Nutrition on Ozempic or Mounjaro: Protein, Muscle and Supplements

If you are using a GLP-1 medicine such as Ozempic, Wegovy or Mounjaro, the main nutrition goals are getting enough protein, doing regular strength training, eating fibre-rich whole foods, drinking enough fluid and keeping an eye on vitamins and minerals, because you are eating much less food than before. No supplement replaces or copies what these medicines do. A few, such as creatine, may have a small supporting role alongside training, but the evidence in GLP-1 users specifically is still thin.

Weight-loss injections have changed the conversation about weight in South Africa too. In October 2025 SAHPRA approved tirzepatide (Mounjaro) for chronic weight management, adding to semaglutide (Ozempic, Wegovy). These are prescription medicines, and the advice below is meant to sit alongside your doctor's care, not replace it.

Why nutrition matters more on a GLP-1, not less

GLP-1 medicines turn down appetite. That is how they work, but it also means every meal has to do more. In 2025, four US professional bodies (the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association and The Obesity Society) published a joint advisory on nutrition during GLP-1 treatment. It lists the main challenges as stomach side effects, nutrient shortfalls from eating less, loss of muscle and bone, and weight regain when people stop.

The message is simple: the medicine reduces how much you eat, so what you eat matters more than ever.

How much of the weight lost is muscle?

When anyone loses weight, part of it is lean mass (muscle, organs, water and other non-fat tissue). In the STEP 1 trial of semaglutide 2.4 mg, which followed 1,961 adults for 68 weeks, people lost an average of about 15% of their body weight. In the subgroup who had body scans, the joint advisory reports that of an average 13.6 kg lost, about 62% was fat and 38% was lean mass. Trials of tirzepatide show a broadly similar pattern, with fat making up the larger share.

A few things put this in context:

• "Lean mass" is not the same as muscle. It includes water and organ tissue, so the muscle share is likely smaller than the headline figure.
• Diet-only weight loss shows a similar split; the concern with GLP-1s is the speed and size of the loss.
• Muscle loss matters most for older adults and anyone with low muscle mass already.

Protein: how much do you need?

Low appetite makes protein easy to under-eat. A 2025 US study asked 69 adults on GLP-1 medicines to keep three-day food records. Their average protein intake was about 77 g a day, and fewer than half (43%) reached 1.2 g per kilogram of body weight, a level often used to help protect lean mass during weight loss.

A 2026 review in Metabolites suggests higher-protein eating patterns, commonly around 1.2 to 1.5 g of protein per kilogram of body weight per day during active weight loss, while noting that evidence specific to GLP-1 users is still limited. Your dietitian may adjust this, especially if you have kidney disease.

Practical ways to get there when you are not hungry:

• Eat protein first at each meal, before starchy sides.
• Spread it across the day rather than one big meal, which is hard to manage with a smaller appetite.
• Lean on easy, soft options: eggs, plain yoghurt or maas, cottage cheese, tinned fish, chicken, lentils, beans, tofu and milk.
• If whole food is a struggle, a protein shake can help, but check the sugar content.

Strength training is not optional

Protein alone does not keep muscle. Muscle needs a reason to stay, and that reason is resistance exercise. In a 2021 trial published in the New England Journal of Medicine, 195 adults who had lost weight on a low-calorie diet were assigned to exercise, the GLP-1 medicine liraglutide, both, or placebo for a year. The combination of exercise plus medicine kept off more weight and improved body composition more than either alone.

A reasonable starting point, if your doctor agrees:

• Strength work two to three times a week, covering legs, back, chest and core (squats to a chair, step-ups, wall or knee push-ups, resistance bands, gym machines).
• Gradually add weight or repetitions over time.
• Keep walking or other cardio for heart health and mood.
• If you are new to training, a biokineticist or qualified trainer is worth the investment.

Fibre and fluids

Constipation, nausea and reflux are common side effects of GLP-1 medicines. These are worth discussing with your doctor or pharmacist, who may adjust your dose or suggest medication. The joint advisory encourages adequate fluids and fibre from foods, increasing fibre gradually rather than all at once.

• Build fibre slowly with oats, beans, lentils, vegetables, fruit with the skin, and wholegrain bread.
• Sip water steadily through the day. Because GLP-1 medicines also blunt thirst, many people drink less than they realise.
• Smaller, lower-fat meals and eating slowly are often easier to tolerate.

We are not suggesting any supplement to manage side effects. If they are severe or persistent, speak to your prescriber.

Nutrient gaps reported in research

Eating less food means taking in fewer vitamins and minerals. Two recent US studies point to real gaps:

• The 2025 food-record study found many participants fell short on vitamin D, calcium, magnesium, iron, potassium and fibre (average fibre was 14.5 g a day).
• A 2025 analysis of insurance records for more than 461,000 adults starting a GLP-1 medicine (mostly people with type 2 diabetes) found a recorded nutritional deficiency diagnosis in 12.7% within six months and 22.4% within a year, with vitamin D deficiency the most common.

The joint advisory lists iron, calcium, magnesium, zinc and vitamins A, D, E, K, B1, B12 and C as nutrients to watch. This does not mean everyone needs a handful of pills. It means asking your doctor whether blood tests make sense, eating a varied diet within your smaller portions, and using a standard multivitamin or specific supplement if your doctor or dietitian recommends one.

