fiber-rich carbohydrates – The remaining 25% of your plate should include high-fiber carbohydrates such as peas, quinoa, barley, whole wheat pasta, couscous, or whole grain bread. A balanced intake of protein, fiber, and carbohydrates at each meal supports overall nutrition and sets the stage for a lifetime of healthy eating.
• Limit fatty, greasy, oily or creamy foods– These can upset your stomach and are often high in calories. (Fatty, oily foods are the highest calorie food we have). Eating too many high calorie foods can stall or slow weight loss, making it harder to maintain a healthy weight long-term. Fatty, greasy foods may also worsen common GLP-1 side effects such as nausea or digestive discomfort.
• Stay hydrated – Choose calorie-free or very low-calorie beverages (under 10 calories per serving) and aim for at least 64 oz per day. Proper hydration is essential for overall health and can help prevent GLP-1-related side effects such as constipation and acid reflux.
• Stay active –Engage in a mix of cardiovascular (aerobic) exercise such as walking, hiking, biking, swimming, or dancing, along with resistance exercises such as weightlifting, squats, lunges, and core workouts. Regular physical activity helps burn calories, maintain muscle, and support long-term weight management. Follow the exercise plan given to you by the Exercise Physiologist during your Comprehensive Exam.
• Limit sugary foods – Foods high in added sugars can hinder weight loss progress if eaten too often or too much. They can also add to the common gastrointestinal side effects from taking GLP1 medications.
• Consider smaller, more frequent meals – If you experience GLP-1-related side effects such as nausea or loss of appetite, eating 4-6 smaller meals throughout the day may help. This is not the same as snacking—meals should still be planned and balanced.
• Track your food and fluid intake – Using an app like LoseIt! can help you stay mindful of your nutrition, protein intake, and hydration while providing a level of accountability.
• Seek professional support – In addition to regular check-ins with your doctor, work with a Registered Dietitian (RD) to evaluate your diet and ensure you’re meeting your protein, fiber, and hydration needs. RDs can also help adjust your diet to alleviate side effects and develop long-term healthy eating habits. 

Don’t:

• Skip meals – Skipping meals makes it harder to meet your protein and nutrient needs. Even if your appetite is suppressed, your body still requires protein, fiber, and other essential nutrients to function properly.
• Eliminate entire food groups – There is no need to avoid carbs or any other food groups. It is important to learn eating habits that are sustainable and support maintaining a healthy weight.
• Mindlessly snack – While a planned snack between meals or after dinner is fine, avoid mindless snacking (also known as grazing, picking, nibbling, or noshing). When we snack – we do not have a plan and often eat more than we think – this can lead to poor weight loss and weight re-gain.
• Consume excess alcohol – Alcohol can contribute a significant number of calories to the diet if consumed regularly, which can prevent weight loss or cause weight re-gain. It can also exacerbate gastrointestinal side effects such as nausea, reflux, or bloating. It’s best to minimize or avoid alcohol altogether while taking GLP-1 medications.
• Drink your calories – When hydrating, choose zero calorie beverages or beverages with less than 10 calories per serving (see above – Keeping Hydrated). The best options include water and unsweetened teas. If you need variety, try diet iced tea, flavor enhancers (such as Mio or Crystal Light), or infusing water with fresh lemon, lime, orange, ginger, or cucumber slices. Some find enhancing the flavor of your water makes it easier to reach your fluid goals.
• Be mindful of high-calorie beverages – Juices, sports drinks, sweetened teas, and any drink with more than 10 calories per serving can contribute a significant number of unnecessary calories, slowing or stopping weight loss. (This does not include protein drinks used as a meal replacement.)