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Expert Consensus: Nutrition and Lifestyle Recommendations for People Taking GLP-1 Weight Loss Drugs

evidence
The takeaway

An international expert panel developed 52 consensus statements providing practical nutrition and lifestyle guidance for people using GLP-1-based therapies for weight management, from pre-treatment through maintenance and discontinuation.

52 consensus statements

Practical recommendations covering pre-treatment, active weight loss, maintenance, and discontinuation phases of GLP-1 therapy for obesity

What the researchers found

The expert panel produced 52 consensus statements covering nutritional and lifestyle management for patients on GLP-1-based therapies (GBTs). Key areas addressed include: nutritional factors related to obesity and body composition, physical activity recommendations, and management of common gastrointestinal symptoms (nausea, vomiting, diarrhea, constipation).

The recommendations are organized by treatment phase: before starting a GBT, during active weight loss, during weight maintenance, and upon GBT discontinuation. The panel emphasized that GI side effects, obesity-associated nutritional insufficiencies, and poor long-term adherence may limit the health benefits of these drugs without proper supportive care.

Why it matters

Millions of people are now taking GLP-1 drugs for weight loss, but most clinical trial data focuses on drug efficacy rather than day-to-day supportive care. This consensus fills a critical practice gap by providing healthcare professionals with structured guidance on how to help patients optimize their results and manage side effects throughout their treatment journey.

How the study worked

An initial scoping review searched PubMed, Embase, Web of Science, Cochrane, and Medline for publications from January 2021 through June 2025. An international multidisciplinary panel then used a modified Delphi process — a structured method where experts independently rate statements through multiple rounds until consensus is reached — to develop clinical practice recommendations.

What this study cannot tell us

The consensus statements were primarily derived from indirect evidence — existing guidelines for bariatric medicine nutrition therapy and clinical experience — rather than direct evidence from studies specifically conducted in GLP-1 therapy patients. The authors explicitly note that direct evidence is urgently needed. Consensus-based recommendations may reflect expert opinion rather than proven best practices.

How to read the evidence

This is an expert consensus statement developed using a modified Delphi methodology. While it represents structured expert opinion from an international multidisciplinary panel, the recommendations are based primarily on indirect evidence rather than direct clinical trials in GLP-1 therapy patients.

When this study was published

Published in 2026 with a literature search through June 2025, this is a very current resource reflecting the latest thinking on supportive care for GLP-1 therapy users.

The bigger picture

As GLP-1-based obesity treatments scale to tens of millions of users globally, the need for comprehensive supportive care protocols becomes urgent. This consensus represents one of the first systematic attempts to standardize nutritional and lifestyle recommendations specifically for GLP-1 therapy users, moving beyond the drug itself to the whole-person treatment approach.

Questions still open

  • What specific dietary strategies are most effective for minimizing GI side effects during GLP-1 dose escalation?
  • How should nutritional supplementation be tailored for patients on long-term GLP-1 therapy to prevent deficiencies?
  • What are the best strategies to maintain weight loss and nutritional status after discontinuing GLP-1 therapy?

Common questions

Why do people on GLP-1 drugs need special nutrition guidance?
GLP-1 drugs like semaglutide cause significant appetite reduction, which can lead to very low food intake and potential nutritional deficiencies. Common GI side effects (nausea, vomiting, constipation) can further limit food variety and intake. Rapid weight loss also carries risks like muscle loss and bone density reduction, making targeted nutrition and exercise strategies important for preserving health during treatment.
What happens if you stop taking a GLP-1 weight loss drug?
Weight regain is common after stopping GLP-1 therapy, which is why the expert panel specifically included recommendations for the discontinuation phase. The consensus emphasizes that nutritional and lifestyle strategies should be in place before, during, and after treatment to help maintain weight loss and nutritional status even if the medication is stopped.

Read the original research

Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 - based therapies: An expert consensus statement using a modified Delphi approach.

Obesity pillars, 17, 100228

Citation

Sievenpiper, J L; Ard, J; Blüher, M; Chen, W; Dixon, J B; Fitch, A; Gigliotti, L; Khunti, K; Lecube, A; Lean, M E J; Mittendorfer, B; Pfeiffer, A F H; Ryan, D H; Vilsbøll, T; Van Gaal, L F. (2026). Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 - based therapies: An expert consensus statement using a modified Delphi approach.. Obesity pillars, 17, 100228. https://doi.org/10.1016/j.obpill.2025.100228