What is GLP-1 (Ozempic/Wegovy) Nutrition Counseling? – Could This Be the Next Big Opportunity for RDs and Nutritionists?

glp-1 under magnifying glass
Modified by

Created by NutritionED.org Contributor

Part 1 of Our Series on GLP-1 Nutrition and Dietary Counseling

 

It’s been a truism for almost as long as there have been such a thing as professional nutritionists: most of the job is about explaining to people how to lose weight.

A healthy diet and reasonable portions have always been a hard sell to the average American, of whom over 40 percent are categorized as obese according to 2020 CDC data. Just under 10 percent are categorized as severely obese, a group that has been growing quickly across the country.

These are numbers that come with serious health consequences, including diabetes and heart disease. They are some of the greatest concerns for any nutritionist or registered dietitian. And for the country as a whole, they are significant drag on the healthcare system.

The annual medical costs are almost $2,000 higher for the overage obese American, and over $3,000 higher for those ranked as severely obese.

So the fact that healthcare and nutrition professionals have a new therapeutic technique in the holster for these individuals is big news. Figuring out how to safely and effectively use it to provide care to millions of Americans may be the most significant thinking happening in the world of nutritional counseling today.

The following bachelors and Master’s programs offer career-focused instruction delivered by trained nutritionists with experience in the field. Find out more what each individual course of study offers through the locations below.

Featured Nutritionist Programs

What Are GLP-1 Drugs Like Wegovy and Ozempic?

That therapy is based around a new category of drugs known as GLP-1 receptor agonists.

GLP-1 is shorthand for glucagon-like peptide-1, an amino acid secreted in the intestine and used by the body to send a signal when the stomach is full. This, in turn, is received by various other organs to increase insulin production, glucose uptake, even taste sensitivity.

Receptor agonists are a synthetic product that mimic GLP-1 in the body. They attach to the same receptors and cause many of the same effects, all without requiring any food intake.

Discovered in the 1990s as substance in Gila monster venom, the product was duplicated in the lab and called exanatide. It went through clinical trials and was approved by the FDA in 2005.

Overlooked at First, GLP-1 Receptor Agonists Suddenly Took Bariatric Medicine by Storm

Initially, the pharmaceutical industry didn’t pay a lot of attention to the drug category. It was marketed as a medication for treating type 2 diabetes in a drug cocktail that increased natural insulin production.

But doctors noticed something interesting in the early users of GLP-1 receptor agonists: not only did their diabetic symptoms reverse, but they were also losing weight.

Before long, the drugs were making the rounds for weight-loss alone. Manufacturers took note, and began to tune them for weight-loss and convenience.

Today, a weekly injection of Ozempic or Wegovy offers safe treatment, typically resulting in 10 percent to 15 percent weight-loss among patients.

Even more effective formulations, such as Zepbound and Mounjaro, have been concocted that lead to 18 percent loss of body weight. Trials are underway for drugs that are promised to lead to up to 24 percent loss.

Clearly, it’s a new era for obesity treatment in America.

A Brief History of Weight Loss Drug Fads in the United States

fad diets don't work on spelled out on tilesOzempic is far from the first miracle cure for obesity that has hit the market in America. The seductive promise of a pill to melt the pounds away has been a dream for nearly a 100 years here… a dream that pharmaceutical companies and quacks alike struggled to make real.

Diet pills like Newman’s Obesity Cure and Frank J. Kellog’s Safe Fat Reducer were common in the late 1800s, with dubious results. As early as the 1930s, over-the-counter pills such as Dinetrophenol were acting on the thyroid, with real results—but also significant side effects, like cataracts and death by hyperthermia.

In the middle years of the 20th century, doctors turned to amphetamines, other thyroid hormones, laxatives, or even combinations of all the above called Rainbow Pill therapy; none worked very well, and many proved dangerous.

The drugs kept coming, but the side effects, addictiveness, or lack of efficacy kept pointing to a healthy diet as the only real resolution to obesity. Some, like Leptin, introduced in 1999, managed to produce limited weight loss without severe side effects… but not enough to be worthwhile.

That left, in every case, a healthy diet and exercise as the preferred solution to obesity. Nutritionists have been a vital piece of that answer for decades; now they will have to adapt to new shifts in obesity treatment.

