Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions

Obesity is a heterogeneous systemic chronic disease associated with excess adiposity and a complex etiology and is increasing in prevalence worldwide. Initially used to treat type 2 diabetes mellitus, glucagon-like peptide-1 (GLP-1) based therapies are now widely prescribed for individuals with overweight and obesity as an adjunct to a reduced-calorie diet and increased physical activity. However, despite their impressive weight reduction capabilities, many patients on GLP-1 based therapies do not receive appropriate nutrition advice and struggle to maintain their weight reduction.

This narrative review explores and summarizes existing literature on the challenges associated with nutrition intake in people with obesity taking GLP-1 based therapies and practical applications of nutrition and lifestyle interventions for the management of these individuals to ensure their best long-term health outcomes.

Delivering optimal nutrition management to people with obesity treated with GLP-1 based therapies presents healthcare providers with many challenges including addressing the impact of obesity and weight reduction on body composition (particularly muscle mass loss and risk of sarcopenic obesity), and poor nutrition. Physicians should work with dietitians and other healthcare providers to deliver comprehensive lifestyle counselling that is patient-centered, aligning with the needs and preferences of the individual. This should include advice on: timely and appropriate nutrition that centers on adequate macronutrient, micronutrient and fluid intake, particularly increased protein intake alongside resistance training for the preservation of muscle mass; mental health; sleep hygiene, physical activity; and medication adherence and persistence. Evidence-based nutrition guidelines can also provide an important framework for healthcare professionals, helping to ensure nutrition advice is consistent and based on rigorous scientific research.

Our findings underscore the importance of ensuring that patients treated with GLP-1 based therapies are closely monitored and provided with comprehensive nutrition and lifestyle support to ensure they achieve the best long-term health outcomes.