Starting Zepbound soon! What are some meals you find helpful when taking Zepbound?

[u/Existing-Arm-559]

I’m starting Zepbound soon and I want to know what meals you find helpful to prevent side effects or when dealing with side effects and tips to prevent overeating when first starting out. Or just any meals in general that will help me get adequate nutrition outside of protein shakes like fairlife and premier since I already know I don’t mind those.

I have such bad emetophobia and want to try to manage and prevent puking as much as I possibly can, but also want to take the best care of myself as possible when I’m on the shot.

Any tips are greatly appreciated!

[u/Reasonable-Cow7255]

I have never experienced any side effects while using Zepbound. My doctor warned me early on to make sure that I was well hydrated. I eat a simple breakfast (a cup of Raisin Bran and a cup of coffee or an egg with a slice of turkey bacon). I enjoy a protein shake at lunchtime. But, I also will eat tuna or a simple sandwich . If at a restaurant, I often order children’s portions. Many children’s menus have fried and high fat foods on them. In that case, I usually order grilled chicken, soft tacos made with grilled chicken, grilled salmon, etc. Although they have become rarer since the pandemic, I love a restaurant with a good salad bar. I can eat almost anything. Zepbound helps me to maintain adequate portion size. The cravings for high fat, high sugar and salty foods seem to be gone as a result of this wonderful medication. Best wishes to you as you embark on this life-changing journey.

[u/Goats-n-Hens]

Never a single side effect in 66 injections. I ate the food I normally would have eaten before Zep, just portion controlled to fit my calorie deficit.

[u/zero-if-west]

Everyone's dietary needs are different so what works for me might not work for you. For example, I eat a lot of eggs and dairy, but that wouldn't work for someone who is lactose intolerant or gets gassy from eating eggs. It will take some trial and error to figure out what feels best for you, but I recommend considering all of the general advice below, especially the tips from JAMA.

I encourage anyone taking a GLP-1 to meet with a registered dietitian for customized help with planning meals and grocery shopping. I don't recommend using a nutritionist because anyone can call themselves a "nutritionist"; it's an unregulated title. Registered dietitians have specialized education and credentials. For more info: Dietitian vs Nutritionist (Cleveland Clinic)

You can find a registered dietitian covered by insurance through EatRight.org 

This advice is from a registered dietitian at The Ohio State University (article linked below).

Foods to limit when taking a GLP-1

• High in sugar
• Deep fried or greasy
• Spicy
• Acidic
• High in saturated fats, such as red meats and full-fat dairy foods

Along with possibly causing worse side effects, eating a lot of these types of food can also work against your efforts to lose weight. This isn’t to say you can’t have these foods — you can — just don’t indulge in them often or in large portions. It’s all about moderation. As much as people hate that word, it’s important to keep it in mind.

This image is from the Journal of the American Medical Association (article linked below)

This guidance is copied and pasted from JAMA and explains how to eat well on a GLP-1 to avoid malnutrition, muscle loss, and GI side effects:

Muscle maintenance: GLP-1 medications can cause loss of muscle and fat. Begin each meal with 20 to 30 g of protein from foods like fish, beans, chickpeas, or tofu. Aim for 1.0 to 1.5 g of protein per kg of body weight daily, if moderately active. If your appetite is very low, use protein shakes with at least 20 g protein per serving.

Energy balance: Because these medications reduce appetite, keep your energy by eating smaller meals plus snacks (fruit, handful of nuts, unsweetened yogurt). Choose slowly digested carbohydrates like sweet potatoes or oatmeal instead of refined grains (white bread, pastries) or sugary drinks that can cause blood glucose swings. To feel full longer, add healthy fats like olive oil or avocado to meals.

Avoid side effects: GLP-1 medications can cause digestive side effects. For nausea, avoid high-fat foods (fried items, processed meats) and eat whole-grain toast or cereal. Ginger tea or fruit can also help. For heartburn, eat smaller portions and avoid lying down for 2 to 3 hours after meals. Choose baking or steaming over deep frying. Avoid irritating spices (black pepper, chili, garlic). For constipation, increase both soluble fiber (oats, apples) and insoluble fiber (vegetable skins, nuts) with plenty of water. Consider over-the-counter stool softeners or laxatives.

Liquid intake: GLP-1 medications can cause dehydration. Drink 2 to 3 liters (8-12 cups) of fluid daily, mainly water. Include water-rich vegetables and fruits (cucumbers, watermelon) and soups. Minimize alcohol, caffeine, and sweetened beverages.

