Is it safe to follow the keto diet while taking a GLP-1 medication?

What you’ll learn:

• You shouldn’t switch to a keto diet when first starting a GLP-1 medication.
• Both the keto diet and GLP-1 medications can cause side effects, and using them together can increase these effects.
• Noom’s color-coded food system and GLP-1 Companion can help you create a healthy eating plan that maximizes the benefits of a GLP-1 medication.

If you’re considering the ketogenic (keto) diet or thinking about a prescription for a weight loss medication, you’re not alone. A 2023 survey shows that 4% of Americans already follow the keto diet. Another study predicts that by 2030, 9% of Americans might be using GLP-1 medications like Ozempic® for weight loss. Due to their growing popularity, there is likely to be an overlap in people interested in using these methods together over the coming years. But is it a safe and effective combo?

Studies have shown that both keto and GLP-1 medications can lead to meaningful weight loss when combined with lifestyle changes. However, it has been shown that a keto diet is more effective in the first six months, but it is not a better option for weight loss long term. Long-term data shows a keto diet is as effective as any other diet that cuts calories but it might be harder to continue due to its restrictive nature.

While combining keto and GLP1-s safely can be done, there is no evidence that a keto diet combined with GLP-1s is more effective long-term. You should never plan to start a keto diet plan at the same time as beginning treatment with a GLP-1 medication. Let’s get into the details and uncover the answers to all your questions about combining keto and GLP-1 medications.

Combining keto and GLP-1 medication

The keto diet and GLP-1 medications are two very different approaches people can consider to manage weight. The keto diet refers to a method of eating where people significantly limit carbohydrates and achieve a state of ketosis. They get most of their calories from fat and protein. If you are not in ketosis, it is not a keto diet, it is just a low-carb diet. 

With the exception of people with certain medical conditions, most people can use the keto diet to lose weight. On the other hand, GLP-1 medications are strictly prescribed to people who need to lose weight for health reasons. Let’s break down each approach:

What is a keto diet?

The keto diet is a low-carb, high-fat eating style designed to shift your body into burning fat for energy. Common keto-friendly foods include meat, fish, eggs, dairy, non-starchy vegetables, nuts, and healthy fats Here’s how it works:

Normally, your body relies on carbohydrates as its main source of energy. These carbs can come from healthy foods like whole grains and sweet potatoes, as well as less nutritious options such as white bread, sugary drinks, cookies, and other sweets. When you reduce your carbohydrate intake to less than around 50 grams per day, your body enters a state called ketosis. In ketosis, your body burns fat for energy instead of carbs. This can lead to significant weight loss in the first few weeks of the diet but it tends to level out after that Plus, much of early “weight loss” is water because carbohydrates store water. Again, studies show that long-term keto is no better than traditional low-calorie diets.

How does a keto diet affect weight loss?

Limiting carbohydrates can help a person lose weight in a few key ways:

• Curbs your appetite: Ketones produced when your body achieves a state of ketosis can suppress appetite, making you feel less hungry. Translation: You might have an easier time sticking to your calorie goals. And, because you aren’t eating carb-heavy foods that can cause greater blood sugar fluctuations, your blood sugar levels will be more stable. As a result, you’ll avoid the hunger associated with these shifts. 
• Tells your body to burn fat:  In ketosis, your body burns fat for energy instead of carbs.
• Helps you keep muscle: Unlike some diets that can lead to muscle loss, keto tends to preserve muscle mass while promoting fat loss. 

What are GLP-1 medications?

GLP-1s are prescription medications designed to help manage blood sugar levels and promote weight loss. These meds mimic a hormone your body naturally produces to regulate blood sugar and appetite. Some popular GLP-1 medications include Ozempic®, Wegovy®, Mounjaro®, and Zepbound®. Ozempic® and Mounjaro® are approved for diabetes management but can be prescribed off-label for weight loss. Wegovy® and Zepbound® are approved for chronic weight management.

