As Dietitians, These Are the 2 Biggest GLP-1 Pitfalls We See
- Shana Cables MS RDN LD, Certified Intuitive Eating Counselor
- 1 day ago
- 5 min read
GLP-1 medications such as semaglutide and tirzepatide have quickly become some of the most commonly prescribed medications in metabolic health. They reduce appetite, slow gastric emptying, and alter hunger and fullness cues. For many people, this leads to significant changes in what and how much they eat.
While we do not recommend GLP-1 medications as a short-term solution or a quick fix, we also recognize the cultural pressure that exists in our thin-focused society. Many people feel pulled toward these medications after years of messaging that smaller is better. Our role is not to judge that decision, but to help you approach it thoughtfully, protect your health, and build sustainable habits that last far beyond any prescription.
So while these medications can be powerful tools, they are not a replacement for nourishment, skill-building, or a healthy relationship with food.
If you are taking a GLP-1, your nutrition strategy matters more — not less.
Pitfall #1: Poor Nutritional Intake
You might be asking - isn't the whole goal of a GLP-1 to eat less calories? Yes! But, we are seeing that appetite suppression, gastrointestinal side effects and lack of professional educational support and guidance can cause people to have poor nutritional intake; excessive low calorie intake, muscle loss, decreased metabolic rate, poor skin/hair health, etc. - NOT the goals of a GLP-1.
Under-Fueling and Muscle Loss
One of the most common issues we see with GLP-1 use is unintentional under-eating. Appetite suppression can make it easy to skip meals or eat very small portions without realizing how little your body is receiving.
When calories drop quickly — especially without adequate protein — the body does not just lose fat. It also loses lean muscle mass. Over time, this can impact:
Strength and energy
Metabolic rate
Hair and skin health
Long-term weight stability
Overall resilience once the medication is reduced or discontinued
The goal is not to eat as little as possible. The goal is to nourish your body adequately while the medication is working.
Protein Is Foundational
Because appetite is lower, food quality and composition matter. Protein plays a central role in preserving lean mass and supporting satiety.
Most individuals benefit from including a protein source at each meal or snack, such as:
Chicken, turkey, fish, beef, pork
Eggs
Greek yogurt
Cottage cheese and other cheese
Protein shakes and bars
Nuts, tofu or beans (as tolerated)
If fullness comes quickly, prioritizing protein first (but not solely!) can help ensure your most essential nutrient needs are met.
Smaller, Balanced Meals Often Work Best
Large meals may worsen nausea, reflux, or the sensation that food is “sitting” in the stomach. Many people tolerate:
Three smaller meals
One to two balanced snacks
Eating slowly and chewing thoroughly
Stopping at comfortable fullness
Avoiding large portions of greasy, creamy or fried foods (slow digestion)
Carbohydrates are still important. Fruit, oats, rice, potatoes, and pasta provide energy for daily functioning and help prevent excessive fatigue. Restricting them excessively often worsens under-fueling.
Fiber also deserves attention, as slowed digestion can increase constipation if intake is too low. Make sure to incorporate fiber into your meal plan to help keep bowel movements consistent. Some examples of food high in fiber include;
Whole grains
Nuts, beans, seeds
Fruit: berries, kiwi, apples, bananas, prunes, avocado
Vegetables: broccoli, asparagus, potatoes (with skin), Brussels sprouts, kale, carrots
Hydration Matters
GLP-1 medications can reduce thirst cues — not just hunger. That means many people drink less without realizing it. Over time, this can contribute to uncomfortable and preventable side effects.
Adequate hydration is especially important while taking a GLP-1 because slowed digestion can increase the risk of constipation. Lower overall intake combined with reduced fluids can also contribute to headaches, fatigue, dizziness, and that general “off” feeling some people experience.
To stay ahead of it:
Keep water nearby and drink consistently throughout the day
Pair fluids with meals and snacks
Use gentle reminders if needed
Aim for steady intake rather than waiting until you feel thirsty
Pitfall #2: Not addressing relationship with food or eating skills and behaviors.
GLP-1's can help with things like food noise and decreased time thinking/obsessing about food. However, GLP-1's cannot help improve your relationship with food or help you implement sustainable, positive nutrition habits long-term. Currently, GLP-1's are meant to be temporary. Therefore, addressing your relationship with food, gaining knowledge of nutrient dense food choices, and building healthy eating habits is foundational to long-term success.
GLP-1s Are a Tool — Not a Long-Term Strategy by Themselves
One of the most overlooked aspects of GLP-1 treatment is what happens after the medication.
If someone has relied solely on appetite suppression without building nutrition skills, food preparation habits, or a sustainable relationship with food, long-term maintenance becomes much more difficult.
This is where deeper work matters.
Your Relationship With Food Still Matters
GLP-1s change hunger signals, but they do not automatically heal:
Food guilt
Fear of certain foods
Chronic dieting patterns
Emotional eating patterns
All-or-nothing thinking
If those patterns are not addressed, they often resurface when appetite returns.
Working on your relationship with food while on a GLP-1 helps you:
Recognize internal cues (even subtle ones)
Reduce fear/anxiety around food choices
Let go of restrictive food rules
Build confidence in balanced eating
Sustainable change requires more than medication — it requires mindset work.
Food Preparation Skills Create Long-Term Stability
Another key component of sustainability is practical skill-building.
Learning how to:
Plan balanced meals
Grocery shop intentionally
Prep simple protein-forward meals
Build easy, repeatable meal routines
Stock balanced snacks
…creates independence and confidence.
If the medication changes or stops, these skills remain. They reduce reliance on willpower and make nourishment more automatic and manageable.
A Comprehensive Approach Leads to Better Outcomes
GLP-1 medications can be incredibly helpful. But the best outcomes occur when they are paired with:
Adequate protein and total intake
Strategic meal structure
Fiber and hydration support
Relationship-with-food work
Practical meal planning and preparation skills
If the goal is weight loss at any cost, this could be setting yourself up for weight regain or poor health outcomes short-term and long-term. We encourage our clients to consider their long-term health, quality of life and the sustainability of their eating and exercise habits - whatever this looks like for them.
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