What is GLP-1 Nutrition Counseling?

nutritionist showing app to patientGLP-1 agonists like Wegovy or Ozempic don’t achieve their full effect alone, however.

Studies have shown that patients who receive structured nutrition guidance in addition to GLP-1 therapy achieve:

  • Greater levels of weight loss
  • Better stability in maintaining losses
  • Greater adherence in long-term weight loss

One trial study combined weight loss drug administration with intensive behavioral therapy and an initial low-calorie diet. It founds that there was significantly greater weight loss over a placebo among participants.

It’s also true that removing weight medically doesn’t do much to address the underlying behaviors that caused it—there’s a significant risk of relapse coming off these drugs without some sort of supportive counseling.

This is where nutritionists and registered dietitians have a big role to play. With their expertise on top of the appetite suppression and reductions in consumption, patients can get the full benefits of their Ozempic or Wegovy therapy.

Weight Loss Isn’t the Only Objective in Obesity Treatment

It’s important to note that weight loss alone doesn’t necessarily make for a healthier life, either. Nutritional deficiencies can still lead to muscle and bone loss, risk of disease, and electrolyte imbalance. Just reducing calorie intake doesn’t magically make up for other gaps in a healthy diet; in fact, it can make them worse.

A magic injection to reduce weight doesn’t address the behaviors that led to the weight gain in the first place.

It’s also true that for most patients, the weight gain is only a symptom of other unhealthy nutrition and exercise choices. Eating less may help them drop the pounds, but doesn’t necessarily address other issues. While losing weight alone certainly comes with a host of health and psychological benefits, it’s often the lifestyle changes that lead to weight loss that really deliver the greatest impact.

How Registered Dietitians and Nutritionists Are Counseling GLP-1 Patients Today

For the typical trained nutritionist or dietitian, the evidence-based guidelines that have been developed for supporting GLP-1 patients with structured counseling will look pretty familiar.

A Joint Advisory on nutritional support for GLP-1 therapy for obesity was issued by the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society in May of 2025. It includes eight elements that are considered key to minimizing risks and maximizing benefits from the treatment:

  1. Adopting a Patient-Centered Approach to GLP-1 Therapy – One of the keys to success is to individualize the therapy plan with a holistic approach to health and well-being rather than weight-loss alone. This can require counseling from nutritionists, since many patients tend to focus only on weight issues.
  2. Complete a Baseline Nutritional Assessment and Screening – This is bread and butter stuff for nutritionists, who routinely examine weight history, nutritional needs, existing medical conditions, and goals.
  3. Manage Gastrointestinal Side Effects – The GI side effects are some of the most common in GLP-1 treatments, and are often managed through changing dosage. But nutritionists can also make meal recommendations including avoiding fatty or high fiber foods and changing eating patterns to mitigate nausea, constipation, and diarrhea.
  4. Balance Dietary Preferences and Intakes – Many patients on Ozempic show impacts on food preferences and changes in eating habits. Studies have shown that having nutritional guidance through these shifts can help nudge them toward more beneficial, more effective patterns with a long-term improvement in health.
  5. Prevent Nutritional Deficiencies – The same shifts in intake can inadvertently create real deficiencies in key nutritions. Dietitians can prevent this by pushing patients toward nutrient-dense, minimally processed foods that will deliver energy and key vitamins even as calorie intake goes down. They may also prescribe multi-vitamins as appropriate for individuals.
  6. Preserve Muscle and Bone Mass Through Treatment – A similar issue arises with bone and muscle mass in many patients. Keeping intake of protein high even as appetites decrease is a goal for nutritionists, as well as monitoring body composition to prevent secondary health issues.
  7. Maximize Weight Reduction Impact – There are genuine differences between patients who just get a shot of Ozempic once a week and go about their day versus those who receive extensive nutritional counseling on top of the drug. Adding a nutritionist to the treatment gets more bang for the buck out of GLP-1 treatments, which can make them faster for hitting healthy target weights as well as achieving longer lasting results.
  8. Promote Other Supportive Lifestyle Measures – Ultimately, weight and nutrition are really just two pieces in the larger puzzle of individual health and wellness. So dietitians and nutritionists should also be prepared to integrate with other clinicians on a larger care team, looking at interventions to:
    • Improve sleep quality
    • Manage mental stress
    • Nurture positive social connections
    • Minimize other substance use

The advisory also notes that this sort of structured, evidence-based therapy is not commonly in use with GLP-1 administration today, however. You can learn more about getting trained and qualified to administer this kind of counseling in Part 2 of our series.

