The rise in the use of weight loss injections such as Wegovy and Mounjaro has placed pharmacists in a pivotal position to guide patients on health and wellbeing, particularly concerning diet and supplements. Dual-qualified pharmacist and nutritionist Sarah Gray emphasizes a “food-first” approach, cautioning against the over-reliance on protein powders and supplements.
Gray, speaking to Pharmacy Daily, highlighted the importance of adequate protein intake to prevent muscle mass loss. However, she advised that protein supplements should not be the default solution. “Protein supplements may be helpful in some cases, such as helping people meet or top up protein targets due to low appetite, those struggling with nausea or early satiety, people having trouble recovering from exercise, or older people at higher risk of sarcopenia,” she said.
She further explained that while supplements can be beneficial, it is preferable to meet nutritional needs through food. “Ideally, it is best to have a food-first approach, but as food intake can reduce significantly, powders added to yoghurt, smoothies, porridge or snacks can be helpful,” Gray noted.
Guidance on Selecting Supplements
When advising patients on supplement choices, Gray suggested pharmacists recommend products with fewer additives, low in added fillers and artificial sweeteners, and importantly, those that the patient tolerates and enjoys. “Start slow and assess tolerance before adding to every meal,” she advised.
Patients experiencing gut symptoms from weight loss injections often seek advice from pharmacists. Gray recommends supporting gut health through a varied diet rich in fruits, vegetables, fibre-rich whole grains, legumes, and fermented foods. “If symptoms persist or dietary variety is limited due to reduced appetite, probiotic supplementation may be considered,” she said.
“I have not seen robust evidence to show which specific strains and which dose are for GLP-1 users, but Lactobacillus and Bifidobacterium show promise for general gut symptoms,” she explained.
Understanding Gut Health and Supplements
Gray elaborated on the benefits of probiotics, prebiotics, and fermented foods. Probiotics are live microorganisms often found in processed foods like yoghurt and kefirs. Prebiotics are fibres that nourish beneficial gut bacteria, found in foods such as garlic, onion, and leeks. Fermented foods like tofu, tempeh, and kimchi, while not always containing live probiotic strains, still offer gut health benefits.
Constipation is a common side effect of weight loss injections due to delayed gastric emptying and reduced food intake. Gray advised aiming for adequate fibre intake through a mix of soluble and insoluble fibres, such as oats, fruits, vegetables, beans, legumes, and whole grains. “A psyllium husk or other fibre supplement may be needed if diet alone does not help,” she added.
“Actively encourage regular fluid intake, and consider an oral rehydration solution,” she suggested, warning against the risk of dehydration due to reduced thirst.
Regular Monitoring and Medical Guidance
No other supplements, including vitamins and minerals, are routinely recommended. Gray stressed the importance of regular medical check-ins to monitor for any deficiencies and to assess bone health, which can be affected by weight loss. “If dietary assessment indicates something may need proactive supplementation, it is best for the patient to see a dietitian,” she concluded.
This guidance from pharmacists like Gray underscores the critical role they play in patient health management, especially as the use of weight loss injections becomes more prevalent. The emphasis remains on a balanced diet and careful consideration of supplements, ensuring patients receive comprehensive care tailored to their individual needs.
