Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a class of drugs widely prescribed by physicians to control blood sugar in the treatment of type 2 diabetes and are nowbeing highly acclaimed for their advantages in weight management as well. GLP-1RAs mimic the physiological effects of the glucagon-like peptide-1 (GLP-1) hormone, which is among a large group of satiety hormones naturally produced by the body and released into the intestines in response to food intake. GLP-1 signals the release of insulin by the pancreas for glucose uptake from the blood; it slows the transit of food through the stomach inducing fullness and satiety; and it mediates nutrient absorption, breakdown, and utilization.

Studies on GLP-1RAs have shown they induce a slew of other favorable biological effects as well, such as reduced inflammation, improved heart function, reduced body fat storage, and improved hypothalamic regulation of body weight and energy (calorie) expenditure. Altogether GLP-1RA therapy leads to weight loss by way of appetite control and reduced food intake, and also by way of efficient sugar, fat, and energy metabolism. However, it is critical for GLP-1RA drugs, such as semaglutide and tirzepatide, to be used in conjunction with improved diet and exercise to better guarantee results and a healthier body long term.

Specific foods and eating behaviors boost the secretion and effects of GLP-1 naturally, and may, therefore, safely enhance the effects of GLP-1RA therapy. The production of gut peptides is greatly influenced by the integrity of the gut microbiota. Food that cultivates a strong microbiota, like fermentable carbohydrates, dietary fiber, and probiotics have been found to increase secretion of GLP-1 into the gut. Tea, curcumin, cinnamon, wheat, soybean, and resveratrol have also been found to promote GLP-1 release into the gut. Furthermore, the timing of food intake throughout the course of a day has profound effects on digestion and satiety hormones, with daytime eating being significantly favorable for GLP-1 production and action. Aside from diet being a fundamental means of achieving health, good nutrition can work in tandem with GLP-1RA therapy to reach weight and health goals more efficiently and rapidly.

Nutrition and dietary behaviors can also mitigate or prevent common side effects of GLP-1RA therapy. Short-term side effects are predominantly gastrointestinal, with patients frequently experiencing nausea, vomiting, and diarrhea. A registered dietitian can help patients eat in specific ways that alleviate such gastrointestinal symptoms, in addition to monitoring the onset of more severe symptoms. Those utilizing the medications at higher doses or for longer duration, specifically for weight loss, tend to be at greater risk of more severe side effects, such as acute cholecystitis (inflammation of the gallbladder) and pancreatitis (inflammation of the pancreas).

Although GLP1-RA are acclaimed for their reduced tendency to induce hypoglycemia, it is always a risk to be considered with diabetic medications. Adequate carbohydrate, fat, and protein intake remains critical to maintain blood nutrient levels and avoid deficiencies. Medical nutrition therapy protocols can reduce the risk of mild or severe side effects; and with the help of a registered dietitian, this can be done according to the patient's personal condition and needs.

Exercising while on GLP-1RA therapy is also critical to enhance health outcomes both short-term and long-term. One study found that GLP-1RA together with habitual physical activity enhanced pancreatic insulin function more so than GLP-1RA alone, making it easier to manage blood sugar and quicker to lose weight. Weight loss often comes with muscle mass loss as the body taps into fat and protein reserves in a setting of caloric restriction. Muscle loss can lead to a reduced resting metabolic rate and, in turn, an increased risk for future weight regain.

Appropriate exercise type and frequency can slow or prevent the decrease in muscle mass during weight loss and, instead, maintain, or even build, muscle strength and one’s resting metabolic rate. In addition to making GLP-1RA therapy more effective, exercise helps one reap the benefits of weight loss without the metabolic costs that may come with it, making it easier to achieve and maintain goals long-term.

