Patients prescribed the new weight loss molecules need professional support to avoid potential nutritional deficiencies and muscle loss, warn British researchers.
Molecules like semaglutide and tirzepatide – which are marketed under names like Ozempic, Wegovy and Mounjaro – suppress appetite, increase feelings of fullness and reduce cravings by mimicking the natural hormone GLP-1, which is normally released into the bloodstream in response to eating.
It is therefore more important than ever to ensure that these patients benefit from optimal nutrition, commented Professor Jean-Philippe Drouin-Chartier, of the NUTRISS Centre at Laval University.
“We know very little about the effects of these medications on nutritional status,” admitted Professor Drouin-Chartier. “We have many legitimate questions considering the significant effects of these medications on the amount of food people eat in a day.”
These medications can reduce calorie intake by 16 to 39 per cent. Available data also suggest that lean mass, including muscle, can account for up to 40 per cent of the total weight lost during treatment.
However, little information is available regarding the impact of these molecules on diet quality, protein intake, or micronutrient adequacy. Observations do suggest, however, that these patients consume excessive amounts of fat, particularly saturated fat.
Insufficient micronutrient intake can expose individuals to various health problems, such as fatigue, an inadequate immune response, hair loss, and osteoporosis. The loss of lean mass, primarily muscle in most cases, increases the risk of weakness, injury, and falls.
“It’s one thing to eat less in terms of quantity, and that will obviously lead to weight loss,” said Professor Drouin-Chartier. “But the other aspect is that, regardless of the number of calories we eat in a day, quality is crucial and will be a determining factor in the health effects of our diet. Good nutritional quality is essential to health, no matter how much food we eat.”
Without proper nutritional advice and support from healthcare professionals, the University of Cambridge researchers stressed, there is “a real risk that reducing food intake will compromise the quality of the diet, meaning that (patients) may not be getting enough protein, fiber, vitamins and minerals essential for maintaining good overall health.”
“These people need to be supported in a multidisciplinary, multiprofessional way,” said Professor Drouin-Chartier, who is conducting his own research on the diet of patients prescribed a GLP-1 inhibitor. “Nutritionists need to be involved in monitoring these individuals to manage the effects of the medication.”
Moreover, he added, it is still not known for certain whether some of the observed side effects, such as nausea or digestive problems, are caused by the medications themselves or by the patients’ diet. Professional guidance could therefore help to shed some light on the matter, said Professor Drouin-Chartier.
But we still need the necessary resources to offer this support to patients who need it, whether it’s to learn how to prepare their own meals or to make better choices at the grocery store, the researcher added.
“Are we capable of supporting all those who want to use these medications in the best possible way with multidisciplinary support?” asked Professor Drouin-Chartier. “For me, asking the question is answering it, so we need to target the most vulnerable people.”
Eating less is one thing, but eating better is much more complex, he concluded.
Until reliable scientific data is available, British researchers suggest drawing inspiration from the guidelines given to patients undergoing bariatric surgery to support those prescribed GLP-1 antagonists.
The findings of this literature review were published by the journal Obesity Reviews.
–This report by La Presse Canadienne was translated by CityNews
