Nutrition Support for GLP-1 Weight Loss Protocols - How to Minimize GLP-1 Side Effects
The Research is Clear
As promising as GLP-1 weight loss protocols are, for both weight loss and cardiometabolic markers, the research is starting to come back on long-term use of GLP-1s, and long-term discontinuation without functional support. What’s clear is that the benefits of GLP-1 weight loss protocols are not long-lasting on their own.
Unfortunately, the harmful effects caused by a drastically slowed digestive system on inflammation, hormone balance, and metabolic health last long after stopping a GLP-1… that is, unless the individual also receives guidance and functional support to address the systems being impacted.
It comes down to this - Long-lasting success without the harmful side effects of GLP-1 use is possible. The key is proactivity.
Hello, my little muffin tops. I’m Hilary Beckwith, ex-dieter and functional health expert. Women with PCOS/PMOS, IBS, and autoimmune conditions come to see me with signs of adrenal stress, insulin resistance, and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively and fill in the gaps between their lab values and how their body actually feels. Before you continue, click here to read my Medical Disclaimer.
In this article, you’ll learn:
How GLP-1s work
What the research is saying about GLP-1 use - during and after
Steps to mitigate side effects and get lasting results
the desire to feel seen…
For decades, women have been taught to stay small - both in size and in expression. As absurd as it is to see it typed out, the truly infuriating part is that many of us live in a constant state of belief that we are, indeed,too much.
Right or wrong, this belief and its ever-present desire to shrink is exactly what drives us to dangerous health trends like restrictive diets and weight-loss meds (remember Fen-Fen?). We develop eating disorders, we grasp at every diet, supplement, and workout protocol that promises a bikini body, all with the hope that we will finally become small enough to be seen and accepted. (I’m not crying, you’re crying!)
I see you, friend. And as infuriated as I am that we live in a world that works hard to keep us so small, I also understand the realities of navigating these expectations and beliefs. That’s why, instead of staying silent in my anger, I want to help you get the most benefit out of your GLP-1 weight loss protocol, without the harmful long-term effects.
how GLP-1s work
So here we are in a skinny-obsessed era, and GLP-1s are playing a major role. They’re touted as a miracle drug because, in addition to easy weight loss, they also improve cardiometabolic markers and blood sugar stability markers.
But those improved markers come at a big cost - the negative health impacts of drastically slowed digestion, if not mitigated with functional health support, can lead to increased intestinal permeability (leaky gut syndrome), damaged and inflamed intestinal tissue, bowel toxicity, sex hormone imbalances, and increased risk of SIBO, candida overgrowth, parasites, and gallstones. Not to mention a major disconnect from your body’s intuition and relationship with food. I go into more detail about the negative health impacts of GLP-1 weight loss protocols here.
This post is focused on practical steps you can take to stay proactive in your GLP-1 weight loss journey to support functional health and enjoy lasting benefits of GLP-1 use that would otherwise disappear with time.
In order to understand how to support functional health while undergoing a GLP-1 weight loss protocol, it’s important to understand how GLP-1s work.
HOW DO GLP-1S WORK?
GLP-1, or Glucagon-Like Peptide, is a naturally occurring hormone produced in the body after meals to stop the release of stored glucose from the liver, fat, and muscle; it also stimulates insulin release and slows gastric emptying (the rate at which chewed food enters the intestinal tract). The effects of endogenous GLP-1 last for 1-2 minutes.
GLP-1 agonists are a synthetic form of GLP-1 that can be injected to simulate the effects of endogenous GLP-1s. The effects of exogenous GLP-1s (GLP-1 medications) typically last for one week.
When using GLP-1 agonists (going forward, I will refer to GLP-1 medications as “GLP-1s”) for weight loss, the goal is to drastically slow digestion in order to keep individuals feeling full for longer periods of time, in order to eat fewer calories, and thus, lose weight.
during and after GLP-1 weight loss
The clinical research has been largely unanimous in showing GLP-1 weight loss protocols improving cardiometabolic markers (inflammatory markers, HbA1c, blood pressure, and cholesterol, in addition to rapid and steady weight loss.
