Weight loss drugs: How to stay healthy and maximize weight loss

Weight-loss drugs, like Ozempic, have taken the world by storm. Most people with overweight or obesity who take them lose a substantial amount of weight in a relatively short time.

There’s no doubt that for those who need these drugs, they provide a lifeline. However, there are risks associated with this class of weight loss medications, and they don’t work as effectively for some people as they do for others.

So, in this article, we’ll explain how to support your body while taking weight loss drugs and how you can increase the chances that they will work well for you. We’ll also cover what you should do if you stop taking them.

What are they, and what do they do?

The weight loss drugs we’re covering here include Ozempic (drug name semaglutide), Dulaglutide, Exenatide, and Liraglutide. Collectively, they’re called glucagon-like peptide 1 receptor agonists (GLP-1 RAs).

Because they lower blood sugar levels, they were initially used to treat people with diabetes. But scientists noticed that people who took them also tended to lose weight. 

Their effectiveness varies, but in some studies, people lost up to 25% of their body weight. 

Because GLP-1 RAs significantly reduce your appetite and the amount of food you eat, they increase your risk of nutrient deficiencies. So, ensuring people know how to support their health while on these drugs is vital.

To help tackle this issue, four major organizations — the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society — published a joint advisory. 

The report explains how to stay healthy while taking GLP-1 RAs. We’ll draw from their advice here. 

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What to eat when taking GLP-1 RAs

When taking GLP-1 RAs, your appetite is reduced, so you’ll eat much less food. This makes it even more important that what you do eat is high quality and nutrient-dense.

It may also be challenging to hit your protein requirements when eating smaller portions. This matters because if you don’t eat enough, you could experience loss of muscle mass and bone mineral density. 

So, what should you eat?

Foods to eat

The authors of the advisory suggest focusing on eating more:

• Fruits: Including berries, apples, citrus fruits, bananas, grapes, and avocados.

• Vegetables: Including broccoli, leafy greens, tomatoes, carrots, peas, and squashes.

• Whole grains: Including oats, quinoa, brown rice, and whole-grain breads, cereals, and pastas

• Dairy: Yogurt, cheese, and milk.

• Lean proteins: Including poultry, fish, seafood, and eggs.

• Nuts and seeds: Including almonds, peanuts, chia seeds, sesame seeds, and hemp seeds.

• Plant fats and oils: Like olive, canola, and avocado oils.

Foods to avoid

The experts recommend minimizing your intake of:

• Refined carbohydrates, such as processed grains, flours, and added sugars.

• Soda.

• Red and processed meats.

• Fast food.

• Sweet and savoury snacks.

Eating habits to adopt

They also recommend some changes to your eating habits that might be helpful:

• Eat small meals at regular intervals.

• Enjoy only small portions of “treats.”

• Drink enough water.

• Limit alcohol intake.

Eating habits to avoid

• Emotional, mindless, or nighttime eating.

• Leaving long periods between eating: Don’t let yourself get too hungry.

• Large meals.

What about protein?

Although grocery stores are stocked full of highly processed protein bars, most adults in the United Kingdom and the United States already eat enough protein.

However, if you’re on GLP-1 RAs and have a reduced food intake, you need to pay more attention to getting enough.

Experts are still discussing the protein needs for people on GLP-1 RAs who are actively losing weight.

Here’s how to work that out if your target weight is 80 kilograms and you are moderately active: 

80 x 1.6 = 128

So, you should aim for 128 grams of protein per day.

And here’s the calculation if your target weight is 70 kilograms and you are not very active: 

70 x 1.4 = 98

So, you should aim for 98 grams of protein per day.

How to track protein intake

If you live in the United States, download our free app here. Simply snap a photo of a food product or whole meal, and it provides all the nutrition information you need, including how much protein it contains and how healthy it is. 

This will help ensure you’re getting enough protein from good-quality foods each day.

Because low protein intakes can cause muscle wasting and bone issues, the authors of the recent advisory suggest eating the protein component of a meal first to help hit your target. 

Here are some healthy protein sources:

• beans

• peas

• nuts and seeds

• lentils

• whole grains

• soy and soy foods like tofu and tempeh

• dairy, including Greek yogurt and cottage cheese

• seafood

• eggs

• lean poultry

Nut butters are also a great (and delicious) source of protein and other healthy plant compounds. But not all nut butters are equally healthy: Opt for a product with the fewest ingredients and no added salt or sugar. 

