What are the nutritional effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs when used with lifestyle interventions? A systematic review published in Diabetes, Obesity and Metabolism evaluated dietary strategies and nutritional outcomes in individuals receiving these therapies.

The review followed PRISMA guidelines and included randomized clinical trials identified through PubMed, Embase, Scopus, and Web of Science. Eligible studies evaluated adults treated with GLP-1 RAs or dual GIP/GLP-1 RAs alongside lifestyle or dietary guidance. Outcomes included gastrointestinal (GI) symptoms, muscle and bone health, and nutritional adequacy. In total, 16 trials involving 7096 participants were included, with most studies assessed as having a low risk of bias.

Across trials, GLP-1 RAs and dual agonists consistently increased GI symptoms, including nausea, diarrhea, constipation, and vomiting. These effects were often dose-related and occurred despite background lifestyle or dietary interventions. Lean mass was generally preserved, with reductions proportional to overall weight loss. No study directly assessed bone health, and no clinically relevant nutritional deficiencies were reported.

These findings show that GLP-1-based therapies are associated with increased GI symptoms while maintaining lean mass during weight loss. Evidence on optimal nutritional strategies remains limited, and further trials are needed to define dietary approaches and assess musculoskeletal outcomes in this setting.