Don’t Forget About Diet and Exercise when Using a GLP-1

Over 1 in 10 American adults are using a GLP-1. If you are one of these individuals, or if you are someone thinking about taking a GLP-1, you may wonder whether diet and exercise are still important when using this medication.

Here are a few factors to consider when thinking about how a GLP-1 fits with diet and exercise.

Creating a Diet and Exercise Plan while Using a GLP-1

Consideration #1: What outcome(s) are you focusing on?

Many individuals use a GLP-1 to lose weight. This makes sense because GLP-1s can be very helpful for weight loss, and weight loss can have many benefits for individuals with a higher body weight or with obesity. However, it’s also worth considering outcomes beyond weight loss.

Healthful eating and physical activity offer many benefits beyond their impact on weight. Engaging in at least 150 minutes per week of moderate-to-vigorous physical activity—the level recommended for all American adults—lowers the risk of 200+ diseases, things like depression, heart disease, diabetes, and several types of cancer.

Similarly, a healthy diet that includes lean proteins like fish, beans, and chicken; fruits and vegetables; and healthy fats like olive oil helps to prevent and manage chronic diseases. Practicing these healthy behaviors while on a GLP-1 allows you to experience these benefits.

Weight loss is rarely just about the number on the scale. Usually, people want to lose weight for a bigger reason, whether that be preventing other health issues, enhancing energy and mobility, improving body image to feel more confident in your skin, or something else, weight loss is typically not the end goal in and of itself. Often, diet and exercise can also help promote these broader goals.

Consideration #2: Why are diet and exercise important when using a GLP-1?

GLP-1s are a powerful tool. Many individuals experience considerable weight loss when using a GLP-1 without intensive diet and exercise. This can be a major pro, especially if you:

• have limited resources to support a healthy diet and exercise (e.g., limited money to buy fresh foods)
• have limited access to behavioral interventions (e.g., no or limited insurance coverage to meet with a behavioral health provider who can guide and support you with diet and exercise)
• are experiencing other barriers to practicing healthy behaviors (e.g., limited time)

At the same time, GLP-1s are meant to be paired with healthy eating and physical activity for weight loss. GLP-1s were tested alongside lifestyle modification programs.

In other words, in the studies that looked at how much weight loss GLP-1s produce, their safety and side effects, and that ultimately led to their Food and Drug Administration (FDA) approval, participants also received lifestyle counseling sessions focused on healthy eating and physical activity.

The packaging and instructions that come with GLP-1 medications typically note the medication is meant to be used with diet and lifestyle. So, while most people will likely experience weight loss (and, in some cases, quite a bit of weight loss) even without doing an intensive diet or exercise program, it’s best to pair the medication with healthy behaviors.

There are other aspects of your weight loss experience to think about, too. Modifying diet and adding physical activity allow people to avoid many of the gastrointestinal side effects (like heartburn, bloating, and constipation) that accompany unhealthy eating patterns with lots of fried, fast foods, and large portions.

Getting adequate protein in your diet (at least 60 to 120 grams per day) is also essential for maintaining muscle mass while losing weight on a GLP-1. We’re still learning exactly how GLP-1s affect body composition and whether the amount of lean muscle mass loss people experience is a health issue. Either way, paying attention to diet and exercise, especially strength training, can help to strengthen your body, enhance your fitness, and improve your balance as you lose weight.

Consideration #3: Focusing on the long term and weight maintenance

Obesity is a chronic, multi-faceted disease that, like other chronic diseases, requires ongoing management. For many people who use a GLP-1, it may be helpful to continue using this medication for many years to keep experiencing its benefits (just like someone with high blood pressure typically remains on blood pressure medication).

That said, if people stop  using a GLP-1, it will be especially important to prioritize diet and exercise. Focusing on eating a healthy diet and getting regular physical activity now can help you build healthy habits and routines to support you well into the future, including if/when this time comes.

You may also find that some behavior changes are easier to make when on a GLP-1 due to the medication’s effects: for example, cutting back on sweets can feel easier when hunger and food noise are lower. It may be helpful to take advantage of these benefits to really focus on healthy habits you want to build now, with the idea that the more time you have for these habits to take hold, the better.

Talk to Your Physician

While many people may experience weight loss on a GLP-1 even without an intensive focus on diet and exercise, it’s still important to prioritize healthy eating and exercise (to the extent you are able) for many reasons.

If you are on a GLP-1 or want to start one, we encourage you to talk to your health care provider about specific questions you may have about diet and exercise, since they know you best and can help develop a tailored plan to meet your goals. Because healthy eating and exercising can be hard, especially if you lack resources or support, they may also be able to help connect you to people or programs to support you in your health journey.

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