Adopting appropriate nutrition and exercise habits would allow one to eventually wean off of a GLP-1RA with significantly lower risks of rebounding to previous unfavorable weight and health status. It is preferable to avoid drug dependency and the unknowns that come with it. Pumping the body with one hormone for too long may throw off the metabolic harmony innately desired for smooth physiological function. Patients who require GLP1-RA therapy to achieve specific metabolic and weight goals must adopt nutrition and exercise practices in order to eventually, and more quickly, discontinue use and still be able to maintain the numbers they have achieved.

It is proven that good nutrition coupled with habitual physical activity is the most effective means of achieving optimal all-around health of the body (and mind) without any adverse effects when done safely. Just as importantly, nutrition and exercise education and practice give a patient autonomy over his or her own health, which itself is empowering, motivating, and promising to the individual—not to mention, relieving to the medical professional and overall health system. Nutrition and exercise lifestyle improvements while on GLP-1RA therapy will not only enhance the beneficial effects of the GLP-1RAs, it will also set patients up for health success long-term.

References
[1] Zhao X, Wang M, Wen Z, Lu Z, Cui L, Fu C, Xue H, Liu Y, Zhang Y. GLP-1 Receptor Agonists: Beyond Their PancreaticEffects. Front Endocrinol (Lausanne). 2021 Aug 23;12:721135. doi: 10.3389/fendo.2021.721135.
[2] Dungan K, DeSantis A. Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus.UpToDate. 2023 Nov.
[3] Shah M, Vella A. Effects of GLP-1 on appetite and weight. Rev Endocr Metab Disord. 2014 Sep;15(3):181-7. doi:10.1007/s11154-014-9289-5.
[4] Yaribeygi H, Jamialahmadi T, Moallem SA, Sahebkar A. Boosting GLP-1 by Natural Products. Adv Exp Med Biol.2021;1328:513-522. doi: 10.1007/978-3-030-73234-9_36.
[5] Covasa M, Stephens RW, Toderean R, Cobuz C. Intestinal Sensing by Gut Microbiota: Targeting Gut Peptides. Front Endocrinol (Lausanne). 2019 Feb 19;10:82. doi: 10.3389/fendo.2019.00082.
[6] Janus C et al. Habitual physical activity is associated with lower fasting and greater glucose-induced GLP-1response in men. Endocrine Connections. 2019 Dec; 8:12, 1607-1617. doi.org/10.1530/EC-19-0408
[7] Weiss EP, Jordan RC, Frese EM, Albert SG, Villareal DT. Effects of Weight Loss on Lean Mass, Strength, Bone, and Aerobic Capacity. Med Sci Sports Exerc. 2017 Jan;49(1):206-217. doi: 10.1249/MSS.0000000000001074.

About the Author
Marissa Zarco Hoffman is the founder of her private practice, Marissa Zarco Nutrition, where she provides personalized nutrition therapy for a wide range of needs, including weight management, athletic performance, pre- and post-natal nutrition, and medical conditions. She also conducts seminars for businesses and volunteers in the community to educate youth. Marissa holds a Master of Science in Nutrition and Exercise Physiology from Columbia University
and a Bachelor of Science in Biological Anthropology and Anatomy from Duke University. You can visit her online at www.marissazarconutrition.com or on Instagram (@MarissaZarcoNutrition).

Disclaimer: The content contained in this article has been written by Marissa Zarco Hoffman, MS, RD, LD/N of Marissa Zarco Nutrition, LLC in good faith, but is not intended to be a substitute for advice, diagnosis or treatment by a qualified medical professional. Marissa Zarco Hoffman, MS, RD, LD/N is not held liable for the use of and reliance on the opinions, estimates, forecasts and findings in this document.

Welcome to another wellness-focused discussion from Effecty! Today, we’re taking a closer look at the holistic side of weight management. While our medications are pivotal in managing weight and blood sugar levels, complementing them with holistic therapies can enhance your overall health journey. Let’s explore some of these complementary therapies and how they can support your GLP-1 experience.

