Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 - based therapies: An expert consensus statement using a modified Delphi approach
Bibliographic record
Abstract
Background: Liraglutide, semaglutide and tirzepatide have transformed the management of obesity. However, dose-related gastrointestinal effects, obesity-associated nutritional insufficiencies, and poor long-term adherence may limit their long-term health benefits. Despite a recent joint advisory summarizing nutritional and lifestyle supportive care priorities with these therapies, there is still a significant lack of direct evidence to guide clinical practice, making consensus-based recommendations necessary. Methods: The consensus statement development was based on an initial scoping review that included searching PubMed, Embase, Web of Science, Cochrane, and Medline for relevant scientific publications from January 1, 2021 through June 30, 2025. An international multidisciplinary panel consisting of physicians, clinical researchers, and dietitians employed a modified Delphi process to develop clinical practice recommendations for nutritional and lifestyle strategies that may assist people on glucagon-like peptide 1 based therapies (GBT) in optimizing treatment experience and improving health outcomes. Results: A total of 52 consensus statements were developed, outlining key considerations for the practical management of obesity and associated complications with GBTs, with a focus on nutritional factors in relation to obesity, body composition, physical activity, and the management of common gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and constipation. The consensus statements include practical strategies supporting the weight loss journey, from before starting a GBT, during the weight loss and weight maintenance phases, and in case of GBT discontinuation. The statements were primarily derived from indirect evidence, including from existing evidence and established guidelines for nutrition therapy in bariatric medicine and relevant clinical experience. Conclusions: These expert consensus recommendations offer healthcare professionals practical guidance on nutritional and lifestyle interventions for patients undergoing GBT-related weight management, complementing current recommendations. Further direct evidence is urgently required to inform and enhance optimal clinical care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.280 | 0.247 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.007 |
| Bibliometrics | 0.010 | 0.005 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.006 | 0.007 |
| Open science | 0.005 | 0.017 |
| Research integrity | 0.008 | 0.009 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".