Taking a prescription weight-loss medication? You'll want to make these changes, too
It may seem like prescription weight-loss medications like GLP-1s are star solo acts. The drugs can help people eat less without feeling hungry, resulting in some pretty considerable weight loss. But in order to perform, these drugs 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 weight-loss drugs work?
Weight-loss medications are FDA-approved for those who either have obesity or who have overweight and meet certain criteria—like having type 2 diabetes. And they can make a huge difference for people who are trying to lose weight.
GLP-1 agonists, which are the newest drugs to be approved, imitate a gut hormone released after you eat. As a result, they help slow down how fast food moves from the stomach to the small intestine, increase feelings of fullness, and stabilize blood sugar levels. (That last bit is what they originally developed to do, as a treatment for type 2 diabetes.)
Other weight-loss drugs work in totally different ways. Phentermine-topiramate and naltrexone-bupropion activate various areas of the brain to decrease appetite and cravings and increase feelings of fullness. Orlistat, on the other hand, aids weight loss by decreasing the amount of dietary fat your body can absorb.
For those who have tried to lose weight through tweaks to diet and exercise without much luck, incorporating these medications can be game-changing. “The rationale for using these medications is to help achieve and sustain more weight loss than can be done through lifestyle interventions alone,” says Ivania Rizo, MD, 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.”
As exciting as that is, it’s important to note that these medications are approved for long-term use. Accepting this might require a bit of a shift in how you think of obesity treatments. “These drugs are pharmacological interventions for the chronic disease of obesity,” says Rizo. “Pharmacological interventions for all chronic diseases will stop working once stopped. For example, if someone stops taking a statin medication, their cholesterol will increase. It’s the same logic for weight-management medications.”
Why healthy habits are important if you’re taking a weight-loss medication
Medications for many chronic conditions, like type 2 diabetes and high blood pressure, work best when paired with healthy habits. Prescription weight-loss medications are no different. Studies show promising results—like that weekly semaglutide injections can help people lose 15% of their body weight over a 17-month period—but the participants in those studies also followed 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, Illinois.
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 program. “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 healthy lifestyle changes and weight-loss drugs 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.”
How can you prioritize healthy habits while taking weight-loss medication?
Here are some ways to stay focused on your overall wellness while using a prescription weight-loss drug:
1. Focus on food quality
People on weight-loss medications 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 weight-management drugs 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: lean protein (think: chicken breasts, lean beef, beans, Greek yogurt, and tofu); complex carbs (e.g., quinoa, brown rice, oats, potatoes); produce (like spinach, berries, tomatoes); and moderate servings of healthy fats (such as avocado, seeds, nuts, and fatty fish like salmon). 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 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. “Any weight loss leads to a decrease in lean muscle mass. Therefore it is important to do resistance training,” Rizzo 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 zzz’s 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.
The bottom line
Prescription weight-loss drugs suppress appetite, change signaling in the brain, or reduce how much fat you digest—all actions that can fuel weight loss. But they don’t work in a bubble. For these medications to have the biggest impact on health and body weight, they should be combined with lifestyle changes like exercise, stress reduction, adequate sleep, and a nutrient-rich diet.