As a Registered Dietitian, I’m working with more clients on GLP-1 medications than ever before. While Ozempic, Wegovy, and Mounjaro are remarkably effective for weight loss, they create a unique nutritional challenge: how do you eat enough to stay healthy when you have virtually no appetite?
Let me walk you through a practical nutrition protocol that addresses the most common issues I see.
The Muscle Loss Problem
Here’s what keeps me up at night: studies show people on GLP-1s can lose 25-40% of their weight from lean muscle mass, not just fat. That’s a metabolic disaster. Muscle is your metabolic engine: lose it, and you’ll struggle to maintain weight loss long-term.
The solution is non-negotiable protein prioritization.
Aim for 100-150 grams of protein daily (or 0.7-1.0g per pound of goal body weight). This sounds impossible when you can barely finish a few bites, but it’s achievable with a little bit of good ole’ strategy:
- Front-load protein at every eating opportunity. Eat your protein source first, before anything else touches your plate.
- Choose dense protein sources: Greek yogurt (20g per cup), cottage cheese, eggs, lean meats, protein shakes
- Divide into 4-5 small servings rather than three meals you can’t finish
- Use liquid calories strategically: Protein shakes, bone broth with collagen, Fair-life milk (or other ultra-filtered milk)
If you only eat 600 calories in a day, 400+ should come from protein. Yes, really.
Managing the Side Effects
Nausea: This is the most common complaint. Combat it by:
- Eating small amounts every 2-3 hours instead of traditional meals
- Avoiding high-fat foods that slow digestion even more
- Choosing bland, easy-to-digest proteins: chicken breast, white fish, eggs
- Sipping ginger tea or adding fresh ginger to smoothies
- Taking your medication at night so nausea hits during sleep
Constipation: Slowed gastric emptying plus eating very little is a recipe for digestive backup.
- Prioritize fiber even when you don’t feel like eating (more on this below)
- Stay hydrated: aim for 64+ oz water daily
- Include prunes, kiwi, or ground flaxseed
- Consider magnesium oxide or citrate supplementation (discuss with your doctor)
Gastroparesis/Extreme Fullness: Some people develop severe delayed stomach emptying.
- Choose smaller, more frequent mini-meals
- Avoid raw vegetables and high-fiber foods that sit in your stomach
- Focus on easily digestible proteins and cooked vegetables
- Eat slowly and stop at the first sign of fullness
What Your Plate Should Look Like
Since you’re eating such small volumes, every bite must count nutritionally. Here’s a helpful framework that can help serve as some inspiration (keep in mind everyone’s needs are different though):
Meal 1 (Breakfast):
- 2-3 eggs or Greek yogurt with berries
- Small serving of avocado or nut butter for healthy fats
Meal 2 (Mid-morning):
- Protein shake with protein powder, spinach, berries, and chia seeds (fiber!)
Meal 3 (Lunch):
- 3-4 oz grilled chicken or fish
- ½ cup roasted vegetables
- Small portion of quinoa or sweet potato
Meal 4 (Afternoon):
- Cottage cheese with cucumber or
- Handful of almonds with string cheese
Meal 5 (Dinner):
- 3-4 oz lean protein (whatever sounds tolerable)
- Vegetable soup or cooked greens
- Possibly skip if genuinely not hungry
The Fiber Equation
You need 25-30g of fiber daily to prevent constipation and support gut health, but high-fiber foods are filling and hard to eat in volume. Keep in mind some individuals experience worsening constipation with too much fiber, so go slow when adding it into your diet. Strategic choices:
- Chia seeds in smoothies (10g per 2 tablespoons)
- Raspberries or blackberries (8g per cup)
- Lentils or beans in small portions (7-8g per ½ cup)
- Ground flaxseed on yogurt (3g per tablespoon)
- Psyllium husk in water if food-based fiber isn’t enough
Supplements to Consider
When eating is difficult, certain supplements become critical:
- Multivitamin: Non-negotiable to prevent deficiencies
- Vitamin B12: Especially if eating minimal animal products
- Calcium and Vitamin D: Bone health protection during rapid weight loss
- Omega-3s: If you’re not eating fatty fish
- Electrolytes: Especially if experiencing nausea/vomiting
The Bottom Line
GLP-1 medications are tools, not magic bullets. Your nutrition strategy can make the difference between healthy, sustainable weight loss with preserved muscle mass and metabolic damage that makes maintenance impossible.
Treat eating like medication: scheduled, intentional, and protein-focused. Your future self will thank you!
Note: This information is for educational purposes only. Always discuss with your healthcare provider and registered dietitian when using GLP-1 medications!
