GLP-1 medications such as Ozempic, Wegovy, Mounjaro, Zepbound and Saxenda are rapidly transforming how we treat obesity and type 2 diabetes. Originally developed to mimic a hormone called glucagon-like peptide-1, they help to regulate appetite, blood sugar and insulin sensitivity.

Whilst physical evidence (we've all seen the celebrity 'before and after' photos!) and numerous clinical trials have already demonstrated these drugs can result in meaningful weight loss, enhanced glucose control, improved cardiovascular health and possible neurological benefits - it’s important to be clear: they are not a silver bullet. They’re not the all-in-one solution to the growing list of modern health concerns we’re being led to believe they solve.

What's not being discussed or addressed is the nutritional deficiencies that often accompany severe calorie intake, and the negative implications for the whole body systems that are currently being overlooked.

As a Naturopathic Nutritionist, I work with clients to bridge the gap between taking these drugs and maintaining longer-term health —helping them feel well during and especially after, GLP-1 use.

What Is GLP-1?

GLP-1 is a hormone naturally produced by the L-cells of the intestine in response to food. It has receptors found throughout the body—particularly in the gut, pancreas and brain.

GLP-1 plays several roles:

• Stimulates insulin release
• Slows gastric emptying
• Promotes satiety
• Lowers blood glucose
• Supports the brain’s appetite and reward centres

GLP-1 RAs, like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound), enhance or mimic the effects of this hormone—but in a much longer-lasting and more potent way. However, despite their powerful metabolic effects, these medications can introduce new challenges:

• Nutrient deficiencies from prolonged low food intake
• Constipation, bloating, reflux due to slowed digestion
• Loss of muscle mass if protein or physical activity is inadequate
• Altered gut motility and risk of SIBO (small intestinal bacterial overgrowth)
• Rebound weight gain and dysregulation after medication is discontinued

How Nutrition Supports Every Stage of the GLP-1 Journey

Whether you’re starting a GLP-1 medication, currently using one, or preparing to come off, nutrition is key to CONTINUED success. Nutrition plays a central role in supporting gut function, metabolic resilience, mental wellbeing and quality of life.

1. Fibre and the Microbiome: Fuel for Satiety, GLP-1 and Butyrate.

Fibre intake often drops on GLP-1 medications due to reduced appetite, increasing the risk of constipation, microbial imbalance and SIBO (Small Intestinal Bacteria Overgrowth - more on that later)

I always say "Fibre is your friend!" It does far more than just regulate bowel movements—it feeds gut bacteria, which in turn produce short-chain fatty acids (SCFAs) like butyrate, acetate and propionate.

These SCFAs:

• Stimulate natural GLP-1 secretion from L-cells
• Promote satiety and reduce inflammation
• Support gut integrity and protect against leaky gut
• Influence thyroid hormone regulation and mood via the gut-brain axis

To maintain gut health and natural appetite regulation, I recommend simple ways to increase fibre:

Adding ground flaxseed, chia, and psyllium husk to your food (overnight oats/topping yoghurt etc.)
Using cooked and cooled lentils, beans and potatoes (resistant starch) as a base for a meal.
Oats, barley and rye (beta-glucans). Overnight oats are easy to prepare and easy to eat in small batches.
Brassicas, leafy greens and rainbow-coloured vegetables. Making at least 1/2 your plate vegetables will massively increase your fibre intake.

Diversity matters—dietary fibre from a wide variety of plants promotes microbial diversity, which directly influences butyrate production, satiety, and long-term metabolic health.

2. Micronutrients, Protein and Muscle Preservation

GLP-1s can reduce appetite to the point where people under-consume not just calories, but essential nutrients:

• Fat-soluble vitamins (A, D, E, K)
• Magnesium, potassium, calcium
• B vitamins and iron
• Protein

These nutrient deficiencies can lead to low energy, hormone disruption and impaired detoxification. More critically, lean body mass governs metabolic rate, which determines how quickly you burn calories and influences how fast you lose weight. This can decline rapidly without adequate protein or resistance training. Maintaining muscle is essential for long-term metabolic health—and nutrition is central to protecting it.

