5 Nutrition & Lifestyle Non-Negotiables for GLP-1 Therapy

Is this the Ozempic era, Wegovy, and Zepbound? Is this really the cure for our obesity problem?

These are the  5 NON-NEGOTIABLES for starting a GLP-1 Therapy.

Let’s explore who these GLP-1 medications are safe for. Are they really effective? Do you have to take them for life? How to optimize them? What are Ozempic therapy nutrition tips?

Let’s explore what are the outcomes of taking these medications.

• Who do they benefit?
• Why do they work so well?
• What are the contraindications?
• Things to look out for.
• THE TOP 5 NON-NEGOTIABLES FOR A GLP-1 Treatment.
• What type of diet plan for Ozempic should you include and what foods should you be avoiding?
• What are the results?
• Where can I find support?
• Is there a way to achieve the same results without taking the medication?

Read this blog for the answers to all these questions so often asked…

The GLP-1 craze…

Scientists and celebrities such as Oprah or others claim that obesity is a disease that cannot be treated with diet and exercise alone. Advertised as a quick solution to fit into your dress for the event or to feel more comfortable at the pool. All you need is an easy-to-administer injectable drug that is mailed to you or your pharmacy monthly. Is it effective in achieving these results? Yes, but it comes with caveats.

Ozempic and Wegovy are types of GLP-1 medications. Ozempic, or semaglutide, was initially and continues to be one of the first-line medications to effectively reduce blood sugar levels and HbA1c levels of 1% reduction in 3 months or more with additional weight loss, which then improved insulin sensitivity. This treatment has helped thousands of patients reduce or discontinue insulin therapy, which requires one to multiple insulin shot injections and constant monitoring of blood sugars. I have worked with patients and this medication for over 6 years now, and when combined with a balanced, tailored diet focused on muscle preservation, patients achieved great results and improved their overall health.

So yes, it is an effective drug for improving blood sugar levels and promoting weight loss. But like all drugs, it comes with side effects and words of caution. Some mild side effects and some severe.

There are 5 non-negotiable items that I will share with you about receiving GLP-1 Therapy.

How the GLP-1 Medications Work:

Well, it targets different pathways, some in your gut and others in your brain. The natural GLP-1s made in your gut enhance the availability of glucagon-like peptide agonist nutrient/enzyme which helps regulate the sense of hunger and satiety and regulation of insulin release and blood sugar use. In people with no issues of insulin resistance or overweight, this system works efficiently and regulates blood sugars and satiety levels efficiently. But this only makes ⅓ of the population or less.

The rest of us fall into the ⅔ of the population with insulin resistance or beginnings of diabetes and/or excess body fat, especially around the abdominal area. For those of us that fall under that category, our GLP-1 production is lower and thus we get hungrier sooner and more frequently and don’t feel that sense of satiety early on. We have the “food noise.” I know this because mine ramps up after 1900 hours and especially after putting the kids down and long days that you feel extra tired.

The other way GLP-1 works is by sending a signal to your intestinal system to slow down the digestion of your foods. This will keep you feeling fuller longer and also slow down how quickly your blood sugar is released as you are digesting and breaking down nutrients slower, some that convert into glucose in the blood.

Contraindications to GLP-1s:

So now that you understand this concept, you will better understand the contraindications.

1. History of pancreatitis. If you have had pancreatitis (inflammation of the pancreas), GLP‑1 agonists are generally avoided​ (ncbi.nlm.nih.gov​endocrinenews.endocrine.org). Several reports suggest a link between GLP‑1 drugs and pancreatitis, so doctors recommend not starting or continuing a GLP‑1 medication in anyone with prior pancreatitis.
2. Severe stomach/digestive problems. Avoid GLP‑1 agonists if you have serious gastrointestinal disease such as gastroparesis (very slow stomach emptying) or active inflammatory bowel disease (​ncbi.nlm.nih.gov). These drugs can slow digestion, so they are not suitable for people with severe stomach or intestinal issues.
3. Pregnancy and breastfeeding. GLP‑1 medicines are generally not recommended during pregnancy​(ncbi.nlm.nih.gov). Their safety for the baby is unknown, so women who could become pregnant should use effective birth control when on these drugs. These medicines are also usually avoided while nursing (breastfeeding) because effects on the infant are not well studied.

