Patients taking agonists from Peptide 1 of glucagon type (GLP-1 RAS) can lose between 5% and 15% From their body weight, but even if weight loss is an important aspect of a healthy lifestyle, without diet and balanced exercise, it may be easy not to come across the fitness objectives.
When patients get ras GLP-1, their appetites drop considerably and they lose weight, but they also lose muscles. In addition, their lack of appetite can make it difficult to consume enough fruits, vegetables and protein necessary to respond to food recommendations. This is why it is crucial for health care providers to advise patients on how to avoid muscle loss and nutrient deficiencies.
Once on GLP-1 RAS, patients are much more open to making positive changes to their diet and their lifestyle because they see results. The scale finally turns, which offers patients an excellent opportunity to be enthusiastic about the idea of making health improvements that change their life.
“Generally, people feel lighter, happier and much more motivated once on these drugs. They want to go to the gymnasium and eat a healthy diet, “said Ziyad al-Ay, MD, head of research and development and GLP-1 RA Expert in the health system of veterans St. Louis, St. Louis.
Educate patients to make healthy changes
However, for many patients, education is essential. It is a question of finding ways to integrate enough nutrients in their day. Reduced appetite can make it difficult to obtain enough proteins, fruits, vegetables and whole grains to avoid losing muscle mass and also obtaining enough nutrients such as iron, folate, B12 and calcium.
Clinicians should also remind patients the importance of establishing a healthy diet when they lose weight, which is essential to be able to maintain weight loss in the event that they were no longer able to take the drug or the drug no longer works for them, said Tonya F. Turner, RDN, South Caroline for clinical services at the South Center for the South Center for South Center.
“Providers should use these drugs as a tool to help their patients access good nutritional habits for the future,” said Turner.
Turner advises his patients “to be the best version of themselves” both in their weight loss and nutrition, using resistance training to reduce lean muscle loss and cardio to keep their hearts in good condition. Resistance is particularly important to help reduce the muscle loss that occurs when they lose large amounts of weight.
It is also important to note that most research on these weight loss drugs coincide with appropriate lifestyle changes. In many cases, patients may not lose as much weight without exercise and a healthy diet, which can also be a motivation factor.
“The evidence does not only apply to the drug, but also includes lifestyle interventions,” said Silvana Pannain, MD, endocrinologist and director of Chicago Weight, a multidisciplinary weight loss program at the University of Chicago Medicine, Chicago.
Keep an eye on the dosage of drugs
It is important for primary care physicians to keep an attentive eye on the dosage of their patient’s medicines, because if their appetite is too decreased, it is much more difficult to eat a balanced diet, al-Ay said. Patients should gradually increase their dosage so that they lose weight in a lasting way. Although you can take a multivitamin as a way to save nutrition, it should not be a substitute for a healthy diet.
“You can put a dressing on it and make them take supplements or drink protein shakes, but the best approach is to think of the dosage if patients seem to eat too few calories,” said Al-Ay. “It’s a marathon, not a sprint.”
How to adapt to healthy changes when appetite is decreased
For patients who find it difficult to integrate into enough protein, fruits and vegetables, Turner advises eating small mini-me-me-mewans throughout the day to sneak in nutrients and adding vegetables to soups or smoothies so that they are easier to digest. Hydration should occur between meals because often, drinking water with meals is more likely to make you feel too full.
Expenses and location caused by food deserts can also make it difficult to have access to many fruits and vegetables, which means that having a plan in place in advance can help patients succeed. Talk to the patients where they made the grocery store, for example, can be useful, says Ivania RizoMD, director of medical obesity at the Boston Medical Center, Boston.
Another motivation factor, in addition to the weight loss of a patient, is that positive lifestyle changes are important to avoid some of the negative side effects that can accompany these drugs.
For example, obtaining enough fiber in fruits, vegetables and whole grains helps reduce constipation that afflicts some patients, said Turner. In addition, drinking water prevents food from sitting in the stomach and causing nausea and vomiting. Maintaining an active lifestyle is also essential to help the gastrointestinal system to operate gently. And drink enough water throughout the day also helps reduce the risk of kidney stones, listed as a side effect of drugs.
Meet patients where they are
Regularly advising patients on the importance of lifestyle choices has major impacts on their ability to see all the positive results for health beyond the weight loss that accompany these drugs. The lasting change is progressive and the patients will not always be perfect, “but small changes over time can make a big difference,” said Turner.
Doctors should recognize that many people have been traumatized over the years following the food culture in which we live, and he can take time to change this, said Rizo. For patients who have followed years who ordered them not to eat, the idea of jumping meals may seem like a good idea. Doctors must meet patients where they are, understanding that change can take time.
“It is a question of defining expectations from the start that it is not only a question of losing weight but also of optimizing their health,” said Rizo.