To optimise important nutrient intake, I would recommend:

• Protein intake (20–30g per meal, adjusted to weight/activity). Plant protein has the additional benefit of fibre. 
• Making each small meal count by making it as Nutrient-dense as possible, especially incorporating as much plant food into your meals to maximise fibre and nutrient content.
• Include supplements to fill targeted nutritional gaps (a good multi-vitamin)

3. Gut Motility and SIBO Risk: When Digestion Slows Too Much

GLP-1 medications reduce the biochemical action we call the migrating motor complex (MMC); this is a rhythmic pattern that sweeps food and bacteria through the small intestine. However, when the MMC slows, food and bacteria stagnate, which can develop into SIBO (Small Intestinal Bacterial Overgrowth).

Undigested food staying too long in the small intestine creates an ideal environment for bacteria to overgrow. This can lead to symptoms like bloating, gas, diarrhoea, nutrient deficiencies and even systemic symptoms like fatigue or joint pain.

Left unchecked, SIBO can damage the gut lining, contributing to 'leaky gut' (see my blog on this) and further metabolic disruption. This is why supporting digestive health and motility is essential when using GLP-1 medications — and where personalised nutrition plays a powerful role.

I support gut motility with:

• Bitter herbs or food-based bitters to stimulate digestive secretions
• Meal spacing (3–4 hours between meals) to allow MMC activity
• Hydration: this is fundamental as the GLP-1 drugs can reduce the sensation of thirst, potentially leading to decreased fluid intake. Dehydration not only exacerbates some of the side effects of GLP-1 medications, such as nausea, fatigue, but more importantly, contributes significantly to constipation.  Sipping 1 litre of water throughout the day and having other hydrating fluids such as mineral-rich broths or herbal teas will substantially help.

4. Mental and Emotional Health: The Missing Piece

GLP-1s interact with the hypothalamus and reward centres of the brain—which can alter emotional connections with food, appetite perception and even mood.

Some clients have expressed:

• Reduced enjoyment of food
• Emotional blunting leading to feelings of numbness, detachment, or indifference.
• A shift in cravings or food aversions
• Difficulty identifying hunger/fullness cues

Through nutrition, mindful eating and lifestyle strategies, I help clients reconnect with the emotional and sensory aspects of food, regain confidence and build sustainable eating habits they can enjoy—medicated or not.

5. The Rebound Phase: Life After GLP-1s

Appetite often returns—rapidly—when GLP-1 medications are discontinued. Without nutritional and lifestyle strategies in place, this can lead to:

• Overeating and digestive distress
• Emotional frustration
• Weight regain
• Renewed insulin resistance.

Adopting healthy eating patterns whilst on the medication will significantly reduce the rebound weight. Being able to continue to maintain the weight loss without medication is the ultimate aim and this is utterly achievable. It comes down to reconnecting with food and seeing it as an incredible fuel for your body.  Feeding your body properly will not only help you maintain the weight loss but it will continue to have other profoundly positive impacts on  your health that perhaps you hadn't considered: anti-ageing, increased energy, emotional well-being, to name but a few. Like a car, we all need the right kind of fuel to run at our optimal best...........Let's feed ourselves well!

How I Support Clients on GLP-1 Medications

Nutrition is the foundation when coming off GLP-1 medications and these are some of the supportive strategies I would recommend:

Protein + fibre at every meal.

Hydration: 1 + litre water a day, broths or herbal teas.

Resistance training 2–3x per week to rebuild muscle mass and improve metabolic rate.

Maintaining satiety through whole foods.

 Developing healthy sleep patterns and reducing stress through exercise, meditation, yoga.

Prebiotic-rich foods to feed GLP-1-supportive bacteria like Faecalibacterium prausnitzii and Lactobacillus reuteri