Experts Introduce First Dietary Guidelines for People Taking Anti-Obesity Drugs

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  • The first comprehensive evidence-based review of dietary recommendations for people taking anti-obesity medications has been published. It provides guidance on calorie and nutrient intake.
  • Almost 40% of American adults are living with obesity. Some will need to take these new medications to achieve and maintain a weight that better supports their health.
  • Not eating enough contributes to nutritional deficiencies and loss of muscle mass for people looking to lose weight.

About 42% of all adults in the United States are obese. Eating a nutritious diet and exercising are a basic part of weight management, but some people need more help to gain weight and stay at a weight that supports their health.

As new anti-obesity medications enter the market, there has been little nutritional guidance for patients on these drugs.

A recent research paper provides a comprehensive review of nutritional recommendations for patients on Wegovy or Zepbound, which can reduce appetite and increase satiety. This new guideline can help clinicians identify and manage patients at risk of nutritional deficiencies due to reduced food intake, the researchers wrote.

The authors of the paper acknowledged that target nutrient intakes vary from person to person, and there is no one dietary pattern that is considered the best or most effective for weight loss.

They recommend a balance of nutrient-dense foods and drinks that provide plenty of vitamins and minerals. In addition, they recommend choosing foods that are low in added sugars, saturated fats and sodium.

Here’s a general breakdown of nutrient intake guidelines for people on Wegovy or Zepbound.

Calories

Calories provide your body with the energy it needs to perform basic functions such as breathing, moving and thinking. The general energy intake during weight loss is between 1,200 and 1,500 calories per day for women and between 1,500 and 1,800 for men.

That said, energy needs vary depending on your age, sex, body weight, physical activity levels, and other factors. Your energy intake should be personalized according to your needs and goals and by a nutritionist.

Tracking calories may be useful, but Isabella Ferrari, MCN, RD, CSO, LD, senior clinical manager at Doherty Nutrition, told Verywell that calorie counting can be harmful for some people.

“It’s really important to have a dietitian on your side when trying to lose weight because we don’t want calorie counting or calorie tracking to become an obsessive behavior where people can’t live their lives without knowing who they are high in calories. “You’re going to be tracked,” said Ferrari.

Protein

People living with obesity must have a protein intake of at least 60 to 75 grams per day, and up to 1.5 grams per kilogram of body weight per day is recommended, especially if bariatric surgery or receiving other weight reduction treatments.

The recommended protein allowance for most adults with no health concerns is 0.8 grams per kilogram of body weight per day.

Carbohydrates

A common weight loss misconception is that you need to cut carbohydrates to lose weight. However, research has shown that severe carb restriction does not lead to long-term weight loss and may limit the nutrition you might normally get from eating plenty of fruits, vegetables and whole grains.

If you’re taking newer anti-obesity medications, Almandoz recommends focusing on balanced nutrition. The recommended amount of carbohydrates for healthy adults can work for people trying to lose weight: 135 to 245 grams per day for a 1200- to 1500-calorie diet, or 170 to 290 grams per day for a 1500 to 1800-calorie diet.

For patients who are recommended or prefer a low-carbohydrate diet, Almandoz recommends making sure you’re drinking 2 to 3 liters of fluid per day.

Fat

Dietary fats help your body absorb fat-soluble vitamins, such as vitamins A, D, E, and K. Although there is less evidence for recommended fat intake ranges, the Acceptable Macronutrient Distribution Range is 20% to 35% ( AMDR) for most adults. % of energy intake for a 1,200 to 1,500-calorie diet.

Fiber

About 90% of Americans don’t get enough fiber, but this nutrient is critical to preventing constipation and helping you feel fuller longer. The adequate fiber intake level is 21 to 25 grams per day for women and 30 to 38 grams for men. To meet your fiber needs, focus on fiber-dense foods such as:

  • Results
  • Vegetables
  • Whole grain

“Unfortunately, many people in the US eat a lower-quality diet that is high in ultra-processed foods,” Almandoz said. “Without proper nutritional assessment and guidance, people taking these new anti-obesity medications run the risk of eating less of a low-quality diet.”

If you don’t eat enough fiber, you’ll want to go up slowly to avoid problems like constipation.

Since you don’t want to risk nutritional deficiencies and losing muscle mass, talk to your health care provider and nutritionist about your diet if you’re considering anti-obesity medications.

What This Means For You

If you are considering an anti-obesity drug, be sure to talk to your health care provider and a nutritionist about how to make sure you are getting adequate nutrition while taking the medications.

Verywell Health uses only quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we check and keep our content accurate, reliable and trustworthy.
  1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. 2020.

  2. Almandoz JP, Wadden TA, Tewksbury C, et al. Nutritional considerations with anti-inflammatory medications. Obesity (Silver Spring). Published online June 10, 2024. doi:10.1002/oby.24067

  3. Koliaki C, Spinos T, Spinou Μ, Brinia ΜE, Mitsopoulou D, Katsilambros N. Defining the best dietary approach for safe, effective and sustainable weight loss in overweight and obese adults. Healthcare (Basel). 2018; 6(3):73. doi:10.3390/healthcare6030073

  4. Salleh SN, Fairus AAH, Zahary MN, Bhaskar Raj N, Md Jalil AM. Unraveling the effects of soluble dietary fiber supplementation on energy intake and perceived satiety in healthy adults: evidence from a systematic review and meta-analysis of randomized controlled trials. Foods. 2019; 8(1):15. doi:10.3390/bianna8010015


By Kayla Hui, MPH

Hui is a health writer with a master’s degree in public health. In 2020, she won a Pulitzer Center Fellowship to report on the mental health of immigrant truck drivers from China.

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