How to Talk to Patients About Eating Enough on GLP-1s
One of the biggest challenges we face when supporting patients on GLP-1 therapy is ensuring they get enough nutrition. For some, rapid weight loss feels like a win, making it tough to have conversations about why what they eat still matters. Today’s resource is about helping you navigate these conversations with confidence.
Bridging Nutrition Shortfalls on GLP-1 Therapy
Recognise the Challenge
Patients on GLP-1 medications often experience a significant loss of appetite, which may lead to inadequate nutritional intake. Even when dietitians raise concerns, some patients dismiss under eating because they see rapid weight loss as a success. Acknowledging this mindset is the first step in creating a supportive plan that balances safe weight reduction with optimal nutrition.
Assess Readiness to Change & Use Motivational Interviewing
Before suggesting interventions, identify where the patient may be in their willingness to consider change. Motivational interviewing underpins these conversations by helping patients explore the benefits of adequate nutrition and any ambivalence they might have. Through open-ended questions, reflective listening, affirmations, and summarising, you can guide patients toward recognising the importance of meeting their nutritional needs.
Highlight the Importance of Nutrient Intake
Many patients become more open to change when they understand how nutrition supports their overall health and goals:
Link nutrition to medication efficacy: Balanced intake can optimise GLP-1 results, stabilise energy levels, and protect metabolic function.
Explain health risks: Under eating can lead to nutrient deficiencies, fatigue, and muscle loss, which can undermine long term weight management.
Quantify progress: Encourage baseline and follow up blood tests and consider body composition tools like DEXA scans to track changes beyond the scales.
Offer Practical Strategies
Even if patients are reluctant, small, targeted steps can prevent nutrient shortfalls:
Protein first approach: Suggest starting meals with a high-protein food, especially if appetite is low.
Liquid nutrition: For those who find solid food too filling, encourage nutritionally complete shakes or soups fortified with protein and micronutrients.
Supplement guidance: Consider multivitamins or specific supplements based on lab results and dietary intake.
Individualise Goals and Follow-up
Set realistic expectations and schedule regular reviews:
Collaborative goal setting: Work with the patient to define “success,” balancing their desire for weight loss with the need to maintain adequate nutrition.
Frequent feedback: Monitor changes in muscle mass, body composition, and blood tests. Celebrate small wins, such as stable muscle mass or improved lab results.
Adapt as necessary: If patients show minimal progress or disengagement, move toward a harm reduction approach
Respect Autonomy While Providing Guidance
Some patients remain unconcerned about inadequate intake. Continue to provide education and open communication:
Empowerment: Offer accurate information so patients can make informed decisions, even if they opt not to change.
Supportive environment: Avoid guilt or shame. Emphasise your role in helping maintain health alongside weight management goals.
When to Refer
If you suspect disordered eating or other mental health barriers, consider referring the patient back to their prescriber. Collaboration with psychologists and other healthcare professionals also promotes comprehensive support.
Key Takeaways
Balancing readiness to change with motivational interviewing can help uncover the reasons behind patients’ reluctance to address their reduced intake. Encouraging baseline and follow-up blood tests, as well as body composition assessments, offers tangible evidence of how low intake may affect their health and goals. By focusing on practical nutrition strategies, ongoing monitoring, and open communication, dietitians can support patients in protecting both their progress and their overall well-being.
Thanks for reading!
Leif
Got feedback? Email leif@glp1dietitianhub.com, I'd love to hear from you.
Note: This newsletter is for educational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for personalised guidance.
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