If you’re concerned about medication shortages or are looking for a potentially lower-cost alternative, see if you qualify for Noom Med. Ask your clinician about our compounded semaglutide* option through Noom GLP-1-^Rx. Compounded semaglutide contains the same active ingredient as Ozempic^®, but its pricing starts at $149 for the first month. The price includes medication and access to clinicians, Noom’s proven psychology-based approach to losing weight, a vibrant community, and food and exercise tracking tools. If prescribed, it will be delivered right to your door in seven days. Find out if you are eligible today.

*Compounded semaglutide available on the Noom platform is produced in an FDA-registered facility but not reviewed by the FDA for safety, efficacy, or quality.

How do GLP-1 medications affect weight loss?

GLP-1 medications are like a two-for-one deal when it comes to weight loss. They not only put the brakes on your appetite but also slow down digestion. This means you’ll feel fuller for longer, so you’re less likely to snack between meals or overeat. Plus, by keeping your blood sugar levels steady, they can help reduce those energy crashes that often lead to hunger.

What are the potential benefits of using GLP-1 medications combined with a keto diet?

There is some evidence that shows that combining GLP-1 medications with a keto diet can increase weight loss in the first 6 months. Knowing how each of these approaches works, here are some possible reasons why:

• Double the appetite control: Both GLP-1 medications and following the keto diet can help suppress your appetite. GLP-1s also slow digestion and make you feel full longer. 
• Enhanced fat burning: Keto shifts your body into fat-burning mode and GLP-1 meds directly affect fat metabolism. 

Keto diet and GLP-1 safety tips

Using a keto diet along with GLP-1 medications could potentially help with weight loss and blood sugar control, but they should not be started at the same time. It’s important to do it safely with your doctor’s approval. Let’s look at some common questions about combining these methods safely.

What should be considered when combining keto and GLP-1 medications?

Everyone’s body is different. What works wonders for one person may not be the best fit for another. Take time to discuss these factors with your doctor and find out if combining keto and GLP-1 medications is safe for you.

Here are some key factors to consider with your doctor:

• Your current health status: Your doctor will perform tests to make sure you are healthy or have any underlying medical conditions that could be affected by dietary changes or medication.
• Existing medical conditions: If you have conditions like diabetes, kidney disease, or gastrointestinal issues, your doctor will need to carefully evaluate how these conditions might interact with both the keto diet and GLP-1 medications.
• Current medications: Discuss all medications you’re currently taking, including birth control, over-the-counter drugs and supplements, with your doctor. Some medications can interact with GLP-1 meds or be affected by a keto diet. 
• Any history of digestive issues: If you’ve experienced problems like nausea, vomiting, or diarrhea in the past, your doctor may need to monitor you more closely or adjust your treatment plan to minimize the risk of side effects or complications.

What are the potential risks of combining a keto diet with GLP-1 medications?

If you combine keto and GLP-1 medications you need your doctor’s approval and should consider the risks. In general, you can remain on keto and begin a GLP-1 if your body is used to the diet. If you are thinking about starting a keto diet, do it only after your GLP 1 dose is stable and you know it is well tolerated. Here are some other things to watch out for:

• Hypoglycemia for people with diabetes (low blood sugar): Both keto and GLP-1 medications can lower blood sugar levels. When combined, there’s a slightly higher risk of experiencing hypoglycemia, if you’re also taking insulin or other diabetes medications.
• Nutritional deficiencies: GLP-1s and following the keto diet can both suppress appetite which can lead to nutrient deficiencies. Since the keto diet cuts out a lot of healthy foods, it can be difficult for people to get all the nutrients they need without careful planning with a nutritionist.
• Fatigue: Feeling tired or lacking energy can be a common side effect when combining keto and GLP-1 medications. This can happen initially as your body adjusts to using ketones for fuel (on keto) and the effects of the medication. Additionally, the appetite suppression often experienced with GLP-1 medications might lead to lower calorie intake, further contributing to fatigue.
• Dehydration: Both the keto diet and GLP-1 medications can lead to increased urination, especially in the beginning. This is because they both affect how your body handles fluids. Make sure to drink plenty of water to stay hydrated and consider taking electrolytes.

How can these risks be managed effectively?

Always work with your doctor and a qualified nutritionist when deciding to combine keto and GLP-1 medications. True keto diets and GLP-1s should be supported by professionals. 

