Navigating Side Effects of Weight Loss Drugs

Mechanism of GLP-1 Receptor Agonists

GLP-1 is a naturally occurring peptide hormone, primarily made in the intestines. When eating, GLP-1 is released, activating GLP-1 receptors which stimulate the pancreas to release insulin, which controls blood sugar and slows gastric emptying, resulting in a feeling of fullness, which can reduce appetite. GLP-1 also stimulates satiety centers in the hypothalamus, resulting in a feeling of satiety and fullness. When managing weight, the feeling of fullness and satiety can reduce appetite and decrease intake, resulting in weight loss. This mechanism is also effective in the management of diabetes, through weight loss as well as the release of insulin.

Side Effects of GLP-1 Receptor Agonists

Those taking GLP-1 receptor agonists are at an increased risk for gastrointestinal issues, such as nausea, vomiting, constipation, intestinal obstruction, and pancreatitis. Those taking GLP-1 receptor agonists are at a 4.22 times higher risk of intestinal obstruction than those who do not. An intestinal obstruction occurs when the intestines are unable to pass their contents and can be serious and potentially fatal when it occurs. Signs of an intestinal obstruction can be constipation and/or abdominal pain. Those taking GLP-1 receptor agonists are at a 3.67 times higher risk of gastroparesis, which is when the stomach takes too long to empty its contents, resulting in signs such as nausea and vomiting.

Navigating Side Effects

The most important component of navigating side effects is to monitor symptoms and keep your physician informed. When it comes to gastrointestinal side effects, track your bowel movements and any symptoms such as abdominal pain, nausea, constipation, etc. Consider taking an OTC stool softener if you are going multiple days between bowel movements. Consult your physician before taking a laxative or stool softener.

Consider natural remedies to alleviate some gastrointestinal symptoms. Consider using ginger as a natural way to alleviate nausea. Add in natural sources of probiotics, such as yogurt and fermented foods, to promote good bacteria in your gut. Increase fiber and water intake to aid with the digestion process and help things move along. Food is medicine; let's use it!

Addressing Decreased Appetite & Decreased Intake

With the mechanism of GLP-1 receptor agonists and the potential for severe side effects, it may be difficult to actually eat enough while taking these medications. Clients have told me they went from eating a foot-long sub at Subway to barely being able to finish 1/4 of that. With that comes concern of nutrient deficiencies, inadequate fiber and protein intake, as well as concern for rapid weight loss and malnutrition. Inadequate intake can lead to loss of muscle mass, which is concerning especially throughout the aging process.

Track your weight throughout this process and monitor trends & patterns. Consult your physician if your intake has significantly decreased and you are losing significant weight. Significant weight loss can increase your risk for malnutrition.

Significant weight loss in considered as:

• Loss of 5% body weight or greater in 1 month or less
• Loss of 7.5% body weight or greater in 3.5 months or less
• Loss of 10% body weight or greater in 6 months or less
• Loss of 20% body weight or greater in 1 year or less

With decreased appetite and intake, focus on having protein-focused meals with complex carbs, healthy fats, and vegetables to get more bang for your buck. If you are only able to eat a little bit at your meals, eat the protein portion of your plate first. Eat smaller, more frequent meals throughout the day to optimize intake when you get full quickly. Aim for 6, small meals throughout the day, rather than 3 large ones. Incorporate protein-focused snacks and consider sipping on protein shakes if you are unable to meet your daily protein goal through food alone.

Consult a dietitian to navigate nutrition-related side effects and achieve sustainable weight loss.

Sources:

https://www.healthline.com/health-news/taking-glp-1-drugs-for-weight-loss-can-lead-to-serious-gi-symptoms#A-deep-dive-into-the-data