AS THE use of weight loss injections increases, pharmacists are well-placed to guide patients on health and wellbeing around diet and supplements.
Dual-qualified pharmacist and nutritionist Sarah Gray (pictured) spoke to Pharmacy Daily about helping patients meet nutritional needs and addressing symptoms and other concerns arising from the use of Wegovy, Mounjaro and the like.
While adequate protein intake to prevent the loss of muscle mass is important, Gray said protein supplements in the form of powders are not always recommended, and it is better to meet requirements through food.
"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 told Pharmacy Daily.
"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."
When selecting a product, Gray suggested pharmacists recommend one with fewer additives, low in added fillers and artificial sweeteners, and importantly one 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 may ask pharmacists about their options, and again Gray said the best way to support gut health is through diet, including a variety of fruits and 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.
"Including probiotics, prebiotics and fermented foods in the diet, along with adequate fibre, is a good place to start."
Probiotics are live microorganisms, often added back into processed foods - yoghurt and kefirs usually contain probiotics but check labels to be sure.
Prebiotics are fibres that feed beneficial gut bacteria and help probiotics thrive - for example garlic, onion, leeks, barley, red kidney beans.
Fermented foods such as tofu, tempeh, miso and kimchi may or may not contain live probiotic strains, but still offer gut health benefits, she said.
Constipation is a common side effect of weight loss injections to due to delayed gastric emptying, and reduced food intake, Gray pointed out.
"Aim to get adequate fibre through food, with a mix of soluble and insoluble fibre - for example, oats, fruits, veggies, beans, legumes, and whole grains.
"A psyllium husk or other fibre supplement may be needed if diet alone does not help."
She also warned that reduced thirst may increase the risk of dehydration.
"Actively encourage regular fluid intake, and consider an oral rehydration solution," she suggested.
No other supplements, including vitamins and minerals, are routinely recommended, but she pointed to the need for regular medical check-ins to monitor for any deficiencies, as well as bone health which can also 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. KB
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