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Manjaro, Wegovy Ozempic, Oh My - Working with a Dietitian- Part 2



Nutritional Guidance

Dietitians play a crucial role in supporting individuals undergoing GLP-1 therapy to optimize its effectiveness and promote overall health. They optimize success, tolerability, mitigate side effects, and offer accountability. Dietitians also provide personalized nutritional guidance tailored to each individual’s health status, lifestyle, and medication regimen, whether or not GLP-1 medications are integrated into the treatment plan. Emphasizing quality over quantity, they advocate for a balanced diet abundant in fruits, vegetables, whole grains, lean proteins, and healthy fats. Portion control, carbohydrate counting, and strategic meal timing are highlighted to stabilize blood sugar levels and mitigate potential side effects associated with GLP-1 therapy. Incorporating low-fat diets can enhance toleration and alleviate gastrointestinal symptoms. Given the restricted dietary intake, recommendations may include supplementing with a multivitamin and possibly psyllium husk to boost fiber intake. Additionally, emphasizing the importance of mixed exercises, such as resistance or strength training alongside cardiovascular activities, is crucial for overall health improvement and weight management.


What Follow Up w/ a Dietitian Looks Like

When working with a dietitian on your weight loss journey, especially while on GLP-1 therapy, expect a comprehensive approach that goes beyond just dietary recommendations. Your dietitian will monitor and adjust various aspects of your health and lifestyle to optimize success. This includes assessing not only weight but also body composition, examining dietary intake beyond simple recall to understand appetite, hunger, and dietary patterns, and checking biochemical measurements like blood sugars. Mitigating side effects of therapy through behavioral and lifestyle changes, collaborating with the healthcare team, and ensuring a balanced combination of strength training and cardio in your physical activity routine are also key focuses. Moreover, your dietitian will provide education and support for healthy lifestyle behaviors, including stress management and adequate sleep, and may address complementary behavior changes like smoking cessation. They’ll also be there to address any barriers or challenges you may face in adhering to dietary and lifestyle recommendations, offering practical strategies for overcoming them.




Mitigating Side Effects

Mitigating side effects associated with GLP-1 therapy involves targeted dietary management and lifestyle adjustments. Nausea, vomiting, and burping, often caused by delayed gastric emptying, can be managed by consuming the largest meal before injection followed by low-fat meals, staying hydrated with limited caffeinated or carbonated beverages, and rotating injection sites. Constipation or diarrhea, also stemming from delayed gastric emptying, can be addressed with small, frequent meals rich in fruits, vegetables, and whole grains, meeting fiber needs and maintaining hydration. Routine physical activity aids in bowel motility, with considerations for a low residue diet in cases of diarrhea. To combat accelerated muscle loss due to decreased appetite, protein distribution throughout the day is recommended, alongside options like protein shakes or bars, and adjusting medication doses to appetite levels. Managing appetite cues, preferences for cold or hot foods, and incorporating supplements like multivitamins and psyllium husk are essential, with attention to the emotional relationship with food and self-esteem effects.


For the Long-Term

When utilizing GLP-1 therapy for weight management, it’s essential to adopt a long-term perspective. These medications are not meant for short-term fixes, aiming to avoid the pitfalls of yo-yo dieting and weight cycling. They promote sustained weight loss by addressing increased appetite and reduced energy expenditure. Plateaus are a natural occurrence in the weight loss journey and do not necessarily indicate medication failure. Gradual adjustments may be necessary to achieve the desired weight, potentially involving a reduction in dose or frequency of medications, although further study is needed to determine the optimal strategy.

Long-term support is crucial for individuals undergoing weight management with GLP-1 therapy. This involves offering ongoing guidance and support to maintain dietary and lifestyle changes over time. Continuous assessment and reassessment of nutritional needs and goals allow for adjustments in the meal plan and counseling approach as needed. Empowering individuals to take an active role in managing their diabetes and overall health through informed decision-making and self-care practices is key to long-term success and overall well-being.

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