GLP-1 medications are changing the conversation around weight loss. But losing weight and becoming healthier aren’t always the same thing.
Medications such as Ozempic®, Wegovy®, Mounjaro® and Zepbound® have helped many people make significant progress with weight management. They can reduce appetite, improve blood sugar regulation and give people momentum that may have been difficult to achieve through lifestyle changes alone.
But there’s another side of the conversation that deserves more attention:
What are you losing along with the weight?
And perhaps an even bigger question:
What happens when the shot is no longer part of the equation?
That’s the focus of Episode 3 of Built to Heal, the podcast from Pinto Innovative Health & Wellness. In “GLP-1 Done Right: Nutrition, Muscle & Life After the Shot,” Dr. Emilie Pinto and Dr. Anne Pinto are joined by Caroline Fornshell, MS, RDN, CDCES, CES, founder of LWell, for a practical conversation about getting healthier—not simply lighter.
GLP-1 Weight Loss Is a Tool, Not the Entire Strategy
Caroline has worked with metabolic disorders and complex weight management for approximately 20 years. Her practice began incorporating GLP-1 medications into weight-management care around 2023, building on her previous experience working with these medications in diabetes care.
In the episode, Caroline explains how commonly prescribed GLP-1 medications work and discusses important differences between semaglutide medications such as Ozempic and Wegovy and tirzepatide medications such as Mounjaro and Zepbound.
One of their most obvious effects is reduced appetite. You may feel full sooner, think about food less often and simply eat considerably less than you did before.
That can be helpful for weight loss—but it introduces an important nutritional challenge:
Your appetite may have decreased. Your body’s nutritional needs haven’t disappeared.
When you’re eating dramatically less food, getting adequate protein, fiber, healthy fats, vitamins, minerals and other nutrients requires more thought.
The Scale Doesn’t Tell the Whole Story
One of the most important discussions in Episode 3 centers on skeletal muscle.
When someone sees the scale dropping week after week, it’s easy to assume everything is going exactly according to plan. But scale weight doesn’t tell you whether you’re losing fat, muscle, water—or some combination of all three.
Caroline discusses reports suggesting that a significant portion of weight lost during GLP-1 treatment can come from skeletal muscle. She also explains why that doesn’t have to be inevitable.
That’s why Dr. Em encourages patients to think beyond pounds and start paying attention to body composition.
Preserving muscle is particularly important as we get older. Muscle supports much more than the ability to lift weights. It contributes to mobility, stability, metabolic health, physical resilience and our ability to remain independent and continue doing the things we enjoy.
In other words, the goal shouldn’t simply be:
“How much weight can I lose?”
A better question may be:
“How can I lose excess body fat while keeping my body strong?”
Protein Becomes Especially Important on a GLP-1
If you aren’t very hungry, it’s easy to skip meals or eat only a few bites at a time. Unfortunately, that can make it difficult to consume enough protein.
During the podcast, Caroline discusses practical strategies for incorporating protein throughout the day rather than trying to consume a large amount in a single meal.
The exact amount needed varies by the individual, including factors such as body size and activity level. That’s one reason personalized nutritional guidance can be valuable for people using GLP-1 medications.
Simple foods can help. Eggs, Greek yogurt, nuts, cheese and other protein-containing foods can provide nutrition without requiring an enormous meal.
And don’t forget another essential ingredient for preserving muscle:
Use it.
Strength Training May Be One of Your Best GLP-1 Partners
Nutrition and exercise work together.
Dr. Em and Caroline emphasize the importance of resistance training during GLP-1-assisted weight loss. If you’re consuming fewer calories while asking your muscles to do very little, maintaining lean tissue becomes more difficult.
Strength training tells your body that muscle is still needed.
But there’s a real-world obstacle: What if pain, weakness or deconditioning makes exercise difficult?
That’s a common problem we see at Pinto Innovative Health & Wellness.
In Episode 3, Dr. Em and Dr. Anne discuss how technologies such as Emsculpt NEO® can complement a broader wellness strategy by stimulating powerful muscle contractions. For some patients who struggle to exercise because of pain or deconditioning, it may provide another tool for engaging and strengthening muscles as they work toward becoming more active.
The long-term objective remains the same: movement.
Healthy aging isn’t simply about adding more years to your life. It’s about maintaining the physical capacity to enjoy those years.
What Should You Eat on a GLP-1?
