GLP-1 medications can be an effective tool for managing weight and improving metabolic health. They work partly by reducing appetite, increasing feelings of fullness and reducing food cravings.
However, eating less does not necessarily mean eating well. When your appetite is reduced, the nutritional quality of the food you eat becomes particularly important.
Good nutrition, regular movement and healthy lifestyle habits can help you feel well during treatment, protect muscle and bone health, manage side effects and establish habits that support your health in the longer term.
Focus on protein
During weight loss, we lose some muscle as well as body fat. Preserving muscle is particularly important during and after menopause, when changes in muscle mass and strength are already more likely to occur.
Including a source of protein at each meal can help you meet your requirements even when your appetite is reduced.
Protein-rich foods include:
• Fish
• Chicken and lean meat
• Eggs
• Greek or high-protein yoghurt
• Cottage cheese
• Tofu and tempeh
• Beans, lentils and other pulses
• Nuts and seeds
Your individual protein requirements will depend on factors including your body size, age, activity levels, health and weight loss goals. A dietitian can help you establish an appropriate target and how best to achieve it.
Don't forget fibre
Fibre supports bowel and gut health and can help with cholesterol and blood glucose management. It can be particularly important while taking GLP-1 medication because constipation is a common side effect.
A Mediterranean-style diet naturally provides plenty of fibre through:
• Vegetables and salad
• Fruit
• Beans and pulses
• Wholegrains
• Nuts and seeds
In the UK, the recommendation for adults is 30g of fibre per day. This can still be achieved
while taking a GLP-1 medication, but you may need to make more intentional food choices
when your appetite is reduced.
Aim for variety rather than perfection. If your fibre intake is currently low, increase it gradually and ensure you are drinking enough fluid.
Think Mediterranean
There is no special "GLP-1 diet".
A Mediterranean-style way of eating provides an excellent foundation and is associated with a range of cardiovascular and metabolic health benefits, which are particularly relevant to health during and after menopause.
Build your diet around plenty of vegetables and fruit, wholegrains, beans and pulses, nuts and seeds, olive oil, fish and other sources of protein, while keeping highly processed foods and foods high in saturated fat, salt and added sugars to a smaller proportion of your overall diet.
Try to eat regularly
Because GLP-1 medications suppress appetite, it can become surprisingly easy to miss meals.
For most people, having more than two opportunities to eat across the day can make it easier to meet protein, fibre, vitamin and mineral requirements without needing to eat large meals.
Very large meals may also be uncomfortable because GLP-1 medications slow the rate at which food leaves the stomach.
Listen to your appetite, eat slowly and stop when you feel comfortably satisfied.
If your meals become too small, you may need to include one or two nourishing snacks to help you meet your nutritional requirements.
Do I need to count calories or fast?
Not necessarily.
Some people find approaches such as calorie awareness, food tracking or intermittent fasting helpful, while others find them restrictive or difficult to maintain.
GLP-1 medication often naturally reduces calorie intake through appetite and craving suppression. Adding further dietary restrictions on top of this may make it more difficult to meet your nutritional requirements.
There is no single approach that works for everybody. Your dietitian can help you find a way of eating that fits your health, lifestyle, preferences and relationship with food.
Could I become deficient in any nutrients?
GLP-1 medications do not directly cause vitamin and mineral deficiencies. However, because they can significantly reduce your appetite and the amount of food you eat, it may become more difficult to meet all of your nutritional requirements.
This is particularly important if your diet becomes very limited, you regularly skip meals or you are eating very small portions.
Try to include a good variety of nutritious foods, including fruit and vegetables, wholegrains, protein-rich foods, dairy foods or fortified alternatives, nuts and seeds.
Do I need a multivitamin and mineral supplement?
Not everyone taking a GLP-1 medication needs a supplement. However, a daily multivitamin and mineral supplement may be appropriate for some people, especially when overall food intake or dietary variety is low.
Individual requirements vary, and taking supplements unnecessarily or in high doses is not always beneficial. Your dietitian can review your food intake and advise whether a supplement is appropriate for you, as well as recommending specific nutrients where necessary.
