Key learning points
- The first comprehensive evidence-based review of dietary recommendations for people taking anti-obesity drugs has been published. It provides guidelines for calorie and nutrient intake.
- Nearly 40% of American adults are living with obesity. Some of them will need to take these new medications to reach and maintain a weight that better supports their health.
- Eating too little contributes to nutrient deficiencies and muscle loss in people trying to lose weight.
About 42% of all adults in the United States are obese. A nutritious diet and adequate exercise are essential for weight management. However, some people need more help to achieve and maintain a healthy weight.
More and more new anti-obesity drugs are coming onto the market, but there is still little nutritional advice for patients taking these drugs.
A recent research paper provides a comprehensive overview of dietary recommendations for patients taking Wegovy or Zepbound. These recommendations can reduce appetite and increase satiety. This new guideline may help physicians identify and treat patients at risk for nutritional deficiencies due to reduced food intake, the researchers wrote.
The authors of the article acknowledge that nutrient intake varies from person to person and that there is no single dietary pattern considered the best or most effective diet for weight loss.
They recommend a balance of nutrient-dense foods and drinks that are high in vitamins and minerals, and choosing foods that are low in added sugars, saturated fats, and sodium.
Below is a general overview of nutrient intake guidelines for people taking Wegovy or Zepbound.
Calories provide your body with the energy it needs to perform basic functions, such as breathing, moving, and thinking. The typical energy intake during weight loss is between 1,200 and 1,500 calories per day for women and between 1,500 and 1,800 for men.
However, energy needs vary depending on your age, gender, body weight, level of physical activity and other factors. Your energy intake should be tailored to your needs and goals by a nutritionist.
You may find it helpful to track calories, but Isabella Ferrari, MCN, RD, CSO, LD, senior clinical manager at Doherty Nutrition, told Verywell that counting calories can be harmful for some people.
"Having a dietitian on your side when you're trying to lose weight is incredibly important because we don't want counting or tracking calories to become an obsession where people can't live without knowing how many calories they're going to track," Ferrari said.
People with obesity need a protein intake of at least 60 to 75 grams per day. A maximum of 1.5 grams per kilogram of body weight per day is recommended, especially if you are undergoing bariatric surgery or other weight-loss treatments.
The recommended amount of protein for most adults without health problems is 0.8 grams per kilogram of body weight per day.
Carbohydrates
A common misconception about weight loss is that you need to cut out carbs to lose weight. However, research has shown that severely restricting carbs does not lead to long-term weight loss and can actually limit the nutrients you would normally get from eating lots of fruits, vegetables, and whole grains.
If you're taking newer anti-obesity medications, Almandoz recommends focusing on a balanced diet. The recommended amount of carbohydrates for healthy adults may work for people trying to lose weight: 135 to 245 grams per day for a 1,200- to 1,500-calorie diet, or 170 to 290 grams per day for a 1,500- to 1,800-calorie diet.
For patients who are recommended or prefer a low-carb diet, Almandoz advises ensuring they drink 2 to 3 liters of fluid per day.
Dietary fats help your body absorb fat-soluble vitamins, such as vitamins A, D, E, and K. Although there is less evidence for recommended fat intake ranges, the acceptable macronutrient distribution range (AMDR) for fat for most adults is 20% to 35% of energy intake for a diet of 1,200 to 1,500 calories.
About 90% of Americans don't get enough fiber, even though this nutrient is essential for preventing constipation and keeping you feeling fuller longer. The appropriate fiber intake is 21 to 25 grams per day for women and 30 to 38 grams for men. To meet your fiber needs, it's best to focus on fiber-rich foods such as:
"Unfortunately, many people in the U.S. are consuming a lower-quality diet that is high in ultra-processed foods," Almandoz said. "Without appropriate dietary assessment and counseling, we run the risk that people taking these new anti-obesity medications will simply eat less of a low-quality diet."
If you don't eat a lot of fiber, it's best to build it up slowly to avoid problems like constipation.
Because you don't want to risk nutritional deficiencies and muscle loss, it's best to talk to your healthcare provider and nutritionist about your diet if you're considering taking obesity medications.
What this means for you
If you are considering taking obesity medications, talk to your healthcare provider and a nutritionist about how to ensure you get enough nutrients while taking the medications.
By Kayla Hui, MPH
Hui is a health writer with a master's degree in public health. In 2020, she won a Pulitzer Center Fellowship to report on the mental health of Chinese immigrant truck drivers.