Experts release eight nutritional priorities to support GLP-1 weight loss therapy

Four US organizations have developed the advisory “Nutritional Priorities to Support GLP-1 Therapy for Obesity” to help clinicians support patients on these medications for weight management with evidence-based nutritional and behavioral strategies. 

The recommendations aim to enhance obesity treatment outcomes, improving adherence, health gains, and long-term weight maintenance. 

The guidance was jointly developed and released by the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. 

“GLP-1s represent an important advancement in obesity care,” says lead author and advisory chair Dariush Mozaffarian from the US Food is Medicine Institute at Tufts University. “But these medications can present challenges, including gastrointestinal side effects, risk of micronutrient deficiencies, muscle and bone loss, poor long-term adherence with subsequent weight regain, and high costs; and, on their own, are not enough.” 

“Nutrition therapy and lifestyle support are essential components to address these challenges, help patients maximize and maintain health gains over time, and ensure we are using these drugs wisely, effectively, and without bankrupting the healthcare system.”

The article, published in four online journals, concludes that nutritional and lifestyle strategies are pivotal to addressing key challenges around GLP-1 treatment of obesity. The authors encourage clinicians to use the tools and frameworks to help patients translate nutrition guidance into sustainable behaviors.

The eight nutritional priorities to support patients on GLP-1 medications emphasize the importance of:

• Patient-centered initiation of therapy. 
• Careful baseline nutritional assessment.
• Management of gastrointestinal side effects.
• Personalized, nutrient-dense, minimally processed diets.
• Prevention of micronutrient deficiencies.
• Adequate protein intake and strength training to preserve lean mass.
• Leveraging a good diet to maximize weight reduction.
• Promoting other lifestyle changes around activity, sleep, mental stress, substance use, and social connections to maximize long-term success.

Lifestyle medicine

Despite the known benefits of nutritional counseling or behavior support, most people on GLP-1 medications do not receive these services. 

The study notes that most people on GLP-1 drugs don’t receive nutritional counseling or behavior support, which are crucial for long-term benefits.They note that GLP-1 therapies in clinical trials demonstrate average placebo-adjusted weight reductions of 5–18%. Moreover, they are linked to improved metabolic, functional, and cardiovascular outcomes. 

However, sustaining maximum benefits requires integrating lifestyle interventions like nutrition therapy into the treatment plan. The study highlights recent evidence supporting such an integrative model. 

In studies combining medicinal and lifestyle interventions, patients achieved more significant weight loss and better adherence. They were also more likely to sustain weight loss after discontinuing the medication compared to people who only receive the medication. 

“GLP-1s are reshaping the landscape of obesity treatment, but it’s clear that medication alone is not a complete solution,” says John Courtney, Ph.D., CEO of the American Society for Nutrition. 

“This consensus-based guidance highlights the critical role of nutrition in supporting patients on GLP-1 therapy, with clear recommendations for health care providers to optimize outcomes, reduce risks, and fill urgent gaps in care through practical, evidence-informed nutrition strategies.”

Overcoming GLP-1 challenges

The article highlights several key challenges limiting the use of GLP-1 medications for long-term success in healthy weight management, including gastrointestinal (GI) side effects, risk of nutrient inadequacies, loss of muscle and bone mass, high costs, frequent discontinuation, and weight regain.

To mitigate these challenges, the authors recommend that clinicians develop care plans that include nutritional and lifestyle counseling before, during, and after the weight reduction period. 

They suggest these plans emphasize healthy eating, physical activity, and resistance training; screening and management around substance abuse, eating disorders, mental health, and sleep; and micronutrient or protein supplementation, if needed.

Comprehensive approaches can reduce GI side effects, micronutrient deficiencies, and muscle and bone loss.“As an obesity specialist grounded in both lifestyle and culinary medicine, I see food not just as fuel but as a foundational tool in clinical care,” adds Lydia Alexander, immediate past president of the Obesity Medicine Association. 

“GLP-1 therapies are powerful but most effective when paired with intentional, nutrient-dense eating patterns that support metabolic health and long-term success. Nutrition is not an afterthought — it’s a therapeutic partner that helps patients sustain weight loss, preserve lean mass, and translate medication-driven progress into lasting well-being.”

Beyond healthy weight management, the authors say these comprehensive approaches can reduce GI side effects, micronutrient deficiencies, and muscle and bone loss and improve general metabolic health and well-being. 

They also highlight the benefits of supportive strategies, including group-based visits, registered dietitian nutritionist counseling, telehealth, digital platforms, and Food is Medicine interventions. 

Meanwhile, they note that drug access, food and nutrition insecurity, and nutrition and culinary knowledge influence equitable obesity management with GLP-1 medications. 

They also call for more research into dietary modulation of endogenous GLP-1, strategies to improve compliance, nutritional priorities for weight maintenance post-cessation, combination or staged intensive lifestyle management, and diagnostic criteria for clinical obesity.