The 50+ Ozempic Diet

2. Schedule your meals

Because the drugs suppress your appetite, “it becomes very easy to skip meals, to forget to eat,” says Selvi Rajagopal, an obesity medicine physician and director of the Healthful Eating, Activity and Weight Program at John Hopkins University.

For some people, nausea caused by the medication can make eating even harder.

To avoid muscle loss and fatigue, it’s crucial to ensure you’re getting enough calories.

As a general rule women over age 50 should aim for 1600 to 2200 calories a day and men over age 50 should aim for 2000 to 2800 calories a day, according to the National Institute of Aging.

But calorie needs can vary based on factors like your age, sex, body weight and physical activity level, so it’s best to ask your health care provider for a personalized target.

If you find yourself not eating for long periods or feeling weak or shaky, Rajagopal suggests scheduling your meals or even setting an alarm to remind yourself to eat.

3. Make protein a priority

Protein is the building block of muscle, and getting enough is crucial for preventing muscle loss, especially when you're consuming fewer calories, Sowa says.

A 2024 review study that made diet recommendations for GLP-1 patients based on the latest research recommends at least 60 grams of protein a day.

Sowa suggests aiming for 20 to 40 grams of protein at every meal. On a typical day, that could mean a protein shake or Greek yogurt parfait for breakfast, a chicken breast and salad for lunch, a handful of almonds or cheese stick for an afternoon snack, and grilled salmon, brown rice and vegetables for dinner. For more on protein timing, see the AARP book, the Whole Body Reset.

Other good sources of protein include eggs, water-packed tuna, cottage cheese, beans and other legumes, tofu, string cheese and lean meats such chicken, fish and seafood.

“At every meal, I want you to focus on getting protein first,” Sowa says. “Not for weight loss, but honestly, because you might not have as much of an appetite beyond that.”

Prioritizing protein is especially important for older adults, who naturally lose muscle with age, Sowa says.  

Al-Zubaidy says prioritizing protein was key for her. A typical breakfast, she says, is a protein shake mixed with her coffee and then yogurt with walnuts, fruit and protein-packed granola.

“Protein makes me feel more energized,” she says.

Protein powders and packaged protein drinks can be a great option if you’re new to GLP-1s, feel nauseous or have little appetite, Sowa says. Mix them with water or milk and some berries to create a super-palatable, portable, high-density meal that might be easier to get down than a piece of meat or fish, she suggests.

Bone broth is another alternative if you’re fighting nausea or having trouble eating, she says. With 12 grams of protein per cup, it provides at least some nutrition and will help you stay hydrated.

4. Aim for 64 ounces of fluid a day, plus electrolytes

The same hormonal pathway that regulates hunger also affects your thirst signals, so you need to be diligent about staying hydrated when you’re taking a GLP-1 medication, Sowa says.

Dehydration can contribute to constipation, which is a common side effect.  It can also cause an electrolyte imbalance that can make people feel tired or drained when they’re taking a GLP-1.

Sowa recommends aiming for 64 ounces of fluids a day. That can include tea, coffee, low-fat milk, non-dairy milk and even an occasional diet soda, but the focus should be on water.

If you feel like you’re drinking and eating enough, but you still feel tired or light-headed, or if you’re having muscle cramps, you might need electrolytes, Sowa says. In that case, consider adding a flavored electrolyte powder to your water once a day, or simply add a pinch of salt and a citrus twist to a glass.

5. Avoid fatty and greasy foods

Much like Al-Zubaidy, many people on GLP-1s struggle to digest fried foods and high-fat meals. Since high-fat foods take longer to digest, combining them with a medication that slows gastric emptying can cause unpleasant side effects, including bloating, diarrhea, belching and vomiting. 

To limit discomfort, avoid heavy, greasy foods like pizza, fast food meals, French fries, doughnuts and fatty processed meats like bacon and sausage.

Even whole milk dairy foods can cause discomfort, Sowa says, especially if you’ve just started taking the meds.

