Optimizing Dietary Management in Obese Patients Undergoing Glucagon-Like Protein-1 Agonist (GLP-1 agonist) Therapy for Weight Control

Abstract

The prevalence of obesity in Thailand has steadily increased over time and remains a long-standing public health concern. Currently, various treatment approaches are being applied, including behavioral modifications related to dietary intake, physical activity, and sleep behavior, as well as surgical therapy and pharmacological treatment. Among pharmacological options, GLP-1 receptor agonists have gained widespread use for weight control. These drugs have been endorsed by the World Health Organization (WHO) and the Thai Food and Drug Administration (FDA) for their safety and effectiveness. Nevertheless, treatment with GLP-1 agonists may lead to side effects, which may increase the risk of malnutrition. In response, this study has compiled nutritional recommendations to guide dietary intake among obese patients undergoing GLP-1 agonist therapy. Recent literature highlighted that liraglutide at 3 mg daily and semaglutide at 2.4 mg weekly are associated with side effects, including nausea, vomiting, diarrhea, constipation, and reduced appetite. These symptoms may lead to dehydration and prolonged inadequate energy and protein intake, contributing to loss of muscle mass. Dietary modifications—such as increasing protein intake to 1.0–1.5 grams per kilogram of body weight, ensuring adequate fluid consumption of 2–3 liters per day, incorporating 20–35% of total energy from good quality fats, and regulating micronutrient levels. These approaches intend to mitigate the risk of malnutrition associated with medication side effects while enhancing the efficacy of GLP-1 agonists in promoting weight loss, thereby contributing to an overall improvement in quality of life.