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Optimizing GLP-1 therapies for obesity and diabetes management
Jarvis C Noronha1,2, Luc F Van Gaal3, Ian J Neeland4,5
1Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Obesity Pillars
|December 1, 2025
Summary
Glucagon-like peptide-1 (GLP-1) therapies enhance weight loss but can cause muscle loss and GI issues. Combining GLP-1s with nutrition and exercise, plus managing side effects, optimizes outcomes for obesity and type 2 diabetes.
Area of Science:
- Metabolic disorders and endocrinology
- Obesity management
- Pharmacological interventions
Background:
- Glucagon-like peptide-1 (GLP-1) therapies are effective for weight loss and metabolic improvement in obesity and type 2 diabetes.
- Clinical challenges include lean muscle mass loss and gastrointestinal (GI) side effects, impacting adherence and long-term results.
Purpose of the Study:
- To synthesize evidence and expert opinions on integrating nutrition and physical activity with GLP-1 therapies.
- To provide practical recommendations for managing GLP-1 therapy in obesity and type 2 diabetes.
Main Methods:
- Consensus recommendations from a global working group, based on presentations from the 42nd International Symposium on Diabetes and Nutrition.
- Review of clinical trial evidence on combined GLP-1 therapy and lifestyle interventions.
- Development of strategies for lean mass preservation and GI side effect management.
Main Results:
- Combining GLP-1 therapies with structured diet and exercise yields additive weight loss.
- Preserving lean mass requires protein intake >1.2 g/kg/day and resistance training.
- Recommendations provided to mitigate common GI side effects and prevent complications like cholelithiasis.
Conclusions:
- A multidisciplinary approach integrating nutrition, physical activity, and GI side effect management is crucial for maximizing GLP-1 therapy benefits.
- This integrated strategy enhances adherence, preserves functional capacity, and sustains long-term therapeutic outcomes.
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