Nutrient intake while using weight-loss medication

This is not only a logical consequence of eating less; it is also supported by a large US study involving more than 460,000 adults with type 2 diabetes who were using GLP-1 medication. Within one year, more than one in five users had been diagnosed with a nutrient deficiency. This is concerning.

Vitamin D deficiency was the most common, followed by deficiencies in B Vitamins and Iron. A small proportion of users, around 3%, also showed signs of muscle loss. The study focused specifically on people with type 2 diabetes, but the underlying mechanism (eating less and therefore consuming fewer nutrients) may also apply when this medication is used for weight loss.

Why can weight-loss medication affect your nutrient intake?

Weight-loss medication reduces your appetite. As a result, you may:

• feel full sooner;
• feel less hungry;
• sometimes experience nausea;
• eat smaller portions;
• eat less often.

If you consistently eat less, your overall nutrient intake may fall. Eating less is not necessarily dangerous, but it can mean that you consume fewer Vitamins, Minerals, Protein and Fluids than your body needs.

Which nutrients are most likely to fall short?

Recent studies show that the intake of certain nutrients is particularly likely to fall when people eat less while using weight-loss medication. The nutrients most commonly affected include:

Vitamin D

Your body produces most of its Vitamin D in the skin under the influence of sunlight. A smaller proportion comes from food, particularly oily fish, eggs and meat. In the Netherlands, Vitamin D is also added to margarine, low-fat spreads and cooking fats.

If you eat less, and particularly if you eat fewer of these foods, you will also obtain less Vitamin D from your diet. This deserves particular attention during autumn and winter, when reduced sunlight means that your skin produces little Vitamin D and you rely more heavily on dietary sources.

B Vitamins

B Vitamins are found in a wide range of foods, including wholegrain products, meat, fish, dairy products, eggs, pulses and green vegetables. Your body can store very little of most B Vitamins, so a regular intake is important.

If you eat smaller portions or leave out entire food groups, your intake may fall. Vitamin B12 is found almost exclusively in animal products. If you eat fewer animal products or follow a mainly plant-based diet, it is particularly important to pay attention to your Vitamin B12 intake.

Iron

Iron from meat and fish is absorbed more readily than Iron from plant-based foods such as pulses and wholegrain products. If you eat less meat and fish, your intake of this more easily absorbed form of Iron may fall.

Combine plant-based sources of Iron with vegetables or fruit containing Vitamin C, as this improves Iron absorption. Women who menstruate have a higher Iron requirement.

Protein

Loss of muscle mass requires particular attention during rapid weight loss, regardless of whether medication is used. An inadequate Protein intake can make this worse.

Spread your Protein intake throughout the day instead of relying on one large meal. This is often more practical when you can only manage small portions. Protein contributes to the maintenance of muscle mass.

Fluids

You obtain a considerable proportion of your Fluids from food without necessarily realising it. If you eat less, this source of Fluids also decreases.

A reduced sense of thirst can further increase the risk of dehydration, particularly during warm weather, in older people, or if you are also experiencing nausea or diarrhoea. Do not wait until you feel thirsty. Drink small amounts of water at regular intervals throughout the day.

How can you tell if your nutrient intake is becoming unbalanced?

You will not usually notice immediately that your nutrient intake is becoming unbalanced. A reduced nutrient intake often develops gradually.

Signs that may indicate that your diet is becoming unbalanced include:

• fatigue;
• dizziness;
• muscle weakness;
• reduced energy;
• rapid weight loss;
• feeling less thirsty.

These symptoms do not necessarily indicate a nutrient deficiency, but they may be a reason to take a closer look at your diet.

If you experience extreme fatigue, dizziness, muscle weakness, persistent nausea, rapid weight loss or signs of dehydration, it is advisable to contact your GP or dietitian.

Is hair loss your main concern? Read Hair loss caused by weight-loss medication: causes and what you can do about it. [ENGELSE URL CONTROLEREN]

How can you help prevent deficiencies?

The following points apply not only when using weight-loss medication, but during any period of rapid weight loss:

• Avoid losing weight too quickly. Gradual weight loss gives your body more time to adjust.
• Include a source of Protein with every meal, such as meat, fish, eggs, pulses or dairy products, even if you only eat small portions. Protein contributes to the maintenance of muscle mass.
• If you cannot obtain enough Protein from food alone, a Protein supplement, such as a shake or powder, can be a practical addition.
• Choose nutrient-rich foods rather than ‘light’ or diet products with little nutritional value.
• Spread your meals throughout the day to make it easier to meet your overall nutritional needs.
• When you eat less, every bite needs to provide more nutritional value. Choose nutrient-rich foods such as Protein-rich products, vegetables, wholegrain foods and dairy products.
• Drink enough water, even if you feel less thirsty.
• Pay particular attention to Vitamin D, B Vitamins (including Vitamin B12), Iron and Zinc, as the intake of these nutrients is especially likely to fall during weight loss.
• If you consistently eat less, consider taking a daily multivitamin with Minerals as a safety net. This does not replace a varied diet.
• Ask your GP or dietitian to review your diet and any symptoms regularly.
• Take symptoms such as persistent fatigue, dizziness or noticeable hair loss seriously and discuss them with a healthcare professional.

Has a deficiency been confirmed?

• If your symptoms persist, ask your GP about a blood test to determine which nutrient or nutrients may be too low.
• Correct a confirmed deficiency in a targeted way based on the test results, rather than taking high doses at random.
• Discuss the appropriate dose and duration of supplementation with your GP or dietitian.
• Combine supplementation with improvements to your diet. A food supplement cannot provide a lasting solution to a consistently inadequate nutrient intake.
• Give your body time to recover. Hair loss, for example, may take several months to improve, even after your diet has returned to balance.

New food supplement category

A new product category has been created for people who use weight-loss medication. This category helps you find food supplements that may be suitable when your food intake or appetite is reduced.

Not sure whether your diet is still balanced, or would you like some advice? Our qualified specialists are happy to help you work out which nutrients deserve extra attention while you are using weight-loss medication. Contact us during opening hours via WhatsApp (+31 683 702 040), e-mail (info@gezondheidaanhuis.nl) or chat, or call us on +31 318 64 89 89.

Sources

• NPN: Nutritional deficiencies in more than one in five users of GLP-1 medication (in Dutch)