Clinical Frameworks for Managing GLP-1 Side Effects and Nutrition in General Practice

The rapid uptake of GLP-1 receptor agonists has reshaped metabolic care in Australian General Practice. Prescribing has increased quickly, patient demand continues to grow, and the clinical landscape is evolving in real time.

Recently, 253 General Practitioners registered for a webinar hosted by Myhealth Academy, where Dr Angela Kwong was invited to speak on navigating side effects and nutritional changes during GLP-1 therapy.

The strong attendance reflected something important. GPs are not only prescribing these medications, they are seeking clearer, structured frameworks for supporting patients safely over time.

What GPs Are Seeing in Practice

In everyday consulting rooms, it is not uncommon for GPs to be navigating side effects such as:

• Fluctuating nausea
  
  
• Reflux
  
  
• Constipation
  
  
• Early satiety that compromises protein intake and overall nutrient adequacy
  
  
• Reduced food volume with unintended nutritional consequences
  
  

These presentations are often nuanced rather than dramatic. Symptoms may settle, recur, or vary with dose changes. Patients may report “not feeling like eating” without recognising the downstream impact on protein sufficiency or micronutrient intake.

Without a structured approach, these patterns can lead to reactive prescribing, unnecessary escalation, or fragmented care.

Why Clinical Frameworks Matter

GLP-1 therapy is not simply about appetite suppression or weight reduction. It sits within the broader context of metabolic medicine.

When energy intake declines, protein adequacy becomes more important - not less. Lean muscle mass, functional strength, hydration and micronutrient sufficiency all require proactive attention. Early satiety may be an expected pharmacological effect, but if it significantly limits protein intake, the long-term implications deserve careful review.

Clinical frameworks help us move beyond symptom management and toward comprehensive care.

They encourage us to ask:

• What is the timing and trajectory of symptoms?
  
  
• Are side effects dose-related or transient?
  
  
• Has overall protein intake changed meaningfully?
  
  
• Is there risk of reduced muscle mass or nutritional compromise?
  
  
• Can medication burden be rationalised before layering additional prescriptions?
  
  

This shift from reaction to structured review - is where safer prescribing begins.

Nutrition Is Not Secondary

One of the key themes explored in the session was the importance of integrating nutritional assessment alongside pharmacological management.

As food volume decreases, dietary quality and protein density matter more. Patients may unintentionally reduce high-protein foods first, particularly if tolerance to heavier meals declines. Fibre adjustments, hydration strategies and protein distribution across the day can all influence gastrointestinal tolerance.

These considerations highlight why GLP-1 care cannot sit solely within prescribing.

It intersects with dietetics.
With behaviour-focused care.
With long-term preventive health.

Multidisciplinary language and collaboration are not optional in this space. They are foundational.

A Field That Is Still Evolving

GLP-1 therapies are moving quickly. Formal guidelines, by necessity, take time to adapt, while real-world prescribing continues to expand.

General Practice sits at the centre of this change. Clinicians are balancing innovation with safety, patient demand with long-term outcomes, and pharmacology with nutrition.

Events such as this webinar create space for reflection. They allow us to examine emerging patterns, refine our frameworks, and share practical approaches grounded in physiology rather than assumption.

We extend our thanks to Myhealth Academy for hosting the session and to the many GPs and allied health professionals who contributed thoughtfully to the discussion.

As this area of medicine continues to mature, structured, collaborative and patient-centred care will remain essential.

Better outcomes are rarely achieved through speed alone.
They are built through thoughtful systems, shared learning and clinical integrity.

You are not alone in navigating this evolving landscape.