If you’re on a GLP-1 medication such as semaglutide (Ozempic) or tirzepatide (Mounjaro) for type 2 diabetes, or semaglutide (Wegovy), tirzepatide (Zepbound), or orforglipron (Foundayo) for weight loss, you probably know that your food and beverage choices make a big difference in how well you do on these drugs
Certain foods and drinks tend to worsen GLP-1 side effects like diarrhea, nausea, and constipation, which result from changes in the speed at which your stomach empties
Also problematic are foods and drinks that fill you up with “empty” calories because they might displace options that really deliver on protein, fiber, and other nutrients — essential for people on GLP-1s, who have limited appetites
That doesn’t mean you should label certain choices “good” or “bad,” but knowing which food and drinks to limit and what to reach for instead can help ensure you’re feeling good and achieving your health goals
1
Sugary Drinks
Since GLP-1s may reduce thirst as well as appetite, it’s important to prioritize getting enough fluids. But soda and juice drinks are not the best choices because they can add a lot of sugar quickly without much protein, fiber, or staying power, saysMaria Tucker, RD, MPH, a registered dietitian and certified diabetes educator at Duke Health in Durham, North Carolina
Not only can these drinks add to the risk of blood sugar spikes and crashes, but they can also fill you up, dampening your appetite so you might not eat enough to get the nutrients you need
Healthier Substitute
Water is the best place to start. If plain water feels boring, try sparkling water, fruit-infused water, or herbal tea. A good goal is 8 to 10 glasses of water or sugar-free beverages a day.
2
Candy and Desserts
Aim to limit candy, cookies, cake, and other sweets because they provide little in the way of fiber or nutrients while adding a high amount of “indulgent” carbohydrates and saturated fats, says Carly Dureiko, RD, a registered dietitian in Cleveland Clinic’s Endocrinology and Metabolism Institute
Healthier Substitute
Fresh or frozen fruit can help satisfy a sweet tooth, says Tucker. “Frozen grapes are a great summertime sweet — both crunchy and refreshing,” she says
Other options include sugar-free gelatin, or a homemade soft serve–style treat made with frozen ripe bananas, protein powder, low-fat or fat-free milk, and Greek yogurt
If you choose sugar-free sweets, check the label for sugar alcohols. “Ingredients that often end in ‘ol’ can cause gas and bloating and so you may want to avoid them, especially if you’re already having those side effects,” says Tucker
Chia seed pudding or chocolate-covered bananas or strawberries are good options, says Dureiko
“You can also modify homemade baked goods to reduce sugar content, such as making black bean brownies or chocolate zucchini bread with less sugar than the recipe calls for,” she says
3
White Bread
White bread, a refined carbohydrate, has less fiber than whole-grain options. Fiber can help with regular bowel movements and overall gut health.
