GLP-1s and Women’s Nutrition: Why Supplementation and Support are Essential, Not Optional

March 30, 2026

By Georgie Murphy MSc DipNt mBANT mNTOI, Nutritionist & Gut Health Expert at SISTERLY

The Key Takeaways

GLP-1 medications can be highly effective for weight loss by affecting intake and appetite, but they also come with an increased risk of nutrient deficiencies.
Women may experience stronger effects and more side effects than men, partly due to higher drug exposure.
The biggest nutritional risk is under-eating, leading to insufficient protein, vitamins, and minerals.
Rapid weight loss and low protein intake can lead to muscle loss (impacting strength, metabolism, and long-term health.)
Common nutrient gaps include iron, vitamin D, B vitamins, magnesium, zinc, and calcium.
Nutritional support is often overlooked during GLP-1 treatment, but combining diet, resistance training, and targeted supplementation can help.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed obesity and metabolic care. For many women, these medications reduce appetite, improve insulin sensitivity, and finally allow weight loss after years of struggle.

At the same time, GLP-1s may affect women disproportionately, causing more adverse reactions such as nausea, vomiting, diarrhoea, constipation, hair loss, dizziness, and potential muscle and bone loss.^1-5 To use GLP-1s safely and effectively in women, it is critical to understand why these issues arise and how to prevent them.

How GLP-1s Affect Women Differently

GLP-1s influence nutritional status through three main mechanisms:^7-9

Appetite suppression and early satiety, leading to substantial reductions in energy intake.
Delayed gastric emptying, increasing prolonged fullness and potential nausea.
Dietary narrowing, driven by food aversions and tolerance issues.
While all three play a role, evidence consistently shows that reduced intake, both in terms of quantity and quality, is the dominant driver of nutritional risk. ⁴

Studies show that women may have approximately 32% higher circulating GLP-1 drug concentrations at equivalent doses and that they experience more adverse side effects than men, particularly gastrointestinal symptoms such as nausea and diarrhoea. This may reflect greater drug exposure or sensitivity and could partly explain differences in treatment response.²

For example, studies show that women usually lose more total body weight than men when using GLP-1 medications, and because about 20–30% of that weight loss comes from muscle, women may end up losing more muscle overall.⁶

The Biggest Issue: Under-Eating

GLP-1 therapy can reduce energy intake by 30–50%, which doesn’t just lower calories and change eating behaviours, it compresses the entire nutrient intake landscape. ^7-10 Some nutrients are especially vulnerable because they rely on specific food sources, dietary fat, or regular intake frequency, all of which are disrupted in a low-appetite state.

Protein intake is often the first casualty of GLP-1 therapy. Many individuals fall below 0.8g protein/kg/day, well under levels required to preserve lean mass during weight loss.⁹

Without adequate protein intake and resistance training, approximately 25-40% of weight lost may come from lean tissue rather than fat, particularly during pharmacologically induced or rapid weight loss. This has direct consequences for resting metabolic rate, functional strength, physical resilience, and long-term weight maintenance.¹¹

Nutrients Impacted

Inadequate micronutrient intake increases the risk of outcomes ranging from fatigue and impaired immune function to hair loss and osteoporosis, while loss of muscle raises the risk of weakness, injury, and falls later in life.

Individuals on GLP-1s have been shown to have a higher incidence of nutrient deficiencies. Nutrients of concern include iron, calcium, magnesium, zinc, and several key vitamins, including A, D, E, K, B1, B12, and C. When deficiencies develop, symptoms may include disproportionate fatigue, noticeable hair shedding, skin changes, muscle weakness, slower wound healing, or increased bruising. Ongoing gastrointestinal side effects may further increase risk by reducing dietary intake and worsening existing nutrient shortfalls. ^4,12

In a large observational cohort of over 461,000 adults prescribed GLP-1s, diagnosed nutritional deficiencies occurred in 12.7% within 6 months and 22.4% within 12 months of therapy initiation, with vitamin D deficiency being the most common. Smaller percentages of patients were diagnosed with deficiencies in thiamine (vitamin B1), other B-vitamins and vitamin C. Among mineral deficiencies, zinc, selenium, and calcium insufficiencies were recorded and an increased diagnosis of nutritional anaemia, including iron-deficiency anaemia.¹²

In addition to diagnosed deficiencies, dietary data show clear nutrient gaps in people using GLP-1s. In a cross-sectional analysis, a snapshot of what people were eating at one point in time, intakes were consistently low for calcium, iron, magnesium, potassium, vitamins A, C, D and E, and choline, alongside very low fibre. Overall diet quality was reduced and protein intake was often insufficient, raising the risk of muscle loss during weight loss.⁹

Source: Nutritional Priorities to Support GLP-1 therapy for Obesity

Lack of Nutritional Support Amplifies Risk

While there is a need for more research in this area, nutritional compromise on GLP-1s is compounded by gaps in routine care.

