Breaking Down the New GLP-1 Advisory with Lara Zakaria, IFMCP

In this episode, we unpack the updated 2025 GLP-1 consensus advisory with Lara Zakaria, IFMCP. Lara reframes GLP-1 medications as a window of opportunity for lifestyle transformation and emphasizes that prescribing should be paired with proactive nutrition, movement, and lab monitoring. She outlines a three-tiered approach to lab work, highlights the importance of muscle preservation for long-term metabolic health, and shares practical tips for addressing common gastrointestinal side effects.

Clinical Takeaways from This Episode

• GLP-1 Therapy as a Catalyst for Metabolic Health: How to use GLP-1 medications as a tool to initiate lifestyle change, reset eating patterns, and improve overall body composition rather than relying on medication alone.
• GLP-1 Nutrition Screening & Eating Disorder Risk Assessment: Why clinicians should screen for disordered eating and evaluate baseline diet quality—including fiber, protein, and phytonutrient intake—before initiating GLP-1 therapy.
• Protein Intake & Muscle Preservation During GLP-1 Treatment: Evidence-informed guidance on maintaining protein intake (0.4–0.5 g/kg/day) and combining GLP-1s with resistance training to reduce muscle loss and support long-term metabolic health.
• Micronutrient Monitoring for GLP-1 Patients: Recommended lab tests to monitor iron, vitamin D, RBC magnesium, zinc, and fat-soluble vitamins (A, D, E, K) to help prevent nutrient insufficiency and support patient energy and recovery.
• Managing GLP-1-Related GI Side Effects Naturally: Stepwise strategies for reducing nausea, constipation, and bloating with smaller meals, fiber, hydration, magnesium, ginger, and digestive bitters.
• Tracking Body Composition in GLP-1 Weight Loss: Why measuring visceral fat, lean mass, and muscle density provides a more complete picture of progress than weight alone—and how to use body composition scales effectively.
• Multidisciplinary GLP-1 Care Team Approach: How dietitians, physical therapists, trainers, mental health providers, and pharmacists can collaborate to create comprehensive, patient-centered care plans.
• Optimizing Clinical Workflows for GLP-1 Prescribing: How to build visit templates, lab panels, and follow-up systems to integrate guideline-based nutrition, exercise, and lab monitoring into everyday practice.

Guest Introduction

Lara Zakaria, PharmD, MS, CNS, CDN, IFMCP, is a licensed pharmacist and functional medicine practitioner specializing in metabolic health, neuroinflammation, and chronic disease. As a faculty member for the Institute for Functional Medicine, she teaches clinicians how to integrate pharmacology with nutrition and lifestyle medicine. Lara is passionate about helping practitioners use GLP-1s as a bridge to sustainable habit change—rather than as a stand-alone solution. Learn more at larazakaria.com or follow her at @foodiepharmacist on Instagram and LinkedIn.

GLP-1 Lab Monitoring for Nutrient Status

• CMP, CBC with iron studies
• RBC magnesium
• Vitamin D
• Full thyroid panel (TSH, free T4/T3, reverse T3, antibodies)
• Functional testing options: NutrEval, organic acids, stool test

GLP-1 Nutrition & Supplement Support for Metabolic Health

• Targeted protein intake (0.4–0.5 g/kg/day)
• Multi-mineral or multi-nutrient powder, divided doses
• Vitamin D + K2, B-complex, and iron as clinically indicated
• Electrolyte support during titration

GLP-1 Constipation Toolkit from Lara Zakaria

• Magnesium citrate or Cal-Mag combination for low magnesium constipation
• Buffered vitamin C (titrated to bowel tolerance) and hydration for osmotic constipation
• Triphala, ginger, digestive bitters as appropriate to support peristalsis
• Squatty potty and morning routines to activate parasympathetic tone and support optimal pelvic floor function

GLP-1 Lifestyle & Movement Recommendations

• Strength training 2–3x per week to protect muscle mass
• Walking, yoga, gardening, or functional movement on non-training days
• Sleep and stress hygiene support to balance circadian rhythm

Citations:

Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society. 2025.

Timestamps:

• 00:00 – Episode introduction and overview of prescribing considerations for GLP-1s
• 03:28 – Historical context: GLP-1 development and off-label use for weight loss
• 05:54 – The recent consensus statement and its implications for practice
• 06:43 – Decision tree considerations: muscle loss, fat distribution, and diet quality
• 09:05 – The importance of nutrition counseling and the gut-brain axis
• 12:05 – Holistic assessment framework: screening, laboratory biomarkers, and functional testing
• 14:10 – The role of fiber and gut health in optimizing GLP-1 outcomes
• 17:50 – The significance of screening for nutrient deficiencies: iron, vitamin D, magnesium, B vitamins, zinc
• 22:07 – Prevention of sarcopenic obesity during weight loss interventions
• 25:51 – Importance of assessing micronutrient status before and after GLP-1 therapy
• 27:54 – Lab assessments for liver, thyroid, and metabolic health indicators
• 40:51 – Advanced testing considerations and personalized evaluation strategies
• 47:02 – Managing GI side effects proactively: counseling, lifestyle, herbal supports
• 50:56 – Gut motility, herbal supports, and the importance of lifestyle factors
• 54:43 – Titrating and off-boarding GLP-1 medications for long-term health
• 55:30 – Resources