Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have substantially changed pharmacologic management of obesity and type 2 diabetes, yet treatment persistence remains a challenge. A perspective published in The Journal of Nutrition reviews nutritional considerations during and after GLP-1RA therapy, with emphasis on dietary fiber supplementation.

GLP-1RAs can produce gastrointestinal adverse effects, including constipation and diarrhea, and nearly half of individuals discontinue therapy within one year. Following discontinuation, maintaining weight reduction and stable glycemic control may be more difficult because appetite suppression and glucose-regulating effects are no longer present. Current evidence suggests that sustained weight effects generally require continued GLP-1RA therapy, although data on post-treatment weight maintenance remain limited.

Existing research provides guidance for nutritional care during and after GLP-1RA use. A comprehensive position paper supports adequate fiber intake; however, high-fiber diets are difficult to achieve in practice, and only 5% of individuals in the United States meet recommended intake levels. Human clinical trials have reported improved bowel function and stool consistency with fiber supplementation. Meta-analyses have demonstrated improvements in glycemic control among individuals with obesity and type 2 diabetes, along with favorable changes in digestive health, obesity indices, lipid profiles, and blood pressure.

The perspective proposes fiber supplementation as a low-cost nutritional option to support care during and after GLP-1RA therapy.