Pairing GLP-1s with a dietitian

Glucagon-like peptide-1 (GLP-1) medications have been gaining popularity recently. So popular that they can be difficult to obtain at times! Not a day goes by that consumers and healthcare professionals won’t read a catchy headline or hear a peer proclaiming the benefits or raising concerns about the effects of these medications.

Historically, GLP-1 meds have been helpful as a treatment for Type 2 Diabetes. However, they have also been found to be beneficial when used as an anti-obesity medication and are approved by the FDA in a higher dose to support weight loss. The best results are seen when used in conjunction with healthy lifestyle modifications. Working with a dietitian can be pivotal in optimizing these outcomes.

How do GLP-1 medications work?

These medications work by mimicking the effects of a hormone called glucagon-like peptide-1. This hormone plays an active role in appetite regulation and controlling blood sugar levels. The majority are given as an injection once weekly and work to slow down digestion. This creates feelings of fullness, which in turn, reduces overall food intake supporting weight loss.

Are there side effects?

While they are relatively well tolerated medications, there can be side effects. The most common side effects include gastrointestinal upset, such as nausea, vomiting, diarrhea or constipation, abdominal pain, or indigestion. Most are temporary and can be relieved with certain strategies such as diet modifications. However, more serious side effects can occur, which should be explored thoroughly with a physician before beginning any medication.

How can a dietitian optimize your experience while taking GLP-1 medications?

Dietitians are well-versed in the side effects of GLP-1 meds. They understand that side effects can and do occur and are there to encourage and support management. As mentioned, many common side effects can be managed with diet modifications. A dietitian will strategize with you to reduce your risk of side effects, so it doesn’t interfere with your ability to continue treatment.

These medications work best when used in conjunction with a healthy lifestyle, consisting of balanced meals and appropriate physical activity levels. Unfortunately, like anything in life, there is not a one-size-fits-all approach that works here. When food intake is reduced, it becomes of utmost importance that the food we are consuming is giving our body the nutrients it needs for optimal functioning. A dietitian will help to create a personalized meal plan that is catered to your likes or dislikes and one that is specified to your nutritional needs while promoting sustainable weight loss.

Dietitians will also focus on habits and strategies (mentally and physically) that not only ensure weight loss occurs at a healthy rate but also promote the ability to maintain a lower weight once achieved. Attempting to lose weight can be a vicious, frustrating cycle (with or without medication assistance). Dietitians provide empathy and encouragement throughout all the ups and downs that inevitably arise. Again, personalization is key for developing sustainable habits that make obtaining and maintaining a lower weight achievable.

Weight loss and weight maintenance is a long-haul journey, but continued support from a dietitian can be immensely helpful. Ensure your journey is one filled with confidence and empowerment to make informed food choices with a lifestyle that supports your goals.

Dietitians On Demand is a nationwide staffing and recruiting company for registered dietitians, specializing in short-term, temporary and permanent-hire positions in acute care, long-term care and food service positions. We’re dedicated to dietitians and helping them enhance their practice and excel in the workplace. Check out our job openings, request your coverage, or visit our store today!

References:

Pais, R., Gribble, F. M., & Reimann, F. (2016). Stimulation of incretin secreting cells. Therapeutic Advances in Endocrinology and Metabolism, 7(1), 24–42. https://doi.org/10.1177/2042018815618177

Tan, Q., Akindehin, S. E., Orsso, C. E., Waldner, R. C., DiMarchi, R. D., Müller, T. D., & Haqq, A. M. (2022). Recent advances in incretin-based pharmacotherapies for the treatment of obesity and diabetes. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.838410

Bartel, S., McElroy, S. L., Levangie, D., & Keshen, A. (2024). Use of glucagon‐like peptide‐1 receptor agonists in eating disorder populations. International Journal of Eating Disorders, 57(2), 286–293. https://doi.org/10.1002/eat.24109

Richards, J., Bang, N., Ratliff, E. L., Paszkowiak, M. A., Khorgami, Z., Khalsa, S. S., & Simmons, W. K. (2023). Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study. Obesity Pillars, 7. https://doi.org/10.1016/j.obpill.2023.100080