Rajagopal recommends planning your meals out in advance and cooking at home as much as possible since many restaurants use a lot of fat and butter in their cooking.

6. Steer clear of sugary foods, alcohol and refined carbs

Most doctors advise GLP-1 patients to avoid sugary foods, but Sowa also recommends avoiding refined carbohydrates, even those that don’t seem inherently unhealthy.

Although it’s not commonly known, highly processed carbohydrates — like white bread, pasta and crackers — can be heavy and difficult to digest when you’re taking a GLP-a medication, she says.

Even a sandwich, because of the bread, might not agree with people, she says.

Sowa explains that GLP-1 drugs work best with minimal side effects when your diet helps keep your blood sugar stable. But processed carbs spike your blood sugar. When your body responds, it sometimes lowers your blood sugar too much, making you feel hungry, tired, nauseous or light-headed.

Alcohol, which also causes blood sugar to spike, can have a similar effect.

The carbs that have the least impact on blood sugar come from whole foods like vegetables, fruits, legumes and whole grains, Sowa says. In other words, the best way to eat when taking weight-loss medications is to focus on eating a healthy diet.

Sowa recommends tracking your food and symptoms to pinpoint whether refined carbs are a specific trigger for you.

7. Maintain muscle with resistance training

To maintain muscle mass and overall strength, incorporate resistance training into your routine. For the best results, aim for two to three sessions a week for 20 minutes at a time, Rajagopal suggests.

You can use resistance bands, free weights or even your own body weight. “You don’t have to do anything fancy,” Rajagopal says. Focus on working the major muscle groups.

If you’re new to strength training, Rajagopal suggests asking your doctor to refer you to a physical therapist for guided instruction. Because of their background in exercise physiology, they can create a safe, effective strength program for you, she says. Plus, having regular appointments helps hold you accountable.

If you have hip, back or joint pain, the visits may be covered by your insurance, she says.

8. Eat smaller portions more frequently

Overeating is a big cause of discomfort in those taking a GLP-1 medication, Sowa, Rajagopal and Evans say.

If you’re struggling with nausea, heartburn or frequent burps, forget three meals a day and try eating small, frequent meals — perhaps even just a bite at a time — to allow your body time to properly digest.

“This concept is very hard for people to understand,” Sowa says, “because they will be like, ‘but I'm eating so much less than before.’ But sometimes it's still too much for their bodies to process.”

She advises patients to focus on getting in protein first, then pause before continuing to eat.

9. Add fiber to your diet

Because the drugs slow down digestion, constipation is a common side effect, affecting up to a third of users.

To keep things moving, doctors recommend incorporating plenty of fiber into your diet. The authors of the 2024 review study that investigated the best diet for GLP-1 users recommend at least 21 grams of fiber a day for women and 30 grams a day for men.

Foods rich in fiber include whole grains, vegetables, fruits, beans, peas, lentils, nuts and seeds. You can get about 10 grams of fiber from 1 cup of raspberries, two cups of oatmeal, one ounce of chia seeds or 2/3 cup of cooked lentils, black beans or split peas.  

Many doctors also suggest taking an over-the-counter fiber supplement when starting a GLP-1, because it can be challenging to eat a lot of vegetables in the early stages of being on the drug.

Al-Zubaidy, for instance, said taking gummy fiber supplements helped ease her constipation when she first started taking the medication.

10. Talk to your doctor if you’re having side effects

Here’s some good news: most people find that side effects diminish after they have been on the medication for a while. But if they are bothering you, you don’t have to live with them — talk to your doctor about ways to manage them.

For example, an over-the-counter stool softener or laxative can help you stay ahead of constipation. Or, if you are experiencing loose, watery stools, your doctor might want to check your labs to make sure you’re not low in any minerals, Rajagopol says.  

Often, your doctor can prescribe something to help with persistent symptoms, whether it’s an antacid to ease heartburn or a medication to manage nausea.

By proactively discussing these concerns, you can get the support you need and prevent small issues from becoming bigger problems that force you off the medication altogether.