This EASO–EFAD–ECPO Consensus Statement synthesizes evidence and provides pragmatic guidance on nutritional (protein targets, dietary quality, micronutrients, GI side-effect mitigation), functional (fat-free mass preservation, resistance exercise), and psychological (food reward, eating disorders, identity, mental health screening) considerations for adults receiving incretin-based therapies—specifically GLP-1 receptor agonists and dual GLP-1–GIP receptor agonists—for obesity management.
The statement recommends: adequate protein intake and progressive resistance exercise to mitigate fat-free mass loss during rapid weight loss; routine monitoring of diet quality, micronutrient status (including thiamine), and functional measures (e.g., handgrip strength); psychological screening for eating disorders and mental health challenges; and shared decision-making around dose titration and discontinuation given the risk of weight regain on cessation.
- Based on expert consensus rather than original trial data; recommendations are pragmatic and evidence-graded from a heterogeneous literature. - Longitudinal data on micronutrient status, macronutrient requirements, and musculoskeletal outcomes specifically during incretin-based therapy are sparse. - Disparities in access and representation (sex, race, BMI) in underlying clinical trials limit generalizability across populations.
When prescribing GLP-1 or dual GLP-1–GIP agonists for obesity, proactively target adequate protein intake, prescribe progressive resistance training, and screen for micronutrient deficiencies and eating disorders at baseline and throughout treatment. Discuss the risk of weight regain and muscle loss with patients when considering dose changes or stopping therapy.
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