If you are starting a weight loss medication — or if it’s not working for you — here are some things to know.

Medications like Ozempic®, Wegovy®, and Rybelsus® (semaglutide), Mounjaro® and Zepbound® (tirzepatide), and Trulicity® (dulaglutide) are in a class of medications known as Glucagon Peptide-Like 1 Receptor Agonists (GLP-1 RA). These medications are designed to help patients manage type 2 diabetes and lose weight by mimicking the GLP- hormone.

By mimicking the GLP-1 hormone, which is produced naturally by your body, GLP-1 RAs slow digestion, which delays stomach emptying. This creates the feeling of satiety more quickly and for longer periods of time. GLP-1 RAs also boost the release of insulin and reduce the release of glucagon, a hormone produced by the pancreas to help regulate blood glucose levels.

Except for Zepbound, these GLP-1 medications were FDA-approved to treat type 2 diabetes. Zepbound was FDA-approved for weight loss, and it, along with Monjauro include glucose-dependent insulinotropic polypeptide (GIP). GIPs enhance the effects of GLP-1 such that your body can burn fat more quickly.

Ozempic®, Wegovy®, and Rybelsus®, and Trulicity® have increasingly been used off-label to help patients with obesity lose weight. These medications function optimally when paired with a healthy diet and exercise.

If you are considering Ozempic®, Wegovy®, and Rybelsus®, and Trulicity®, Monjauro®, or Zepbound® here are some things to know.

Dietary Considerations

While there is no Ozempic diet plan, Zepbound diet plan, or Monjauro diet plan per se, when taking a GLP-1 medication or GLP-1 + GIP medication, it is important to follow a healthy diet.

An Ozempic diet plan, a Zepbound diet plan, or a Monjauro diet plan, etc., will be very similar, if not identical. Let’s look at what a Zepbound diet plan might look like.

Foods to eat on Zepbound include proteins like lean beef, pork, skinless white meat poultry, or fish or seafood, eggs, tempeh, or tofu. It is important to consume the RDA for protein (0.8 grams / kilogram of body weight) to ensure muscle mass is maintained during active weight loss. Protein can also manage nausea, a side effect of Zepbound and other GLP-1 medications.

In addition to protein, beans and legumes should be part of a healthy eating plan. Options include lentils, chickpeas, cannellini beans, chickpeas, or red kidney beans.
Fiber is another import source of energy. According to the Dietary Guidelines for Americans, adults should try to consume 14 grams of fiber per 1,000 calories eaten. Fiber-rich foods include whole grains, beans, legumes (double dip for vegetables and protein!), fruit, vegetables, nuts, and seeds.

Healthy fats are another important element of a Zepbound diet plan or Monjauro diet plan. Healthy fats come from plant oils such as avocado, sunflower, olive, or canola oil. Fatty fish like salmon, trout, tuna, or mackerel are also good sources of healthy fat. Nuts and seeds are also good sources of healthy fats.

What to eat while taking Zepbound, Monjauro, Ozempic, Wegovy, Rybelsus, or Trulicity is just as important as what not to eat.

Foods to avoid or limit on GLP-1 or GLP-1 + GIP medications include fried or greasy food, foods high in sugar, carbonated beverages like soda, refined carbohydrates such baked goods, and alcohol. Be sure to look for hidden sugars in foods like ketchup, salad dressing, sports drinks, granola bars, or instant oatmeal.

Dosing

• Ozempic Dosing Schedule. Ozempic comes in 0.25 mg, 0.5 mg, 1.0 mg, and 2.0 mg does. Ozempic dosing begins with 0.25 mg for four weeks and then increases to 0.5 mg during week 5. If additional A1C control is needed, your dose may increase to 1.0 in week 8, and then 2.0 in week 12, at your health care provider’s discretion.
• Wegovy Dosing Schedule. Wegovy comes in 0.25, 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg doses. Dosing begins with 0.25mg for four (4) weeks and increases every four (4) weeks until the maximum dose, not to exceed 2.4mg, is determined by the treating physician.
• Rybelsus Dosing Schedule. Rybelsus doses rang from 3 mg to 14 mg. Rybelsus dosing typically begins with 3 mg for 30 days as treatment initiation and then increases to 7 mg. The dosage may be increased to 14 mg if additional blood sugar control is needed.
• Trulicity Dosing Schedule. Trulicity doses are 5mL, 0.75mg, 1.5mg, 3.0mg, and 4.5mg
  
• Monjauro Dosing Schedule. Monjauro doses are 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. The starting dose is 2.5 mg for four weeks and then it increases to 5 mg for at least four weeks. If additional glycemic control is needed, your physician may increase dose in four-week increments until the maximum 15 mg dose is prescribed.
  
• Zepbound Dosing Schedule. The starting does of Zepbound is 2.5 mg weekly for four weeks. After four weeks, the dose will be increased to 5 mg for four weeks and then it increases to 7.5 mg for at least four weeks. If additional glycemic control is needed, your physician may increase dose in four-week increments until the maximum 15 mg dose is prescribed.

Why is my GLP-1 Medication Not Working for Me?

Wegovy, Monjauro, or other GLP-1 or GLP-1 + GI medications may not be working for several reasons:

• Underlying medical conditions that may make it difficult for you to lose weight
• Other medications you are taking may be slowing down weight loss
• Stress
• Poor sleep quality
• Not following a healthy diet
• Not exercising
• Dose is too low
• Hormonal imbalance
• Plateaued

The Importance of Healthy Lifestyle Changes

If you decide to take a weight loss medication, it is important to pair it with a healthy diet and physical activity. If you and your health care provider think a GLP-1 or a GLP-1 + GIP is right for you, it is important to read all the accompanying information provided with the medication. To optimize the benefits of these medications, it is critical to pair them with healthy lifestyle changes such as following a healthy eating plan and weekly exercise.

Managing GLP-1 Side Effects

According to an article in the New England Journal of Medicine, 74% of people taking GLP-1 medications have gastrointestinal disorders, including nausea (53%) and constipation (31%). Additional studies note that people taking weight loss medications experience significant decreases in daily calorie intake by as much as 40 to 50 percent, including reduced intake of protein, fiber and essential micronutrients. Adding Biocare®*, a scientifically-designed dietary beverage created specifically for people taking these medications, can help reduce side effects, preserve lean muscle mass and counteract nutritional deficiencies associated with these drugs.

Prior to starting any weight loss program, whether it includes anti-obesity medication or not, be sure to consult with your health care provider to make sure your desired weight loss strategy is right for you.

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

* Wegovy^® and Ozempic^® are registered trademarks of Novo Nordisk A/S. Novo Nordisk is a registered trademark of Novo Nordisk A/S.