Thinking about a GLP-1. Here’s what to consider before starting
In 2026, GLP-1 receptor agonists like semaglutide and tirzepatide have moved from "trend" to "standard of care." In my practice, I’ve seen these medications transform mind-body-food connections and I’ve also seen them come with major life interrupting side effects. As an expert, I think these medications can absolutely be a tool for long term health and vitality but only when the focus shifts from weight loss to body composition.
If you are thinking of starting a GLP-1 medication this year, here are the four non-negotiables I recommend having in place before your fill a prescription.
1. Protect Your Metabolic "Engine"
Rapid weight loss can cost you up to 40% in lean muscle mass—a disaster for your long-term metabolism and bone density.
The RD Rule: Prioritize .8 - 1.0 grams of protein per lb of body weight.
The Fitness Fix: You must lift. Progressive load strength training 2–3 times weekly signals your body to burn fat while sparing the muscle that keeps you strong and mobile. Additionally, muscle mass houses insulin receptors, making your body more effective and efficient at taking up glucose to be used rather than stored.
2. Fiber: Your Gut Health Insurance
Slowed digestion is how these drugs work, but it can lead to "the GLP-1 backup."
The Target: Aim for 28–35g of fiber daily. Focus on cooked vegetables and chia seeds, and whole grains which are gentler on a slowed digestive tract than raw ruffage.
3. Mastering Sleep Hygiene
Sleep is when your body repairs muscle, and regulates the very hormones these drugs target.
The 3-Hour Rule: Close the kitchen 3 hours before bed to prevent the acid reflux often triggered by delayed gastric emptying.
The Goal: Aim for 7–9 hours of quality rest to keep cortisol low and your metabolic flexibility high.
4. Intentional Hydration
GLP-1s can mute your thirst (and hunger) cues. Dehydration is the #1 cause of the fatigue and "brain fog" reported by users.
The Strategy: Sip 2–3 liters of water daily, supplemented with electrolytes to maintain energy during your workouts.
The bottom line here is that a GLP-1 is a powerful tool, but it is not a "set it and forget it" solution. To emerge healthier, not just smaller, you must train like an athlete and nourish your body for strength, resilience, and stamina.