What nutrition and lifestyle recommendations should be made for people taking GLP1 therapy?

This is the fourth post in my GLP-1s for weight loss series.  Find the first three posts here:

• Part 1: What does every nutrition professional need to know about GLP-1s?
• Part 2: How can dietitians manage GI side effects from GLP-1s?
• Part 3: How and why do GLP-1s change dietary intake?

The Key Reference for this series of posts is: Mozaffarian, Dariush, et al. “Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society.” Obesity Pillars (2025): 100181.

How can dietitians help prevent nutrient deficiencies?

To help prevent nutrient deficiencies, recommend diets high in:

• Fruits & Vegetables
• Whole Grains
• Legumes
• Lean proteins
• Nuts & Seeds

Recommend limiting:

• Refined carbohydrates
• Sugar-sweetened beverages
• Red and processed meats
• Fast food
• Ultra-processed sweets and savory snacks

Dietitians can consider recommending dietary supplements for at risk nutrients, which include:

• Vitamin D
• Calcium
• Vitamin B12
• Consider a multi-vitamin and mineral tablet

For people with low appetites, specific strategies to help prevent deficiencies include:

• Recommending small, frequent meals
• Smoothies or protein drinks prepared with fruits, vegetables, dairy products
• Homemade soups made with nutritious foods
• Recommend setting an alarm or reminders to eat
• Prioritize protein

How much protein should dietitians recommend?

The authors of paper acknowledge that protein recommendations differ depending on the group making the recommendations.  However, the authors highlight that clinicians often recommend amounts of 1.2-1.6g/kg/day for people during active weight reduction.

How do I calculate protein requirements?

The authors acknowledge that the science is unclear if one should calculate protein requirements using actual body weight or adjusted body weight for people living with obesity.  However they highlight that protein intake below 0.4-0.5g/kg/day is always too low, while prolonged intake above 2.0g/kg/day is likely too high.

Experts consider protein intakes of 1.5g/kg lean body mass the most accurate; however, determining lean body mass requires body composition data, which clinicians don’t always have readily available.

Another option is to use an absolute target of 80-120g per day, or 16-24$ of total energy intake based on a 2000kcal/day diet.

Will protein intake alone preserve bone and muscle mass during weight loss?

Protein intake is not sufficient for preserving bone or muscle mass.  Resistance training is considered a required component. Aerobic activity, while beneficial for health, does not preserve muscle mass as well as resistance training. 

What exercise should I recommend for people taking GLP1 therapy?

Recommend strength training 3 times per week + 150 minutes moderate-intensity aerobic exercise to help preserve muscle and bone mass.

 Customize plans to match individual fitness level and physical capacity to help with adherence and effectiveness.

Take Aways

For many patients GLP-1s are effective agents for weight loss, in some cases providing results before only seen in bariatric surgery.  However, like with any type of weight loss, weight reduction is accompanied by bone and muscle mass losses.

Nutrition therapy can help improve GI symptoms and help preserve bone and muscle loss.