The 5 Non-Negotiables to Using GLP-1 Therapies:

1. GLP-1 Therapy Nutrition means meeting your OPTIMAL levels of protein.

Most people are now beginning to understand that protein is the key ingredient in the best diet while on Ozempic (or other forms of glp-1s).

While the carbs and fat wars have been waging on, protein has solidly stayed standing by quietly and doing what it does best—it makes the building blocks of our body and DNA. Without protein we cannot survive. It fuels not just your brain and muscles but all your vital organs. We can store unlimited amounts of energy in the form of body fat as we have learned in recent decades; those limits can be pushed beyond what we thought was possible.

Carbohydrates we store in our muscles and liver, and when we deplete them then we turn to stored fat as a form of fuel. But protein is not stored, and when the body does not receive sufficient amounts that can only come from foods then it goes into a catabolic state (muscle wasting and breaks itself down), starting with your skeletal muscle so it can fuel your vital organs which prioritize protein usage, especially in times of shortage.

So the addition of GLP-1 medication can lead to decreased appetite as we have discussed, and therefore you are eating less of all nutrients including protein. The majority of Americans aren’t meeting their optimal levels of protein, surprisingly so. There are outdated recommendations of protein of 0.8 gm/kg of body weight that are really the bare minimum amount to prevent severe muscle wasting, not to perform and live in an optimal state. Skeletal muscle dictates our longevity, quality of life, and predisposition to diseases. So if muscle is depleted as a result of inadequate protein intake during calorie reduction, then our overall health is worsened. This is not the price we should pay for weight loss.

So let’s meet our protein goals and increase those levels of optimal performance to twice the RDA, so 1.5 gm per kg of ideal body weight.

GLP-1 Diet: Optimal Protein Intake Example: A 150 lb woman would need only RDA levels of 54 gm of protein per day, but for optimal levels she would eat closer to 100 gm to support optimal protein synthesis and performance, especially as we age. So 25 – 40 grams of protein per meal is ideal for this example individual!

What Does High Protein Mean?

High protein is not cheese, nuts, peanut butter, bacon, or sausage. It is lean meats, eggs, protein-rich dairy, complete plant proteins, legumes, and certain grains, as well as high-quality protein powder supplementation.

See top 5 recommended safe protein powders on my fullscript dispensary here.

2. Increase your intake of nutrient-dense foods especially gut health-promoting foods while on GLP-1 medications.

As you are consuming less food, then you are also consuming fewer nutrients, fewer vitamins, and fewer minerals. All which can affect not just your metabolism but all the biochemical functions that make your body operate properly. This can result in micronutrient deficiencies (lack of vitamins and nutrients from diet causing health deficiency).

Symptoms of nutrient deficiencies can be vague or specific. Vague symptoms can include low energy levels, decreased alertness, feeling more down or anxious. While more specific can be hair loss, hair thinning, brittle nails, drier skin, eczema, or irregular bowel patterns. Most of us are already deficient in the nutrients we eat, combine that with the lower quality of nutrients available in our food today due to decreased nutrient absorption and quality from soil.

Most Americans, especially women, are already low in iron, calcium, zinc, magnesium, and vitamin D, so ensure you’re eating enough!

Adopt a plan where you start adding one fruit and one vegetable per day. Even if it is just the same thing like one California orange with a balsamic vinaigrette salad with blue cheese per day most days of the week. A repeat is fine. Start there, build up to add more color from your fruits and vegetables. Juices do not count, smoothies can be helpful especially made with a high-quality, or you could utilize an easy digestible protein powder. Increased protein and fiber have to come accompanied by increased water intake to help digest and absorb nutrients and to lubricate your joints, skin, and bodily functions of all types.

When available or in season, support your local farmers market and rancher for the most improved nutrient content and taste of most foods grown or raised. I can attest to this.

3. Avoid the Ozempic face by pushing or pulling at least three times per week.

People can lose up to 35% of their skeletal muscle especially during rapid weight loss. This is detrimental to one’s health. Loss of muscle mass means your metabolism will also slow down as fat-free lean muscle mass is the biggest contributor to one’s metabolism.

So what happens is you begin to see rapid weight loss around your waist and hips, but since you are not meeting your optimal protein levels and you are not promoting strength-building activities weekly, then you are now losing muscle throughout your body. Not just from your arms that people notice as loose or flappy skin that remains after rapid weight loss, as this might have been worsened because you have lost muscle, but also from your legs and hips. Loss of hip and leg muscle means loss of mobility and physical function.

