Taking a GLP-1? You need to make these changes, too

It may seem like GLP-1s are star solo acts. The medications can help people eat less without feeling hungry, resulting in some pretty considerable weight loss. But in order to perform, they actually need to share the stage — with healthy habits like moving your body more, eating a balanced diet, prioritizing sleep, and managing stress. Read on to better understand why those kinds of habits are so important to both weight loss and overall health.

How do GLP-1s work?

GLP-1 agonists, which include Wegovy (semaglutide) and Zepbound (tirzepatide), are the newest drugs to be FDA-approved for weight loss. They work by mimicking a gut hormone that your body naturally releases after you eat. As a result, they help slow down how fast food moves from the stomach, increase feelings of fullness, and stabilize blood sugar levels and decrease sense of hunger by acting on appetite and satiety center in the brain. (That last bit is what they were originally developed to do, as a treatment for type 2 diabetes.)

For those who have tried to lose weight through tweaks to diet and exercise without much luck, GLP-1s can be game-changing. “The rationale for using these medications is to help sustain more weight loss than can be done through lifestyle interventions alone,” says Dr. Ivania Rizo, M.D., the director of obesity medicine at Boston Medical Center. “Because people feel full after only consuming a small amount of food, these medications can benefit people who need to lose weight for health reasons.”

Why healthy habits are important if you’re taking a GLP-1

Studies that show promising results — like that weekly semaglutide injections can help people lose 15% of their body weight over a 17-month period — all had participants follow a reduced-calorie diet and exercise.

“People who want the successful results of those research studies need to mimic what those participants did, which is change their diet and add exercise,” says Dawn Jackson Blatner, RDN, a registered dietitian nutritionist based in Chicago.

This is also a good time to remember why doctors recommend certain people lose weight in the first place. “Ultimately, the goal of losing weight is to feel good and be healthier long-term,” says Blatner. “In order to truly reach that goal, you need a holistic approach.” That means that in addition to taking the medication, you include behaviors like managing stress, getting enough sleep, eating well, and being physically active daily — habits you can get help with through the WeightWatchers GLP-1 Companion Program, which is designed to help people feel their best while taking weight-loss medications. “All these things can impact your weight, but they can also improve other aspects of your well-being like your heart health and immune system,” says Blatner.

Rizo explains that while lifestyle changes alone may work for many people, they don't work for everyone. Healthy lifestyle changes and GLP-1s complement each other by treating obesity on multiple fronts. Believing that you should only rely on lifestyle interventions “implies that obesity is the result of ‘bad behavior’ or ‘failure of willpower,’” she says. “Now that we understand the physiology of obesity, we know there are complex biological and environmental aspects at play, so we should utilize multiple interventions for obesity when appropriate.

This multi-pronged approach to weight loss is supported by the World Health Organization’s new guidelines. They recommend that those on a GLP-1 pair the medication with behavior changes, like having a healthy diet and increasing physical activity, and that they view the medication as a long-term treatment for obesity.

How can you prioritize healthy habits while taking a GLP-1?

Here are some ways to improve your overall wellness while taking these meds:

1. Focus on food quality

People on GLP-1s often notice they have a significantly reduced appetite (it’s one of the main mechanisms that leads to weight loss). This has its pros and cons. On the one hand, when you’re not hungry, you can make more intentional decisions about your diet. “Weight-loss drugs can help take that ‘emergency’ hunger feeling out of eating decisions,” says Blatner.

But on the other hand, when you’re not very hungry, ensuring you get enough nutrients to maintain good health may be challenging. “Since people on GLP-1s are eating less, the quality of each bite becomes more important,” says Blatner.

This means prioritizing foods rich in vitamins, minerals, and other important nutrients that your body needs to thrive. To do this, make sure something from each of these categories is on your plate at most meals: complex carbs (e.g., quinoa, brown rice, oats, potatoes); produce (like spinach, berries, tomatoes); moderate servings of healthy fats (such as avocado, seeds, nuts, and fatty fish like salmon); and protein (think: chicken breasts, lean beef, beans, Greek yogurt, and tofu), which is key for mitigating muscle loss.

Nothing’s off limits, just be mindful that fried foods, packaged snacks, and desserts don’t crowd out more nutrient-rich foods, says Blatner. Plus, fried and greasy foods and foods high in sugar can increase symptoms that can occur with these medications, like nausea.

2. Prioritize daily activity

Grab any chance to move your body that you can. While the World Health Organization (WHO) recommends at least 150 minutes a week of moderate-intensity aerobic activity (like brisk walking or an easy bike ride), that can be broken up into much smaller increments. The good news: Every kind of physical movement counts, like taking the stairs at the office, walking the dog, or biking to see a friend.

Also, don’t forget about strength training when taking a GLP-1. “Any weight loss leads to a decrease in lean muscle mass. Therefore it is important to do resistance training,” Rizo notes. New to strength training? Try basic movements like bodyweight squats to a chair (slowly sit down and stand back up again) or incline push-ups (with your hands on a table or kitchen counter). And if you’re new to exercise entirely, Rizo recommends checking in with a healthcare provider before starting a new physical activity routine to get the all-clear.

3. Stick to a sleep schedule

Lack of sleep has been linked to many chronic health problems, including high blood pressure, diabetes, and depression. Plus, it may make weight-loss interventions (including medications) less effective by impacting hormone levels related to hunger and fullness. In addition to talking to your healthcare provider about any ongoing sleep struggles, Blatner says there are a number of other things you can do to get more restful sleep.

For one, wake up and go to bed around the same time each day, even on weekends. This can be a change for people who usually sleep in on Saturdays and Sundays. “It’s easier to do when you keep in mind that weekend mornings can be relaxed and chill, not your usual weekday hustle,” Blatner says. It might also help to use a sleep mask and earplugs, even if you don’t think you are particularly disturbed by light or noise. “Research suggests these interventions may help sleep by decreasing cortisol — a stress hormone — and increasing melatonin, a sleep hormone,” Blatner says.

4. Manage your stress

Speaking of cortisol, if stress hormones are constantly circulating in the body, that can make it harder to lose weight by both making you hungrier for comfort foods and increasing the amount of belly fat you hold on to. They can also increase the risk of other health issues, including heart attack, high blood pressure, and stroke, so it’s vital to find healthy stress reducers that work for you.

While the behaviors mentioned above, like getting regular exercise and sleeping well, can help your body manage stress better, don’t stop there. “Meditating, prioritizing what you need to accomplish most, and maintaining strong relationships can also help,” says Blatner. Research shows that having close, intimate relationships can make you more resilient when faced with stress and actually reduces how much cortisol your body produces. Having regular contact can help foster closeness, so try setting up standing dates with your closest friends or catching up on the phone whenever you’re stuck in traffic.