Ozempic Can Make You Thin, Not Necessarily Healthy

Ozempic and Wegovy can make you thinner, but the drugs alone won’t guarantee good health. 

For those taking these drugs, exercise is still vital to keep your heart healthy and muscles strong. Exercise lowers your risk of cardiovascular disease, cancer, Type 2 diabetes and Alzheimer’s disease, according to scientific studies. And strength-training is especially important when you lose a lot of weight quickly.

People taking these drugs to lose weight also need the right foods to provide nutrients, fuel their body and keep them healthy. This approach isn’t just about eating better. It’s about eating a specific diet tailored to these drugs. If you don’t, that could lead to health problems down the road or exacerbate side effects. 

Ozempic and Wegovy are popular medications for Type 2 diabetes and obesity, sometimes referred to as GLP-1 drugs. They suppress appetite, slow the emptying of the stomach and make people feel full longer. So they eat less. 

With fewer opportunities to get important nutrients, each bite counts more, says Dr. Kimberly Gudzune, director of the healthful eating, activity and weight program at Johns Hopkins Medicine and medical director of the American Board of Obesity Medicine. 

“Even though you can survive on doughnuts and chips, think about veggies, lean proteins and whole grains,” she says. 

When people lose weight, particularly when they lose a lot of weight quickly as can happen with Ozempic and other GLP-1 medications, they lose not only fat but also lean muscle mass. Lean muscle is important for strength and metabolism (since muscle burns more calories than fat) and high-protein foods like chicken, fish, eggs and tofu contain the amino acids that are building blocks of muscle, says Dr. Amanda Velazquez, director of obesity medicine at Cedars-Sinai in Los Angeles. 

She advises patients who are losing weight to consume between 0.8 and 1 gram of protein daily for each kilogram they weigh. 

Do squats and lunges 

Strength or resistance training is also important to maintain and build muscle. Focus on your legs and buttocks: As your body’s biggest muscles, that’s where you have the opportunity to build the most mass, says Dr. Todd Shaffer, a professor of family medicine at the University of Missouri-Kansas City School of Medicine. 

Start with squats and lunges with just your body weight, says Neal Pire, an exercise physiologist at the Gym in Englewood, N.J. As you build strength, do them while holding hand weights. Pire also recommends push-ups. Beginners can do them against the wall. 

Gudzune is particularly concerned about the loss of muscle mass with her patients ages 70 and older who are on GLP-1 drugs. Muscle loss can lead to falls and difficulty doing daily movements that are important for remaining independent, such as getting up and down from a chair, she notes. Gudzune says she starts her older patients taking GLP-1 medications on a strength-training routine with a resistance band.
 

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Drink water even when you may not feel thirsty

The new diabetes and weight-loss medications make people feel less hungry. Velazquez says many of her patients on them are also less thirsty. 

To make sure people don’t get dehydrated, she advises patients to remind themselves to drink water by setting alarms on their phones and using bottles with ounce markings so they can see how much they are drinking. 

Staying hydrated also helps with weight loss, notes Shaffer. He advises patients trying to lose weight to first try drinking something when they feel hungry. Sometimes when people think they are hungry, they are actually thirsty, he says.

Up your intake of vitamin C, zinc and foods like yogurt

GLP-1 medications reduce the amount of acid in your stomach. Stomach acid acts as a barrier to bacteria and other bugs. So people on these drugs should consider eating more foods high in vitamin C, like kiwi, lemon and oranges, and zinc, like beans and cashews, says Sue-Ellen Anderson-Haynes, a registered dietitian in the Boston area and a spokeswoman for the Academy of Nutrition and Dietetics. Some research has found that vitamin C and zinc are linked to healthy immune function. 

Anderson-Haynes also recommends that people on these drugs eat foods like yogurt, kefir and tempeh that contain live active cultures that support good gut bacteria. Research has found a link between the gut microbiome and immune function. 

Eat slowly and avoid fatty and highly processed foods 

The newer weight-loss drugs can come with unpleasant side effects like nausea, vomiting, diarrhea and constipation. Since food sits in the stomach longer, eating quickly can make nausea and vomiting more likely, says Shaffer. 

“If somebody is used to scarfing down their food in five minutes, they are going to be the first one throwing up,” he says. “People on these medications need to slow down and let their body tell them they’re full.” 

Velazquez steers people away from fried foods and items that are highly processed like chips. These foods sit in the digestive tract longer since they are harder to break down, she says. That can exacerbate side effects.  

These kinds of foods, of course, aren’t healthy anyway, she says. She reminds patients that weight loss isn’t the only aim. 

“Our overall goal is health,” she says. “Having people have a high quality of life and live as long as possible in a healthy way.” 

Write to Andrea Petersen at andrea.petersen@wsj.com