Can I take Ozempic and not of making nutrition changes? Sure you can! But we really have to address if it is worthwhile to take Ozempic and not make any nutrition changes or be on a nutritious diet.
Does Everyone with Obesity Have a Poor Diet?
Not everyone with obesity has poor nutrition habits. Having worked with thousands of patients by now, I know that many people with obesity have a reasonably nutritious diet and are maintaining their weight. Why that is the case can be a detailed discussion for another time, but I will explain one reason here.
There may be a mismatch between amount of food intake and energy needs. A person may eat more calories than their body needs due to having a high appetite. The quality of their food intake can be very nutritious, but their calorie intake can still be more than their body needs. This can happen if someone's energy needs are typical, and it can happen even more frequently if someone's energy needs are lower than expected. The quantity of their food intake may be reasonable, but their body needs even fewer calories.
Taking Ozempic With No Diet Changes
This person may be a great candidate for Ozempic for weight loss. They already have a nutritious eating pattern, and Ozempic will help them by decreasing their appetite to match their actual calorie needs.
Poor Dietary Habits While Taking Ozempic
What if someone's diet is of poor nutrition quality at baseline? Can they take Ozempic too? Sometimes this questions comes from a place of "This person doesn't deserve a weight loss medication. They have a bad diet!" Let's back up and think about if we ask this question with other medical conditions.
Do we restrict metformin from people who have diabetes and are not ready for making lifestyle changes? Is dialysis only reserved for people with end stage kidney disease with good nutrition? Clearly the answer to these questions is that people with medical conditions should be offered medical treatments regardless of their lifestyle choices.
Of course the person with diabetes will have better health improvements with good nutrition and metformin together and the person with end stage kidney disease will likely also have better outcomes with good nutrition, but giving the medical treatment is not predicated on passing a nutrition test.
Benefits of Ozempic Without Diet Changes
I firmly believe that a person with poor nutrition habits should be offered Ozempic as a medical treatment for obesity. Of course that person will likely have better health outcomes with a combination of good nutrition and Ozempic, but can't the person have at least the benefit of the medication until they are ready for lifestyle change?
Additionally, once this person with a poor quality diet starts Ozempic, a lot can change. With the changes in appetite will likely come initial weight loss. Often when people start to see a change in the number on the scale, they feel more motivated with the lifestyle behavior change. They see what they view as success, and they want more of this. That is when some people are ready to make changes in their eating habits.
Good Nutrition for Those Who Started Ozempic with a Good Diet
I have also seen some movement in the other direction. Due to the appetite changes from Ozempic, some people shift to a lower protein, higher carb diet. This is because with the hedonic drive to eat inhibited, the most hedonically enticing foods are the only ones that pull a person. Often those foods are simple carbohydrates.
When working with patients on Ozempic and other GLP1-RA's, that is a pattern I often see. After their appetite is decreased, and they are losing weight, their diet tends to move towards cereals, breads, and pasta, often with little protein alongside. Patients learn to be very intentional about choosing what they are eating to maximize how their body will feel afterwards. We work on choosing a protein with all meals, aiming for high fiber carbohydrates, and planning to have fruits and vegetables. Even when a person started with a good diet, these later re-modifications become necessary.
So, yes, I think it is OK to start Ozempic without making any nutrition changes. But I understands the value of a nutritious diet. If you are my patient, I hope we can also make good nutrition a goal, and not just weight loss.