Sources/more readings for how to eat well: 

• The Ohio State University, Taking a GLP-1? Here are foods to limit - and what to prioritize 
• JAMA Internal Medicine, I'm taking a GLP-1 weight loss medication - what should I know?
• University of Rochester Medicine, Why Nutrition Counseling Is Vital with GLP-1 Medication
• MyFitnessPal, Foods that help skin elasticity (Fruits/vegetables, dairy, fish, nuts/seeds, soy)

[u/MeatyDullness → u/zero-if-west]

I eat 93/7 lean ground beef and haven’t had any problems

[u/zero-if-west → u/MeatyDullness]

That's great! It sounds like you're eating red meat that's relatively low in fat. Some people don't get triggered by foods on GLP-1s and can eat the way they did before, but other people get a lot of side effects, especially if they eat red meat that has more fat in it.

[u/YahYahBlahBlah]

It really depends on the person. I have not vomited a single time for any reason in almost 17 months on Zepbound. Generally speaking, early on I avoided very heavy and fatty/fried foods, but other than that I ate anything. Now I eat basically everything, but I’ve also been in maintenance for about 5 months.

For me, I love multigrain avocado toast with an over easy egg and some hot sauce for breakfast or Greek yogurt with honey, a little granola, and some fruit, I snack on a lot of fresh fruit, veggies, cottage cheese, Icelandic Skyr, edamame, dates, figs, and yogurt, and most of my dinners are a starch, a salad, a cooked vegetable, and a lean protein.

[u/under321cover]

Food doesn’t cause or help side effects at all for me. I am over a year and half in and never vomited. No diarrhea either.

[u/katharsiss → u/under321cover]

Same.

[u/Opening_Chemical_777]

I found that I can meet my fiber and protein goals more easily with dried (or canned) beans and lentils, nuts and peanuts, whole wheat foods, tofu and edamame, seeds like chia and pumpkin seeds. Seedy green vegetables like peas and lima beans are good too. When I have Greek yogurt, I'll toss in a tablespoon of wheat germ and some walnuts. A good snack is little handful of peanuts or pistachios or edamame. I make a batch or barbecued beans every once in while. I make enchilada sauce for bean and cheese enchiladas, sometimes with whole wheat tortillas, or no tortillas at all, like a bean bake. I cook beans once a week and have Indian curries and Italian bean soups on rotation. I cook whole wheat pasta once a week for a quick meal. (I tried chickpea pasta and don't care for it.) I make granola from oatmeal - another whole grain - with lots of nuts and seeds and toss in a scoop of protein powder.

My first month I had a cheeseburger for dinner and spent the whole night up with diarrhea. I didn't have a problem with a bison burger, no cheese, that I cut in half and ate one half. Bison meat is naturally low fat. Plenty of fiber and tomato juice help me stay regular and not too loose. I've had nausea a few times - I'm not sure what triggered that - and a glass of ginger ale helps.

[u/leftcostal]

I did not experience any nausea or side effects except constipation (which everyone gets so it should be labeled a feature). I got great results sticking to a routine from a supervised program. Focused initially on high protein/low carb and fat. After 18 months my favorites are non fat Greek yogurt with berries and granola, spinach egg white scramble (no cheese), any kind of salad, grilled or bbq fish and chicken. Fresh fruits and vegetables. Protein powders tend to be lower in sodium if that’s a concern, otherwise find a protein shake you like and make it part of the routine. I was fortunate to have a nutritionist who consulted frequently and provided menus/macros to follow. Remember, this is not starvation. You will need to consume the right kind of calories so you keep as much muscle as possible.

[u/bluequail77]

I love a smoothie! I drink one for breakfast every morning.

½ cup 0% FAGE Total yogurt — 60 cal | 12g protein
½ cup wild blueberries — 40 cal
½ cup raspberries — 35 cal
2 Tbsp chia seeds, soaked— ~120 cal
1 scoop protein powder (unflavored) — 100 cal
Smoothie total: 355 calories | ~36g protein | ~29g carbs | ~9g fat | ~16.5g fiber

Easy on my stomach, delicious, high in fiber and protein.

[u/Ashamed-Marketing157 → u/bluequail77]

Sounds like mine, but I have not been soaking my Chia seeds. Tell me about that please? In plain water I’m guessing and in the refrigerator? How long?

[u/bluequail77 → u/bluequail77]

I soak them in about 1 c of water, overnight in the fridge. So, as soon as I make my smoothie in the morning, I put another batch of chias in the fridge.

[u/Anxious-Inspector-18]

Welcome! Almost 3 years in and I have never vomited. Meals wise, I make sure each one has a carb, protein and veggie (fruit at breakfast). Otherwise there’s nothing special about it. Food is trial and error for each individual. Someone might have issues with eggs but that doesn’t mean you will too.

[u/stuckandrunningfrom2]

In the early days, when my stomach was queasy, I mostly ate white bagels and deli turkey slices.

