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All obesity medications have side effects and contraindications that must be considered before starting them. Common adverse events are listed in Obesity medication details. All obesity medications are contraindicated in pregnancy and during breastfeeding. All obesity medications, except for orlistat, must be slowly titrated up to minimize side effects (OMA, 2025).
Because GLP-1s reduce appetite and caloric intake, they can increase the risk for insufficient nutrient intake, including both essential vitamins and minerals and protein. People with obesity may have suboptimal dietary patterns that do not provide sufficient nutrient intakes before initiating pharmacotherapy. As a result, they may be predisposed to nutritional deficiencies before starting therapy and, therefore, it is important to carefully monitor dietary intake during treatment. Nutritional Priorities to Support GLP-1 Therapy for Obesity from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society provides guidance for nutritional and lifestyle interventions during GLP-1 use.
Recommendations for managing adverse GI events associated with obesity medications include (Almandoz et al., 2024):
Eating smaller, nutrient-rich meals more frequently and limiting high-fat foods, spicy foods, and alcoholic or carbonated beverages.
Dose reduction, slower dose escalation, treatment cessation, or switching to alternative therapy.
Considering over-the-counter medications for short-term symptom control.
Overview | Goal Setting | Evaluate Treatment Guidelines | Physical Activity Interventions | Nutritional Interventions | Counseling and Behavioral Interventions | Evaluate Digital Health Options | Pharmacotherapy | Prepare People to Manage Common Medication Adverse Events| Recommend Dietary Supplementation When Appropriate | Evaluate Interventions for Sarcopenic Obesity | Evaluate for Metabolic Surgery Referral | Resources