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As we already mentioned, it’s best to limit your intake of red and processed meats. They do contain protein, but they’re also linked to an increased risk of type 2 diabetes, heart disease, and colon cancer.

If you’re struggling to hit your protein needs, adding a protein isolate without high-risk additives, such as whey or soy, is something you could discuss with your healthcare professional. 

What about physical activity?

Consuming adequate protein is vital for maintaining healthy muscle mass, but alone, it’s not enough. You need to do regular resistance (weight) training alone or in combination with aerobic exercise.

The advisory suggests:

“Regular strength training at least 3 times weekly plus at least 150 min of moderate-intensity aerobic exercise weekly to preserve muscle and bone mass.”

Not only will this ensure your bones and muscles stay strong, but it’s also likely to help you reduce weight more successfully and maintain a stable weight once you’ve reached your goal.

Other tips to support weight loss when on GLP-1 RAs

Aside from eating well and getting active, the authors recommend:

• Focusing on getting good sleep: Poor sleep is associated with increased hunger and weight gain.

• Developing stress management strategies: Chronic stress is linked to insulin sensitivity and weight gain.

• Avoiding recreational drugs: Tobacco, alcohol, and other recreational drugs may interact with how GLP-1 RAs work.

• Building social connections: As the authors explain, “Robust social networks improve health outcomes by reducing stress, increasing motivation, and encouraging accountability.”

What happens when you stop taking GLP-1 RAs?

Although experts recommend continued use of GLP-1 RAs for maintaining long-term weight loss, many people stop taking them. This is for a number of reasons, including the high cost, changes in insurance coverage, and the side effects.

When people stop taking GLP-1 RAs, their appetite returns to normal, and they start regaining weight.

So, while you’re taking them, it’s vital to build healthy eating and physical activity habits that you can continue once you stop. 

The National Weight Control Registry has shown that the following food-based tips are associated with maintaining weight loss in the long run:

• Eat at regular times in the day.

• Eat breakfast.

• Choose more minimally processed foods higher in nutrients, fiber, and/or protein.

• Avoid sugary drinks, highly processed foods, and snack foods. 

• Allow yourself flexibility and occasional “treats” rather than severe restrictions.

Aside from dietary tips, they also found that the following supports long-term weight maintenance:

• Regular physical activity (at least 60 minutes each day).

• Monitoring your body weight, food intake, and activity. 

• Limiting screen time. 

• Using coping strategies, like social support and advanced meal planning.

Summary

GLP-1 RAs can be incredibly effective as a weight-loss treatment, but they are not without dangers.

It's important to only take these medications under the supervision of a healthcare practitioner with holistic support for nutrition, movement, and mental health. 

Developing these healthy habits before and during GLP-1 treatment will keep you healthy and help you maintain your weight loss once you stop taking the medication.

FAQs

Can I eat anything I want on GLP-1 RAs like Ozempic?

No. Because your appetite is reduced, you will eat less food overall, which makes it even more important to eat high-quality foods. It’s important to focus on nutrient-dense foods and an adequate micronutrient and protein intake. 

What happens if you overeat when taking GLP-1 RAs?

You are less likely to want to overeat because your appetite will likely be reduced. However, if you do overeat, you may feel sick, bloated, and uncomfortable. This is because these drugs slow digestion.

To avoid this, it’s best to eat small, nutrient-dense meals regularly throughout the day and avoid letting yourself get too hungry.

How can I get enough protein when taking Ozempic?

Focus on lean protein sources like legumes, chicken and other poultry, fish, eggs, beans, soy, and dairy. You can also try protein isolate supplements. When eating a meal, consume the protein first.

Can I drink coffee while on GLP-1 RAs?

Yes. There are no known issues with drinking coffee while taking GLP-1 RAs. But if you find that it makes you feel nauseous, try limiting intake or avoiding it.

Can I eat eggs while on Ozempic?

Yes. Eggs are a good source of protein and micronutrients. However, they may make some people feel sick, so only eat them if they don’t cause you any trouble.

What foods should I avoid when taking GLP-1 RAs?

It’s best to avoid refined carbohydrates, such as processed grains, like white rice and white pasta, and added sugars. Also, avoid soda, red and processed meats, fast foods, and sweet and savoury snacks, like cakes and chips.