Acupuncture for Appetite and Stress Management:

• Specifics: When working with an acupuncturist they can target specific points to help regulate digestion and control appetite. Impress your acupuncturist  when you ask them about points like 'ST36' (Stomach 36) and 'PC6' (Pericardium 6).
• Benefit with GLP-1s: Can help manage potential side effects like nausea and aid in appetite control, aligning well with the appetite-suppressing nature of GLP-1s.
• Finding a Practitioner: Look for acupuncturists who specialize in weight management and digestive health.

Yoga and Mindfulness for Emotional Balance:

• Specifics: Practices like 'Vinyasa Yoga' for physical health and 'Mindfulness-Based Stress Reduction' (MBSR) for mental well-being.
• Benefit with GLP-1s: Enhances body awareness, helping to distinguish between physical hunger and emotional eating; reduces stress, which can be a trigger for overeating.
• Getting Started: Join local classes that cater to all levels, ensuring a supportive environment for beginners.

Herbal Supplements for Metabolic Support:

• Specifics: Herbs like Berberine for blood sugar regulation and Milk Thistle for liver support.
• Benefit with GLP-1s: These herbs can complement GLP-1s in managing blood glucose and overall metabolic health.
• Consultation is Key: Always discuss with a healthcare provider to avoid interactions with GLP-1s or other medications.

Optimized Nutrition:

• Specifics: A diet rich in fiber, lean protein, and healthy fats; low in processed sugars and high glycemic index foods.
• Benefit with GLP-1s: A well-balanced diet enhances the efficacy of GLP-1s in weight and blood sugar control.
• Personalized Plans: A dietitian can tailor dietary plans that work synergistically with your GLP-1 regimen. Plus, be on the lookout for our popular recipe emails.

Targeted Exercise for Sustainable Weight Loss:

• Specifics: Combination of cardio (like brisk walking or cycling) and strength training (like resistance bands or weightlifting). Check out one of our pre recorded videos to kickstart your routine. (Check it out here!)
• Benefit with GLP-1s: Exercise supports the weight loss effects of GLP-1s, improves insulin sensitivity and is a great mood booster.
• Professional Guidance: A physical therapist or a certified trainer can design a routine considering your medical background and physical capabilities.

Incorporating these specific holistic practices can significantly enhance the benefits of your GLP-1 medication. At Effecty, we’re committed to supporting you in finding the perfect balance for your health, both physically and mentally.

Engage with Us:

Have you found a particular holistic practice that works well with your GLP-1 regimen? Share your story with us at Effecty – let’s inspire and learn from each other on this comprehensive path to wellness.

Navigating meals on GLP-1 medications can be a game-changer for your health, but it often means rethinking your plate. The key? Nutrient-dense, easily digestible, and protein-packed smaller portions that keep you feeling satisfied without the discomfort. That's why we're thrilled to share a recipe that's not just delicious, but perfectly tailored for your GLP-1 journey.Say hello to the Zesty Summer Salmon & Berry Power Bowl – a vibrant, light, and seriously satisfying meal that embraces fresh, whole ingredients. This isn't just a recipe; it's a strategic culinary ally designed to nourish your body and support your well-being on GLP-1s.Why This Bowl is Your GLP-1 Best Friend:This power bowl isn't just pretty; it's packed with purpose. Let's break down why it's a superstar for those on GLP-1 medications:

• Protein Powerhouse (Salmon): At its heart, this bowl features wild-caught salmon, an exceptional source of lean, high-quality protein. On GLP-1s, prioritizing protein is non-negotiable. It's crucial for triggering satiety signals, helping you feel full faster and for longer, and, critically, preserving precious muscle mass during weight loss. Salmon also provides omega-3 fatty acids, known for their anti-inflammatory benefits and support for heart and brain health.
  