For this reason, GLP-1s have been touted as a miracle drug, as these improved markers can significantly lower an individual’s risk for cardiovascular disease. But patients are not being told the whole story.
The research is finally starting to surface on the long-term health impacts of GLP-1 weight loss protocols.
HERE’S WHAT RESEARCHERS ARE FINDING:
MOST OF THE WEIGHT IS REGAINED - In a recent systematic review, it was found that roughly 60% of the weight lost using a GLP-1 weight loss protocol was regained within about 1-2 years.
INCREASED RISK OF SARCOPENIA - Sarcopenia is a loss of muscle mass. Because most of the weight lost with GLP-1s is lean mass (i.e. muscle tissue), this results in a drastic loss of muscle which can be dangerous, and unsupportive of long-term metabolic health. Muscle mass is essential to maintaining insulin sensitivity, bone density, and mobility.
Additionally, it’s been found that much of the weight regained after discontinuing a GLP-1 weight loss protocol returns as adipose (fat) tissue, not the lean mass that was lost. This causes downstream issues with hormone imbalance, increased inflammation, and metabolic issues.
CARDIOMETABOLIC MARKERS RETURN - Similarly, a recent meta-analysis showed that most pre-GLP-1 cardiometabolic markers returned after discontinuing a GLP-1 weight loss protocol.
INCREASED RISK OF GALLSTONES - Slowed digestion and motility, paired with an increased movement of fat, double the likelihood of gallstone formation, which can lead to inflammation, increased toxicity, and impaired fat digestion.
INCREASED RISK OF SIBO (SMALL INTESTINAL BACTERIAL OVERGROWTH) - While the GLP-1 itself can reduce certain inflammation markers, slowed motility greatly increases fermentation of food in the small intestine, feeding both harmful and beneficial bacteria, and giving them the perfect environment to thrive. This increase in harmful bacteria will ultimately lead to intestinal inflammation, bowel toxicity, and increased intestinal permeability, not to mention the discomfort of bloat, fatigue, suppressed immune activity (if unaddressed for too long), and constipation and/or diarrhea.
INCREASED RISK OF GUT PATHOGENS - A healthy digestive system acts as a frontline defense against pathogens ingested by food - yeast, bacteria, viruses, and parasites, mainly. Drastically slowing digestion reduces your body’s ability to disinfect food with sufficient levels of stomach acid, and the damaged mucosal lining of the intestines due to increased fermentation (see above) no longer carries the immune cells needed to further fight off and eliminate such pathogens.
DEHYDRATION - Sufficient, and even optimal, hydration is essential to blood volume, lymphatic flow (carries waste from tissues, carries immune cells to areas of need, etc.), nutrient transport throughout the body, and lubrication of muscle tissues and joints. GLP-1s significantly decrease thirst cues, leaving individuals on GLP-1 weight loss protocols dangerously dehydrated.
INCREASED RISK OF OSTEOPOROSIS - More research is needed to confirm this hypothesis, but an interesting paper published recently by UC Davis pointed out that reduced food intake leads to undernourishment, and undernourishment puts individuals at risk for bone loss, as the body cannot maintain bone density without the necessary dietary nutrients.
minimizing negative health effects of GLP-1s
Medications like GLP-1 and even nutritional supplements will only go so far if the root-causes of the symptoms you are addressing are left untouched.
A GLP-1 weight loss protocol might drop scale numbers, improve metabolic markers, and reduce inflammatory markers for a time, but unless you also address the underlying causes of the dysfunction that got you to that point - the research is clear - the results will not last.
YOU CAN HAVE THE BEST OF BOTH WORLDS
If you have made the decision to use GLP-1s to help you lose weight, and you want to enjoy the benefits for many years without creating a new onslaught of health problems - you must stay proactive. Here’s how to do that:
1) OPTIMIZE GUT HEALTH:“Gut Health” is more than just digestion and probiotics. It is the health of your intestinal tissues, the state of your microbiota, and the ability of your mucosal immune system to fight off harmful infections.
