GLP-1s Not Enough: New Guidelines Emphasize Diet and Lifestyle for Effective Obesity Management

Developed by the American Society for Nutrition (ASN), the American College of Lifestyle Medicine (ACLM), the Obesity Medicine Association (OMA), and The Obesity Society (TOS), the guidance outlines eight key nutritional priorities designed to optimize outcomes, minimize adverse effects, and enhance long-term adherence to GLP-1 therapy.

“GLP-1s mark significant progress in obesity treatment, but medication alone isn't enough,” according to Dr. Dariush Mozaffarian, lead author and advisory chair. “To sustain benefits and avoid pitfalls like nutrient deficiencies or weight regain, a structured lifestyle approach is essential.”

The advisory emphasizes several practical considerations:

• Personalized initiation of GLP-1 therapy based on patient goals and health status
• Baseline nutrition and lifestyle assessments, including dietary habits and physical activity
• Management of common gastrointestinal side effects
• Emphasis on minimally processed, nutrient-dense meals
• Monitoring and prevention of micronutrient deficiencies
• Ensuring sufficient protein intake and resistance training to preserve muscle mass
• Leveraging diet to support weight loss
• Addressing other lifestyle factors such as sleep, stress, substance use, and social connections

GLP-1s are known to reduce appetite and promote early satiety, but can also lead to side effects like nausea and reduced nutrient intake. A recent study in Frontiers in Nutrition highlighted common deficiencies in patients on GLP-1s, including low intakes of fiber, calcium, iron, magnesium, potassium, and several key vitamins.

Dr. Fatima Cody Stanford of Massachusetts General Hospital noted that many patients prescribed these medications receive little to no nutritional counseling. “Tailored dietary guidance is crucial—not just for safety, but to help patients maximize therapeutic benefits,” she said. “Care plans must be individualized, factoring in cultural preferences, medical conditions, and lifestyle patterns.”

The advisory also recommends collaboration with registered dietitians and the use of digital tools or group-based counseling to make care more accessible and effective.

Despite proven benefits, adherence to GLP-1 therapy in real-world settings often falls short, with many patients discontinuing use due to side effects or lack of sustained support. This comprehensive guideline aims to close that gap and empower clinicians with actionable, patient-centered tools.

As obesity rates continue to climb, integrating structured nutritional counseling into pharmacologic treatment could be a cost-effective and sustainable strategy for long-term health improvement. The advisory will be a key topic at the upcoming NUTRITION 2025 conference in Orlando.

Reference:

Mozaffarian, D., Agarwal, M., Aggarwal, M., Alexander, L., Apovian, C. M., Bindlish, S., Bonnet, J., Butsch, W. S., Christensen, S., Gianos, E., Gulati, M., Gupta, A., Horn, D., Kane, R. M., Saluja, J., Sannidhi, D., Stanford, F. C., & Callahan, E. A. Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Obesity. https://doi.org/10.1002/oby.24336