By Karen Marschel, RDN, LD, CDCES, Dietitian, Diabetes Educator
If you’re taking Wegovy or Zepbound, thinking about starting one, or considering stopping treatment, there’s more to success than the prescription itself. Understanding how these medications work — and how nutrition support fits in — can help you feel better and get better results.
This article covers FDA-approved GLP-1 medications. Wegovy (semaglutide) is a GLP-1 (glucagon-like peptide-1). Zepbound (tirzepatide) is a GLP-1 and GIP (glucose-dependent insulinotropic peptide).
How do GLP-1 medications work?
Our bodies naturally make GLP-1 and GIP hormones to help control blood sugar and appetite. These hormones are released in the intestines when we eat, especially carbohydrates and fat. Along with other gut hormones, they support digestion, nutrient absorption, hunger, fullness, and hydration.
GLP-1 medications do the same job, but at a much stronger dose than our bodies make, like an espresso shot compared to a cup of coffee. They also last longer in the body, and that’s why side effects can happen.
Is it safe for me to take weight loss medication?
If you’re considering Wegovy or Zepbound, talk with your primary care provider first. These medications aren’t a good fit for certain health conditions. Expect some lab tests if you haven’t had them checked in several months.
Already on a medication and want to stop? Work with your provider on a plan for tapering or staying at a low dose. Every person’s situation is different and depends on your health goals.
What are the common side effects?
Because these medications slow down digestion, the most common side effects are:
- Nausea or vomiting
- Constipation or diarrhea
- Acid reflux
- Feeling full faster or losing your appetite
Not everyone gets side effects, and other side effects are possible. If you already have digestive problems, it helps to improve how your digestive system works before you start the medication.
Dose increases can trigger or worsen side effects, so keep your provider in the loop. The usual schedule is to increase the dose each month, but it doesn’t have to be done that way. If side effects are bothering you, it’s often best to stay at the lower dose longer until they improve.
Is there a special diet I need to follow?
No — there’s no one specific diet. But there are many food and nutrient considerations that should be personalized for you.
A dietitian can help you find practical strategies that fit your health needs and daily life. This may include managing side effects, improving digestion and energy, supporting healthy blood sugar, maintaining muscle, staying hydrated, choosing meals and supplements, and addressing sleep, inflammation, stress eating, and other nutrition concerns.
How can a dietitian help?
There are at least 11 nutrients your body could become deficient in when you drastically cut back on food. Your dietitian can help you monitor vitamin and mineral deficiencies and decide what foods or supplements you might need.
Muscle and bone loss are also a risk when you eat less and lose weight. Protein matters, but you need it throughout the day, not just at one meal. Exercising your muscles is necessary to stay strong, among many other benefits.
Remember to focus on wellness, not just weight loss. It’s not about the scale; it’s about being healthier. You’ll likely lose inches and notice your clothes fitting better before the scale moves, so weighing yourself too often isn’t a good measure of success. Additionally, if you lose weight too fast, you’ll lose even more muscle. Slow and steady wins the race.
Hydration is another key piece, and it’s not just about drinking a certain amount of water — your body needs to be able to absorb it. The best choices for water, artificial sweeteners, and electrolytes can vary from person to person. Your dietitian can help you decide what works best for your health and nutrition needs.
Talk With Your Provider and Dietitian
Weight loss medications can be an effective tool for improving health, but regular follow-up is an important part of treatment. Talk with your provider and dietitian about your progress, side effects, nutrition concerns, or challenges you’re experiencing. They can help you make adjustments and get the most benefit from your treatment.
If you’re thinking about starting or stopping Wegovy or Zepbound, your provider can help you decide what’s right for you. Watch for my upcoming article about what to consider when stopping GLP-1 medications.