When A Prescription Isn’t Enough: Support For Weight-Loss Medications

It seems like weight-loss medications such as semaglutide—better known by the brand names Ozempic and Wegovy—are ever-increasing in popularity.

Many people have used these medications to achieve significant weight loss. But even so, these drugs aren’t a magical weight-loss solution. And for many people, a prescription isn’t enough.

If you’re taking or considering a weight-loss medication, it’s important to make sure you know how to handle potential side effects, how to support your health goals through nutrition and exercise, and how to proceed if you’re considering stopping the drug.

Managing diet, exercise and side effects with weight-loss medications

Weight-loss injections—which include semaglutide, liraglutide (Saxenda) and tirzepatide (Zepbound)—are not “get it and forget it” medications. You still need to take care of your body with nutrient-rich foods and physical activity, or you may experience negative effects.

First, you need to make sure you’re eating or drinking enough. In particular, it’s important to make sure you’re meeting your protein needs and are sufficiently hydrated. This can sometimes be difficult because your appetite is low or because you’re experiencing common side effects like nausea, vomiting and diarrhea. If these concerns aren’t addressed, you may be undernourished.

Second, even if you’re eating enough food, it’s important to make sure your diet provides all the nutrients you need. Since you tend to eat less on these medications, habits like mindless eating or snacking on foods that don’t offer vitamins, minerals or protein (think pantry snacks) can more easily replace a well-balanced diet. If that happens, you miss out on essential nutrients.

Third, you’ll want to avoid eating habits that can worsen side effects. For example, dehydration can cause headaches or dizziness, which are already possible side effects of these medications. It’s best to eat slowly, stay hydrated and avoid large portions of food.

Finally, while it’s impossible to avoid muscle loss (this happens during any kind of weight loss), you should practice strength training on a regular basis to reduce loss of lean mass, also known as non-fat mass.

Discontinuing a weight-loss medication

People on a weight-loss medication also may wonder, “What happens when I stop taking it? Will I gain all the weight back?”

Weight regain is a common and legitimate concern for those who may not want or be able to stay on their medication long-term. Hunger and what is sometimes called “food noise” (that pesky voice in your head that won’t stop talking about food) are likely to return to baseline levels when you stop taking a weight-loss medication.

That’s why establishing healthy habits is key for the long haul. Healthy eating and regular exercise are crucial for any weight-loss intervention, including the use of medications or weight-loss surgery. That means that tools like weight-loss surgery and medications are not an “easy way out”—and certainly come with unique risks.

Seeking support for weight-loss medications

Unfortunately, a prescription doesn’t always come with the necessary support. Some people who are prescribed weight-loss medication feel like they have to deal with side effects, put together a balanced diet, and figure out if and when to stop the medication on their own. If this describes how you feel, try:

• Reaching out to your prescribing health professional. They may be able to answer your questions or can refer you to others — such as registered dietitians and endocrinologists — who can.
• Using an online program. To support all people living with obesity, the Mayo Clinic Diet has designed a prescription companion program for those currently using weight-loss medications, as well as a Medical Weight Loss Rx program for members seeking weight-loss medications. The goal of these programs is to help members achieve lifelong weight management while building sustainable healthy habits. The subscription program includes a meal plan, webinars, content, and an eBook, all specific to weight-medications.
• Looking for a healthcare professional who specializes in obesity care. The Obesity Medicine Association offers a helpful online tool to locate nearby healthcare professionals with expertise in obesity treatment. The Academy of Nutrition and Dietetics also has a Find a Nutrition Expert database to help you find registered dietitians by both in-person and telehealth offerings.