Malnourishment / Nutrient Deficiencies
Users on Reddit report a variety of experiences related to malnourishment and nutrient deficiencies while on GLP-1 medications, often stemming from severe appetite suppression, nausea, and altered food preferences. They also share numerous remedies and preventative measures, primarily focusing on dietary strategies and lifestyle adjustments.
Experiences with Malnourishment / Nutrient Deficiencies:
Muscle Loss (Sarcopenia): A significant concern is muscle loss. Users have reported losing "a lot of muscle"[4] and experiencing a drop in physical performance, such as running speed decreasing. [4] One user noted, "The biggest downside seems to be some muscle loss which is exactly what ide expect with a large sustained calorie deficit. "[5] Healthcare professionals in the threads also commented on observing sarcopenia, with one mentioning, "People on GLP-1s who look like they have no business having mobility concerns... needing SNF placement because they can barely walk or stand from a chair. "[6] Another confirmed seeing "sarcopenia in older folks for sure. "[7]
Fatigue and Low Energy: Persistent fatigue is a common complaint. Users mention being "fatigued all the time"[8, 1] or experiencing "exhaustion, especially for the first 2-3 days after injection. "[9] This lack of energy can also hinder efforts to exercise and build muscle. [9]
Poor Diet Quality: The intense appetite suppression can lead to poor dietary choices if not managed. One user confessed, "I have kind of adjusted to super small high calorie consumption. Like I'm pretty sure I was living on sweetarts for a whole month. (Don't do this). "[10] Another mentioned eating "a few bites of junk sweets instead of a mountain of potatoes and cheese. "[11]
Dehydration: Dehydration is a reported issue, sometimes severe. One user described "becoming so dehydrated you stop peeing is no fun either even though I was drinking as much as possible. "[12] Another ended up in the ER for "severe pain and dehydration from vomiting. "[13] AKI (Acute Kidney Injury) from dehydration was also mentioned as a serious effect. [7]
Specific Nutrient Concerns:
Protein: Difficulty consuming adequate protein is frequently mentioned. Users state they are "Trying to find ways to get enough protein into me. "[14] Some find protein powder causes nausea,[15] or that meat becomes hard to digest. [14]
B12: One user mentioned their blood tests were green after starting GLP-1s, having previously had low B12, though this was in the context of improving their IIS-D. [16]
Severe Complications: In extreme cases, the inability to eat and rapid weight loss can have dire consequences. One comment described a patient who lost 100 lbs in 3 months and was "hospitalized and on TPN for a month. "[17]
Remedies and Preventions Recommended:
Eat Nutrient-Dense Foods: When appetite is low, focusing on the quality of food is key. Users suggest choosing "the most nutrient-dense, low caloric and carb concentration" foods. [9] Another mentioned their doctor's advice to "keep the carbs and fats low. "[20] One user highlighted the need to "get nutrient dense foods into her system" if struggling to eat enough. [21]
Stay Hydrated: Adequate fluid intake is emphasized. Recommendations include to "stay very well hydrated"[20] and one user shared their strategy: "120oz of water per day, and one electrolyte package at some point per day. "[22]
Electrolytes: Supplementing with electrolytes is suggested. [22]
Fiber and Probiotics: To manage common GI issues like constipation, one user takes "4g fiber gummies morning and night. "[23] Another user, however, advises, "DO NOT take fiber! " and instead recommends "Daily probiotic supplements. "[24]
Exercise, Especially Weight Training: To combat muscle loss, users advocate for starting a "gym habit"[25] or being "consistent at the gym. "[5] One user mentioned, "weight training is what I need to concentrate on. "[26]
Learn and Implement Healthy Eating Habits: Many users stress the importance of using GLP-1s as a tool alongside developing sustainable eating habits. One user advised to "Use it, learn proper eating habits and work yourself off of it. "[27] A dietitian in one thread confirmed, "When taking meds that reduce appetite, people need a plan to be strategic when they DO eat. Otherwise they are on the path to muscle wasting and overall undereating which leads to malnutrition. "[28]
Mindful Eating: Paying attention to hunger and fullness cues is important. One user shared, "The biggest change for me is that I get full quicker... I recognize mentally that I’m getting full before the feeling hits, and then it’s no big effort to just stop eating. "[22]
Avoid Trigger Foods: Identifying and avoiding foods that cause severe GI side effects, like "heavy carbs,"[29] is recommended.
Supplements: Besides electrolytes and probiotics, one user mentioned their Tirzepatide includes B12. [30]
Medical Supervision and Guidance: The necessity of working with a doctor is highlighted, including for dietary advice. One user's prescribing physician "screens for a history of these both and will not prescribe to anyone with such a background. His advice to me when starting was to keep the carbs and fats low, stay very well hydrated, and avoid alcohol entirely. "[20] However, it was also noted that "Many patients receive little to no guidance from their prescribing physicians on what to do or not do while on GLP-1 medications. "[20]
Dosage Adjustments: If side effects severely impact eating, reducing the dosage might be necessary. One user suggested, "If she can’t eat right, she should lower her dosage. "[21] Another user had to back down their dose due to constant nausea.
Experiences with Malnourishment / Nutrient Deficiencies:
- Severe Appetite Loss and Reduced Intake: Some users describe an extreme reduction in appetite, leading to significantly low food consumption.
Remedies and Preventions Recommended:
- Prioritize Protein Intake: This is the most frequently cited advice.