In the United States, 7 out of every 10 adults have obesity or are overweight and incur approximately $173 billion in associated medical costs annually. According to Boston Consulting Group, around 16 million Americans are taking GLP-1 medicines for Diabetes Mellitus or Obesity. For those patients who were able to continue treatment with GLP-1 medications, over 80% achieved meaningful weight loss. Unfortunately, over 70% of patients on GLP-1 treatment experience side effects, which may include nausea, vomiting, diarrhea, constipation, abdominal pain, bloating, delayed gastric emptying, gallbladder problems, and dehydration. Additionally, a growing body of evidence raises concerns that the marked reduction in food intake with GLP-1 medications can cause significant nutritional deficiencies and muscle loss, particularly in people whose intake becomes very low or whose diet is not nutrient-dense. Interestingly, Integrative Medicine can complement care to help mitigate the side effects of GLP-1 medications.
Nutritional Counseling
Nutritional Counseling is essential for patients taking GLP-1 medications to ensure adequate nutritional intake to prevent anemia, monitor micronutrients and macronutrients, preserve energy, and prevent muscle loss.A preliminary study of 387 patients taking GLP-1 medications reported an average intake of only 753 kcal/day and 33.4 g protein/day, with fewer than 10% meeting recommendations for protein, fiber, vitamin D, calcium, and potassium. The 2026 CRAVE study is a small prospective study of only 28 participants on a GLP-1 medication for 24 weeks. Participants were not given structured nutritional counseling.The results showed not only that patients experienced significant reductions in total energy intake and insufficient intake of multiple micronutrients and macronutrients, but also that about 25% of the weight lost was estimated to be skeletal muscle mass (not just fat loss). The study also found that higher absolute protein intake was associated with better preservation of estimated muscle mass.
Nutritional Counseling can support reducing common side effects and nutritional challenges associated with GLP-1–based medications, particularly when integrated with standard medical care. Evidence-based strategies include medical nutrition therapy, individualized dietary counseling, adequate hydration, gradual increases in dietary fiber, and sufficient protein intake to help address nausea, constipation, reduced appetite, and the risk of inadequate nutrient intake. Smaller, slower meals and limiting high-fat foods may reduce nausea and gastrointestinal discomfort, while fiber and fluids can help prevent constipation.
Naturopathy
Ginger may help reduce nausea. Its bioactive compounds, gingerols and shogaols, may work by modulating serotonin receptors, promoting gastric emptying, and influencing gut, vagal nerve, and central nervous system pathways involved in nausea and vomiting. Multiple randomized controlled trials and analyses have shown the efficacy of ginger for the treatment of nausea in pregnancy, post-chemotherapy, and post-operative patients.
Acupuncture
Acupuncture may provide additional symptom relief for selected patients with nausea, constipation, dyspepsia, abdominal bloating, and early satiety.
The following meta-analysis of 28 randomized controlled trials involving 3,525 people found acupuncture increased complete spontaneous bowel movements and improved constipation symptoms compared with sham acupuncture.
Additional evidence below is a systematic review of 16 randomized controlled trials with 1,436 patients with functional dyspepsia, which that concluded acupuncture achieved overall symptom improvement and improved quality of life compared with sham acupuncture,, and that acupuncture treatment was superior to medication treatment.
Individualized nutritional counseling is essential for patients taking GLP-1 medications to ensure they maintain adequate protein, fiber, fluid, and nutrient intake. Nutritional counseling, naturopathy, and acupuncture may also provide useful complementary support for selected patients experiencing gastrointestinal side effects. Complementary therapies should be prescribed under the care of a healthcare professional to avoid any interactions with medications or further worsening of side effects.
References:
- Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960-1962 through 2017-2018. National Center for Health Statistics. 2020. Accessed August 24, 2021. https://www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm
- Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLoS One. 2021;16(3):e0247307. doi:10.1371/journal.pone.0247307
- Khan SS, Ndumele CE, Kazi DS. Discontinuation of glucagon-like peptide-1 receptor agonists. JAMA. Published online November 13, 2024. doi:10.1001/jama.2024.22284
- Korus, Sebastian et al. “Dietary intake patterns and nutritional adequacy among adults with overweight or obesity treated with GLP-1 or dual GIP/GLP-1 receptor agonists- preliminary study.” Journal of Translational Medicinevol. 24,1 532. 11 Apr. 2026, doi:10.1186/s12967-026-07702-4
- Mozaffarian, Dariush et al. “Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society.” American journal of lifestyle medicine, 15598276251344827. 30 May. 2025, doi:10.1177/15598276251344827
- Viljoen, Estelle et al. “A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting.” Nutrition Journal vol. 13 20. 19 Mar. 2014, doi:10.1186/1475-2891-13-20
- Wang, Lu et al. “The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis.” Evidence-based complementary and alternative medicine : eCAM vol. 2020 6137450. 17 Jun. 2020, doi:10.1155/2020/6137450
- Pang, Bo et al. “Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Evidence-based complementary and alternative medicine : eCAM vol. 2016 (2016): 3862916. doi:10.1155/2016/3862916