HOW TO DO IT: Gut health is highly individualized - there are no magic gut-support foods or probiotic supplements, because your gut has its own unique microbiome, mucosal health, and motility ability.
Seek out a functional practitioner who is trained to assess and address microbiome imbalances, dysbiosis, and inflammation. Address any findings and optimize inflammation, tissue health, and beneficial bacteria before disrupting it with slowed motility. (Click HERE to connect with me)
2) OPTIMIZE DIET: The weight lost on a GLP-1 weight loss protocol is primarily lean mass. Consuming good-quality protein and developing a strong routine for strength training will help to counter this. But when digestion is slowed, as it is with a GLP-1, there is little appetite for protein.
HOW TO DO IT: Prioritize protein-forward meals. If all you have the appetite for is a few bites of food, prioritize good-quality proteins. Click HERE to learn how to choose good-quality proteins. Most mild-to-moderately active individuals require 1.2-1.8 grams of protein per 1 kilogram of desired body weight.
3) OPTIMIZE HYDRATION: Sufficient hydration is important for bowel movements, blood pressure, and detoxification, but thirst cues are stunted when on a GLP-1.
HOW TO DO IT:Most individuals with normally functioning kidneys require a minimum of 0.5 fluid ounces per 1 pound of body weight daily. Electrolyte minerals are also essential to fluid balance within cells and tissues, especially if you may be undernourished from GLP-1 use. Click HERE to get a free pack of my favorite electrolyte supplement.
4) ADD RESISTANCE TRAINING: GLP-1 breaks down lean mass (muscle tissue), and most weight lost while on a GLP-1 weight loss protocol comes back as fat mass. Staying proactive in your strength training routine can help mitigate this loss. The best time to start this routine is before starting your GLP-1 weight loss protocol. The second best time is now.
HOW TO DO IT: Add 30 minutes of resistance training to your routine, at least 2-3 times per week. Building muscle supports insulin sensitivity long-term and will help you build up a reserve of lean mass. Working with a trainer who is knowledgeable in GLP-1 use is essential, as it may be unsafe to work out too intensely without proper nourishment. Start small, listen to your body’s cues.
5) MAKE A PLAN FOR PLEASURE: Suppressing appetite with GLP-1 use can potentially eliminate a major source of pleasure if you are a food lover like myself. Food releases dopamine and endorphins that block pain. Without this resource, you might risk seeking out other, potentially harmful sources of pleasure and comfort, such as recreational drugs, prescription pain medications, alcohol, scrolling, self-harm, video games, or unsafe sexual behaviors.
HOW TO DO IT: Make a list. Name 3-5 easy-to-access things that bring you comfort or joy, besides food. No need to reinvent the wheel, just keep it simple and fun, and try to avoid more addictive behaviors like scrolling or substances.
In the moment - When you find yourself reaching for those more harmful behaviors, or just wanting something to “take the edge off”, pick something from your list that feels accessible in that moment, and do it. “Catching” yourself in these moments and counteracting with a more positive behavior can help create new neural pathways, allowing the brain to learn new coping skills.
Staying proactive - Sometimes when we reach for these more harmful behaviors, it’s because we feel depleted - in the red, so-to-speak. Keeping your bucket full on a daily basis can help prevent those empty feelings. One way to do this is to schedule 1-3 of these items from your list into your day, every day.
Your list might include:
reading a chapter of a book
single-song dance party
gratitude journal
sitting/walking in nature (without headphones)
grab a coffee or tea at your favorite shop
jumping on a trampoline
tell yourself a silly joke (really!)
tell someone else a silly joke
was this helpful?
What’s your story navigating GLP-1 use? Has it been helpful? What’s been challenging about it, and how did you navigate it?
I hope you’ll share your thoughts in the comments below!