What Drawbacks Do Nutritionists Have To Watch Out for When Working With Patients on Ozempic or Other GLP-1 Drugs?

measuring male patient's waistline with measuring tapeAlthough Wegovy and Ozempic are generally safe, they aren’t without side effects. Fatigue, headache, gastroesophageal reflux, bloating, and nausea all appear in some patients.

While those side effects rarely cause people to abandon the therapy, they are another area where trained dietitians and nutritionists can offer some relief. Alterations in diet can help counteract many of these side effects. In other cases, simply having a trained professional to evaluate and explain them could lead to greater continuity in treatment.

There are also issues that patients face that stem directly from the drugs working perfectly. A caloric intake drop of anywhere from 16 to 39 percent is significant, and can lead to deficiencies in getting essential vitamins and minerals. This can exacerbate fatigue, lead to hair loss, muscle weakness, and slow wound healing. In some cases, patients go into metabolic acidosis and require hospitalization.

Muscle and bone loss is a common result of GLP-1 receptor agonist therapy.

This is all on top of a predisposition for poor dietary choices in many candidates for weight-loss drugs in the first place. So nutritional counseling may be essential to help these people find a happy medium to continue a healthier lifestyle once the pounds are off.

How the Field of Dietetics and Nutrition Could Take off With the Popularity of GLP-1 Obesity Treatments

Finding that happy medium is exactly where the opportunity emerges for dietitians and nutritionists.

It’s a significant area of growth. A report from Trilliant Health in 2023 found that prescriptions for GLP-1 drugs increased by 300 percent from 2018.

According to the United States Preventive Services Task Force, all available evidence supports also putting adults with obesity into behavioral interventions as well as any medical treatment. That should include nutrition, peer support, and relapse prevention.

Becoming a specialist in working with GLP-1 intervention cases should definitely be on your radar if you are starting a career in nutrition or dietetics today.

These are all areas where even a basic bachelor’s degree in nutrition and dietetics will give you excellent preparation.

The Costs of GLP-1 Treatment Can Be Brought Down by Expert Nutritional Advice

nutritionist examining foods Miracle drugs sometimes come with price tags to match. That’s the case for Ozempic and Wegovy, where the average annual list price ranges up to $16,000 for a full year of treatment.

Insurance coverage for the drugs is all over the map, and Medicaid coverage varies by state. Medicare currently doesn’t cover GLP-1 receptor agonist treatment at all. And since obesity and wealth have a strong inverse correlation in the American population, many of the people who need these drugs the most are least able to afford lengthy treatments.

This makes the participation of dietitians and nutritionists in therapy that much more important, since they offer a realistic, low-cost, covered alternative to medical obesity therapy alone. A structured nutritional program that comes right after an intensive round of weight-loss can reduce the amount of time that patients have to stay on the drugs.

Adopting healthier lifestyle and nutrition choices also reduces the odds of a relapse that will require going back on Ozempic later on. With the kind of recommendations that nutritionists can bring to the table, patients can treat their GLP-1 therapy as one-and-done… saving both lives and money in the long run.

Better yet, this kind of therapeutic assistance doesn’t necessarily fall into the medically restricted categories that would require a license as a nutritionist or registered dietitian. Instead, they are interventions that take a holistic approach to integrating GLP-1 with healthier diet and lifestyle… just the sort of training that the typical graduate receives as an undergraduate.

On the other hand, RDs and RDNs may be more likely to become involved in these cases through medical settings, since these are prescription medications. This is particularly likely to be the case when patients come to RDP-1 therapy for serious cases of obesity or those with additional complications requiring bariatric specialist treatment.

Questions People Also Ask About Nutritional Counseling in GLP-1 Treatments for Obesity

These are new drugs, new therapies, and new ground for clinicians and patients alike. Many nutritionists don’t have any formal training in working with clients who are also on Ozempic, and may have earned their degrees before GLP-1 treatments were even available.

