5 Questions About Food and Weight Loss Medication

With obesity affecting over 42% of U.S. adults according to the CDC [1], weight loss medications are becoming a more common tool for patients seeking additional support.? In fact, almost 2 million people in the U.S. were taking semaglutide medications in 2021. [2] Patients often wonder what foods work best alongside the medication, and if there are restrictions they need to follow. These inquiries are likely to come up in your practice, even for those not specializing in obesity medicine. This post tackles 5 of the most frequent patient questions regarding weight loss medications and dietary considerations, empowering you to provide clear and concise guidance.

1.Is there a certain diet I need to follow while taking a weight loss medication?

There's no one-size-fits-all diet for someone on a weight loss medication. A balanced, whole-foods approach is ideal. Sustainable weight loss and healthy blood sugar control rely on healthy eating habits. Weight loss medication can be a great tool, but building a healthy relationship with food is key for long-term success. Furthermore, some popular weight loss diets, including the ketogenic diet, may worsen GI symptoms. Most of the available weight loss medications, like Ozempic, work by regulating blood sugar and appetite, but it can also cause side effects like nausea, constipation, vomiting and diarrhea. If your patients are struggling with any of these uncomfortable side effects, it’s important to dig a little deeper to ensure that you rule out a more serious cause including biliary disease, pancreatitis, bowel obstruction, and gastroparesis. Gastroparesis is an interesting side effect to pay attention to, especially in patients with obesity and diabetes, as diabetes is also a contributing factor for gastroparesis. [3] Your patients should be working with a Registered Dietitian to help them make the best food choices.

2. I heard I should avoid fatty foods. Is that true?

Fatty foods can worsen nausea, a common weight loss medication side effect. Suggest your patient limit fried foods and fatty cuts of meat. Lean proteins like fish and chicken are better choices. However, healthy fats like those in nuts, avocados, and olive oil are still important and should be encouraged.

3. Should I cut out sugary drinks altogether?

Sugary drinks can contribute to weight gain and blood sugar issues, so moderation is key. Encourage patients to consume water or unsweetened tea/coffee most of the time.

4. What about vegetables? Are there any I should avoid?

Cruciferous vegetables like broccoli and cauliflower can cause gas, which might be worse due to weight loss medication use. If your patients experience bloating, try introducing them slowly or steaming them to make them easier to digest. Most vegetables are a great source of nutrients and fiber, so they should be encouraged.

5. Can I still drink alcohol while on a weight loss medication?

The short answer is, yes, however there are some things to consider. While there aren't direct interactions between alcohol and most weight loss medications (that we know of at this time), it's best to advise patients on moderation. Alcohol can irritate the gut, worsen medication side effects, and increase one’s risk of pancreatitis. Encourage patients to stick with recommended drink limits (1 drink/day for females, 2 drinks/day for males) or abstain altogether for optimal results. Alcohol consumption can also potentially slow weight loss due to its calorie content (around 7 calories per gram) and sugary mixers. For example, a typical espresso martini packs 200-300 calories, and a mojito can range from 170 to 250 calories, often with over 20 grams of sugar.

Emphasize the importance of a healthy diet and physical activity alongside medication for successful weight management.

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Resources:

1.????? https://www.cdc.gov/nchs/data/nhsr/nhsr158-508.pdf

2.????? https://www.pewresearch.org/short-reads/2024/03/21/as-obesity-rates-rise-in-the-us-and-worldwide-new-weight-loss-drugs-surge-in-popularity/

3.????? https://jamanetwork.com/journals/jama/fullarticle/2810542