If you’re using a GLP1 or GLP1/GIP medication to address weight, you’ve made a very impactful health decision! Here are some ways that you can maximize the benefits while minimizing side effects to enhance your success with the medication.
Managing side effects:
Nausea/lack of appetite:
- Don’t skip meals! Eat smaller portions at more frequent intervals. Also, skipping meals means you’re not getting the full benefit of the medication’s action. Also, following an intermittent fasting routine (ie only eating during a 4- or 6-hour window each day) is not recommended because the medications are only active when food is digesting.
- Try Pepto-Bismol (bismuth) chewables for nausea.
- Vary your nutrition regularly to sustain interest in food. Even if you enjoy it, eating the same thing over and over can lead to missing important nutrients and increasing cravings. Altering food seasonings or changing to different flavors can help to enhance how foods taste, which can be helpful for dysgeusia (altered taste) while on the medications.
Bloating/fullness:
- Slow down your eating (put the fork down between bites).
- Don’t eat past the point of fullness (this can cause vomiting and stomach pain).
- Try some over-the-counter Gas-X (simethicone) chewables.
- Increase dietary fiber intake gradually to a goal of about 30 grams per day. Increasing too fast can make bloating and pain worse.
- Keep a food diary to help identify specific food triggers.
Constipation: This common side effect occurs because the medication slows digestion. You’ll also be eating less, which can further slow bowel pattern.
- Address it promptly! If you miss a day of having a BM, try these tips right away.
- Increase fluid intake (aim for at least 64 ounces per day, and if you’re already getting this, drink more!).
- Gradually increase dietary fiber (fruits, vegetables, whole grains).
- Increase physical activity (walking works great!).
- Try non-stimulant stool softener like Colace as needed.
Low blood sugar: It’s normal to temporarily experience some weakness or shakiness when first starting these medications since they lower overall blood glucose as they stabilize it. This symptom is mild and usually goes away after 1-2 doses.
- Don’t skip meals! (if you’re not hungry for a full meal, have a balanced snack like cheese & crackers or greek yogurt).
- Try to avoid consuming carbs by themselves (combine with protein).
- Limit intake of simple sugars like soda and candy.
- Moderate alcohol (7 or fewer drinks per week for women; 14 or fewer drinks per week for men); don’t drink alcohol on an empty stomach.
Managing Nutrition:
- Plan ahead as often as possible. Don’t rely on yourself to make healthy food decisions when you’re rushed, starved, stressed or tired! If your healthy nutrition is planned out, you’re way more likely to notskip meals or indulge in something heavier.
- Consistency is key. One way to help establish and maintain a healthy, efficient metabolism is to eat the same way each day. This doesn’t mean you have to eat the same FOOD every day; it means try to keep your nutrition predictable to avoid any frustrating weight stalls.
- Reduce your portions by about half. Try using a smaller plate or bowl to help you adjust to smaller meals.
- Eat at regular intervals to regulate metabolism. The mechanism of action of GLP1 medications works only when you’re eating, so if you’re regularly skipping meals, you’re not getting the full benefit of the medication. In general, you should eat about every 4 to 5 hours.
- Start your day with a high protein breakfast. Aim for 25-30 grams of protein within 1 hour of getting up. A high-carb breakfast can make your blood sugar unstable for the whole day, leaving you feeling low on energy and hungry.
- Meals and snacks should have a balance of protein, carbs and fats. For weight loss in general, your nutritional intake should be about 30% from protein, 30% from fats and 40% from carbohydrates. Keep in mind that this is a general guide, and you can expect your medical provider to adjust this if necessary to help you with your individual situation. For instance, protein proportion will be higher for bariatric patients. A patient who follows a vegetarian diet may take in about 50% from carbohydrates. Please note that a ketogenic (“keto”) diet is not recommended with GLP1 and GLP1/GIP medications because the mechanism of action requires a consistent carbohydrate intake in order to be effective and to minimize side effects.
- Fluid intake – Ideally, you should be drinking around 64 ounces of water every day. You can add flavor with fruit slices or sugar-free sweeteners. Drinks with caffeine tend to dehydrate, so make sure you’re not trying to hydrate with coffee or soda.
- Moderate alcohol – This is important enough to mention again! Moderate intake means 7 or fewer drinks per week for women and 14 or fewer drinks per week for men. Don’t drink alcohol on an empty stomach. Alcohol is not recommended for post-bariatric patients.
- Honor your hunger and fullness cues. If your body is telling you that you’re hungry, that means that your last meal has been burned off. Your hunger can be a metabolism signal, so try not to ignore it regularly. If you do, your body will respond by slowing your metabolism. By the same token, when your body signals you’re full, respond by putting the fork down. Learning to listen to and trust your body can take some time, so have patience with the process.
- Challenge the all-or-nothing. Everybody has a bad day once in a while, and this can be frustrating when you’re trying to practice healthy habits and something gets in the way. If you struggle with a few meals, or even a few days, challenge the urge to criticize yourself, because then you won’t look for a solution. When things aren’t going smoothly, use it as an opportunity to learn what your barriers are and search for ways to reduce them. You can still make progress even when you’re not perfect!
Physical activity:
Getting more active can be a challenge for people, because exercise can be intimidating, especially for people with larger bodies. But, as you are working for a smaller, lighter body, you should also commit to gradually increasing your exercise as your weight decreases.
- Find something you like. You do NOT have to go to a gym to exercise! Some people might like this, but it’s not for everyone. If you enjoy being outdoors, find some area parks to visit for a walk. If you like games, try shooting hoops or learning pickleball. The more enjoyable it is, the more likely it is that you won’t avoid it! Exercise can also be a great remedy for stress!
- Incorporate exercise into other established habits. Search for a daily habit that is already established and use that to remind yourself to exercise. For instance, when you go out to pick up your mail, put your tennis shoes on and take a 10-minute walk beforehand. Or, if you are going shopping, commit to making extra laps around the store or mall.
- Increase your overall activity. Most of your daily calories are burned when you’re doing your normal activities, so make an effort to gradually increase your movement all day. Try standing instead of sitting for conference calls (standing still burns 40% more calories than sitting down). Fill your water bottle from a water fountain on a floor below or above. If you’re watching TV, use the commercial breaks for movement around the house. Turn on some upbeat music while you clean or do laundry to get your heart rate up!
Hopefully, these tips will help lay the groundwork for a successful weight journey. Take it as an opportunity to make the permanent changes that will not only reduce your weight, but will also increase your confidence in your healthy new lifestyle.