This means there can be a lot of details that you are rightfully curious about when it comes to taking up a new practice counseling clients taking Wegovy or Ozempic. And we’ve dug into those details and come up with answers to the questions people most frequently ask about nutritional counseling in GLP-1 therapy.

Do People Need a Prescription for Ozempic, Wegovy, or Other GLP-1 Receptor Agonists?

Yes, all the available GLP-1 receptor agonist treatments available in the United States today require a doctor’s prescription.

Of course, these decisions are made individually based on medical assessment and judgment. In general, however, many doctors will likely provide a prescription to anyone with a BMI of at least 30, qualifying as obese. Even individuals with a lower BMI may qualify if they all have a weight-related condition such as type 2 diabetes, high blood pressure, or high cholesterol.

Of course, there are also conditions that can rule out such medication. A history of pancreatitis, or temporary conditions such as women who are pregnant or breastfeeding can nix a script almost immediately. For patients in this category, nutritionists will use more standard dietary counseling and weight loss approaches.

How Are Therapies Like Ozempic and Wegovy Administered?

Current GLP-1 receptor agonists are delivered via subcutaneous injection. Most instructions call for injections into the abdomen, thigh, or upper arm. Originally, GLP-1 therapies called for daily, or even twice a day injections. The large molecules in these drugs aren’t easily absorbed in the gut, so have to go directly into the body by needle.

Today, most therapies count on weekly injections, which can be performed by patients themselves, at home, using auto injectors that are pre-calibrated and safe. Ozempic has a dial-a-dose pen which patients set to the number prescribed by their doctor, while Wegovy comes in color-coded pens with different dosage levels.

There is at least one type of oral semaglutide available, sold as Rybelsus, but it is primarily prescribed for type 2 diabetes rather than weight loss.

Are Drugs Like Ozempic and Wegovy Used for Other Conditions?

Although they haven’t been officially approved for other treatments, the semaglutides in Ozempic and Wegovy have shown a variety of other health benefits. They may reduce:

  • Cardiovascular issues
  • Sleep apnea and other breathing problems
  • High blood pressure
  • Alcohol depedency
  • Kidney and liver disease
  • Some types of cancer

Of course, although both Ozempic and Wegovy are semaglutides, it’s important to note that they themselves are already approved for separate conditions. Ozempic is actually primarily prescribed for type 2 diabetes, while Wegovy is branded for weight loss. However, there’s a great deal of overlap between diabetes treatment and the need for weight loss in many patients, and clinicians are well-aware of the effects.

Are Wegovy and Ozempic the Only GLP-1 Weight Loss Drugs Available Today?

While they are unquestionably the most popular GLP-1 receptor agonists, Ozempic and Wegovy aren’t the first or even the only drugs based on the GLP-1 action. Other formulations include:

  • Byetta
  • Victoza
  • Trulicity
  • Rybelsus
  • Adlyxin

Most either never gained the traction of the more modern formulations due to more intensive administration routines or less effective outcomes, however.

There are other new drugs that are closely related however, such as tirzepatide, found in Mounjaro and Zepbound. These increase production of a different hormone, GIP (glucose-dependent insulinotrpic polypeptide), but also impact the GLP-1 receptors. They have similar effects, with even greater efficacy in weight-loss. It is possible that nutritionists specializing in GLP-1 therapies today may shifting to GIP therapies in the future. The types of counseling required are similar.

Do You Need a License in Dietetics or Nutrition To Offer Counseling for GLP-1 Therapy?

No, there’s currently no requirement for a specific license or other kind of professional qualification specific to GLP-1 counseling in any state. However, you must still comply with any state laws regarding nutritional counseling in general, so if you need a license to be a nutritionist where you are already, that’s still true if you decide to provide GLP-1 counseling.

In any case, both providers and clients are more likely to trust a nutritionist who has a CNS (Certified Nutrition Specialist)®™ or who has become a Registered Dietitian Nutritionist (RDN). The education and experience required for those credentials—particularly the new requirement for RDNs to hold a master’s degree in nutrition—offers assurance that you can provide professional advice in line with best practices and medical requirements.