If you are concerned about a possible deficiency, discuss this with your healthcare team, who may recommend further assessment or blood tests.
Protect your muscles
Nutrition is only part of the picture.
Resistance or strength-based exercise helps maintain muscle mass and strength during weight loss and becomes increasingly important through midlife and menopause.
Examples include:
• Weight training
• Resistance bands
• Body-weight exercises
• Pilates and other appropriate resistance-based activities Alongside resistance training, regular walking and other cardiovascular activity can support overall physical and cardiovascular health.
What about cravings?
Many people find that GLP-1 medications reduce food cravings and the amount of time they spend thinking about food. This can be a useful opportunity to develop strategies that may help with managing cravings in the longer term.
Some approaches include:
• Eat regularly: Becoming overly hungry can make cravings more difficult to manage. Try to establish a regular pattern of balanced meals rather than routinely skipping meals.
• Include protein and fibre: Meals containing protein and fibre tend to be more satisfying and can help you feel fuller for longer.
• Notice what triggers cravings: Cravings aren't always driven by physical hunger. Stress, tiredness, boredom, emotions, habits and your environment can all play a part.
Simply recognising your own patterns can be helpful.
• Pause before responding: If a craving appears, give yourself a little time to consider whether you are physically hungry or responding to something else. If you are hungry, eat!
• Avoid making foods "forbidden": Overly restrictive eating can sometimes make particular foods feel even more desirable. Aim for a flexible and balanced approach rather than trying to eat perfectly.
The aim isn't to eliminate cravings completely. Instead, use this time to understand your eating patterns and establish habits that feel realistic and sustainable for you.
If cravings, emotional eating or your relationship with food are something you would like more support with, your dietitian can help you explore individual strategies.
Managing common side effects
GLP-1 medications can cause gastrointestinal side effects, particularly when treatment is started or the dose is increased.
• Nausea or feeling very full
Try smaller meals, eat slowly and avoid eating beyond comfortable fullness. Very rich, high-fat or spicy foods may make symptoms worse.
• Constipation
Pay attention to fibre, fluids and regular movement.
• Diarrhoea
Keep well hydrated and speak to your healthcare team if symptoms are persistent.
• Heartburn or reflux
Smaller meals and avoiding lying down soon after eating may help.
If side effects are severe, persistent or preventing you from eating or drinking adequately, contact your Menopause Care clinician.
Use this time to build habits
One of the benefits many people notice while taking GLP-1 medication is a reduction in hunger, cravings and "food noise".
This can provide an opportunity to establish habits that support your health beyond the medication itself. Rather than simply eating less, think about how you can use this time to establish an eating pattern that is nutritious, satisfying and sustainable in the longer term.
Think about:
• Eating regular, balanced meals
• Including protein consistently
• Increasing the variety of plant foods, you eat
• Building regular movement into your week
• Developing a resistance training routine, if possible
• Paying attention to sleep and stress
• Learning to recognise hunger, fullness and satisfaction
What if I only want to take GLP-1 medication for a short time?
It is worth discussing this with your clinician from the outset.
Appetite and food cravings may increase again when GLP-1 medication is stopped, and weight regain can occur. This is one reason why developing sustainable nutrition, activity and lifestyle habits during treatment, rather than waiting until medication is stopped, is so important.
Your healthcare team can help you think about the longer-term plan and what is realistic for you.
Would you benefit from personalised nutrition support?
Your nutritional needs while taking GLP-1 medication are individual.
A consultation with our Registered Dietitian can help you look more closely at:
• Whether you are eating enough protein and fibre
• Maintaining muscle and supporting bone health
• Managing constipation, nausea or other digestive symptoms
• Nutritional adequacy when your appetite is very low
• Meal structure and eating patterns
• Cardiovascular health, cholesterol and blood glucose
• Developing sustainable habits for the longer term
Your dietitian can then provide personalised recommendations based on your health, menopause stage, medication, activity levels, food preferences and lifestyle.
If you’d like to learn more about nutrition and staying healthy during menopause, book a consultation with our Menopause Care dietitian - Isabelle Fry.
Contact us: 0208 164 4090 | info@menopausecare.co.uk | www.menopausecare.co.uk