GLP-1s Part 3: Diet, exercise, and cravings

Key Takeaways

• GLP-1s are a tool in the toolbox to help you lose weight. They are most effective when combined with diet and exercise.
• A well-balanced diet is one that is high in protein and fiber and low in fat.
• The Physical Activity Guidelines for Americans recommend 150 minutes of moderate activity each week.
• Those on GLP-1s should include strength or resistance training as part of their exercise routine.
• Cravings can result from not getting proper nutrients and stress. Sometimes, the GLP-1 dose may need increased.

In part one of this series, Dr. Laura Davisson, director of the WVU Medicine Medical Weight Management Clinic in Morgantown, discussed the differences between the various GLP-1s on the market and how to know which one is right for you. 

In part two, she talked about the safety of using an online retailer. 

This time, we’re going to talk about how to maximize your weight-loss results from a GLP-1 by eating right and exercising regularly. And, we’re also going to talk about what to do if your cravings come back. 

One of the biggest misconceptions about GLP-1s is that people think you can just take these medications and lose weight safely and effectively without doing anything else. But, when you think about it, GLP-1s are a tool in your toolbox to help make lifestyle changes easier and more effective.  

We want to make sure people are developing the lifestyle behaviors that they need to help maintain a healthy weight from here on out. 

Diet 

The type of diet you should be on when taking a GLP-1 can vary because of individual needs, like diet and medical history and any medications a person may be taking. However, in general, most people need to be on a diet that is relatively high in lean protein sources. 

That means very lean sources of meat, poultry, fish, eggs, dairy, beans, and pulses – the dried seeds of legumes that come in many different shapes and sizes and include things like lentils, beans, and peas – because we want to make sure people have enough protein to help maintain or preserve their lean body mass and skeletal muscle mass.  

We want to make sure people are getting adequate fiber. All those plant-based foods, like fruits and vegetables, whole grains, and beans and pulses. Most Americans do not get adequate fiber, and generally, some people might be having some trouble with constipation while taking these medications.  

Plant-based foods provide us with fiber and a lot of vitamins and minerals our bodies need. They are great for our digestive health and our cardiovascular health. Without them, we’re not going to meet our nutrient needs very well.  

We also want a diet that’s relatively lower in fat. Often with these medications, high-fat meals are not tolerated very well. We want people to choose good heart-healthy sources of unsaturated fats, such as olive oil, avocados, nuts, seeds, etc.  

Overall, we want a higher protein, higher fiber, and lower fat eating plan. 

Exercise 

When you’re taking GLP-1 medications, we fall back on the Physical Activity Guidelines for Americans, which was developed by the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Those guidelines recommend about 150 minutes of moderate physical activity every week.  

However, the types of physical activity do matter as well. We emphasize strength training or resistance training with our patients to help maintain that skeletal muscle mass. Doing that at least two times a week, maybe even a little bit more, can help with that.  

If people are not familiar with strength training, they’re not comfortable with it, or they’ve never done it before, I recommend seeking out an exercise professional, such as a good personal trainer, an exercise physiologist, or a physical therapist, who will be able to develop a plan with them based on their own needs and their own abilities or limitations to exercise. 

Cravings 

OK, you’re managing your diet, you’re hitting your exercise goals each week, and your cravings come back. Now what? 

First, look at what you’ve been eating. Are you getting enough protein in your diet? Are you getting enough fiber in your diet? 

These nutrients are very satiating. They keep you full and satisfied. If you haven’t been paying attention to that, and you’re not consuming enough protein and fiber, you might notice cravings start to creep back. Or, you might feel a little bit hungrier than usual.  

Also make sure you’re not letting stress get the best of you. This can result in cravings, stress eating, and emotional eating. We may need to address these with stress-management techniques, a mindful eating approach, or behavioral therapy to help deal with these issues on another level.  

If we’ve looked at all those things first and we’re still struggling with cravings and hunger, then maybe it’s time to increase medication dosage. 

It’s something we can all discuss and help you make sure you’re on the right path. 

We’re on your team 

It’s very, very important that you pay attention to your nutritional intake when you’re on GLP-1s.  

I always tell patients they need to get the most nutritional bang for their buck out of the foods and beverages that they’re choosing to eat and drink because they’re eating less. 

When we’re eating less, we’re more at risk of not meeting our nutritional needs. Everything we choose to eat needs to be high-quality nutrition.  

It’s best to work with your registered dietitian on what that looks like, so that we can help you do that and meet your food preferences at the same time. 

For more information about our program, visit WVUMedicine.org/WeightMgmt.