Advisory: Nutrition Priorities for GLP-1 Use in Obesity
METHODOLOGY:
An expert group comprised of multiple clinical and research disciplines assessed the literature to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment for obesity.
Based on the group's findings, The Obesity Society, American College of Lifestyle Medicine, American Society for Nutrition, and the Obesity Medicine Association simultaneously published 'Nutritional Priorities to Support GLP-1 Therapy for Obesity' in their own peer-reviewed journals.
The consensus-based clinical advisory reflects an interdisciplinary collaboration to help clinicians support patients receiving GLP-1 treatment with evidence-based nutritional and behavioral strategies.
TAKEAWAY:
The expert group found that GLP-1s reduced body weight by 5%-18% in trials, with modestly lower effects in real-world analyses, and multiple clinical benefits.
Challenges included side effects, especially gastrointestinal (GI); nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence and subsequent weight regain; as well as high costs resulting in low cost-effectiveness.
The group recommended eight priorities to address the challenges: (1) Patient-centered initiation of therapy; (2) careful baseline nutritional assessment; (3) management of GI side effects, (4) personalized, nutrient-dense, minimally processed diets; (5) prevention of micronutrient deficiencies; (6) adequate protein intake and strength training to preserve lean mass; (7) leveraging a good diet to maximize weight reduction; and (8) promoting other lifestyle changes around activity, sleep, mental stress, substance use, and social connections to maximize long-term success.
IN PRACTICE:
'Medical therapy for obesity and lifestyle changes go and-in-hand,' Marc-Andre Cornier, MD, The Obesity Society president, said in an accompanying press release. 'This guidance lays a nutrition roadmap to help providers support their patients on sustainable and lasting weight reduction journeys. It underscores the importance of nutrition on quality of life and is an important contribution to the literature about incorporating lifestyle interventions into obesity care.'
SOURCE:
The clinical advisory, led by Advisory Chair Dariush Mozaffarian, MD, DrPH, of Tufts University, Boston, was published simultaneously in Obesity , American Journal of Lifestyle Medicine , The American Journal of Clinical Nutrition , and Obesity Pillars .
LIMITATIONS:
Recommendations are based on a literature review and a consensus among expert group members.
DISCLOSURES:
Mozaffarian reported research funding from the National Institutes of Health, Kaiser Permanente Fund at the East Bay Community Foundation, National Association of Chain Drug Stores Foundation, Google Health, and The Rockefeller Foundation; scientific advisory board, Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart Health, January Inc., WndrHLTH; scientific consulting, Amazon Health; equity in Calibrate and HumanCo; and chapter royalties from UpToDate.
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