Diet may be more important than ever when losing weight when taking Ozempic or Wegovy.

Both GLP-1 drugs contain semaglutidewhich mimics a hormone that tells the brain that you’ve had a meal. People taking these medications have a reduced appetite and may experience side effects such as nausea, which may affect the amount of food they can tolerate.

This can lead to big changes in eating habits.

“Patients tend to skip meals due to lack of hunger,” Dr. William Yancy, a medical weight management specialist at Duke Health in Durham, North Carolina, told TODAY.com.

“It’s not a major problem if they skip a meal, but I want to be sure they’re getting enough protein and nutrients every day.”

Jeannine DellaVecchia says she sometimes forced herself to eat when she was taking Ozempic because she would have “absolutely no appetite,” would be “completely nauseous,” and would “throw up all the time.”

“Some days I would have omelets just to try to get something down my throat,” DellaVecchia, 41, who works at a hospital in Philadelphia, Pennsylvania, told TODAY.com.

“You don’t feel like eating…it just wasn’t good for me.”

DellaVecchia was prescribed the type 2 diabetes treatment Ozempic to treat symptoms related to insulin resistance caused by congenital adrenal hyperplasia and polycystic ovary syndrome. Weight loss wasn’t a priority, although she was intrigued that the drug could also help her lose weight.

That’s exactly what DellaVecchia lost 30 pounds between August 2022 and February 2023. However, she stopped taking the drug because she couldn’t tolerate the side effects, she says.

DellaVecchia has not returned to Ozempic since, but says she has managed to maintain her weight loss thanks to the keto diet – “no carbohydrates”, she explains — and help from her dietitian, Emily Rubin.

“I have seen patients with chronic nausea and vomiting on (semaglutide), which can cause dehydration and malnutrition if you fail to consume enough calories or fluids daily,” Rubin, director of clinical dietetics at the Thomas Jefferson Division of Gastroenterology and Hepatology. University Hospital of Philadelphia, tells TODAY.com.

Dr. Maria Daniela Hurtado Andrade, an endocrinologist in the Mayo Clinic Obesity Precision Medicine Program, advises patients taking these medications on the importance of avoiding dehydration.

“You won’t feel like eating, sometimes you won’t feel like drinking, so make sure you remember to drink, making sure you hydrate, even if you’re not hungry,” their said Hurtado Andrade. The doctor is a consultant for Novo Nordisk, the company that makes Ozempic and Wegovy.

How to eat while taking Ozempic and Wegovy

Wegovywhich is approved for weight loss by the U.S. Food and Drug Administration, should be used in addition to a low-calorie diet and increased physical activity, the agency notes.

Ozempic is not approved by the FDA for weight loss, but it is not uncommon for doctors to prescribe it off-label for this purpose.

Patients trying to lose weight with either medication should consult a dietitian to develop a guided meal plan, but in general they should aim to eat between 1,200 and 1,800 calories per day depending on their initial weight, Rubin explains.

Eat lots of different foods vegetables And healthy proteins as the foundation of your diet, advises Dr. Louis Aronne, a physician specializing in obesity medicine and director of the Comprehensive Weight Control Center at Weill Cornell Medicine and NewYork-Presbyterian.

“We’ve done studies showing that if you eat vegetables and protein first, then carbohydrates towards the end of the meal, that’s actually beneficial for your blood sugar, probably also for your weight,” said researcher Aronne. scientist. advisor to Novo Nordisk, tells TODAY.com.

“The cornerstone of nutrition should be real food… healthy food. »

What is the best diet for Ozempic?

Patients taking obesity medications eat less, so nutrient-dense foods become more important, the researchers wrote in the journal Obésité.

The list includes vegetables, fruits, whole grains, seafood, eggs, beans, peas and lentils, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry.

The most ideal situation would be to commit to eating healthier foods, because semaglutide reduces hunger and cravings for unhealthy foods, says Dr. Zhaoping Li, professor of medicine and head of the clinical nutrition division at the University of California, Los Angeles.

She calls this “exploiting the window of opportunity offered by the drug to help patients improve their lifestyle.”

