The GLP-1 Episode: Science, Nutrition, and the Work No Medication Can Do – Episode 190

You’ve seen the headlines. You’ve heard the success stories. Maybe you’ve been prescribed a GLP-1 yourself, or you’re thinking about it. But between the hype and the fear, the full picture is hard to find.

In this episode, Dietitian Dude, David Orozco, registered dietitian nutritionist, certified intuitive eating counselor, exercise physiologist, breaks down the GLP-1 conversation in three parts.

First, he names the tension most providers skip: what these medications actually do, what they don’t, and why the decision to take one carries more emotional weight than any 15-minute appointment can hold. Then he walks through five evidence-based nutritional must-haves for anyone currently on a GLP-1. From the muscle loss most people don’t see coming to the malnutrition risk hiding behind suppressed appetite. Finally, he tackles the plateau and weight regain reality, using the latest research from the STEP trials, the SEMALEAN study, and Lancet-published meta-analyses to reframe adaptation as biology — not failure.

Drawing on nine peer-reviewed studies and rooted in his One Small Bite, intuitive eating, and weight-inclusive approach, David delivers the honest, shame-free conversation men deserve about GLP-1 medications. No verdicts. No moral panic. Just the science, the practical tools, and the internal work that holds.

References
Full citations for all studies referenced in this episode.

Urbina, S., et al. (2026). Micronutrient and nutritional deficiencies associated with GLP-1 receptor agonist therapy: A narrative review. Clinical Obesity, e70070. https://doi.org/10.1111/cob.70070

Malnutrition in GLP-1 Users (2025). Malnutrition is common in patients utilizing glucagon-like peptide-1 agonists prior to total joint arthroplasty. Journal of Arthroplasty. https://doi.org/10.1016/j.arth.2025.01.042

SEMALEAN Study (2025). Impact of semaglutide on fat mass, lean mass and muscle function in patients with obesity. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12673431/

Neeland, I. J., et al. (2024). Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes, Obesity and Metabolism, 26(S4). https://doi.org/10.1111/dom.15728

Hall, K. D., et al. (2024). Physiology of the weight-loss plateau in response to diet restriction, GLP-1 receptor agonism, and bariatric surgery. Obesity, 32(5), 796–809. https://doi.org/10.1002/oby.24027

Lancet eClinicalMedicine (2026). Trajectory of weight regain after cessation of GLP-1 receptor agonists: A systematic review and nonlinear meta-regression. eClinicalMedicine. https://doi.org/10.1016/j.eclinm.2026.103043

Lancet eClinicalMedicine (2025). Metabolic rebound after GLP-1 receptor agonist discontinuation: A systematic review and meta-analysis. eClinicalMedicine. https://doi.org/10.1016/j.eclinm.2025.103614

Penn Medicine (2025). GLP-1 medications may only temporarily suppress brain activity involved in “food noise.” University of Pennsylvania. https://penntoday.upenn.edu/news/penn-medicine-tirzepatide-may-only-temporarily-suppress-brain-activity-involved-food-noise

Frontiers in Nutrition (2025). Investigating nutrient intake during use of glucagon-like peptide-1 receptor agonists: A cross-sectional study. Frontiers in Nutrition, 12. https://doi.org/10.3389/fnut.2025.1566498