• Stay hydrated: Proper hydration is key to preventing dehydration and supporting your overall health.
• Prioritize nutrient-dense, high-fiber foods: Focus on whole, unprocessed foods like leafy greens, low-carb fruits, non-starchy vegetables, lean protein, and healthy fats. Also include low-carb, high-fiber options options like avocados, nuts, and seeds to support digestion and gut health.
• Monitor your blood sugar: Be vigilant for signs of hypoglycemia if you have diabetes, such as, shakiness, sweating, dizziness, confusion, fatigue, extreme hunger, and fast heartbeat.
• Choose healthy fats: While keto is a high-fat diet, be sure to choose healthy fats and be mindful of your overall intake. Too much fat can worsen digestive issues when taking GLP-1s.
• Transition gradually: Take time to get acclimated to your medication before switching to a keto diet. While there isn’t a hard and fast timeframe, you should give your body time to adjust to any unpleasant side effects. Again, never start a keto diet at the same time as beginning treatment with a GLP-1 medication. 
• Talk to your doctor: Stay connected with your doctor while taking a GLP-1 medication. Clear any diet changes with your doctor. They can adjust your medication and offer personalized guidance to ensure you are following a healthy plan. 

Noom can also help you create a personalized plan that works for you. We’ll teach you how to monitor your body’s signals, make smart food choices, and adjust your habits for optimal health and weight loss.

What are the best foods to eat while combining keto and GLPs?

Balancing keto and GLP-1 medication requires careful food selection.  That said, Noom’s food color system for the GLP-1 Companion program was created to help guide healthy, balanced eating, with a focus on prioritizing protein. 

Here’s our guide: 

• Green: Load up on these nutrient-dense, low-caloric density and high-protein foods.
• Yellow: Enjoy these in moderation, balancing them with plenty of green foods.
• Orange: Be mindful of portions, as these are calorie-dense and may contribute to digestive discomfort for some. If you’re practicing keto, you may be eating more orange foods than typically recommended.

Here’s your food cheat sheet:

Food category	Noom color	Examples	Why
Non-starchy vegetables	Green	Leafy greens, broccoli, bell peppers, asparagus, mushrooms	Prioritize these! They are high in fiber, vitamins, and minerals.
Lean protein	Yellow/Green	Chicken, turkey, tuna, salmon, tofu, eggs	Choose these over red meats for lower caloric density, lower saturated fat content, and easier digestion.
Healthy fats	Yellow/Orange	Avocado, nuts, seeds	Enjoy in moderation. Prioritize avocado and nuts for added nutrients.
Low-carb fruits	Green	Berries, like strawberries and raspberries	Enjoy for a touch of sweetness and antioxidants.
Dairy	Green/Yellow/Orange	Yogurt, cheese	Be sure to choose low-fat options.
Oils	Orange	Olive oil	Use sparingly as these can be calorie-dense and may exacerbate digestive issues.
Red meat	Yellow/Orange	Beef, pork, lamb	Limit intake due to higher saturated fat content. Opt for lean cuts if you choose to include them.
Water & sugar-free drinks	Green	Water, unsweetened tea, unsweetened, almond milk, black coffee	Stay hydrated! Avoid sugary drinks, even if labeled “keto-friendly.”

Personalizing your health journey with Noom

Combining the keto diet and GLP-1 medications can increase short-term weight loss, but won’t necessarily lead to any difference long term. Noom can help by offering a personalized approach to reach your goals no matter what eating style you’re interested in.

With Noom, you’ll get:

• Personalized meal plans: We help you create healthy meals that work with your GLP-1 medication for the best results.
• Expert coaching: Our coaches are here to support you, answer questions, and help you stay on track.
• Tools to track your progress: Use our GLP-1 Companion to easily track your weight, protein intake, and health metrics in real-time.
• Education and resources: Learn about a healthy diet and GLP-1 medications with our helpful information, so you can make smart choices for your health.

Starting your journey to a healthier you can be tough, but Noom is here to guide you. We’ll give you the knowledge and support you need to successfully combine keto and GLP-1 medications for your weight loss goals.

Note: Ozempic® and Mounjaro® are not FDA-approved to treat obesity or for weight loss.