What the labels and MedlinePlus say
Wegovy® and Zepbound® are approved for weight reduction alongside a reduced-calorie diet and more physical activity [3][4]. Neither label lists foods to eat or avoid. MedlinePlus advises continuing your normal diet on tirzepatide unless your doctor says otherwise [7], and NIDDK describes weight medicines as support for a healthy eating and activity programme rather than a replacement for it [5]. What changes is quantity: the European product information describes semaglutide as reducing energy intake and the preference for high-fat foods [6], and the nutrition advisory reports that people on these medicines eat substantially less [1].
Food groups, from the guidance
| Group | Examples named in the sources | What the sources say |
|---|---|---|
| Protein foods | Fish and seafood, eggs, poultry, beans, peas, lentils, soy, nuts and seeds [1][2] | Protein at every meal [2]; eat protein-rich foods first and favour lower-volume options [1] |
| Vegetables and fruit | Leafy greens, broccoli, tomatoes, carrots, berries, apples, citrus [1] | Eat a variety through the day; frozen, dried or canned with little or no added sugar also count [2] |
| Whole grains | Oats, quinoa, brown rice, whole-grain bread and pasta [1] | Prioritise fibre-rich whole grains over refined ones [1][2] |
| Dairy | Yoghurt, milk, cheese, cottage cheese [1][2] | Choose dairy without added sugar [2] |
| Fats and oils | Olive, canola and avocado oil [1]; nuts, seeds, olives, avocado [2] | Plant oils are on the advisory’s list [1]; the Guidelines also mention butter and tallow [2] |
| Drinks | Water, still or sparkling; unsweetened drinks; ginger or peppermint tea [1][2] | Ensure adequate fluids [1]; avoid sugar-sweetened drinks [1][2] |
| To minimise | Refined grains and added sugars, sugary drinks, red and processed meat, most fast food, sweets and savoury snacks [1] | Limit highly processed foods and added sugars [2] |
| Alcohol | — | Minimal intake [1]; less is better, and some people should avoid it entirely [2] |
Where the two sources differ
The sources agree on most things and part ways on a few. The advisory lists red and processed meats among foods to minimise, citing links to type 2 diabetes, heart disease and colorectal cancer in the general population [1]; the Dietary Guidelines include red meat among protein foods and focus on limiting additives and added sugars in meat [2]. For cooking, the advisory names plant oils such as olive and canola [1], while the Guidelines prioritise olive oil but also mention butter and beef tallow [2].
The advisory is candid that the effect of specific diets on weight loss with GLP-1 medicines still needs research, and bases its preference for minimally processed food on the wider evidence on nutrition and obesity [1]. If you have a condition that changes what you should eat, your clinician or a registered dietitian is the one to reconcile these.
Nutrients that can run short
When appetite falls sharply, the risk is not only fewer calories but fewer vitamins and minerals. The advisory names iron, calcium, magnesium, zinc and vitamins A, D, E, K, B1, B12 and C as nutrients of concern [1]. It lists signs that can point to a real deficiency: fatigue beyond what is expected, unusual hair loss, flaky or itchy skin, muscle weakness, slow wound healing and easy bruising [1].
It says clinicians may consider supplements for at-risk nutrients, such as vitamin D, calcium, B12 or a multivitamin, tailored to the individual, and that nutrient levels can be rechecked during treatment [1]. That is a decision for your clinician, not something to guess at. The Guidelines add that some older adults need fewer calories but the same or more protein, B12, vitamin D and calcium [2].
Protein, and why it is not enough on its own
Reduced appetite and food aversions can make protein hard to reach, so the advisory suggests eating it first in a meal and choosing compact sources such as fish, eggs, Greek yoghurt, cottage cheese, nuts and nut butters, or fortified shakes and bars if needed [1]. Plant sources, dairy, seafood, eggs and lean poultry are generally encouraged [1].
The advisory also stresses that more protein alone is unlikely to protect muscle without structured strength training, and that protein beyond what muscles need can be stored as fat [1]. A separate article covers what the labels say about lean mass. Any protein target is for you and your care team to set; PepLabo’s protein calculator is an estimating tool, not a prescription.
Special situations the advisory mentions
- Kidney stones: people with a history of stones may be counselled to avoid high-oxalate foods, highly processed foods and animal protein [1].
- Ketogenic or very-low-carbohydrate diets: they should still emphasise minimally processed, higher-fibre and nutrient-dense foods, and with diabetes the combination may raise the risk of ketoacidosis and low blood sugar [1].
- Intermittent fasting: it can raise the risk of low blood sugar for people on glucose-lowering medicines, and the advisory encourages meals at regular times even then [1].
- Vegetarian and vegan eating: the Guidelines advise protein-rich whole foods and attention to nutrients that are often low, such as vitamins D and E and iron [2].
A day, sketched without numbers
This is an illustration of how the guidance fits together, not a meal plan. A small breakfast built around protein, such as plain yoghurt with fruit and a few nuts. A lunch that starts with fish, eggs or beans, then vegetables and a whole grain. A small snack if the gap is long, for example cottage cheese or fruit. A modest dinner that again puts the protein first, with vegetables cooked in a plant oil. Water or unsweetened drinks through the day. Smaller and more regular is the theme throughout, in line with the advisory’s advice against large meals and long gaps [1].
Portions, and whether this suits your health, culture and budget, are yours to decide with your clinician or a registered dietitian.
Wegovy® is a registered trademark of Novo Nordisk A/S. Zepbound® is a registered trademark of Eli Lilly and Company. PepLabo is not affiliated with or endorsed by Novo Nordisk or Eli Lilly and Company.
When to get help
| Sign | Who to contact | How fast | Source |
|---|---|---|---|
| Fatigue beyond what you expected, unusual hair loss, muscle weakness, slow-healing wounds or easy bruising | Your prescriber or primary care clinician | At your next appointment | Nutrition advisory [1] |
| Eating so little that you feel faint or unwell, especially with insulin or a sulfonylurea | Your prescriber | Today | Wegovy® label [3] |
| A history of kidney stones, a special diet or a condition that changes what you can eat | Your clinician or a registered dietitian | At your next appointment | Nutrition advisory [1] |
