This content originally appeared on Everyday Health. Republished with permission.
In recent years, newer drugs like semaglutide and tirzepatide — GLP-1 and GLP-1 and GIP receptor agonists — have changed the type 2 diabetes treatment landscape with their remarkable effectiveness. But along with their introduction have come many other considerations, including how your diet should change if you and your healthcare team decide one of these drugs is right for you.
Read on for tips from registered dietitian nutritionists on how to optimize your diet when on prescription drugs linked to weight loss, including Ozempic, Mounjaro, Wegovy, and Zepbound.
Why Nutrition Is Crucial When You’re on a GLP-1 Drug
GLP-1 receptor agonists work by helping suppress appetite and delaying the rate at which your stomach empties food. This can discourage eating.
They may also be associated with nausea and vomiting, which can interfere with nutrient absorption, says Annapolis, Maryland–based Bonnie Newlin, RD, of Crave Nourishment, who frequently counsels patients taking semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound).
Staying proactive about your daily nutrition can help you stay healthy and feeling your best as you continue your weight loss journey.
Common Questions & Answers
Can you drink alcohol on Ozempic and similar drugs?
There’s no known interaction between alcohol and Ozempic and other drugs linked with weight loss. But knocking back a cocktail without food isn’t prudent. Drinking on an empty stomach can dramatically lower your blood sugar. This may be especially problematic as weight loss drugs already reduce blood sugar.
Are Ozempic and diet soda a good mix?
Artificial sweeteners in diet soda can negatively affect digestion and gut health, especially in larger amounts. Because drugs such as Ozempic may affect your gastrointestinal system, consider steering clear of any foods or beverages with these sweeteners. Opt for water instead.
What are the best foods to eat on a weight loss drug?
Minimally processed, high-protein foods are best to eat when on prescription drugs associated with weight loss. Round out your meals with proteins like chicken breast, tofu, and eggs. For fiber, micronutrients, and antioxidants, eat nonstarchy veggies, lower-sugar fruits, and whole grains.
What foods should I avoid on a weight loss drug?
Fried, greasy foods not only can make you feel unwell but can interfere with the effectiveness of these drugs because they take a long time to digest. Sweets are another category to avoid. Sweet foods can spike blood sugar, then cause it to crash.
Can semaglutide or tirzepatide cause malnutrition?
They can. Associated physical effects such as nausea, vomiting, and diarrhea can increase the risk. Although research is limited, anecdotes of severe nutrient deficiencies have cropped up in the news.
How to Make Sure You’re Getting Enough Calories
Although weight loss is one goal of taking semaglutide or tirzepatide, it’s important to eat enough calories each day. Sufficient intake gives you the energy you need to thrive.
Melissa Mitri, RDN, who’s based in New York City, says eating small, frequent meals that are low in fat can help you get enough calories and preserve lean muscle mass as you lose weight. “Because many people feel full more easily on these medications, eating smaller meals more frequently can prevent overeating,” Mitri says. Clinical recommendations from the Journal of Clinical Medicine include starting with small portions when you begin weight loss meds. Smaller meals that limit fat can also help keep your digestive system happy, reducing the risk for bloating and nausea, Mitri notes.
As for your target number of calories while on weight loss meds, the perfect number will be unique to you. Work with your primary care doctor or a registered dietitian nutritionist to determine your ideal range (in general, many experts recommend around 1,200 to 1,800 calories per day while on these meds). If you like, you can track your daily diet with an app.
The Importance of Hydration
Hydration is particularly critical when you’re on Ozempic or other drugs that affect your gastrointestinal (GI) tract, says Newlin. Because tirzepatide and semaglutide can increase the risk of diarrhea, nausea, and vomiting, you may need to replace fluids by rehydrating more frequently. Newlin also notes that decreased appetite can cause people to drink less fluid (and get less water from food).
Although these drugs don’t come with increased recommendations for fluid intake, it’s smart to keep tabs on your daily hydration habit. While recommendations vary, the National Academies of Sciences, Engineering, and Medicine suggests 2.7 liters (91 ounces) of total water from all beverages and foods for women and 3.7 liters (125 ounces) for men. If you feel this isn’t enough or is too much, talk to your doctor about tailoring hydration to your personal needs.
Do I Need to Worry About Macronutrients if I’m on a GLP-1?
Unlike eating plans such as the ketogenic diet (a very high-fat, low-carbohydrate diet), weight loss drugs don’t require you to stick to an exact ratio of carbs, protein, and fat. But that doesn’t mean you shouldn’t stay mindful of your macronutrients. As mentioned earlier, fat is one macro to consider carefully. “Fat should be more limited as it takes longer to digest and can worsen digestive issues, carbs should be consumed in moderation to support weight loss and healthy blood sugar levels, and protein intake should be on the higher end to preserve lean muscle mass and support overall metabolism,” says Mitri.
A Complete Food List to Follow When on Ozempic or Mounjaro
When taking a drug like tirzepatide or semaglutide, certain foods are better choices than others. Focus meals around foods such as these.
What to Eat
Skinless chicken breast
Eggs
Tofu
Fish and seafood
Beans and legumes
Nuts and seeds
Greek yogurt
Oats
Whole-wheat bread
Brown rice
Quinoa
Broccoli
Spinach
Kale
Bell peppers
Berries
Citrus fruits
What to Avoid
Some foods don’t make good partners with weight loss drugs. Avoid the following:
Fried foods such as french fries, fried chicken, and onion rings
Red meat
Sugar-sweetened beverages like soda, cocktails, and juices with added sugar
High-fat, high-sugar desserts like cookies, cakes, candies, ice cream, and brownies
A 7-Day Sample Meal Plan to Follow When on Ozempic or Mounjaro
We all could use a little inspiration for meal planning (even when we’re not taking weight loss drugs). Try this seven-day plan, which was created with the help of registered dietitian nutritionists Mitri and Newlin, to jump-start your meals and snacks while on newer weight loss drugs.
