Beyond the Prescription: How Registered Dietitians Guide Patients in the GLP-1 Era

GLP-1 medications have undeniably changed the conversation around diabetes management and weight care. For the first time in decades, we have a tool that meaningfully addresses one of the biggest barriers to lifestyle change: hunger itself. That shift is both powerful and incomplete without the right clinical support.  

For years, we framed weight loss as a simple equation: eat less, move more. Patients were expected to “stick to the plan,” often without acknowledgment of the many forces working against them.  

In reality, health behaviors are shaped by several intertwined factors:  

• Physical: hunger, appetite regulation, metabolism, sleep, and blood sugar  
• Emotional: habits, stress, comfort eating, and lifelong patterns  
• Societal: food marketing, time constraints, work schedules, and a culture centered around convenience and consumption  

Expecting patients to overcome all of this through willpower alone has not worked.  

According to the New York Times, this generation may be the first in U.S. history to live shorter lives than their parents; driven largely by diabetes and obesity. Despite decades of effort, our traditional approaches were not enough. GLP-1s arrived at a critical moment.  

What makes GLP-1 intervention different is not just weight loss. It’s the way these medications create a physiological environment where healthier choices become possible.  

When hunger is no longer overwhelming:  

• Patients can pause and make intentional food choices  
• Energy improves, making movement more achievable  
• Blood sugar stabilizes, improving focus and overall well-being

One concern I occasionally hear is whether GLP-1s reduce the need for nutrition professionals. In reality, the opposite is true.  

Patients on GLP-1s often arrive asking, “I’m taking this medication. Now I need a meal plan, accountability and guidance.” They have already taken the first step. Our role as RDs is to ensure that step leads somewhere sustainable.  

With hunger better controlled, it becomes easier for patients to:  

• Choose balanced meals over fast food  
• Build protein intake to preserve muscle  
• Time their meals and exercise appropriately  
• Establish habits they can maintain long-term  

But those outcomes do not happen automatically. They require expert guidance.

In hospital settings, patients on GLP-1s still present with nutrition-related concerns — malnutrition, inadequate protein intake, poor oral intake or uncontrolled blood sugars. We document GLP-1s alongside other medications because they are clinically relevant.  

If a patient is on a GLP-1, there is a reason:  

• Diabetes management  
• Obesity with comorbidities  
• Cardiometabolic risk reduction  

A strong care team recognizes that medication plus RD support is not optional, it’s best practice.  

At the same time, we are seeing growth in direct-to-consumer prescribing through online platforms that offer quick access to GLP-1s without comprehensive education or follow-up. This isn’t new. It’s the weight-loss market repackaged.  

History has shown us the danger of relying on medications without appropriate safeguards (Fen-Phen being a sobering example). While GLP-1s are supported by robust research, we still don’t have full clarity on long-term use across a lifetime.  

That uncertainty makes RD involvement even more critical, not less. 

A patient can lose weight and still:  

• Eat inadequately  
• Lose muscle mass  
• Remain sedentary  
• Have poor sleep or unmanaged stress  

Someone may appear “fit” but still struggle with cardiometabolic risk. GLP-1s may help lower blood pressure or weight, but they do not automatically create health. That requires nutrition, movement, sleep and sustainable habits guided by professionals trained to individualize care.

As research advances, we’re learning that:  

• Different GLP-1 formulations work better for different people  
• Dosage, timing, nutrition and exercise must align  
• Mindful eating and mindful medication use matter  

There is no one-size-fits-all approach and RDs are uniquely positioned to navigate that complexity. GLP-1s represent progress, not a replacement for comprehensive care. Health systems that integrate RD-led services alongside pharmacotherapy are better positioned to:  

• Improve outcomes  
• Reduce complications  
• Support long-term behavior change  
• Deliver value-based care  

As we move forward in this new era, the most successful organizations will be those that look beyond the prescription and invest in the professionals who help patients turn medical advances into lasting health.  

See how Sodexo’s Nutrition & Wellness Center can extend your care team through accessible, expert telehealth nutrition support.