A 2024 analysis led by researchers from University College London and the University of Cambridge highlighted that many people prescribed GLP-1-based weight-loss drugs receive little structured guidance on diet quality, protein intake, or micronutrient needs, despite profound appetite suppression.¹⁰

The research was led by Dr Marie Spreckley, from the MRC Epidemiology Unit at the University of Cambridge, who warned that,

“If nutritional care is not integrated alongside treatment, there’s a risk of replacing one set of health problems with another, through preventable nutritional deficiencies and largely avoidable loss of muscle mass. This represents a missed opportunity to support long-term health alongside weight loss.”¹³

Why a Women-Specific Supplement Like SISTERLY May Be Supportive

Because reduced intake and dietary narrowing are predictable effects of GLP-1 therapy, a high-quality women-specific multi-nutrient can act as preventive nutritional insurance.

The Elevator by SISTERLY is formulated to align with the most common shortfalls identified in women, including:

B-vitamins (including B12) to support energy, cognition, mood and hormones.
Vitamin D to support immune function, bone and muscle health.
Zinc, magnesium, and selenium for immune function and hair, skin and nails.

While no supplement replaces adequate food intake, a targeted multi-nutrient can help buffer predictable gaps during periods of appetite suppression and rapid weight loss.

Bottom Line for Women

GLP-1s create a low-intake physiology that disproportionately affects women. Hair loss, fatigue, weakness, nausea, and reduced exercise tolerance are not inevitable- they are signals of unmet nutritional needs.

When GLP-1 therapy is paired with female-specific nutrition guidance, supplementation, and monitoring, women can achieve weight loss while preserving hair, muscle, metabolic health, and long-term wellbeing.

References

Zaccardi F, et al. Sex differences in adverse drug reactions reported for glucagon-like peptide-1 receptor agonists: a pharmacovigilance study. BMJ Open. 2022;12(4):e055732.
Singh S, et al. Sex differences in pharmacokinetics, tolerability, and adverse event reporting with glucagon-like peptide-1 receptor agonists: insights from real-world data. Diabetes Obesity and Metabolism. 2025;27(2):345–356.
Alsuwailem OA, et al. Hair Loss Associated With Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Use: A Systematic Review. Cureus. 2025;17(9):e92454.
Mozaffarian D, et al. Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society. Am J Lifestyle Med. 2025 May 30:15598276251344827.
Do Ozempic, Wegovy, Mounjaro & Zepbound cause hair loss? Drugs.com Medical Answers. Updated 18 Aug 2025. Available from: https://www.drugs.com/medical-answers/ozempic-wegovy-mounjaro-cause-hair-loss-3575019/
Ceasovschih A, Asaftei A, Lupo MG, Kotlyarov S, Bartušková H, Balta A, Sorodoc V, Sorodoc L, Banach M. Glucagon-like peptide-1 receptor agonists and muscle mass effects. Pharmacol Res. 2025;220:107927.
Blundell J, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obesity and Metabolism. 2017;19(9):1242–1251.
van Can J, et al. Effects of the once-daily GLP-1 analogue liraglutide on gastric emptying, glycaemic parameters, appetite and energy metabolism in obese, non-diabetic adults. International Journal of Obesity. 2014;38(6):784–793.
Johnson B, et al. Investigating nutrient intake during use of glucagon-like peptide-1 receptor agonists. Front Nutr. 2025;12:1566498.
Spreckley M, Brown A, Aveyard P, et al. Nutrition Strategies for Next-Generation Incretin Therapies: A Systematic Scoping Review of the Current Evidence. Obesity Reviews. 2026; DOI:10.1111/obr.70079.
Prado CM, Phillips SM, Gonzalez MC, Heymsfield SB. Muscle matters: the effects of medically induced weight loss on skeletal muscle. Lancet Diabetes Endocrinol. 2024;12(11):785–787.
Butsch WS, Spencer M, Tillman E, et al. Nutritional deficiencies and muscle loss in adults with type 2 diabetes prescribed GLP-1 receptor agonists: A retrospective observational analysis. Front Nutr. 2025;12:1234567.
Lack of support for people on weight loss drugs leaves them vulnerable to nutritional deficiencies, say experts. University of Cambridge News. 08 Jan 2026. Available from: https://www.cam.ac.uk/research/news/lack-of-support-for-people-on-weight-loss-drugs-leaves-them-vulnerable-to-nutritional-deficiencies