Muscle atrophy occurs in your organs as well. Your heart becomes weaker, your brain shrinks increasing the likelihood of developing Alzheimer’s or other forms of dementia. So you lose muscle everywhere, including your face, your eye pads, your cheek muscles, and around your jawline. So yes, you have achieved a 50 lb weight loss in 3 months but at the expense of 18 lbs loss of muscle and vitality. Your face shows it; your body and brain feel it.

This phenomenon is called obesity sarcopenia. This means that you have lost or are losing skeletal muscle and it is shrinking in diameter all over your body. You may be familiar with extreme cases seen in prisoners of war or concentration camps, but the modern form of malnutrition is masked by excess body fat, obesity. The fat around the muscles and in the muscles causes low-grade systemic inflammation throughout every single system and function of your body.

Unable to carry your kids or grandkids, pick up your dog off the floor, or as it worsens, unable to stand up. As we age, the biological clock is against us so we must do everything in our power to preserve our function, to preserve our strength, muscles, and independence for as long as possible.

Forget your social security pay or your 401k or pension if you will spend the last decades of your life, your golden years, going from one appointment to another, taking a cocktail of medications, waiting for insurance or Medicare approvals for specialists, feeling crummy every day and wondering what is the purpose of waking up every day. Then you get the flu and you can’t get out of bed. At this time your muscle loss has accelerated by 7% or more every year and every bout of sickness or hospitalization becomes a loss of major muscle and strength. Then one day as you are trying to make it outside of your house to check the mail to pick up your next medical bills and pills, you lose your balance and come crashing down.

With now loss of major muscle and brittle bones, you fracture your pelvis, crack your femur, or herniate your vertebra. Now you are most likely to drastically begin losing all independence and loss of ability to care for yourself, much less anyone else, and in need of someone helping you care now. So every single day day should be an opportunity to get stronger and secure your future.

Yes, it hurts and it is uncomfortable to exercise but believe me, as I have seen it and experienced it on a daily basis, it hurts more to suffer from these conditions than to push yourself out of your discomfort to improve your strength.

So the recommendation is to body strength train at least 3-4 days per week including all major muscles and focusing on the four major movement types for a well-rounded physique: Push, pull, squat, and hinge. These are all necessary movements for daily living and your independence, so plan to engage them on most days of the week. Keep moving and aim for a minimum of 10k steps per day.

• Make it fun
• Involve the family, throw a frisbee, kick a soccer ball, throw a football. Or take dancing or group exercises.
• Stretch and improve your feet strength and balance. If safe, spend time with your feet on the floor, move your toes, engage your feet, pay attention to how your foot makes contact with the floor. Stretch your body in a controlled manner with controlled breathing. I wake my body like this most mornings when I can.

We cannot see this at first glance, but as trained dietitians, we are trained to do physical assessments to identify and categorize malnutrition.

I make it a priority—not always successfully but at least >80%—to rotate my muscles and do light full-body stretching, even just standing at my standing work desk with my shoes off and a small mat beneath, moving my toes and feet and increasing my NEAT (Non-Exercise Activity Thermogenesis).

Most days, I train doing push-ups, squats, lunges, dead hangs, pull-ups, leg lifts. When I can, I incorporate battle ropes, kettlebell-type swings (but I use ONNIT clubs), barbells, resistance bands to get full-body workouts split into push/pull types of workouts or upper and lower body splits. I am busy working long mornings and nights, being a husband and father of a full house and tending to our goats, chickens, dogs, cats and anything else in between. I aim for 7-10 minute high to medium intensity workouts in the mornings or throughout the day when I can. The goal is to get them done on most days of the week.

Start slow, have a backup plan (home exercises), and most importantly show up every day because your life depends on it. Your family and your community depend on your commitment and consistency.

4. Engage in quality rest and recovery.

Ask yourself–

• Do you wake up yawning wanting to crawl back in bed most mornings?
• Do you hit the snooze button hoping that another miserable few minutes of your mind racing?
• Is your cellphone your main wake-up device?
• Do you open your eyes to check your messages, emails, or social media feed?
• Do you also fall asleep the same way, tired and restless, scrolling through Instagram posts and Facebook drama ? Fifteen minutes pass, now 30 minutes, and now you realize that you have spent the last hour of your night stimulating your brain with nothing productive, and certainly nothing worth losing your sleep over.

