Despite the popularity of semaglutide drugs like Ozempic and Wegovy for weight loss, surveys suggest that most people still prefer to lose weight without using medications.

For those preferring a drug-free approach to weight loss, research shows that certain nutrients and dietary strategies can naturally mimic the effects of semaglutides.

Increased intakes of fibre and monounsaturated fats (found in olive oil and avocadoes) – as well as the time of day when foods are eaten, the order that foods are eaten in, the speed of eating and even chewing – can naturally stimulate increased production of the same hormone responsible for the effects of semaglutide drugs.

As a family physician with a PhD in nutrition, I translate the latest nutrition science into dietary recommendations for my patients. A strategic approach to weight loss rooted in the latest science is not only superior to antiquated calorie counting but also capitalises on the same biological mechanisms responsible for the success of popular weight-loss drugs.

Semaglutide medications work by increasing the levels of a hormone called GLP-1 (glucagon-like peptide 1), a satiety signal that slows digestion and makes us feel full. These drugs also simultaneously decrease levels of an enzyme called DPP-4, which inactivates GLP-1.

As a result, this "stop eating" hormone that naturally survives for only a few minutes can survive for an entire week. This enables a semi-permanent, just-eaten sensation of fullness that consequently leads to decreased food intake and, ultimately, weight loss.

Nevertheless, medications aren't the only way to raise GLP-1 levels.

What you eat

Fibre – predominantly found in beans, vegetables, whole grains, nuts and seeds – is the most notable nutrient that can significantly increase GLP-1. When fibre is fermented by the trillions of bacteria that live in our intestines, the resultant byproduct, called short-chain fatty acids, stimulates the production of GLP-1.

This may explain why fibre consumption is one of the strongest predictors of weight loss and has been shown to enable weight loss even in the absence of calorie restriction.

Monounsaturated fats – found in olive oil and avocado oil – are another nutrient that raises GLP-1. One study showed that GLP-1 levels were higher following the consumption of bread and olive oil compared to bread and butter. Though notably, bread consumed with any kind of fat (be it from butter or even cheese) raises GLP-1 more than bread alone.

Another study showed that having an avocado alongside your breakfast bagel also increases GLP-1 more so than eating the bagel on its own. Nuts that are high in both fibre and monounsaturated fats, like pistachios, have also been shown to raise GLP-1 levels.

How you eat

However, the specific foods and nutrients that influence GLP-1 levels are only half the story. GLP-1 is a good example of how it's not just what you eat that matters, it's also how you eat it.

Studies show that meal sequence – the order foods are eaten in – can impact GLP-1. Eating protein, like fish or meat, before carbohydrates, like rice, results in a higher GLP-1 level compared to eating carbohydrates before protein. Eating vegetables before carbohydrates has a similar effect.

 

 

Time of day also matters, because like all hormones, GLP-1 follows a circadian rhythm. A meal eaten at 8 am stimulates a more pronounced release of GLP-1 compared to the same meal at 5 pm.

 

This may partly explain why the old saying "eat breakfast like a king, lunch like a prince and dinner like a pauper" is backed by evidence that demonstrates greater weight loss when breakfast is the largest meal of the day and dinner is the smallest.

 

The speed of eating can matter, too. Eating ice cream over 30 minutes has been shown to produce a significantly higher GLP-1 level compared to eating ice cream over five minutes. However, studies looking at blood sugar responses have suggested that if vegetables are eaten first, the speed of eating becomes less important.

 

Even chewing matters. One study showed that eating shredded cabbage raised GLP-1 more than drinking pureed cabbage.

 

Not as potent as medication

 

While certain foods and dietary strategies can increase GLP-1 naturally, the magnitude is far less than what is achievable with medications. One study of the GLP-1 raising effects of the Mediterranean diet demonstrated a peak GLP-1 level of approximately 59 picograms per millilitre of blood serum.

 

The product monograph for Ozempic reports that the lowest dose produces a GLP-1 level of 65 nanograms per millilitre (one nanogram = 1,000 picograms). So medications raise GLP-1 more than one thousand times higher than diet.

 

Nevertheless, when you compare long-term risk for diseases like heart attacks, the Mediterranean diet lowers risk of cardiac events by 30 per cent, outperforming GLP-1 medications that lower risk by 20 per cent. While weight loss will always be faster with medications, for overall health, dietary approaches are superior to medications.

 

While natural approaches to raising GLP-1 may not be as potent as medications, they provide a drug-free approach to weight loss and healthy eating.

 

Mary J. Scourboutakos, Adjunct Lecturer in Family and Community Medicine, University of Toronto