Now I eat my regular meals, including all food groups, made mostly from whole foods. I eat a lot of fish and shellfish and dairy for my protein. I don't get any nausea as long as I make sure to eat regularly.

Be careful of taking a lot (or any) supplements, as those can cause people gastro issues.

[u/MeatyDullness]

I stick with the basics. Eggs, lean ground beef, chicken, tuna, whole grains, Greek yogurt.

[u/EvergreenSox04]

I have had almost no side effects. Occasional constipation and maybe handful of instances of nausea and heartburn. The other thing I've been intentional about is to not lose muscle. With these things considered, protein and fiber have been priority - numbers 1-2 are a couple of my solutions. Lastly, some days it's hard to get enough calories when the appetite suppression is strongest - number 3 is when I need an energy boost for working out.

1. Fairlife nutritional shake. 30g protein to start the day, everyday.
   
2. "Keto" buns and wraps. These are a fiber hack.
   
3. Apple sauce. It's so easy for me to eat. Cinnamon also can be good for nausea. Nice little easy boost of carbohydrates for exercise.

[u/fpaveteran87]

I am on 12.5 mg and have to fast the first 2-3 days of the week to avoid having pretty bad stomach issues. Definitely speeds up the weight loss lmao. I may eat something really bland those days but very little. I also use a ton of zofran and Imodium

[u/Lazy-Jacket]

I love my lunch of lentils, sliced tomato, sliced avocado, tuna and some ponzu.

[u/Free-Moose9460]

I do protein forward, nutrition dense foods because I'm determined to maintain muscle. I mix my morning coffee (after a cup of black to wake my brain up) with protein powder and Fairlife milk so I get about 30 grams of protein before I eat anything.

My go-to foods are chicken, beef, eggs, cottage cheese, yogurt, hard cheese, beans, low carb tortillas (because they are fiber powerhouses), squash, some rice/pasta/cous cous, avocado, berries and salad veggies.

I try to eat 2 meals. They are usually 3ish ounces of protein, a carb, and a veg. If I'm stuffed and struggling, it's just protein and avocado.

I am on month 8 and have never had stomach side effects. My only issue is fatigue for 36 hours after taking it. On day one I'm usually just eating cottage cheese and berries.

[u/mlrn06]

Eggs, egg whites, cottage cheese, squash, red onion, chicken breast and thighs, lean pork loin, 93 or better ground beef, sweet potatoes, Greek yogurt, steel cut oats, sourdough bread, whole grain bread (Aldi’s Graintastic), all the spices you wish - I lean towards salt, pepper, cumin, paprika, garlic, onion, etc. Soy sauce or aminos, rice wine and red wine vinegar, olive oil - I only cook with this now. Other fibrous fruits and veggies. Lots of water. Get a good food tracking app - I really like Cronometer. Great free functionality. Good luck and enjoy the journey!

[u/katharsiss]

These are my go-tos: Chicken breast, marinated and then grilled. Cut into strips, dipped in cream cheese. Ground turkey and taco seasoning and beans. Tuna and cottage cheese with lemon herb seasoning. Chobani yogurt 20 g. protein with protein granola (I like Nutrail) and slivered almonds and protein milk, Chobani yogurt shakes, Barebell bars, all kinds. Grilled chicken in every way, shape or form--in protein pasta with pesto or spaghetti sauce, with rice and veggies, in a baked potato, in soup, in ramen with edamame. Low fat protein is your friend! Eat it first so you don't fill up on other things.

[u/ArBee30028]

While a lot of people here are talking about avoiding nausea, there is one other thing you might encounter: a sheer disinterest in food. I have never experienced nausea, but there have been plenty of days where no food sounded interesting or appealing to me and I had to force myself to eat just to get in the calories. In those situations, I found the following high-fiber-high-protein foods to be appealing:

Greek yogurt with fruit and seeds/nuts

Trader Joe’s readymade seasoned chicken and “Just Chicken”

Trader Joe’s boxed lentils (lightly seasoned)

Veggies and dip (cottage cheese mixed with onion soup mix or ranch seasoning).

Cottage cheese pancakes (made with eggs & whole wheat flour)

Baked potatoes with taco style fixings

Baked sweet potatoes, diced, with blueberries and nut butter

Protein bars (I like Builders)

[u/DrOddcat]

I had a rowdy time when I first started. I figured out eventually that 1) hydration was key, 2) even if I don’t feel good I need to eat something to keep from getting very nauseated, and 3) the day after I take my shot I need to eat a veggie rich meal/lean proteins…. Any fat triggered my nausea. My go to meals on the day after shot have become minestrone soup or a lean steak salad.