The light and algorithmic design of these platforms is meant to stimulate you, keeping you looking for something rewarding like a casino nickel-player junkie inserting multiple coins and waiting for that quick, cheap win to light up so you can continue going longer. This is how these social media platforms are designed; drawing from the same psychological field of study as casinos and gambling games. Scrolling your feed before finally tapping out to sleep will not bring you restful sleep. You have now disrupted your cortisol and melatonin mechanisms, and your brain is now getting further away from sleep and rest mode. By the time your brain shuts down, it’s 1-2 hours before you have to wake, and the cycle begins all over again.

Did you know that one night of poor sleep will result in 30% or more insulin resistance and worsening blood sugars for the following day and days to come?

We now know that poor sleep quality affects emotional state, focus, memory, and poor quality sleep will accelerate cognitive deficits, increasing the risk of dementia. Sure, there are nights when you won’t get your restful 7.5 hours of uninterrupted sleep, and maybe you’re in a season of life caring for small children, older adults, or yourself, preventing restful sleep.

Make the few hours you can get count.

Sleeping tips

Follow a couple of these for more optimal sleep and thus, weight and stress support:

• Turn off all electronics (especially phones, or silence notifications leaving them open only for emergencies if necessary) 1.5-2 hours prior to desired sleep time.
• Turn off all TVs, cover all lights with electrical tape if safe, dim any that cannot be covered.
• Turn off overhead lights and use lamps if possible. Lower noise and stimulation, and avoid eating at this time if possible.
• Make a list of things you need to address or do the following day so you don’t have racing thoughts as soon as you lay your head down to rest.
• Use blackout curtains and noise reduction devices if necessary. If available on most nights, take time to step outside and see the sun setting. There are certain hormones in your eyes responsible for sending messages to your body that it is wake-time and then approximately 14 hours later that it will be sleep time. They are receptive to light or lack of light, especially sunlight, both at night before going to sleep and in the morning upon waking.
• Finally, if you are still struggling, ensure you exercise and move your body during the day because a restless body sparks a restless mind. There are specific supplements available that can help you with this. More to follow on this. In the meantime, avoid taking melatonin as it can disrupt hormones, and potency varies from brand to brand and even bottle to bottle.

5. Adopt a simple but consistent eating plan with contingencies that meet your own needs.

Stop wasting time looking for the perfect diet, eating plan, or meal delivery plan. All this can be fun to try, but the practicality of these plans is not feasible long-term. Sure, it’s great not to think about what you need to eat every day and have frozen meals delivered daily, but it quickly gets old eating frozen meals repeatedly. Maybe there’s a week you don’t want whole wheat turkey penne with mushy parsley, but now you’re stuck because you still have another month left of these reheated meals.

People begin taking GLP-1 before adopting an individualized eating plan that works for them. Then you resort to quick breakfast egg sandwiches from the cafeteria or burritos from the vendor outside. Then you eat hamburger patties with cheese to be carb-conscious, but ultimately this is not sustainable and without a plan, you revert to unfavorable eating patterns that led you to gain weight initially.

We have to change our relationship to food and prioritize it as we would for our children or loved ones. Let’s put ourselves first and take time to build a week-long meal plan that includes batch cooking, prepping, grocery shopping, and making efficient, repeatable lists to lessen decision fatigue. If there’s an interruption of GLP-1 treatment, hunger signals return, and old habits resume. You regain weight but not lost muscle mass, lowering metabolism further.

• Choose 5-7 of your favorite meals.
• Make a repeatable grocery list.
• Prep meals on your day off, like Sunday, making it a family event.
• Cook in bulk.
• Keep fruits and snacks handy.
• Have a salad ready.
• Have backup plans like rotisserie chicken or tuna salad.
• Have one free meal day weekly.

Need guidance on your metabolic health questions or are you ready to maximize your GLP-1 results?? Let me know; I can help lay the foundation. Check out my services here to you can finally feel your best, in a more natural and sustainable way.

Takeaways:

• Ozempic, Wegovy, Zepbound are tools, not the solution.
• Protein is a key part of your optimal GLP-1 Nutrition Therapy Diet.
• Optimize your results to achieve ideal body composition and restore metabolic health.
• Start living rather than just going through the motions. Remember these 5 non-negotiables.
• For individualized guidance, please reach out—I have successfully helped many clients taking GLP-1 medications reach their health goals, adopt a specific eating and health strategy that works for them, and achieve lasting results.