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.

Fit and Fun: Exciting Workout Routines for GLP-1 Users

Hello, Effecty community! Are you ready to add some zest to your fitness routine while on your GLP-1 journey? Whether you're a seasoned gym-goer or just starting to embrace physical activity, we've got some exciting, effective, and yes, fun workout ideas that are perfect for anyone on GLP-1 medications like Semaglutide or Ozempic. Let’s get moving!

Why Exercise Matters on GLP-1s:

Exercise is a fantastic partner to your GLP-1 treatment. Not only does it aid in weight management, but it also boosts your mood, improves insulin sensitivity, and enhances overall health. But forget the notion of tedious workouts – it's time to make fitness enjoyable!

1. Dance Cardio Party:

• What It Is: An energetic blend of dance and aerobic movements set to upbeat music.
• Why It’s Great for GLP-1 Users: Dance cardio is not just a calorie burner; it’s a mood lifter too. Plus, the variety of movements ensures a full-body workout.
• Getting Started: Look for dance cardio classes at local gyms or find online videos to groove at home.

2. Aqua Aerobics:

• What It Is: A low-impact, high-energy workout in a swimming pool.
• Why It’s Great: The water’s buoyancy makes it easy on the joints, and the resistance helps tone muscles. Perfect for anyone who needs a gentler approach.
• Getting Started: Many community pools offer aqua aerobics classes – it's a splash!

3. HIIT It Up:

• What It Is: High-Intensity Interval Training (HIIT) involves short bursts of intense exercise followed by rest periods.
• Why It’s Great: HIIT is excellent for improving cardiovascular health and can be modified for any fitness level.
• Getting Started: Start with basic exercises like jumping jacks, squats, or brisk walking. Gradually increase intensity and duration.

4. Yoga for Flexibility and Strength:

• What It Is: A practice that combines physical postures, breathing exercises, and meditation.
• Why It’s Great: Yoga enhances flexibility, reduces stress, and can be tailored to your comfort level.
• Getting Started: Join a yoga class or follow along with online tutorials.

5. Trail Trekking:

• What It Is: Walking or hiking along nature trails.
• Why It’s Great: It's not just good for your body; being in nature is also incredibly soothing for the mind.
• Getting Started: Find local trails suitable for your fitness level and enjoy the scenic views!

With these fun and varied workout options, exercising while on GLP-1 medications can be something you look forward to, not something you have to do. Remember, the best exercise is the one you enjoy and can stick with. So, lace-up those sneakers, grab a water bottle, and let’s get moving towards a healthier, happier you!

Share Your Fitness Journey:

Have you tried any of these workouts? Or do you have a fun fitness activity to recommend to your fellow Effecty members? Share your experiences and tips in the comments below. Let’s inspire each other on this fitness journey!

Mindfulness Tips for Effecty Customers on GLP-1 Medications

Mindful Eating Practices:

• Eat Slowly: Take time to chew your food thoroughly and savor each bite. This helps in better digestion and allows you to recognize your body's fullness cues.
• Recognize Emotional Triggers: Be aware of emotions that drive you to eat, like stress, boredom, or sadness. Acknowledge these feelings and find non-food ways to address them, such as taking a walk or practicing deep breathing.
• Tune into Hunger and Fullness Signals: Before eating, ask yourself if you're physically hungry. After meals, pay attention to how full you feel, and learn to stop eating when you’re comfortably full, not stuffed.
• Regular Practice: Incorporate short daily sessions of mindfulness meditation. Even 5-10 minutes can reduce stress and improve your relationship with food.
• Forgive Yourself: If you have an eating episode that you didn’t intend, be kind to yourself. Understand that one meal or snack doesn’t define your entire journey.
• Enjoy the Moment: Whether you're eating, exercising, or resting, fully engage in the present moment. This can increase your enjoyment and satisfaction in activities beyond eating.
• Mindful Movement: When exercising, focus on the movement and how it feels in your body rather than just the calorie burn.

Supportive Environment:

• Positive Affirmations: Surround yourself with positive affirmations or quotes that encourage a healthy mindset.

• Seek Support: Don’t hesitate to reach out to support groups, friends, family, or professionals when you need encouragement or guidance.