This is where Episode 3 gets particularly practical.
Caroline walks through an example of what a day of eating might look like for someone whose appetite has been significantly reduced.
Rather than forcing down three enormous “healthy” meals, the strategy is to make the foods you can eat count.
That might include a nutrient-rich smoothie with fruits, vegetables and protein in the morning; a small protein-containing snack later; chicken and vegetables at lunch; nuts, fruit or another simple whole-food snack in the afternoon; and a nutrient-dense soup or other balanced meal for dinner.
It’s not about creating the perfect menu.
It’s about being intentional.
Don’t Forget Fiber and Hydration
Digestive issues, particularly constipation, can be a concern for some people taking GLP-1 medications because these medications can slow gastrointestinal motility.
Caroline emphasizes paying attention to fiber and hydration, while increasing fiber gradually rather than dramatically changing intake overnight.
Whole foods remain important here.
Vegetables, fruits and other plant foods don’t just provide fiber. They also contain vitamins, minerals and phytonutrients that become increasingly difficult to obtain when you’re eating substantially smaller quantities of food.
If a giant raw salad suddenly sounds impossible, there are alternatives. Caroline suggests options such as lightly steamed vegetables and smoothies to make nutrient-dense foods easier to incorporate.
The message isn’t complicated:
Eating less makes food quality more important, not less important.
Healthy Fats and Carbohydrates Still Belong on the Menu
Another mistake people can make during weight loss is becoming unnecessarily afraid of entire macronutrient categories.
Carbohydrates, fats and proteins all have roles to play.
Caroline discusses incorporating healthier fat sources such as avocado, nuts, olive oil and omega-3-rich foods while pairing foods strategically to support satiety and steadier energy.
Even something as simple as pairing a piece of fruit with a handful of nuts can turn an ordinary snack into something more balanced.
Sustainable nutrition doesn’t have to be complicated.
Supplements Aren’t a Substitute for Food
With a smaller appetite, it’s tempting to solve every nutritional concern with another powder, shake or supplement.
Supplements may have a place, but Caroline stresses the importance of maintaining a whole-food foundation.
During the episode, the group discusses multivitamins, fish oil, different forms of magnesium and several other supplements that may be considered depending on the individual.
However, supplements aren’t automatically appropriate for everyone. They can interact with medications or be inappropriate for certain medical conditions, so decisions about supplementation should be individualized with your healthcare professional.
The bigger takeaway is that supplements should supplement a healthy diet—not replace one.
What Happens After the Shot?
This may be the most important part of the entire conversation.
GLP-1 medications can create an incredible window of opportunity. Appetite may be easier to control. Food noise may decrease. Weight starts coming off. Movement may become easier.
What are you going to do with that opportunity?
Caroline encourages patients to use their time on a GLP-1 to develop healthier habits rather than relying exclusively on the medication.
Build the strength-training routine.
Learn how to construct a balanced meal.
Find healthy foods you actually enjoy.
Improve your relationship with movement.
Develop strategies for emotional eating.
Build a healthcare and wellness team around you.
Because circumstances change. Medications change. Insurance coverage can change. Your health can change.
The habits you’ve built belong to you.
It’s About Health, Not Just Weight
At Pinto Innovative Health & Wellness, this is where our approach to GLP-1 weight management fits into our larger philosophy of care.
We don’t want the finish line to simply be a smaller number on a scale.
We want patients to move better, feel stronger and build a healthier life they can sustain.
That can mean looking at nutrition. It can mean monitoring body composition. It can mean addressing pain that’s preventing you from exercising. It can mean strengthening deconditioned muscles. And it can mean identifying behavioral patterns that could make maintaining your progress difficult.
That’s what “GLP-1 done right” really means.
It’s not just about the shot.
It’s about what you build while you have the momentum.
Watch Built to Heal: Episode 3
If you’re currently taking a GLP-1 medication, considering one, or have a friend or family member using one, we encourage you to watch the complete conversation:
GLP-1 Done Right: Nutrition, Muscle & Life After the Shot
Featuring Caroline Fornshell, MS, RDN, CDCES, CES, founder of LWell, with Dr. Emilie Pinto and Dr. Anne Pinto of Pinto Innovative Health & Wellness.
Built to Heal is presented for educational purposes and is not a substitute for individualized medical or nutritional advice. Talk with your healthcare provider before changing medications, supplements, diet or exercise programs.
