I’m on a Newer Weight Loss Drug. Should I Take a Supplement?
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To say the excitement about newer weight loss drugs has reached a fever pitch would be an understatement. These drugs — including semaglutide (Wegovy, Ozempic), which are GLP-1 receptor agonists, and tirzepatide (Zepbound, Mounjaro), which are GLP-1 and GIP receptor agonists — are incredibly effective for weight loss, so it’s no wonder why.
For example, in a 2023 meta-analysis of 41 trials and more than 15,000 participants who had obesity or overweight but no diabetes, GLP-1 receptor agonists were associated with reduced body weight, body mass index (BMI), and waist circumference compared with control groups. These drugs can result in greater insulin release, slower stomach emptying, and a reduced appetite. There’s also research to suggest GLP-1s decrease “food noise,” a term that refers to intrusive thoughts about food. When you’re paying less attention to food, you may not eat as much.
Along with a loss of appetite, nausea, vomiting, and diarrhea may result from these drugs, and these factors can certainly impact what and how much you’re eating. This in turn increases the risk of nutrient deficiencies, which raises the question: Is adding a supplement to your regimen prudent if you’re on a newer weight loss drug?
We talked with two registered dietitian-nutritionists to find out.
Do You Need a Supplement if You’re Taking a Weight Loss Drug?
It’s certainly possible, and your healthcare team can help you determine the answer based on your individual health. In general, though, anyone taking a GLP-1 should make some key nutritional considerations.
“These medications are well known to decrease the appetite, which itself causes people to take in fewer calories and possibly eat less balanced, nourishing foods,” says Beth Warren, RD, who practices in New York City. There can be a tendency to rely on the medication completely for weight loss — rather than pairing it with a healthy, balanced diet. “For some people, the drug can take away the motivation to eat well because it’s working so well on its own,” she explains.
If you are taking a GLP-1, it’s important to prioritize a healthy diet; but that goal comes with its own challenges. “With decreased appetite and sometimes heavy nausea or stomach discomfort, even when someone tries to follow a meal plan, they may not be able to,” says Warren. This can leave you more vulnerable to nutrient deficiencies.
These physical effects can also affect how much you eat. “I’ve seen people eating less than 1,000 calories a day because they felt too sick to eat. Others have no GI issues,” says Jess DeGore, RD, CDCES, the owner of the virtual private practice Dietitian Jess in Pittsburgh. For reference, the calorie goal for adults ranges from 1,600 to 2,400 per day, depending on age and sex, according to the 2020–2025 Dietary Guidelines for Americans. “I worry about people who have a poor appetite and are not getting enough nutrients, whether they have a great quality of life when they can’t enjoy food and don’t feel great most of the time,” she says.
What’s more, if you’re losing weight rapidly, that’s another reason you want to be on guard for potential nutrient deficiency and make sure you have your bases covered, says DeGore.
What Nutritional Supplements Do You Need if You’re Taking a GLP-1?
First, maintain the structure of a healthy, balanced meal plan, but consume smaller portions, advises Warren, and certainly prioritize protein in order to maintain muscle mass as you lose weight. It’s also a good idea to limit added sugars and foods that are rich in saturated fats. The goal is to do your best to eat nutrient-rich foods. Then, you might consider supplementation. “Supplement means ‘in addition to.’ These are meant to assist, not replace, nutrients in your diet,” she says.
The supplements that your doctor or registered dietitian might recommend are those that address common deficiencies, particularly those that may arise during weight loss. Talk to your healthcare practitioner for more guidance on exactly how much you need to take. If you are worried about a deficiency, ask your provider about testing.
Vitamin B12
B12 is a B vitamin that’s vital for blood and nerve cell health, and adequate intake prevents a form of anemia, which causes fatigue, according to the National Institutes of Health. “B12 is a common deficiency that we see in weight loss, so you want to make sure you’re getting enough every day,” says DeGore.
Vitamin D
DeGore says she recommends vitamin D, also known as the “sunshine vitamin,” to everyone, especially during the winter months when there’s less sun exposure. Adequate vitamin D is important for strong bones and immune support, and deficiency is commonly seen in people who are on a restrictive diet, she says.
Probiotic
If you’re having GI side effects due to the medication, a probiotic may help repopulate your gut with good bacteria to ease symptoms, says DeGore.
Multivitamin
A multivitamin won’t overcome poor dietary habits, but you can think of it as a security blanket, says Warren. Remember, though, that vitamins and minerals are more effectively absorbed through food than from a supplement, she says.
Summary
Bottom line: The quality of your diet is incredibly important, especially when your diet is limited by appetite changes or side effects from a weight loss medication. “Use these medications as a tool to refocus on eating a healthy, balanced diet, learn how to eat every few hours, try new foods, and educate yourself about nutrition,” says Warren. You can pursue creating healthier habits when you don’t feel the pressure and angst that comes with trying to lose weight on your own.
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