Avoiding malnutrition in the era of GLP-1 medications: emerging evidence and opportunities for integrated nutrition care

: Glucagon-like peptide-1 (GLP-1)–based therapies have transformed obesity treatment, resulting in significant weight loss and broad metabolic improvements. However, their rapid adoption has outpaced the development of adequate nutritional support systems, leaving many patients without dietary guidance despite experiencing profound reductions in appetite and food intake. People often drastically cut their energy consumption, risking inadequate protein intake, micronutrient deficiencies, low fiber intake, and loss of lean mass, consequences that are largely preventable with proper guidance. Yet, in clinical practice, integrated nutritional assessment is rarely provided, despite obesity societies recognizing its importance. This perspective synthesizes emerging evidence on the nutritional risks associated with GLP-1–based therapy, examines the gap between guideline recommendations and real-world practice, and argues that integrated nutritional care must become a core (not optional) part of GLP-1–based obesity treatment. We emphasize the role of registered dietitians and behavioral health professionals in maintaining nutrient adequacy, reducing gastrointestinal side effects, and preserving lean mass. Additionally, we identify key research priorities: developing validated nutritional screening tools, defining evidence-based nutrient targets, characterizing high-risk patient profiles, and researching the long-term outcomes of integrated nutrition and pharmacotherapy. As GLP-1 prescriptions reach millions of patients across diverse and often under-resourced clinical settings, integrating nutrition into this care model is not just advisable; it is urgent.