A Dietitian’s role when taking weight loss medication

Staying healthy before, during and when stopping weight loss medication means you can lose weight safely, minimise any side effects and achieve sustainable weight loss to avoid weight regain.

Weight loss medications go by names such as GLP-1s, GLP-1 receptor antagonists, weight loss medications or incretin. They work by increasing insulin release , stabilising hunger, delaying stomach emptying and reduce sugar production in the liver

Talk to your doctor, healthcare team, or community pharmacist

before starting medications for obesity. They will check if the

medications for obesity are safe for you and if it affects other

medicines, you may be taking

Before, commencing weight loss medication, a dietitian will help you create healthy lifestyle habits by asking you some questions in 4 key areas bellow:

1.    FOOD and DRINK- Are you eating daily regular meals? Are you eating variety and balance to achieve good nutrition? Are your food portions within the required groups enough to minimise any side effects but achieve safe and effective weight loss? Are you drinking enough to stay well hydrated?

2.    MOOD-Are you eating for emotions or are you eating for hunger? Do you know the difference between hunger symptoms and eating for emotions? If you feel you are eating for emotions or always feeling hungry speak with a dietitian first to manage this. A dietitian can help you manage any triggers to eating for emotions alongside referring you to a psychologist or a counsellor if needed.

3.    SLEEP- Are you having sleep problems? Like all health care professionals, dietitian can advise, as lack of enough sleep has been known impact on your appetite.

4.    ACTIVITY – Are you able to do any activity either at home or outdoors or in the gym? A dietitian can recommend you seek safe active advice with professionals expert in supporting you. Alongside a physical expert or physiotherapist, a dietitian can offer you support for achieving a balanced diet and have enough energy to continue staying active.

Writing a food and lifestyle diary can help you reflect and start making slight changes to create healthy food and lifestyle habits before you commence weight loss medication.

During commencing weight loss medication, a dietitian will collaborate closely with you to help you manage your symptoms:

Feeling full? – try 6 small meals rather than 3 meals or even skipping meals. Avoid long gaps between meals. Use a smaller plate to help

Are you restricting food? A dietitian can you help you achieve variety to help you avoid any nutritional deficiencies and eating balanced meals and healthy snacks

Nausea and vomiting?

Do you have constipation or diarrhoea?

Do you burp with an unpleasant smell?

Have you noticed any gut problems?

These symptoms are common when you start taking weight loss medication or when you increase dose.

A dietitian can help you manage these symptoms and help your gut feel better: promoting foods and drinks that are known not to upset your gut, limit food and drinks that are energy dense but not nutritious , slowing down your eating by chewing your food well and which order to eat , having enough food high in fibre and how to stay well hydrated .

Activity during weight loss medication – You may lose muscle as well as body weight making your body weak. A dietitian can help advice you to have enough protein

When you stop taking medications, it is important to avoid weight regain. A dietitian can help you manage weight maintenance once you have achieved your target weight by creating healthy food and lifestyle habits and address any emotional difficulties that may have led you to gain weight in the past.

10 food and lifestyle tips during and after weight loss medication

1.    Eat a mix of healthy food daily

2.    Choose foods high in fibre – wholegrain bread, brown rice, wholewheat pasta, fruit and vegetables, beans, lentils, and nuts

3.    Try to have protein rich foods in your main meals- Your dietitian can advice on how much protein to have

4.    Have regular meals – small frequent meals during weight loss medication

5.    Avoid foods high in fat and have some healthy fats – olive /rapeseed oil, nuts, avocado, seeds, oily fish, olive /rapeseed oil spreads

6.    Stay well hydrated -limit alcohol, sugary and high caffeine drinks which can disturb sleep, aggravate gut problems

7.    Keep active include some strengthening activity

8.    Ensure sleep is not disturbed and have fixed bed and wake times – limit screen times

9.    Manage your emotions with relaxing activities that keep you calm

10.                      Supplements can be helpful if you have been struggling to eat, feel less hungry and have been suffering with dizziness, tiredness, low mood, and loss of hair

Writing a diary to self-monitor your food and drink, mood, activity, and sleep can help you create realist changes and develop long term healthy habits.

Weight loss medications do not address thoughts that led to unhealthy views of food and disordered eating. You may need support with weight loss medication avoid going it alone. Remember if you feel unwell with side effects e.g pain or difficulty eating, speak to your prescriber/GP/ health care team/ community pharmacist

Reference BDA obesity specialist group- Medications for obesity - a guide to eating and living well while taking medications for obesity

For specialized Diet and Nutrition advice seek the advice of a Professional Dietitian and Nutritionist Tabby Kabeer