A nutrition prescription for weight loss

Lifestyle changes are important for achieving and sustaining a healthy weight – even for people who use weight management medications. Drugs such as semaglutide (Wegovy) and tirzepatide (Zepbound) are intended to be used in conjunction with a reduced-calorie diet and increased physical activity.^{1, 2} But making those lifestyle modifications can be challenging – and it’s not just a matter of individual willpower.

Obesity is a complex and chronic disease influenced by multiple factors. Personal and cultural preferences, social and emotional well-being, access to healthy food options and other social determinants of health all influence our dietary choices. These factors, as well as health status and goals, vary by individual. Offering structured support that takes into account a person’s unique needs is key to helping drive optimal and sustainable outcomes, improving overall health, and potentially preventing weight-related conditions and reducing long-term health care costs.

Enter medical nutrition therapy – a more intensive and individualized approach to supporting people in making sustainable dietary changes.

What is medical nutrition therapy?

Medical nutrition therapy, or MNT, is an evidence-based form of nutrition counseling, administered through registered dietitians. MNT goes beyond basic health coaching.³ It’s the approach we built into our CVS Weight Management™ program.

Enrolled plan members meet one-on-one with dedicated registered dietitians in a virtual setting to help assess goals, as well as barriers to achieving them. Together, they develop an eating plan that suits each member’s unique needs and preferences, while also helping ensure a healthy balance of nutrients because nutrition planning for healthy weight loss isn’t only about reducing calories.

You might think of MNT as a nutrition prescription, with ongoing support and monitoring from the dietitian to help keep the member motivated and make adjustments as needed or desired. This type of therapy can even play a role in mitigating side effects and helping minimize muscle loss, a common concern with GLP-1 usage.

CVS Weight Management

MNT aligns with guidance recently released in a joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association and the Obesity Society. The advisory notes that “although GLP-1s alone can produce significant weight reduction and related health benefits, several challenges limit its long-term success for individuals and populations. These include GI side effects; risk of nutrient inadequacies, muscle and bone loss; high costs; frequent discontinuation; and weight regain. Careful attention to evidence-based nutritional and behavior modification can help mitigate the adverse effects of these challenges.”⁷

Looking at the bigger picture of a person’s health

Obesity and overweight often co-occur with other health issues. Higher BMIs are corelated with a higher risk for type 2 diabetes, high blood pressure, high cholesterol, heart disease, stroke, kidney disease, osteoarthritis and even some cancers.⁸ Some health conditions or the medications used to treat them can influence dietary needs and restrictions.

Some weight management programs try to impose the same diet, such as a ketogenic or “keto” diet, on all participants. But highly restrictive eating plans can be risky for some people, potentially causing nutritional deficiencies or even worsening certain health conditions. MNT considers the full context of a person’s health status and needs – beyond just their weight and calorie intake.

A realistic approach based on preferences and access

Dietary changes are also only likely to be successful if a person sticks with them. It’s not realistic to expect someone to sustain a diet that pushes foods they don’t want to eat or are unable to easily access. Food preferences may be personal – we all have our likes and dislikes. Or they may be cultural, such as abstaining from eating meat for religious or ethical reasons. And accessibility of nutritional foods may be based on personal finances, what’s available in the markets or grocery stores in a person’s community, or whether they have reliable transportation to obtain a wider array of foods.

With MNT, a dedicated registered dietitian gets to know the person and understand their dietary preferences and whether there are barriers to accessing certain foods. This is an important step in helping to build nutrition habits that are realistic and sustainable for that individual. And because preferences and social determinants can change over time, continuing to connect for ongoing nutritional counseling allows the dietitian to help make adjustments, whether it’s tweaking meal plans or trying out an entirely new diet.

Support for weight loss and beyond

Maintaining a healthy weight after achieving your goal weight can be a tricky time for many people, especially if motivation has been tied to watching the numbers on the scale decrease. People who lost weight with the help of weight management medication may even want to explore discontinuing their medication once they meet their goals. MNT that continues beyond the weight loss phase can help members stay motivated, navigate challenges and changes, and get support to safely titrate down or off of their medication, if desired.

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