What are the best diets to follow on GLP-1 medications?

When taking a GLP-1 medication, optimizing eating habits is important to get the best results — whether the goal is managing blood sugar levels, losing weight, or both. There is no one-size-fits-all GLP-1 diet, but some of the best options include high-protein, consistent-carbohydrate, plant-based, and Mediterranean diets.

A few diet types may be best suited for supporting health goals while taking GLP-1 medications. People can focus on one of these types or combine elements of each to find what works best for them.

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High protein diet

Eating enough protein is important for most people. It especially helps people who are active and those trying to lose weight or maintain a healthy weight. Some of the benefits of protein include supporting feelings of fullness, rebuilding muscle tissue, improving recovery after exercise, and many other body processes. 

Weight loss from GLP-1 medications can include both fat mass and some lean mass. Because of this, nutrition and strength training are important during treatment.Increasing protein intake can be important for maximizing fat loss while preserving muscle tissue when taking GLP-1 medications.

A 2021 study found that people taking a GLP-1 medication experienced a decrease in fat-free mass compared with people taking a placebo. Fat-free mass refers to tissue in the body that isn't fat, such as muscle, bone, and skin. This means some weight loss didn't come from excess body fat, but from lean tissue.

Research supports that eating a high-protein diet during weight loss helps prevent the loss of lean body tissue. This effect could help ensure that a larger percentage of the weight lost while taking a GLP-1 medication comes from excess body fat instead of muscle. 

There is no exact calculation for the specific amount of protein a person needs, and researchers have assessed different levels. In the referenced study, high-protein diets were listed with ranges such as 1.07 g–1.6 g of protein per kilogram of body weight, or as a percentage range such as 25%–30% of total calories per day.

When adding protein to a diet, a variety of plant-based and animal protein sources can help, such as:

• Poultry

• Fish and seafood

• Beef

• Beans and legumes

• Eggs

• Tofu

• Tempeh

Consistent carbohydrate diet

Healthcare providers often recommend a consistent carbohydrate diet for people who want to manage their blood sugar levels. A consistent carbohydrate diet involves balancing carb intake throughout the day, with the goal of keeping blood sugar levels more stable.

When a person eats foods containing carbohydrates, glucose enters the bloodstream and travels to different areas of the body. Normally, the body can bring sugar out of the blood and maintain a stable level through insulin release from the pancreas. However, in people with insulin resistance, prediabetes, or type 2 diabetes, sugar stays in the blood longer, leading to high blood sugar levels.

Eating a consistent carbohydrate diet spreads the work of processing carbs throughout the day, helping keep blood sugar more stable than eating a meal high in carbohydrates. This approach emphasizes complex carbohydrates, which promote more stable blood sugar levels. Examples of complex carbs include whole grains, vegetables, fruit, beans, and legumes.

Simple carbs are more easily digested and tend to spike blood sugar levels, so it is best to limit foods such as sugar-sweetened beverages, candy, desserts, and white bread.

The exact amount of carbs a person needs depends on individual factors. A healthcare provider or registered dietitian can advise on how many grams of carbohydrates may be best for a given person.

Plant-based diet

Whether one is taking a GLP-1 medication to support blood sugar control or weight loss, a plant-based diet may be a good fit.

A plant-based diet consists of mainly eating, or only eating, plant-based foods. Some people may choose to follow an entirely vegetarian diet, while others may simply reduce the amount of animal products they consume.

One study found that plant-based diets were associated with better gut health and insulin sensitivity. Another study found that plant-based diets may improve blood glucose levels, body weight, blood lipid levels, and blood pressure.

However, the benefits of a plant-based diet depend on the types of foods being eaten. Many foods high in calories and sugar can also be considered plant-based.

A plant-based diet typically centers most meals on whole grains, beans, legumes, fruits, vegetables, nuts, and seeds. For those who continue to include animal products, leaner options that are lower in saturated fat are a good choice.

Mediterranean diet

The popular heart-healthy Mediterranean diet could be a good diet option while taking GLP-1 medications. This diet focuses on eating primarily plant-based foods and healthy fats. 

The main foods in a Mediterranean diet include fruits, vegetables, whole grains, fish, seafood, nuts, legumes, and olive oil. 

One of the biggest challenges after weight loss is maintaining that weight loss over time. A 2020 study found people who consistently followed a Mediterranean diet were twice as likely to maintain weight loss, though the study does not prove the diet was the only reason.

For those taking a GLP-1 medication for blood sugar control, the Mediterranean diet could be a good fit. Following a Mediterranean diet is associated with better blood sugar control.

Regardless of which diet a person follows, the following principles are worth keeping in mind:

• Getting enough protein: Protein needs vary, but many weight loss plans aim for 1.2 g–1.6 g of protein per kilogram of body weight per day to help support lean mass. Protein also supports weight loss since it helps promote feelings of fullness. Lean protein sources are a good choice.

• Staying hydrated: Some people eat and drink less while taking GLP-1 medications, and side effects like vomiting, diarrhea, or constipation can make hydration more important. Try to drink fluids regularly, even if your appetite is low. 2.7 L–3.7 L of total fluids per day (from food and drinks) is generally recommended, but individual needs vary.

• Eating fiber-rich foods: Fiber-rich foods help promote fullness and may help prevent constipation, a possible side effect of GLP-1 medications. Fruits and vegetables are good sources of fiber.

• Choosing whole grain carbs: Whole grains are generally a better choice than refined grains when eating carbohydrates. Whole grains have more fiber and nutrients than refined grains.

There isn't a single best diet while taking GLP-1 medications. The answer depends on how different foods affect an individual's body and food preferences. The best diet is full of healthy foods a person genuinely enjoys eating, supported by sustainable lifestyle changes that align with long-term health goals.

A healthcare provider can help answer questions about GLP-1 medications and following a healthy eating plan.

Some examples of foods to limit while taking a GLP-1 medication include:

• Fried or greasy foods: These foods can work against weight loss goals and may increase the risk of GI side effects, such as nausea and gas.

• Sugary drinks or foods: Sugary drinks and snacks are empty calories that can work against weight loss goals and may lead to blood sugar spikes.

• Refined carbs: When grains are refined, they are stripped of nutrients and fiber. Refined carbs may also lead to blood sugar spikes.

• Alcohol: Alcohol consumption may increase the risk of gastrointestinal side effects from GLP-1 medications. Many alcoholic beverages also contain a lot of sugar.

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There isn't a single best diet for people taking GLP-1 medications, but a few key principles can guide food choices.

• Good options while taking a GLP-1 medication include high-protein, consistent-carbohydrate, plant-based, and Mediterranean diets. Ultimately, the goal is to fill a plate with healthy foods that are genuinely enjoyable to eat.

• Regardless of the specific diet chosen, prioritizing protein- and fiber-rich foods, choosing whole grains over refined carbs, and eating nutritious whole foods such as fruits and vegetables all support the goal.

• To support overall health and help minimize the risk of GLP-1 side effects, limiting fatty or greasy fried foods, sugary drinks or foods, refined carbs, and alcohol is recommended.