Creatine: what the evidence does and does not show

Creatine monohydrate is one of the most researched supplements for strength training. A 2022 meta-analysis of 35 randomised trials found that creatine combined with resistance training increased lean body mass by about 1.1 kg on average, compared with training alone. Without exercise, it made essentially no difference.

Because of this, creatine is often suggested for GLP-1 users who want to hold on to muscle. The honest picture:

• We could not find completed randomised trials of creatine in people taking GLP-1 medicines. The 2026 Metabolites review describes creatine as an option supported mainly by indirect evidence.
• Any benefit depends on doing resistance training. Creatine is not a substitute for it.
• Creatine can slightly raise a blood marker called creatinine, which doctors use to check kidney function. Tell your doctor you take it before blood tests.
• Avoid creatine if you have kidney disease unless your doctor approves, and be careful if you are struggling to drink enough fluid.

Our Creatine Monohydrate Gummies contain 1,500 mg per gummy (4,500 mg in three gummies), within the 3 to 5 g daily range used in most research. They are a food supplement, not a weight-loss product. You can read more in our creatine ingredient guide and creatine gummies vs powder.

Alcohol on a GLP-1

The joint advisory notes that alcohol may worsen nausea and reflux during GLP-1 treatment and recommends keeping it to a minimum. Alcohol also adds calories with no protein or micronutrients, which is a poor trade when your total food intake is low. Many people find their appetite for alcohol drops on these medicines anyway.

What happens when you stop?

This is one of the most searched questions, and the data are clear. In the STEP 1 extension, people who had lost an average of 17.3% of their body weight on semaglutide regained about two-thirds of it within a year of stopping. Improvements in blood pressure, blood sugar and cholesterol also drifted back towards where they started. The researchers concluded that ongoing treatment is needed to maintain the results.

That does not mean you can never stop, but it does mean planning matters:

• Talk to your doctor before stopping, and about whether to taper.
• The habits you build while on the medicine (protein at every meal, strength training, regular activity) are the ones that will carry you afterwards.
• Muscle you have kept or built helps with everyday function and makes staying active easier.

Quick reference

Priority	What it means day to day
Protein	About 1.2 to 1.5 g per kg body weight, spread over meals (check with your dietitian)
Strength training	Two to three sessions a week, gradually progressed
Fibre	Increase slowly from whole foods; most people fall short
Fluids	Sip water regularly; thirst may be dulled
Micronutrients	Varied diet; ask about blood tests, especially vitamin D, iron and B12
Alcohol	Keep to a minimum

See a doctor if…

• You have severe or ongoing stomach pain, especially pain spreading to your back, or repeated vomiting.
• You cannot keep fluids down, feel dizzy, or pass very little urine (signs of dehydration).
• You notice yellowing of the skin or eyes, or pain under the right ribs.
• You feel unusually weak, keep losing strength, or have had a fall.
• Weight loss continues much faster than you and your doctor planned.
• You want to stop, pause or change the dose of your medicine.

In an emergency, call 112 from a mobile or 10177 for an ambulance.

Frequently asked questions

Can a supplement work like Ozempic?

No. GLP-1 medicines are prescription drugs with large clinical trials behind them. No supplement or gummy replicates their effect, and products marketed as "natural Ozempic" should be treated with suspicion.

How much protein should I eat on Mounjaro or Ozempic?

Many experts suggest about 1.2 to 1.5 g per kilogram of body weight a day during active weight loss, spread over meals. Your dietitian can tailor this, especially if you have kidney disease.

Is it safe to take creatine with a GLP-1 medicine?

There is no known direct interaction, but there are also no completed trials in GLP-1 users. Check with your doctor first, particularly if you have kidney problems or struggle to drink enough.

Do I need a multivitamin on a GLP-1?

Not automatically, but studies show many users fall short on several nutrients. Ask your doctor about blood tests and whether a supplement makes sense for you.

Will I regain weight if I stop?

Most people regain a large share of the weight in the year after stopping semaglutide. Keeping up protein, strength training and activity gives you the best chance of holding on to your progress.

Sources

• Mozaffarian D, et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the ACLM, ASN, OMA and The Obesity Society. American Journal of Clinical Nutrition, 2025. Summary: American Society for Nutrition
• Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine, 2021. nejm.org
• Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022. University of Liverpool repository
• Johnson B, et al. Investigating nutrient intake during use of glucagon-like peptide-1 receptor agonist: a cross-sectional study. Frontiers in Nutrition, 2025. frontiersin.org
• Butsch WS, et al. Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: a retrospective observational study. Obesity Pillars, 2025. sciencedirect.com
• Lundgren JR, et al. Healthy weight loss maintenance with exercise, liraglutide, or both combined. New England Journal of Medicine, 2021. University of Copenhagen
• Božić et al. Lean mass and musculoskeletal preservation in GLP-1-based obesity treatment: nutrition, exercise, supplementation, and monitoring strategies. Metabolites, 2026. mdpi.com
• Delpino FM, et al. Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: a systematic review and meta-analysis of randomized clinical trials. Nutrition, 2022. sciencedirect.com
• MedicalBrief. SAHPRA grants Mounjaro jab approval for weight loss. 2025. medicalbrief.co.za

This article is for general information only and isn't medical advice. Elevate gummies are food supplements and are not intended to diagnose, treat, cure or prevent any disease. Speak to your doctor or pharmacist before starting any supplement, especially if you are pregnant, breastfeeding, taking medication or have a medical condition.