GLP-1 medications like Ozempic, Wegovy and Zepbound have made headlines for their impact on weight loss and blood sugar control. But according to a new article in JAMA Internal Medicine, these drugs are only part of the picture.
Experts from Brigham and Women’s Hospital, Mass General Brigham and Harvard Medical School say lifestyle still plays a critical role and ignoring it may lead to muscle loss, nutrient deficiencies and other long-term issues.
“Although GLP-1 receptor agonists (GLP-1 RAs) and dual GLP-1/GIP receptor agonists (GLP-1/GIP RAs) offer clinically meaningful benefits for individuals with obesity or overweight with weight-related complications, they are not stand-alone therapies,” the authors wrote.
Instead, they offer a three-part strategy for patients and clinicians:
Prioritize muscle health: GLP-1s may reduce both fat and lean mass. That’s why the authors recommend resistance training and adequate protein intake to support strength and physical function. This is especially important for women, older adults and people with type 2 diabetes, who are more likely to experience muscle loss.
Manage common side effects: Digestive symptoms like nausea and constipation can derail treatment. Small, low-fat meals, fiber-rich foods and staying hydrated can help. For some patients, temporary food texture changes, like focusing on softer foods, can improve tolerance early on.
Monitor nutrient intake: Because GLP-1s reduce appetite, many people naturally eat less but that can mean not getting enough calcium, vitamin D, vitamin B12, iron and other essential nutrients. The authors recommend routine monitoring, especially in people following restrictive eating patterns or taking medications that affect nutrient absorption.
“Health care professionals must work collaboratively with patients to ensure that healthy dietary and physical activity habits are maintained or adopted when these medications are prescribed,” they wrote.
The authors also note that lifestyle guidance is often overlooked in clinical settings, leaving patients without the support they need to maintain long-term health.
The authors report grant support from the National Institutes of Health and the Department of Defense. One author serves as an unpaid advisor to the American Heart Association. No commercial funding was reported.