Mastering weight management with glp-1 medications
The latest numbers indicate that 73 percent of adults in the U.S. are classified as overweight or obese, and nearly half are attempting to lose weight (1,2). Maintaining weight loss and preventing regaining is a challenging endeavor. Adopting healthy lifestyle changes and sustaining them over weeks, months, and even years can prove to be quite difficult (3).
Opting for healthier food choices in appropriate portions and boosting physical activity are smart strategies for enhancing both physical and mental well-being. Shedding 5-10 percent of your body weight can significantly reduce triglycerides, blood pressure, and blood sugar levels (4). However, even after implementing a healthier lifestyle, there may be a recommendation to further reduce weight (3).
The good news is that there are several weight loss medications approved by the FDA for long-term use. They’re also known as “anti-obesity medications” (AOMs) (5). These medications can provide some extra help. They’re meant to be used alongside healthy eating habits and regular physical activity because these medications aren’t as effective on their own (3,4,5,6).
Most weight loss medications necessitate a prescription from your healthcare provider. They are primarily intended for individuals who have already attempted to lose weight through diet, exercise, and lifestyle modifications. These medications are suitable for those with a BMI of at least 30, or a BMI of 27 or higher along with health concerns such as diabetes or hypertension, where losing additional weight could significantly improve health (5,7).
The goal of these medications is to assist in weight management while maintaining a nutritious diet and engaging in regular physical activity (7). Combining one of these medications] with a healthy lifestyle will help to boost weight loss by 3-12 percent more than diet and lifestyle changes alone (4,7). They are not recommended for anyone pregnant, breastfeeding, or trying to get pregnant (7).
This article briefly discusses the keys to mastering weight management with GLP-1 medications such as their benefits, how they work, their side effects, as well as some important nutrition strategies you need to know when taking one of these medications.
What are the GLP-1 medications and how do they work?
According to the Obesity Medicine Association, “All weight loss medications work best in the context of a healthy eating plan and exercise” (5). There are various mechanisms through which these weight loss medications operate. Most of them assist in reducing hunger, making you feel full more quickly, and/or minimizing cravings (5,7). They achieve this by engaging with hormones (such as leptin and ghrelin), neurotransmitters (like GABA and serotonin), and peptides (including GLP-1) present in the brain, gastrointestinal system, and adipose tissue (5,6).
In recent years, GLP-1 medications like Semaglutide (Wegovy, Ozempic) and Tirzepatide (Zepbound, Mounjaro) have become significant assets in weight management. These injectable drugs are not only effective in controlling type 2 diabetes but also play an essential role in facilitating weight loss. Let’s explore how these medications function and the strategies to optimize their advantages.
GLP-1 medications replicate the effects of the natural hormone GLP-1, released during eating. They assist in curbing hunger and extending feelings of fullness by activating brain receptors. Furthermore, these medications slow down gastric emptying, allowing food to remain in the stomach for a longer period, and aid in regulating blood sugar levels by promoting insulin release from the pancreas.
Semaglutide and tirzepatide are administered as weekly injections. Semaglutide functions as a glucagon-like peptide-1 (GLP-1) receptor agonist, while tirzepatide acts as a dual receptor agonist for both GLP-1 and GIP (4,5). They work by targeting areas of the brain that regulate appetite and food intake (4,5). The dosages start low and are gradually increased over 16-20 weeks (5). The reason for starting with a lower dosage is to reduce side effects (e.g., gut issues, headaches, dizziness, and fatigue) (5). Liraglutide (Saxenda) is a daily injection that acts on gut hormones to help feel fuller faster and decrease hunger (5).
Preventing Muscle Loss
While these medications are effective for weight loss, there's a risk of losing muscle mass due to reduced calorie intake. To counter this, it's essential to:
Consume Sufficient Protein: Aim for 1-1.5 g/kg of body weight to support muscle repair and growth.
Incorporate Resistance Exercises: Keep muscles active to prevent breakdown during weight loss.
Build Long term habits!
Success with GLP-1 medications also hinges on developing sustainable habits:
Meal Prep: Prepping meals in advance can help you stick to healthy eating practices.
Consistent Meal Times: Regular schedules aid in blood sugar regulation and appetite control.
Balanced Plates: Ensure meals are nutritionally complete to prevent weight regain.
Mindful Eating: Focus on the eating experience, paying attention to flavors and body signals.
Managing side effects
Injectable medications such as semaglutide and tirzepatide slow down the movement of food from the stomach to the intestines, leading to side effects like nausea and constipation. Furthermore, some individuals may experience rapid intestinal emptying, potentially resulting in diarrhea.
Here are nutritional strategies for the most common side effects when using GLP-1 medication
Nausea:
Eat smaller portions more often to reduce nausea.
Drink ginger tea. Ginger has been shown to help settle the stomach.
Cold meals are often easier to tolerate than hot foods.
Constipation:
Stay Hydrated: Aim for 8-10 glasses of water each day.
Gradually Boost Fiber Intake: Incorporate more non-starchy vegetables, fruits like kiwi, and limited amounts of whole grains into your diet. You might also want to try magnesium citrate.
Diarrhea:
Stay hydrated
Drink fluids with electrolytes to replace lost minerals.
Eat bland foods: Stick to easily digestible options like bananas and rice.
Monitoring and Support
Tracking progress and receiving support from healthcare providers can enhance your weight management journey. Utilize tools like:
Food tracking apps
Wearable fitness trackers
Body composition scales
Protein and calorie tracking
Custom meal plan services
Journals and logs
DEXA scans
Regular blood tests
Using these strategies and tools, you can effectively manage your weight with GLP-1 medications while maintaining muscle mass and building healthy, long-term habits. Always consult with your physician to tailor your approach to your specific needs.
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Disclaimer: This information pertains only to FDA-approved injectable Semaglutide and Tirzepatide, not to other weight loss medications or compounded versions. Always consult a healthcare professional for medication management.
REFERENCES:
National Institute of Diabetes and Digestive and Kidney Diseases. (2024, February). Choosing a safe & successful weight-loss program. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved January 14, 2025, from https://www.niddk.nih.gov/health-information/weight-management/choosing-a-safe-successful-weight-loss-program
National Center for Health Statistics. (2018, July 12). Attempts to lose weight among adults in the United States, 2013–2016. Centers for Disease Control and Prevention. Retrieved January 14, 2025, from https://www.cdc.gov/nchs/products/databriefs/db313.htm
Mayo Clinic. (2023, November 1). Weight loss basics. Retrieved January 14, 2025, from https://www.mayoclinic.org/healthy-lifestyle/weight-loss/basics/weightloss-basics/hlv-20049483
National Institute of Diabetes and Digestive and Kidney Diseases. (2024, June). Prescription medications to treat overweight & obesity. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved January 14, 2025, from https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
Obesity Medicine Association. (2024, January 26). Top weight loss medications. Retrieved January 14, 2025, from https://obesitymedicine.org/blog/weight-loss-medications/
Cleveland CliniTop Weight Loss Medications | Obesity Medicine Associationc. (2023, November 20). Appetite suppressants. Retrieved January 14, 2025, from https://my.clevelandclinic.org/health/treatments/9463-appetite-suppressants
Mayo Clinic. (2022, October 29). Prescription weight-loss drugs. Retrieved January 14, 2025, from https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832
