The Power of Nutrition and Exercise With GLP-1s

Glucagon-like peptide-1 (GLP-1) medications are exploding in popularity for weight loss. While many are seeing the pounds fall off, without complementing the medication with other healthy lifestyle habits—including proper nutrition and regular exercise—health risks may arise.   

GLP-1s act similarly to hormones naturally created in the gut and brain and trigger the pancreas to release insulin when blood sugars are elevated. They promote satiety by slowing gastric emptying and target brain receptors involved in reducing appetite. These drugs have been shown to help people lose more than 15% of their body weight.

Nutrition

Because GLP-1s change how much you eat, nutrition matters more than ever. A healthy nutrition plan supports optimal results by protecting lean muscle mass and managing side effects. Getting enough protein, fiber and calories as well as staying hydrated are keys to long-term success.

Protein intake is important to help you maintain muscle mass as you lose weight. Protein intake should be up to 1.5 g/kg of body weight per day. For example a 175-pound person, needs 119 g of protein per day.

Tips to Meet Your Protein Needs

• Include a protein source at all meals and snacks.
• When eating your meals, eat the protein first to ensure you consume adequate amounts.
• If needed, consider supplementing with a ready-to-drink protein shake such as Oikos®, Slate®, Fairlife® and OWYN™.

GLP-1s slow down gastric emptying which can lead to constipation. Fiber is important to help manage constipation as it promotes regular bowel movements and supports overall gastrointestinal health. Women should aim for 21 g or more per day and men should aim for 30 g or more per day. Some examples of foods high in fiber include:

• Beans
• Oats
• Berries with seeds
• Chia seeds
• Vegetables
• Whole wheat pasta
• Edamame (steamed or dry roasted)

Fueling your body properly with a reduced appetite can be hard. Cutting calories too low can lead to insufficient intakes of essential vitamins and minerals. Signs of nutrient deficiencies include:

• Fatigue
• Hair loss
• Skin flakiness
• Muscle weakness
• Muscle loss

To better reach your recommended calorie count as well as your fiber and protein goals, eating smaller, more frequent meals might be helpful. Smoothies are another way to add more nutrient-dense foods into your diet, especially if you pair them with protein powder. Some foods to include in your smoothies are:

• Avocado
• Nut butter
• Greek yogurt
• Chia/flaxseeds
• Spinach
• Kale
• Fruits, especially berries

Dehydration can worsen nausea, constipation and fatigue. When your appetite is reduced your thirst mechanism might be also. Staying hydrated is important to help manage side effects as well as support digestion. Sip fluids consistently throughout the day. Try water with fruit, lemon or cucumber along with herbal teas or broths. If you find drinking fluids with your meals fills you up too quickly, consider separating fluids from mealtime.

Exercise

While on GLP-1s, regular exercise and physical activity should be part of your routine to help maintain and increase muscle mass. GLP-1s usually induce a low appetite, and if you are not eating enough protein, your body will begin to lose muscle leading to muscle weakness and its side effects such as decreased mobility and increased risk of falling.

Benefits of gaining muscle mass include:

• Metabolism support
• Blood sugar management
• Improved joint health
• Increased bone density

When selecting exercises to include into your routine, multi-joint exercises are the best choice. With multi-joint exercises, you are able to use most or all of your large muscle groups providing the most return for the time and energy of the workout.

Recommended Movement Patterns

Squat Pattern – Split Squat

• Uses your quads, glutes and inner thighs
• Improves balance and core stability
• Great lower-body exercise without needing heavy weights

Hinge Pattern – Dumbbell Deadlift

• Targets the glutes, hamstrings and muscles supporting your spine
• Targets powerful hip extensions and builds total body strength

Upper Pull – One-arm Dumbbell Row

• Works the lats, upper back, rear shoulders and biceps
• Strong pulling helps posture and shoulder strength

Upper Push – Dumbbell Chest Press

• Trains the chest, shoulders and triceps
• A joint-friendly way to build pressing strength

For these exercises, it is recommended to do six to 12 reps. For those who are just starting, moderate-to-higher repetition ranges (10-15 or even 15-20 reps) are typically more appropriate. A higher range of reps:

• Facilitates learning proper technique
• Improves movement proficiency and joint tolerance
• Builds confidence under load
• Allows meaningful effort without excessive mechanical risk

Shawn Smith and Jonah Villarreal, Professional Fitness Trainers at Cooper Fitness Center, demonstrate these exercises in “Strength Training with GLP-1s” Exercise Moves video.

Managing Common Side Effects

Up to 50% of patients on a GLP-1 may experience side effects which often occur during dose escalation and may decrease over time. Common side effects include nausea, diarrhea, heartburn and constipation which can range from mild to severe. It’s important you speak with your prescribing physician if you experience any side effects. Below are some tips to help you manage side effects with food.

Nausea and heartburn

• Avoid skipping meals
• Choose smaller, more frequent meals
• Avoid lying down after eating
• Limit spicy and high fat greasy foods

Diarrhea

• Reduce high fat greasy foods
• Limit large portions
• Rehydrate with fluids and electrolytes

Constipation

• Slowly increase fiber; women, 21 g or more per day; men, 30 g or more per day
• Stay well-hydrated; it’s recommended to drink half of your body weight in ounces
• Exercise may also help with constipation

If you find navigating your diet confusing or difficult while taking a GLP-1 medication, working with a registered dietitian nutritionist who understands what your body needs can make the process smoother and more sustainable.

For more information about Cooper Clinic Nutrition’s GLP-1 Nutrition for Life services and to schedule a one-on-one consultation, visit cooperclinicnutrition.com or call 972.560.2655.

For more information on personal training at Cooper Fitness Center or to schedule a session with a professional fitness trainer, visit cooperfitnesscenter.com or call 972.233.4832.

Article written by Hannah Salzbrenner, MS, RDN, LD, Cooper Clinic Registered Dietitian Nutritionist, and Shawn Smith, Cooper Fitness Center Professional Fitness Trainer.