MUSC specialists help people on weight loss drugs gain good info about staying healthy

While the obesity specialists at the Medical University of South Carolina have been very involved in the research on new anti-obesity drugs, they are also reminding people on these drugs to pay attention to their eating and exercise choices. Patrick O’Neil, Ph.D., director of MUSC’s Weight Management Center, said eating less means focusing more on what you consume. “If you stop to think about it, it means every bite that you take is that much more important for your health."

The drugs work by making people feel full more quickly, slowing digestion, reducing cravings and decreasing the desire to eat and drink. That goes a long way toward helping them lose weight. But it can also mean they’re at risk for not getting proper nutrition. 

With that in mind, the Weight Management Center has added services for people taking the new weight loss medications. There’s an online group led by a dietitian, on-demand videos, one-on-one visits with Weight Management specialists and other long-term support offerings. 

It’s a new angle for the center. But the center’s registered dietitian, Tonya Turner, said it’s an essential response to the new weight loss drugs. “People need support as they go through what can be dramatic changes,” she said. “With less quantity, quality becomes critical. Helping people to focus on getting proper nutrition while taking these medications can enhance long-term success and health.”

Many patients may experience periods of nausea when going through the dose escalation period for the anti-obesity medications. “This makes it important to consume food that can be tolerated while providing the right nutrients. Individuals should plan on smaller meals throughout the day and should try to avoid food that may increase nausea, such as those that are more acidic or higher in fat, and beverages such as coffee and alcohol,” Turner said.

She called for an emphasis on fiber from fruits, vegetables and whole grains to keep the gastrointestinal system moving. “Protein can assist in getting adequate vitamins and minerals, as well as sustaining lean mass, while seeing weight loss,” Turner said. 

Fluid intake is important as well. “When I've been talking with patients on these medications, they're not thinking about drinking. It's like they don't have those cues,” Turner said. “We want to make sure they're staying properly hydrated. Water is always best, followed by other no-calorie or low-calorie beverages such as unsweetened tea, sugar-free seltzers and things like that. They really just need to emphasize getting enough fluid.”

She and O’Neil have a new report to back them up. An article in the research journal Obesity makes specific recommendations for people on the new weight loss medications. They include:

• Drinking two to three liters of fluid a day.
• Eating a mix of vegetables, fruit, whole grains, lean protein, low-fat dairy or dairy alternatives and healthy fats.
• Consuming 21 to 25 grams per day of fiber for women and 30 to 38 per day for men. That can come in the form of whole grains, vegetables, beans, peas, lentils, fruit, nuts, seeds and fiber supplements.
• Making sure people on anti-obesity medications get vitamins A and D, which are found in foods such as liver, fortified milk and cereal, egg yolks and fish.

Reflecting on their clinical trial experience with these drugs, O’Neil and Turner pointed out that nearly all of the studies included much more intensive dietary and behavioral counseling than most people would get in actual practice. “The FDA approvals always state that the anti-obesity medications are to be used in conjunction with a reduced calorie diet and increased exercise,” O’Neil said, referring to U.S. Food and Drug Administration recommendations.

When used properly, these medications may serve as catalysts for lifelong change, Turner said.“It's just a great opportunity to get a real boost in establishing some healthier eating and exercise patterns while you've got the medication helping you.”