Key takeaways:

• The guideline has eight points of emphasis on specific elements of lifestyle medicine.
• PCPs can use them to support their patients.

ORLANDO — Primary care providers can use a new clinical advisory guideline to nutritionally support patients who are using GLP-1 receptor agonists, according to experts.

The joint advisory was developed by four major medical organizations: the American Society for Nutrition, the American College of Lifestyle Medicine, the Obesity Society and the Obesity Medicine Association. It was published in the organizations’ medical journals: American Journal of Clinical Nutrition, American Journal of Lifestyle Medicine, Obesity and Obesity Pillars. A few of the leading researchers will discuss the advisory at the annual NUTRITION meeting.

GLP-1 receptor agonists may significantly impact a patient’s gastrointestinal function and appetite, Fatima Cody Stanford, MD, MPH, MPA, MBA, MACP, FAAP, FAHA, FAMWA, FTOS, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School, told Healio.

“These medications often lead to reduced appetite, early satiety and sometimes gastrointestinal side effects such as nausea,” Stanford, one of the researchers also presenting on the advisory, said. “Therefore, it is crucial for clinicians to consider a patient’s nutritional needs to ensure they maintain adequate nutrient intake and avoid deficiencies. Proper nutritional guidance can help patients optimize the benefits of GLP-1 therapy while minimizing potential adverse effects.”

A study recently published in Frontiers of Nutrition found that individuals on GLP-1 therapy had insufficient intakes of key nutrients like fiber, calcium, iron, magnesium, potassium and vitamins A, C, D and E.

Most patients who are prescribed GLP-1 receptor agonists do not receive appropriate nutritional counseling, despite the known benefits, so the advisory “seeks to fill that gap with practical, interdisciplinary guidance for implementation in clinical practice,” according to a press release.

The advisory stresses the importance of:

• careful baseline nutritional assessment;
• maximizing weight reduction with a good diet;
• patient-centered initiation of therapy;
• personalized diets that are minimally processed and nutrient-dense;
• lean mass preservation via strength training and adequate protein intake;
• gastrointestinal adverse effect management;
• micronutrient deficiency prevention; and
• promoting other positive lifestyle changes in several areas — like sleep, exercise, substance use, mental stress and social connections — to ensure long-term success.

There are a few ways PCPs can offer nutritional counseling to patients who need it, like “by collaborating with registered dietitians who specialize in diabetes and weight management,” Stanford said.

“They can also provide educational resources and tools to help patients understand portion control, balanced meal planning and the importance of nutrient-dense foods,” she said. “Regular follow-up appointments can help monitor progress and make necessary adjustments to the nutritional plan.”

An essential element of managing patients on GLP-1s is individualizing care, Stanford said.

“While broad dietary guidelines, such as emphasizing whole foods, lean proteins and fiber-rich vegetables, can be beneficial, each patient’s needs, preferences, and responses to the medication can vary significantly,” she said. “Personalized plans that consider the patient’s lifestyle, cultural preferences and specific health goals are more likely to be effective and sustainable.”

Stanford stressed that PCPs should stay informed about the latest guidelines and research on GLP-1 therapies and nutrition because interdisciplinary collaboration and continuous education “can greatly increase patient care and outcomes.”

“The take-home message for PCPs is to recognize the importance of integrating nutritional counseling into the management plan for patients on GLP-1s,” she said. “By doing so, they can enhance the therapeutic outcomes of the medication, improve patient satisfaction and reduce the risk of nutritional deficiencies. Collaboration with dietitians and regular patient follow-ups are key components of successful management.”

For more information:

Fatima Cody Stanford, MD, MPH, MPA, MBA, MACP, FAAP, FAHA, FAMWA, FTOS, can be reached at [email protected].

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