Life on a GLP-1: eating, exercise and injections

What should I eat on a GLP-1?

Smaller meals with protein first. You will eat less, so each bite needs to count for protein, fibre and fluids.

A 2025 advisory from four US nutrition and obesity groups proposes 1.2–1.6 g of protein per kg of body weight a day during weight loss.² The everyday minimum for adults is 0.8 g per kg.²

For a 90 kg person, that works out to 108–144 g a day.² But using your full body weight can overestimate what you need.² So the same advisory offers a simpler goal: 80–120 g a day.² It also warns against staying at 2 g per kg or more for long.²

Eating the protein part of your plate first helps you finish it before you feel full.² The advisory favours dals and beans, dairy, fish, eggs and chicken. It suggests keeping red and processed meat low.²

Protein in everyday Indian foods

Weights are raw (uncooked). We worked out each serving from India's official food tables.³

Source: Indian Food Composition Tables 2017, ICMR-NIN.³ Curd is not in those tables, so its figure is from US data for plain whole-milk yogurt.⁴ Rounded to whole grams.

A worked example: 100 g paneer, 200 g curd and 60 g moong dal add up to about 40 g of protein.^3,4 That is half of the 80 g goal.

Smaller meals, fibre and fluids

• Small, frequent meals. The Endocrine Society of India (ESI) is the professional body of India's hormone and diabetes specialists. Its 2025 obesity guideline advises small, frequent meals, and avoiding very oily, very starchy or very high-fibre meals.¹ Vomiting is more likely after a large meal.²
• If you feel sick: try a small breakfast, then small meals every 3–4 hours.² Ginger, saunf (fennel seeds) or small sips of buttermilk or kokum juice may help.¹ Skip fizzy drinks.¹
• Fibre, slowly. Go easy on high-fibre food in the first few days. After that, add fibre gradually to prevent constipation.²
• Fluids. Losing fluids through vomiting or diarrhoea can harm your kidneys.^2,5 The US advisory says to drink enough fluids.² For alcohol, see Questions people ask.

How do I keep my muscle?

Do strength exercise at least 3 times a week, and eat enough protein. Walking alone protects less muscle than walking plus strength training.²

Not all the weight you lose is fat. In one semaglutide trial, of every 10 kg lost, about 4 kg was "lean mass": muscle and other non-fat tissue. About 2 kg of that was muscle.²

The 2025 advisory suggests strength training at least 3 times a week, plus at least 150 minutes of moderate activity, like brisk walking.² The plan should match your fitness level.²

What about festivals, weddings and fasting?

Big meals make vomiting more likely, so take small plates and stop early.² Fasting needs a plan if you take insulin or a sulfonylurea (a type of diabetes tablet, such as glimepiride or gliclazide).⁶

At weddings and Diwali dinners, the same rules apply: small portions, protein first, fewer fried and sweet dishes.^1,2 You don't have to finish what you're served.

Navratri, Karva Chauth and other fasts

There is far less research on Hindu fasts than on Ramadan fasting (below).¹⁵ We found no guideline written for GLP‑1 users during Navratri or Karva Chauth. A 2017 Indian review on diabetes and Navratri gives practical advice:¹⁵

• Fasting food is often fried, like sabudana, kuttu and singhara dishes. Prefer grilled, boiled or steamed versions.¹⁵
• Going without water in hot weather can cause dehydration.¹⁵
• You and your family should know how to spot and treat low sugar, and be ready to break the fast.¹⁵

Ramadan

The main guidance is the 2021 Ramadan guidelines from the International Diabetes Federation and the Diabetes and Ramadan International Alliance (IDF-DAR):^13,14

• GLP‑1 medicines can be used while fasting, if taken on schedule with a doctor's oversight.^13,14 Don't stop without medical advice.¹³
• Finish dose increases before Ramadan. The guidelines say no further changes are needed if the dose went up step by step at least 2–4 weeks before. A 2023 review says at least 4 weeks.^14,13
• The evidence is from older GLP‑1 medicines (liraglutide, lixisenatide and exenatide). The guidelines don't name semaglutide or tirzepatide, and say more research is needed on newer ones.¹⁴

How do I inject, and what if I miss a dose?

Inject once a week, on the same day, into your belly, thigh or upper arm. Use a new needle and a new spot each time.