• Fiber-Rich & Digestive-Friendly (Quinoa, Berries, Cucumber): The base of fluffy quinoa delivers a substantial dose of complex carbohydrates and fiber. Fiber is your digestive system's best friend, promoting regularity and contributing to sustained fullness. Coupled with the fiber in mixed berries and crisp cucumber, this bowl supports healthy digestion without feeling heavy – a common concern for GLP-1 users.
  
• Antioxidant Abundance (Berries & Herbs): Those colorful berries aren't just for taste! Strawberries, blueberries, raspberries, and blackberries are bursting with antioxidants and vitamins like Vitamin C, which combat oxidative stress and support overall immune function. Fresh mint and parsley add an extra layer of antioxidants and refreshing flavor.
  
• Healthy Fats for Satiety (Olive Oil & Salmon): A drizzle of olive oil and the natural fats in salmon provide healthy monounsaturated and polyunsaturated fats. These good fats contribute to satiety, help with nutrient absorption, and are vital for various bodily functions.
  
• Naturally Whole & Unprocessed: Every single ingredient in this bowl is a whole food, free from the additives, preservatives, and excessive sodium often found in processed foods. This makes it inherently easier for your body to digest and utilize, preventing the potential discomfort that can arise from processed ingredients on GLP-1s.
  
• Mindful Portions & Easy Digestion: This recipe is perfectly portioned for one, encouraging mindful eating. Baked salmon, light quinoa, and fresh, raw salsa are generally very well-tolerated, avoiding the greasy or heavy sensations that can be particularly unpleasant on GLP-1 medications.
  

The Recipe: Zesty Summer Salmon & Berry Power Bowl

‍Yields: 1 serving Prep time: 15 minutes Cook time: 10-12 minutes‍

Ingredients:‍

• For the Salmon:
  
  • 4-5 oz wild-caught salmon fillet
    
  • 1/2 tsp dried dill (or 1 tsp fresh, chopped)
    
  • 1/4 tsp garlic powder
    
  • Pinch of sea salt & black pepper
    
  • 1/2 lemon, thinly sliced
    
  • 1 tsp olive oil
    
• For the Quinoa Base:
  
  • 1/4 cup dry quinoa
    
  • 1/2 cup water or low-sodium vegetable broth
    
• For the Berry & Herb Salsa:
  
  • 1/2 cup mixed berries (strawberries, blueberries, raspberries, blackberries)
    
  • 1/4 cup cucumber, finely diced
    
  • 2 tbsp fresh mint, finely chopped
    
  • 1 tbsp fresh parsley, finely chopped
    
  • 1 tbsp fresh lime juice
    
  • Pinch of sea salt
    
• For Garnish (Optional):
  
  • 1 tbsp raw pumpkin seeds or sunflower seeds
    
  • Small sprig of fresh mint
    

Instructions:‍

1. Quinoa Prep: Rinse quinoa, then combine with water/broth in a small saucepan. Bring to a boil, reduce heat to low, cover, and simmer for 15 minutes until liquid is absorbed and quinoa is fluffy. Fluff with a fork and set aside.
   
2. Salmon Bake: Preheat oven to 400°F (200°C). Line a small baking sheet with parchment paper. Pat salmon dry, drizzle with olive oil, and season with dill, garlic powder, salt, and pepper. Top with lemon slices. Bake for 10-12 minutes, or until flaky.
   
3. Salsa Time: While salmon bakes, gently combine berries, diced cucumber, chopped mint, and parsley in a small bowl. Squeeze lime juice over and add a pinch of sea salt. Toss gently.
   
4. Assemble Your Bowl: Spoon quinoa into your serving bowl. Carefully place the baked salmon on top. Generously spoon the Berry & Herb Salsa over and around the salmon. Garnish with pumpkin/sunflower seeds and a mint sprig if desired.
   

Enjoy this vibrant, protein-packed, and GLP-1 friendly meal. Remember to always listen to your body's unique hunger and fullness cues, which may be more pronounced while on medication. Happy healthy eating!