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Nutritional intake changes during GLP-1 receptor agonist therapy: A systematic review and meta-analysis
Anh Tuan Quan1, Hoang Linh Nguyen2, Tran My Thanh Nguyen3
1Department of Internal Medicine, Van Phuc City Hospital, Ho Chi Minh City, Viet Nam; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
Diabetes & Metabolic Syndrome
|July 27, 2026
Summary
Glucagon-like peptide-1 (GLP-1) receptor agonists significantly reduce lunch energy intake in controlled studies. This highlights the need for nutritional counseling alongside GLP-1 therapies for better weight management.
Area of Science:
- Endocrinology
- Nutritional Science
- Pharmacology
Background:
- Glucagon-like peptide-1 (GLP-1) receptor agonists promote significant weight loss.
- The precise impact of these agents on objectively measured dietary intake requires quantitative synthesis.
- Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist, is among these medications.
Purpose of the Study:
- To quantitatively synthesize the effect of GLP-1 receptor agonists on ad libitum energy intake.
- To assess the impact of these therapies on objectively measured dietary consumption, specifically lunch intake.
Main Methods:
- Systematic review and meta-analysis of randomized, placebo-controlled trials (≥4 weeks) reporting quantitative dietary outcomes.
- Inclusion of studies measuring ad libitum lunch energy intake.
- Pooled analysis using a DerSimonian-Laird random-effects model with sensitivity analyses and an exploratory trial.
Main Results:
- Sixteen studies were reviewed; three trials (209 participants) contributed to the primary meta-analysis.
- GLP-1 receptor agonists reduced ad libitum lunch energy intake by -1132 kJ (-271 kcal) with no heterogeneity.
- Inclusion of an exploratory tirzepatide trial increased the effect but introduced heterogeneity; no significant difference was found between semaglutide and tirzepatide.
Conclusions:
- GLP-1 receptor agonist therapy substantially decreases acute energy intake in standardized meal tests.
- Real-world habitual dietary intake data for these medications remain limited.
- Pharmacotherapy should be complemented by structured nutritional counseling, focusing on adequate protein intake.
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