“Additionally, white bread gets digested and converted to sugar more quickly — that contributes to a quick rise in blood sugar, followed by insulin release and a blood sugar crash,” says Tucker
Healthier Substitute
Sourdough bread can be a good substitute for white bread because it tends to have a lower glycemic impact, says Tucker. Protein bread, keto bread, or low-carb, high-fiber tortillas can also be good options
4
Butter Crackers
Butter crackers — think Ritz or Keebler Club brands — may seem like a good light snack, but most refined crackers don’t offer much fiber or protein and they can have as much fat as potato chips
While the occasional butter cracker is okay, Dureiko recommends limiting them
Healthier Substitute
Try crackers made from whole grains, nuts, or seeds, says Tucker. “If you want something crunchy and salty, protein chips or homemade tortilla chips made from low-carb tortillas can also be better options. Cut the tortillas into triangles, brush or spray with olive oil, season, and air fry until crisp,” she says
5
Packaged Snack Foods Like Potato Chips
Packaged snacks can be convenient, but many are high in sodium, added sugar, or fat and low in fiber
“Highly processed foods may worsen nausea, constipation, or acid reflux for some people taking a GLP-1, especially if they’re higher in saturated fat or added sugar and lower in fiber,” says Dureiko
Tucker adds that chips and cookies often contain mostly empty calories, which may also get in the way of weight loss or maintaining muscle
Healthier Substitute
Roasted edamame, chickpeas, or other beans can provide a satisfying crunch as well as a good amount of protein and fiber, says Tucker. “Eat them on their own or add them to nuts,” she says
Homemade snacks can also be a great choice, says Dureiko. “Kale chips, a fruit bowl, homemade granola with yogurt, overnight oats or a savory Greek yogurt dip served with vegetables are all good options,” she says
6
Pizza With Fatty Toppings
Pizza can be high in fat, especially when there are toppings like pepperoni, and higher-fat meals may be harder to tolerate on a GLP-1. Because GLP-1s slow the rate at which you digest fat, food stays in the stomach longer, and may be more likely to cause acid reflux and nausea and vomiting, says Dureiko
Healthier Substitute
Pizza can still fit into a GLP-1-friendly diet if you choose the right kind, especially if you keep the portion size smaller, says Tucker. “Look for pizza with 5 grams of fat or less per serving, choose thin crust or cauliflower crust, and add toppings like ground chicken or turkey, meat substitutes, tomatoes, broccoli, olives, or mushrooms,” she says
7
Fried Chicken and Other Fried Foods
Fried foods are typically greasy and high in fat. Like pizza, these foods hang out in the stomach longer and are more likely to cause digestive side effects like nausea, vomiting, and diarrhea.
Healthier Substitute
Tucker suggests air-fried chicken, fish, or center-cut pork chops. For a crunchy coating, use crushed nuts or protein chips instead of flour, breadcrumbs, or panko
8
Spicy Foods
Whether or not to avoid spicy foods is more a personal and cultural preference than a hard-and-fast rule, says Dureiko. “For some people they aren’t a problem, but they can trigger GI symptoms and acid reflux in other people,” she says
Eating spicy foods in large portions could trigger side-effects even if your tolerance for heat is generally good, says Tucker
Healthier Substitute
If you can’t tolerate spicy foods, add flavor to your cooking with ingredients like lemon, ginger, mint, cilantro, parsley, and lemongrass, says Tucker
“They add zing without causing heartburn or indigestion. Additionally, ginger has been used for years to manage nausea and add flavor to dishes,” she says
If you like peppers, try the nadapeño, the milder cousin of the jalapeño. “It’s wonderful to add to tacos, salads, and any dish calling for spice,” says Tucker. Sichuan pepper and white pepper can also give a milder heat to dishes, she says
Garlic seasoning could be a more digestible choice than raw garlic. Or try onion (although for some people on GLP-1s, onions can cause gas), says Tucker
9
Protein Bars and Shakes With Lots of Added Sugar or Fat
Protein bars and shakes can be helpful on days when it’s hard to sit down for a full meal or you’re not especially hungry, but not all of these products are equally nutritious
Protein bars and shakes that are high in added sugar or saturated fat may increase nausea, bloating, or blood sugar swings.
“Protein supplements are not meal replacements, and whole foods should come first when possible,” says Dureiko
Healthier Substitute
Choose lower-sugar, lower-fat protein options that fit your needs. Greek yogurt, cottage cheese, eggs, fish, chicken, tofu, beans, or a homemade protein-rich smoothie (where you control the added sugar) can all help you add protein to your diet.
- Cleveland Clinic:Can Certain Foods Impact Your Ozempic Side Effects?
- Mayo Clinic:Dietary Fiber: Essential for a Healthy Diet
- UC Health:Many People Using GLP-1 Weight Loss Drugs May Not Be Eating Enough Nutritious Food
- UVA Health:How to Tame GLP-1 Side Effects: 6 Tips
- American Heart Association:Carbohydrates
