by The excitement surrounding the arrival of newer weight loss drugs was an understatement. These drugs – including semaglutide (Wegovy, Ozempic), which are GLP-1 receptor agonists, and tirzepatide (Zepbound, Mounjaro), which are GLP-1 and GIP receptor agonists – are extremely effective for weight loss, as so it’s no wonder why.
For example, in a 2023 meta-analysis of 41 trials and more than 15,000 participants with obesity or overweight but no diabetes, GLP-1 receptor agonists were associated with reduced body weight, body mass index (BMI), and waist circumference compared with control groups. These drugs may cause more insulin release, slower stomach emptying, and decreased appetite. There is also research that suggests GLP-1s reduce “food noise,” a term that refers to intrusive thoughts about food. When you are paying less attention to food, you may not eat as much.
In addition to loss of appetite, nausea, vomiting, and diarrhea may result from the drug, and these factors can definitely influence what and how much you are eating. This in turn increases the risk of nutrient deficiencies, which begs the question: Is it prudent to add a supplement to your regimen if you are on a newer weight loss drug?
We spoke to two registered dietitians to find out.
Do You Need a Supplement If You’re Taking Weight Loss Drugs?
It certainly can, and your healthcare team can help you determine the answer based on your individual health. In general, however, anyone taking GLP-1 should do some key nutritional questions.
“These medications are known to suppress appetite, causing people to eat fewer calories and possibly eat less balanced foods than they otherwise would,” says Beth Warren, RD, who practices in New York City. It can be tempting to rely entirely on medication for weight loss – rather than pairing it with a healthy, balanced diet. “For some people, the drug can take away the motivation to eat well because it works so well on its own,” she explains.
If you are taking GLP-1, it is important to prioritize a healthy diet; but that goal comes with its own challenges. “With a decreased appetite and sometimes severe nausea or stomach discomfort, even when someone tries to follow a meal plan, they may not be able to,” says Warren. This can leave you more vulnerable to nutritional deficiencies.
These physical effects can also affect what you eat. “I’ve seen people eating less than 1,000 calories a day because they felt too sick to eat. Others have no GI issues,” says Jess DeGore, RD, CDCES, owner of Jess’s virtual private practice Dietitian Jess in Pittsburgh. For reference, the calorie goal for adults is between 1,600 and 2,400 per day, depending on age and gender, according to the 2020-2025 Dietary Guidelines for Americans. “I worry about people who have a poor appetite and are not getting enough nutrients, whether they have a great quality of life when they can’t enjoy food and don’t feel great most of the time,” she says.
Plus, if you’re losing weight quickly, that’s another reason you want to be on the lookout for a possible nutritional deficiency and make sure you’ve got your bases covered, says DeGore.
What Nutritional Supplements Do You Take If You Are Taking GLP-1?
First, keep a balanced healthy meal plan structure, but eat smaller portions, advises Warren, and be sure to prioritize protein to maintain muscle mass as you lose weight. It is also a good idea to limit added sugars and foods rich in saturated fats. The goal is to do your best to eat nutrient-rich foods. Then, you might consider a supplement. “A supplement means ‘in addition to.’ These are meant to supplement nutrients in your diet and not replace them,” she says.
The supplements that your doctor or registered dietitian may recommend are those that address common deficiencies, especially those that may arise during weight loss. Talk to your healthcare practitioner for more guidance on exactly how much to take. If you are concerned about a deficiency, ask your provider about testing.
Vitamin B12
B12 is a B vitamin that is critical for blood and nerve cell health, and adequate intake prevents a type of anemia that causes fatigue, according to the National Institutes of Health. “B12 is a common deficiency that we see with weight loss, so you want to make sure you’re getting enough every day,” says DeGore.
Vitamin D
DeGore says she recommends vitamin D, also known as the “sunshine vitamin,” for everyone, especially during the winter months when there’s less sun exposure. Adequate vitamin D is important for strong bones and immune support, and a deficiency is commonly seen in people on restrictive diets, she says.
Probiotic
If you’re having GI side effects from the medication, a probiotic may help repopulate your gut with good bacteria to ease symptoms, says DeGore.
Multivitamin
A multivitamin won’t overcome bad dietary habits, but you can think of it as a security blanket, says Warren. Remember, though, that vitamins and minerals are absorbed more efficiently through food than from a supplement, she says.
Summary
Bottom line: The quality of your diet is extremely important, especially when your diet is limited by appetite changes or side effects from weight loss medication. “Use these medications as a tool to refocus on eating a healthy, balanced diet, learn to eat every few hours, try new foods, and educate yourself about nutrition,” Warren says. . You can create healthier habits when you don’t feel the pressure and anger that comes with trying to lose weight on your own.
