Abstract
BACKGROUND: GLP-1 dual GIP/GLP-1 agonists significantly suppress appetite, but it is unclear whether the typical diet of patients treated with these drugs still meets their basic nutritional need. OBJECTIVE: To assess nutrients intake among adults undergoing pharmacotherapy and identify dietary predictors of weight loss efficacy. METHODS: This retrospective cohort study was conducted online among social media support groups (April 2024–February 2025). Participants included 387 adults, who reported regular once-weekly use of a GLP-1 agonist or dual GIP/GLP-1 agonist and completed 48-hour food diaries (one weekday and one weekend day). Daily energy and nutrient intake were reconstructed using a specialized software (Diet 6) containing an up-to-date database and standards issued by the National Institute of Public Health (NIZP PZH – PIB 2024). Differences between week and weekends were analyzed using a paired-samples t-test. Multiple linear regression assessed dietary and treatment predictors of weight loss. RESULTS: Average energy intake was 753 kcal (SD 257.8 kcal), with protein 33.4 g (SD 15.3 g), fat 26.5 g (SD 12.4 g), carbohydrates 96.4 g (SD 35.6 g), and fiber 7.2 g (SD 3.1 g). Less than 10% of participants met the recommended intakes for protein. Weekday intake was significantly higher by 170 kcal (95%CI 152–185 kcal; p < 0.001), with greater consumption of fat (8–9 g), and sodium (370 mg). Higher total protein intake was “associated with more weight loss” (β = 0.446; p = 0.014), while a higher proportion of animal protein (β = − 0.517; p = 0.004) and higher sodium intake (β ≈ − 0.002; p = 0.013) were associated with less weight loss. CONCLUSIONS: Adults receiving GLP-1 pharmacotherapy exhibit insufficient protein and critical micronutrients, alongside excess fat and sodium intake on weekdays. Routine dietary education emphasizing protein adequacy and micronutrient sufficiency should accompany incretin therapy to prevent nutritional deficiencies, sarcopenia, and optimize weight loss outcomes.