GLP-1 Medications: Your Resource Guide 101

These days, it feels like everyone is talking about GLP-1 medicines. You might have heard of one called Ozempic. People are talking about it on the news, at the doctor’s, or even around the family dinner table. In this post, we’ll explain what these medications do to the body, questions to ask your doctor if they recommend them, and some actionable healthy habits while taking the medication. Our goal is to support you in making the best choice for your body with the most amount of information.
As you (may) know, our clinicians operate through a weight-inclusive, non-diet lens; while we don’t encourage dieting or endorse these medications–we believe in your right to bodily autonomy and want you to be informed about any choices that you make. 

What are GLP-1 Medications?
GLP-1 medications increase hormones that help with the breakdown of carbohydrates. Originally designed as a medication for people with diabetes, they are now often being used at much higher doses with the intent of weight loss in people with and without diabetes.  With the growing use of GLP-1 medications, understanding their effects on the body is important to your health. 

Current GLP-1 Medications on the US Market: 

• Dulaglutide (Trulicity®)
• Exenatide (Byetta®)
• Exenatide extended-release (Bydureon®)
• Liraglutide (Victoza® and Saxenda®)
• Lixisenatide (Adlyxin®)
• Semaglutide injection (Ozempic® and Wegovy®)
• Semaglutide tablet (Rybelsus® and Wegovy®)
• Trizepitide (Mounjaro® and Zepbound®)

What questions should I ask my doctor before starting this type of medication? 

• What is the main reason you want me to take this medication? 
• What are the most common side effects? 
• Are there any serious risks I should know before taking this medication? 
• Is this medication a long-term or short-term medication? What is your plan for me as an individual patient? 
• What lifestyle changes are needed while taking this medication? 
• What happens if I stop taking this medication? 
• How soon after starting the medication do patients notice improvements or potential side effects? 
• What monitoring is required while taking this medication? Labs, follow-up visits, referrals? 
• How is this medication administered? Are there changes in dosages over time? 
• What is the cost of this medication? Is this medication covered by my insurance? 
• Are there alternative treatments I should try before or can if the medication does not work?
• What is the plan if the medication does not work for me or if the cost is too high? 

Are there dietary changes that I should make if taking one of these medications?

• Small frequent meals: If you feel fuller quicker, smaller and more frequent meals can ensure you receive adequate nutrition during your day, while also supporting digestion. 
• Protein: Consider having a main protein source with each meal to help maintain your muscle mass. 
• Veggie and fruit intake: While veggies also slow down digestion, they provide essential vitamins and minerals. Avoid raw veggies and consider steaming, baking, or broiling them to make them easier to digest. Add fruits to snacks and between meals. 
• Fat: Consider reducing the fat in meals since it can slow down digestion more. 
• Resistance training: Weight-bearing exercises help stimulate muscle, which can help with maintaining your muscle tissue. 
• Hydration: Maintain hydration but consider drinking between meals to avoid feeling overly full at meals. Sip on ginger tea to increase hydration and ease any digestive issues. 

NOTE: If you develop gastroparesis, a frequent side effect of high doses of this medication, seek immediate medical attention.  Additional dietary modifications are needed in this case.  Consult a registered dietitian for support with nutrition therapy for gastroparesis.  
It is possible for GLP-1 medications to be related to nutrient deficiencies such as calcium, vitamin D, vitamin B12, iron, folate and protein.  If you experience the symptoms of fatigue, hair loss, brain fog, muscle weakness, brittle nails or digestive issues; do your best to have a nutrient dense diet and consider working with a healthcare professional on a supplement routine.  

Thinking About ‘GLP-1 Mimicking’ Supplements? Here’s What You Should Know First:
Currently, there are no herbal or non-prescriptive products that are similar to the GLP-1 medications. They do not have the same impact on fullness or digestion of carbs. There is some evidence for the following products. It is best to talk to your health care provider before adding a supplement.

1. Berberine comes from different plants. It has been researched in Type 2 diabetes with some evidence that it can help lower blood sugars. 
2. Akkermansia is a microbe found in the gut. It may support fasting blood sugars and reduce insulin resistance. 
3. Chromium is a mineral that may improve the body’s use of insulin and reduce insulin resistance. 
4. Psyllium husk is a soluble fiber. It may reduce the rise and fall of blood sugar when eating. It has been shown to reduce HgAlc in those with Type 2 diabetes. 
5. Green tea extract is the active compound in green tea leaves. It may improve cardiovascular risk and decrease blood sugar in those with pre-diabetes. 
6. High protein diets/Whey protein/Pea protein naturally increase GLP-1 in the gut and other fullness hormones.
7. Inulin and prebiotic fibers (chicory root, resistant starch, partially hydrolyzed guar gum) are digested by the gut bacteria and might increase the amount of GLP-1 made in the gut.
8. Inositol is a sugar found in foods that may help reduce insulin levels and cholesterol.
9. Cinnamon is a spice made from the bark of trees. It is used to help lower blood sugar and cholesterol.

So what is best for you???
Remember, health isn’t always simple or the same for everyone. Some people notice better blood sugar levels and find it easier to know when they’re hungry or full. Others may need or choose a different approach. The good thing is that there are many options to look at, depending on things like cost, insurance, side effects, and what you prefer.
In the end, your doctor or healthcare provider should help you look at all your choices and answer your questions with clear, honest information. You’re in charge of your own health, and your healthcare team is there to help and support you.