Sunday
Breakfast High-fiber, low-sugar cereal (such as Grape Nuts or Fiber One) with 2 percent milk and banana slices
Snack Melon cubes and cottage cheese
Lunch Mediterranean spinach salad with diced chicken, artichokes, tomatoes, and pine nuts
Dinner Vegetable bean chili
Dessert Dark chocolate pomegranate bark
Monday
Breakfast Smoothie with almond milk, protein powder, and frozen fruit
Snack Handful of pistachios
Lunch Turkey wrap with lettuce and light mayo in a whole-wheat tortilla
Dinner Whole-wheat pasta with shrimp and peas
Dessert Avocado chocolate mousse
Tuesday
Breakfast Two hard-boiled eggs, fresh berries, a slice whole-grain toast, and 1 cup skim milk
Snack Lightly salted popcorn
Lunch Chicken and vegetable soup
Dinner Salmon kale salad
Dessert Berry smoothie (frozen banana, frozen berries, yogurt, and a drizzle of maple syrup)
Wednesday
Breakfast Overnight oats with blueberries, Greek yogurt, and a sprinkle of cinnamon
Snack Turkey jerky and an apple
Lunch Cup of vegetable soup with quesadillas with rotisserie chicken
Dinner Black bean Mexican quinoa bowls
Dessert Dark chocolate and almonds
Thursday
Breakfast Whole-wheat toast with avocado and two over-easy eggs
Snack Cheese slices, seed crackers, and hummus
Lunch Grilled chicken sandwich with baby carrots
Dinner Soy-glazed salmon with basmati rice and a side salad
Dessert Medjool dates stuffed with peanut butter
Friday
Breakfast Oatmeal with pecans and dried cranberries
Snack 2 hard-boiled eggs and ½ red bell pepper, sliced
Lunch Tuna salad sandwich and a banana
Dinner Chicken stir-fry with vegetables over quinoa or brown rice
Dessert Yogurt parfait with mandarin oranges and honey
Saturday
Breakfast 2 percent plain Greek yogurt with a handful of blueberries and ¼ cup toasted walnuts
Snack Trail mix of nuts, seeds, and dried fruit
Lunch Curried chickpea wrap and cucumber slices
Dinner Balsamic chicken breast with brown rice and spinach salad
Dessert Fresh strawberries with a drizzle of chocolate syrup
Can Taking Certain Supplements Help Support Nutrition on a GLP-1Drug?
For the duration of your time on these meds, dietary supplements may have a place in your nutrition toolkit. Newlin says that the combination of low calorie intake and GI effects from meds can add up to low nutrient levels. She suggests including a multivitamin in your daily routine. Other supplements she says may be helpful include probiotics, vitamin B12, and vitamin D. “Probiotic supplements containing strains like lactobacillus and bifidobacterium may support digestive health and weight loss,” she says, while GLP-1 and GIP agonists can interfere with the body’s absorption of vitamin D and vitamin B12.
5 Beginner Tips for Staying Nourished on Ozempic or Mounjaro
Prioritizing your nourishment while on weight loss drugs is worth the effort. Try these simple tips.
1. Make Time for Meal Planning
Making time for meal prep means you won’t find yourself without resources at dinnertime.
2. Choose Nutrient-Rich Foods
Newlin recommends lean protein and fiber-rich fruits and vegetables.
3. Consider Food Journaling
The best way to know how many calories you’re taking in is to record your meals and snacks, whether on paper or in an app.
4. Include Foods You Like
It may sound obvious, but opting for foods you genuinely enjoy is a great way to ensure you eat enough.
5. Consider a Supplement
“If you are not getting enough nutrients from your diet, you may want to consider taking supplements,” says Newlin. “Talk to your healthcare provider about which supplements may be right for you.”
Summary
Even when you’re trying to manage your diabetes or lose weight, getting enough calories and nutrients is critical. If semaglutide or tirzepatide leave you feeling less than interested in food, start with small versions of any of the meals and snacks above. Then as you’re into a new groove with your new diet and lifestyle, branch out to create tasty, diabetes-friendly meal plans of your own.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
An Extreme Risk of Taking Ozempic: Malnutrition. The New York Times. April 21, 2023.
Blundell J et al. Effects of Once-Weekly Semaglutide on Appetite, Energy Intake, Control of Eating, Food Preference and Body Weight in Subjects With Obesity. Diabetes, Obesity & Metabolism. September 2017.
Diabetes & Alcohol. University of California in San Francisco.
Heise T et al. Tirzepatide Reduces Appetite, Energy Intake, and Fat Mass in People With Type 2 Diabetes. Diabetes Care. May 2023.
Report Sets Dietary Intake Levels for Water, Salt, and Potassium to Maintain Health and Reduce Chronic Disease Risk. National Academies of Sciences, Engineering, and Medicine. February 11, 2004.
Shil A et al. Artificial Sweeteners Negatively Regulate Pathogenic Characteristics of Two Model Gut Bacteria, E. coli and E. faecalis. International Journal of Molecular Sciences. May 2021.