Dr Federica Amati, head nutritionist at Zoe and bestselling author, warns about the extreme side effects of GLP-1 medications, which are increasingly used off-label for weight loss. She highlights cases of scurvy, psychotic episodes, and hospital admissions mistaken for dementia or psychosis, all stemming from acute brain malnutrition. 'If you're taking GLP-1s for cosmetic reasons, you're putting yourself at real risk of chronic under-nutrition,' she says. Other risks include loss of skeletal muscle mass and bone mineral density.
Why GLP-1s Are Not a Lifestyle Hack
Amati's new book, The Appetite Reset, explains how to eat, drink, and thrive before, during, and after GLP-1 use. With an estimated 8.25 million people in the UK taking or considering these drugs, Amati finds their availability deeply concerning. 'They've bypassed normal prescribing,' she says, noting that anti-hypertensives cannot be obtained via online forms or Instagram ads. The surge in demand has outpaced NHS capacity, raising safety concerns.
Pre-Treatment Nutrition
Before starting GLP-1s, Amati recommends a pre-treatment phase to prime the gut, liver, and pancreas. 'Introducing GLP-1s across systems that are already cranky is likely to have a less smooth outcome,' she explains. Increasing fibre gradually helps restore gut barrier function and reduce constipation. Eating healthily beforehand also mitigates side effects like nausea, constipation, reflux, and bloating, making the medication more effective at lower doses.
During Treatment: Nutrient Density and Protein
During GLP-1 use, Amati advises focusing on nutrient-dense foods, adequate protein, and resistance training. Hydration and small, regular meals at set times are critical. 'If you don't have a schedule, it's easy to skip meals, but your food intake is often slashed by 40 to 50 per cent,' she warns.
Post-GLP-1: Preventing Weight Regain
Around 60 per cent of people stop GLP-1s within a year, and 75 per cent regain about 75 per cent of lost weight. Amati recommends high-volume, low-energy-density foods like kale, cauliflower, and tofu to stimulate satiety signalling. 'It's not that you've failed; your body is just trying to get back to normal,' she says. Long-term success involves improving metabolic health and changing one's relationship with food.
The Appetite Reset: How to Eat, Drink and Thrive Before, During and After GLP-1s by Dr Federica Amati is published on June 25 (Penguin, £25).