Klausen, M. K., Jensen, M. E., Møller, M., Le Dous, N., Jensen, A.-M. Ø., Zeeman, V. A., Johannsen, C.-F., Lee, A., Thomsen, G. K., Macoveanu, J., Fisher, P. M., Gillum, M. P., Jørgensen, N. R., Bergmann, M. L., Enghusen Poulsen, H., Becker, U., Holst, J. J., Benveniste, H., Volkow, N. D., & Vollstädt-Klein, S. (2022). Exenatide once weekly for alcohol use disorder investigated in a randomized, placebo-controlled clinical trial. JCI Insight, 7(19).https://doi.org/10.1172/jci.insight.159863

Jensen, A. B., Renström, F., Aczél, S., Folie, P., Biraima-Steinemann, M., Beuschlein, F., & Bilz, S. (2023). Efficacy of the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide for the treatment of weight regain after bariatric surgery: A retrospective observational study. Obesity Surgery, 33, 1017–1025. https://doi.org/10.1007/s11695-023-06484-8

Nevola, R., Raffaella Epifani, Imbriani, S., Tortorella, G., Aprea, C., Raffaele Galiero, Rinaldi, L., Raffaele Marfella, & Ferdinando Carlo Sasso. (2023). GLP-1 Receptor Agonists in Non-Alcoholic Fatty Liver Disease: Current Evidence and Future Perspectives. International Journal of Molecular Science, 24(2), 1703–1703. https://doi.org/10.3390/ijms24021703

Du, H., Meng, X., Yu, Y., & Xu, J. (2022). The mechanism and efficacy of GLP-1 receptor agonists in the treatment of Alzheimer’s disease. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.1033479

Evolution of GLP‐1 Receptor Agonists for diabetes treatment | Biopharma PEG. (2022, September 22). Www.biochempeg.com; Biopharma PEG. https://www.biochempeg.com/article/299.html

Sorli, C., Harashima, S., Tsoukas, G. M., Unger, J., Karsbøl, J. D., Hansen, T., & Bain, S. C. (2017). Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. The Lancet Diabetes & Endocrinology, 5(4), 251–260. https://doi.org/10.1016/s2213-8587(17)30013-x

Maloney, A., Rosenstock, J., & Fonseca, V. (2019). A model‐based meta‐analysis of 24 antihyperglycemic drugs for type 2 diabetes: Comparison of treatment effects at therapeutic doses. Clinical Pharmacology & Therapeutics, 105(5), 1213–1223. https://doi.org/10.1002/cpt.1307

Roden, M., Weng, J., Eilbracht, J., Delafont, B., Kim, G., Woerle, H. J., & Broedl, U. C. (2013). Empagliflozin monotherapy with sitagliptin as an active comparator in patients with type 2 diabetes: a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet Diabetes & Endocrinology, 1(3), 208–219. https://doi.org/10.1016/s2213-8587(13)70084-6

Janani, L., Bamehr, H., Tanha, K., Mirzabeigi, P., Montazeri, H., & Tarighi, P. (2021). Effects of Sitagliptin as monotherapy and add-on to metformin on weight loss among overweight and obese patients with type 2 diabetes: A systematic review and meta-analysis. Drug Research, 71(9), 477–488. https://doi.org/10.1055/a-1555-2797

Franz, M. J., MacLeod, J., Evert, A., Brown, C., Gradwell, E., Handu, D., Reppert, A., & Robinson, M. (2017). Academy of Nutrition and Dietetics Nutrition Practice Guideline for type 1 and type 2 diabetes in adults: Systematic review of evidence for medical nutrition therapy effectiveness and recommendations for integration into the Nutrition Care Process. Journal of the Academy of Nutrition and Dietetics, 117(10), 1659–1679. https://doi.org/10.1016/j.jand.2017.03.022

Bezin, J., Gouverneur, A., Pénichon, M., Mathieu, C., Garrel, R., Hillaire-Buys, D., Pariente, A., & Faillie, J.-L. (2022). GLP-1 receptor agonists and the risk of thyroid cancer. Diabetes Care, 46(2). https://doi.org/10.2337/dc22-1148

Gorgojo-Martínez, J. J., Mezquita-Raya, P., Carretero-Gómez, J., Castro, A., Cebrián-Cuenca, A., de Torres-Sánchez, A., García-de-Lucas, M. D., Núñez, J., Obaya, J. C., Soler, M. J., Górriz, J. L., & Rubio-Herrera, M. Á. (2023). Clinical recommendations to manage gastrointestinal adverse events in patients treated with glp-1 receptor agonists: A multidisciplinary expert consensus. Journal of Clinical Medicine, 12(1), 145–162. https://doi.org/10.3390/jcm12010145