“You can have the chance to make the right decisions — to eat the right food,” Li told TODAY.com. “There is nothing better than not only losing weight, but also eating much healthier foods.”

For those taking this medication, Rubin recommends increasing your intake of lean proteins such as chicken, turkey, fish, eggs, beans, soy, and low-fat dairy products. If you don’t have an appetite or feel nauseous, try low-calorie protein shakes, she adds.

“I’m always concerned about whether patients are getting enough protein and nutrients from vegetables, which is why I insist that patients eat them with every meal and eat them first,” says Yancy.

Not getting enough protein can lead to excessive loss of lean mass, weakness, edema, hair loss and skin changes, the obesity study authors warn.

Rubin advises a minimum of 60 grams (about 2 ounces) of protein per day, preferably spread across meals and snacks. Protein preserves muscle mass and provides the amino acids needed for growth and development, says registered dietitian Kristin Kirkpatrick.

Vegetables And fruitswhich are packed with vitamins, minerals and fiber, are essential to a healthy weight loss program, notes Rubin. She also recommends one to two daily servings of healthy fats like avocados, nuts and seeds.

Choose a small amount of whole grains – half a cup per meal – such as whole-wheat pasta, whole-wheat tortillas, quinoa or sweet potato, advises Rubin. These are complex carbohydrates rich in fiber.

The medication can cause dehydration, so it’s important to stay hydrated, says Yancy. Not drinking enough fluids can lead to low blood pressure, tachycardia (rapid heartbeat) and dizziness, the obesity study authors warn.

Drink eight cups of fluids such as water or calorie-free electrolyte drinks per day, Rubin recommends.

How to manage nausea while taking Ozempic and Wegovy

The most common side effects of Ozempic and Wegovy include nausea, diarrhea, vomiting, stomach pain and constipation, according to Novo Nordisk.

Rubin advised patients to talk to their doctor about any bothersome symptoms and discuss the best dose of each medication to minimize side effects.

Patients start with the lowest dose and gradually work their way up to higher doses, Aronne says. Doctors know how to deal with the problem of nausea, he adds.

Some patients are given anti-nausea medications, but Li cautioned against taking another medication. Most anti-nausea medications come with significant side effects, she notes.

“We call (nausea) a side effect, but in reality, that’s how the drug might work – making you feel like you don’t want to eat,” Li says.

Generally, if the dose is increased slowly and doctors advise patients not to eat beyond the point of satiety and to notice which foods may exacerbate their symptoms and eat fewer of them, the side effects are well tolerated, says Dr. Ania Jastreboff, director of weight management and obesity prevention at the Yale Stress Center in New Haven, Connecticut. She serves on the scientific advisory board of Novo Nordisk. (Consult the list of Foods to avoid if you take Ozempic or Wegovy.)

For example, DellaVecchia likes hoagies, but if she tried to eat one, it would make her sick, she said. A better option is yogurt with almonds, peanuts and cinnamon, which she finds delicious and filling.

Another Ozempic patient previously told TODAY.com that fatty foods in general were “really hard” for her to eat after she started taking the medication.

“There are also people who find that sweets are no longer as pleasant as they used to be. I would say, OK, great with that too. If you don’t really enjoy your typical American diet — which may consist of ultra-processed carbs or a high-fat diet — that’s a good thing.

If a patient still experiences many side effects after changing the foods they eat or the amount they eat, it may be time to reduce the semaglutide dose, Li says.

Rubin offered these tips for reducing nausea:

• Drink ginger or peppermint tea.
• Try ginger chews or capsules.
• Eat smaller, more frequent meals.
• Do not eat or cook foods with strong odors.
• Avoid hot, fried or fatty foods.
• Don’t eat too quickly or drink large glasses during meals.
• Do not lie down shortly after eating.
• Do not wear tight clothing around your waist.

Novo Nordisk provided this additional advice:

• Eat bland, low-fat foods, like crackers, toast, and rice.
• Eat foods that contain water, such as soups and gelatin.
• Go outside for some fresh air.