• Where: just under the skin of the belly, thigh or upper arm.^5,6 For Mounjaro, the upper arm is for someone else to inject.⁷
• When: any time of day, with or without food.⁵
• Rotate: use a different spot each week.^6,7 This helps avoid lumpy, thickened skin (lipohypertrophy).¹
• Needles: a new needle every time. Don't store the pen with a needle on.⁶
• Never share a pen, even with a new needle. It can spread serious infection.⁶
• Disposal: put used needles in a hard plastic container with a tight, puncture-proof lid, and label it.⁶ Don't put medicines in household waste or down the drain. Ask your pharmacist.⁹

Missed a dose?

Never take two doses to catch up. The labels say to skip the missed dose and carry on as normal on your usual day.^10,11 If you've missed 2 or more weeks, ask your doctor before restarting. They may restart you on a lower dose.^5,9

On tablets (Rybelsus or generic oral semaglutide)?

Take it first thing, on an empty stomach, with up to 120 ml of plain water. Swallow it whole.⁸ Then wait at least 30 minutes before eating, drinking or taking other tablets.⁸ If you miss a day, skip it and take the next one as normal.⁸

How do I store it in the heat, and travel with it?

Keep unopened pens in the fridge. Once in use, most can sit outside the fridge for a few weeks, but only below 30 °C.

Store new pens at 2–8 °C, away from the cooling element. Never freeze them, and never use one that has frozen.^5,6,7 Protect pens from heat and sunlight.^6,7

US and EU labels give different limits.^5,6,9,10 Always follow the leaflet in your own pack.

Travelling. Diabetes UK's advice for insulin, which also needs fridge storage, fits here. Carry it in hand luggage, because the hold gets very cold and bags get lost.¹² A cool bag helps, but don't let the pen touch frozen ice packs.¹² Some airlines ask for a doctor's letter, so carry your prescription.¹²

How do I know if it's working?

Expect a check-in around 3 months and again around 6 months. A common yardstick is losing at least 5% of your starting weight.

1. Week 0Start on a low dose. Write down your weight and waist.
2. Every 4 weeksThe dose usually steps up, if side effects allow.^5,7
3. Month 3The ESI guideline suggests a 3-month trial to judge whether a medicine works and suits you.¹
4. Month 6UK guidance (NICE): consider stopping semaglutide if under 5% has been lost.¹⁶ For tirzepatide, if under 5% has been lost after 6 months on the highest dose you can tolerate, decide whether to carry on.¹⁷
5. After thatRegular reviews, for as long as you take it.

For a 90 kg person, 5% is 4.5 kg. Falling short doesn't mean you failed. Your doctor weighs up the benefits and risks of carrying on.¹⁷ Guide 3 covers the other options.

Weight isn't the only measure. The ESI guideline also points to sugar control, heart health and kidney health.¹ And the medicine doesn't replace diet and exercise.¹

What should I keep track of?

Your weight, waist and side effects, and your sugar if you have diabetes. Bring the notes to each review.

• Weight and waist: write them down, so you can compare at your 3- and 6-month reviews. Guide 1 shows how to measure your waist.
• Blood sugar, if you have diabetes: check before you start and while you take it.⁵ Low sugar can show as dizziness, sweating, shaking, blurred vision, confusion or a fast heartbeat.⁵
• Doctor checks: your heart rate, because your resting pulse can rise on these medicines. Tell your doctor if your heart races while you are resting.⁵ Kidney tests if you've had bad vomiting or diarrhoea.⁵ If you have diabetes, report any change in your eyesight: a fast improvement in blood sugar can briefly worsen diabetic eye disease (retinopathy).⁵
• Side effects and meals: note what you ate before nausea. Patterns help.

What about food noise and family meals?

Many people find the constant thoughts about food go quiet. Some also lose the pleasure of eating, and that can feel strange at family meals.

Studies show less "food noise", less emotional eating and fewer binges on these medicines.² But some people miss the joy of food, or of cooking for others.² If food has always meant love in your family, that change can be hard. Talking it through, or seeing a counsellor, can help.²

Don't skip meals for hours because you aren't hungry. Getting very hungry can bring back cravings for sweets and refined carbs.²

At home, it helps if the family knows why your plate is smaller. The ESI guideline asks doctors to give both the patient and their caregivers time to understand the treatment.¹ A simple line works: "I'm on a medicine that fills me up fast. I'll have a little of everything."

Questions people ask