With With Karen Hamad, MD, associate chief medical officer for First Physicians Group Primary Care, and Mikka Ipri, RD, from Sarasota Memorial’s RENEW Program
GLP-1 medications have changed the conversation surrounding weight loss. Medications such as semaglutide and tirzepatide can help some people lose significant weight — especially those who have struggled with diet and exercise alone.
But there's an important part of the conversation that can get lost amid the attention these medications receive: GLP-1 medications aren't a replacement for healthy habits.
“They're a tool to help those habits become easier,” says Mikka Ipri, registered dietitian and program coordinator for Sarasota Memorial's RENEW program. “It's not either-or, it's yes-and.”
How Do GLP-1 Medications Help with Weight Loss?
GLP-1 receptor agonists mimic hormones our bodies naturally release in response to eating.
“They tell your brain that you're full,” explains Karen Hamad, MD, associate chief medical officer for Sarasota Memorial's First Physicians Group Primary Care.
These medications can increase feelings of fullness, decrease appetite and slow how quickly food leaves the stomach. The result is that people may feel satisfied with less food and experience less persistent hunger or “food noise” that can make weight management difficult.
Semaglutide is a GLP-1 receptor agonist, while tirzepatide acts on both GLP-1 and another hormone receptor called GIP. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that these medications may help some overweight or obese individuals manage their weight when used along with lifestyle changes.
Why Healthy Habits Still Matter on a GLP-1
Think of medication as one tool in a larger weight-management toolbox.
Dr. Hamad encourages patients to use the period when their appetite is reduced to establish habits that can support their health and weight over the long term.
That includes eating nutritious foods, controlling portions, exercising regularly and incorporating strength training. For some patients, reducing hunger can make those changes feel more manageable.
What Should You Eat While Taking a GLP-1?
Because GLP-1 medications can significantly decrease appetite, eating less doesn't always mean eating better.
“When you're eating less, you need to have more strategy behind what you're eating,” Ipri says.
She encourages patients to pay particular attention to three things:
- Protein: Protein helps preserve muscle during weight loss. Good options can include lean meats, eggs, Greek yogurt, cottage cheese and plant-based proteins such as beans.
- Fiber: Fruits, vegetables, beans and whole grains provide fiber along with important vitamins and nutrients. Fiber can also help with constipation, a common concern for people taking GLP-1 medications.
- Hydration: Eating less, and potentially experiencing gastrointestinal side effects, can make it especially important to drink plenty of water.
Ipri also recommends smaller meals throughout the day rather than waiting until you feel hungry. Because GLP-1 medications suppress appetite, relying on hunger alone may mean you accidentally go too long without eating and miss important nutrients.
Why Is Strength Training Important During Weight Loss?
When people lose weight, they can lose both fat and muscle. That's one reason the number on the scale shouldn't be the only measure of success.
Ipri encourages patients to prioritize protein and strength training to help preserve lean muscle.
Muscle supports strength, mobility and metabolic health. The federal Physical Activity Guidelines for Americans recommend that adults perform muscle-strengthening activities at least 2 days each week, in addition to regular aerobic activity.
“Don't view weight loss as the only measure of success,” Ipri says. Instead, consider whether you're maintaining strength, preserving muscle and feeling better as your health improves.
What Side Effects Can GLP-1 Medications Cause?
Common side effects are often gastrointestinal. Dr. Hamad says patients may experience nausea, abdominal discomfort and constipation.
Eating large meals, high-fat or fried foods may make some symptoms worse. Smaller portions, adequate hydration and working with your healthcare provider to manage side effects can help.
Most importantly, GLP-1 medications should be used with appropriate medical guidance.
The U.S. Food and Drug Administration (FDA) has warned about risks associated with some compounded semaglutide products, including dosing errors. FDA-approved medications undergo review for safety, effectiveness and quality; compounded medications do not go through the same premarket review.
Will You Regain Weight If You Stop a GLP-1?
Weight management doesn't necessarily end when the medication does.
Some people may remain on medication long term, while others may eventually reduce or discontinue it under the guidance of their healthcare provider. The right approach depends on the individual.
Either way, it is important to build a strong foundation of healthy habits: balanced nutrition, appropriate portions, regular physical activity, strength training and adequate sleep.
Is a GLP-1 Weight Loss Medication Right for You?
GLP-1 medications aren't right for everyone. If you're struggling with your weight and wondering whether medical weight management could help, start by talking with your primary care provider.
Be open about what you've tried before, what has or hasn't worked and what you're hoping to accomplish.
A healthcare provider can review your medical history, medications and overall health to determine whether a GLP-1 or another weight-management approach may be appropriate.
Because ultimately, successful weight management isn't just about losing pounds. It's about building healthier habits and improving your health in ways you can sustain.
Want to hear more? Listen to the full HealthCasts episode, “Weight Loss Medication and Forming Healthy Habits,” featuring Dr. Karen Hamad and Mikka Ipri and visit smh.com/podcast for more health information from Sarasota Memorial experts.