Fiber Supplementation during and after Glucagon-Like Peptide-1 Receptor Agonists Treatment: A Perspective on Clinical...

Pharmaceutical advancements with glucagon-like peptide-1 receptor agonists (GLP-1RA) treatment have dramatically shifted medical treatment for obesity and diabetes. The mechanism of GLP-1RA can lead to unwanted side effects, with nearly half of patients discontinuing treatment within 1 year. There is currently limited evidence on weight maintenance after treatment, but available data suggest that sustained benefits require continued use of GLP-1RA. A comprehensive position article encourages fiber intake during and after GLP-1RA treatment, but consuming high-fiber diets can be challenging. In the United States, only 5% of individuals meet the adequate intake for dietary fiber. Fiber supplementation could be advantageous for filling those gaps and providing targeted benefits both during and after GLP-1RA treatment. Therefore, complementary care plans are needed both during and after GLP-1RA treatment.

A review of existing evidence was conducted to assess the potential complementary role of dietary fiber supplementation during and after GLP-1RA. Meta-analyses from prior studies involving populations with obesity and diabetes using fiber supplement interventions were evaluated.

During GLP-1RA treatment, patients may experience gastrointestinal side effects such as constipation and diarrhea. Several human clinical trials have found that fiber supplementation improves bowel function and stool consistency, offering a potential solution for patients experiencing side effects from GLP-1RA. After treatment, patients may experience greater difficulty maintaining weight loss and stable blood glucose. In multiple meta-analyses, fiber supplementation has improved appetite, fasting insulin and glucose levels, and body weight. Fiber supplements have also shown benefits for general digestive health, obesity indices, lipid profiles, and blood pressure.

Although research on optimal nutrition therapy protocols during and after GLP-1RA treatment is still emerging, existing research provides evidence-based guidance to inform patient care. This perspective argues that fiber supplements could be a low-cost, effective nutritional intervention during and after GLP-1RA treatment. Dietary fiber supplementation may help reduce side effects during GLP-1RA and support appetites, glycemic control, and healthy body weight after GLP-1RA.