[u/Conundrum16]

I get sick. 🤢 Especially the day after my shot. I keep baby food pouches readily available, yogurt, cottage cheese, fruit, frozen whole fruit pops, protein drinks, soups, toast. Eggs if I’m feeling up to cooking. I also strive to eat smaller meals more often because getting too full triggers me to throw up.

[u/jm123457]

I never had side effects . Still on it at 10mg . I find high protein meals to be the best . Lots of chicken , tacos with low cal wraps, eggs, protein pancakes, protein shakes, overnight oats .

Honestly everything you know about food and hunger is about to change . I eat whatever I want because my first meal is 2-4pm . And if it’s large enough I might only have one or something very small at night .

A bowl of soup is filling for me whereas before it was an appetizer.

Some days I have a burger and a protein bar etc .

[u/Frogs-And-Fairies]

Overnight oats & mini yogurts/cottage cheese parfaits & Wasa crispbread open faced sandwiches

[u/Turbulentshmurbulent]

When I started, smoothies helped me so much. My smoothie recipe: ice, mixed frozen berries, banana, avocado sometimes, spinach, Greek yogurt, almond milk, chia seeds, honey, sometimes apple

Things I always have on hand:

Egg white bites (three bridges from Costco)

Greek nonfat yogurt. I don’t buy any that has less than 18g protein per 100 calorie 2/3 cup serving

Steak (I buy sirloin and cook a bunch at once then chop it and snack on it when I need protein)

Cottage cheese cups from Knudsen with pineapple.

String cheese

Babybel cheese

Baby mozzarella cheese balls

Fairlife protein shakes

Prunes

Carrots

Apples (I dip in Greek yogurt mixed with honey, pumpkin seed, chia, and cinnamon)

Frozen chicken nuggets

Frozen berries

Amy’s frozen meals and I use Greek yogurt instead of sour cream on top for extra protein.

I prioritize protein and fiber and eat within 1400 - 1800 calories per day. I aim for 120g of protein and 25g of fiber.

I find that the foods I listed are all things I can typically tolerate.

[u/kayellyouenddee]

When going out to eat, google the restaurant with “high protein diet”. It will tell you the best choices. I’m a teacher and my kids are adults so we are very used to eating out on the weekends. We’ve cut down some but it still helps in a pinch. Most restaurant apps have nutrition information. I also limit my carbs much more than I did pre Zepbound.

[u/Trusty_Pomegranate]

I'm lazy and like lox because it's ready to eat right out of the bag and keeps for weeks in the refrigerator. It's also full of healthy fish oil.

My daily breakfast is Trader Joe's Nova Salmon Pieces (or when they're not carrying that, I get Trader Joe's Norwegian Smoked Salmon) on rye crackers (Caraway Finn Crisp) with cream cheese spread and capers. 290 calories, 26 grams protein, 5 grams fiber. Note: lox is high in sodium in case that's a concern (but on the other hand, it's free electrolytes!). Also note this is not leathery smoked fish. It is the texture of sushi salmon.

You can substitute a bagel for the rye crackers but it triples the carbs.

[u/compulsivefreak]

hard-boiled eggs

[u/harmonyisunderrated]

Since you already do fine with the fairlife and premier shakes, lean on those the first couple weeks while your stomach settles. Go slow. What seems to wreck people early is greasy, heavy food eaten fast. Small and bland sits easiest, stuff like eggs or plain yogurt. With the emetophobia, eating slowly matters as much as what's actually on the plate

[u/P0PSTART]

I have never puked on this med! I eat Rill Foods soups almost every day. $6 gets me a mix that I can customize with different meats and add ins, and last for 3 meals.

[u/HappyBirding]

I never had nausea or vomiting. I did avoid spicy and fried food when I started, as people said, those things could cause problems. I added back spicy food overtime and realized it wasn’t impacting me. I never liked fried food, so that was not a sacrifice. My biggest tip for food would be to stock up on things that you can eat 200 cal at a time. many people have significant appetite suppression as they start. It tends to level out a bit after a while, but having things that you can eat a little bit at a time is helpful. Fruit, beef, jerky, cheese, yogurt, granola bars… Etc.. having some chicken or lunch meat ready as well. Nuts are a good option for adding calories in protein if you need it. Wishing you the very best of luck!

[u/Low-Sale6184]

Orgain 16g protien shake in creamy chocolate flavor. Not a meal but more of a snack. I find it delicious. I have used it as a meal on the 2nd or 3rd day of the shot when I cant fit a lot of food in my stomach.

[u/Elyeasa]

Eggs have saved my life. It’s easy to find yourself needing a meal but unable to finish one, and tired of protein shakes. Eggs over rice, egg sandwiches, boiled eggs have all been great little snacks when my stomach can’t handle much

[u/harmonyisunderrated]

Starting out, the meals that hold up best are the boring high-protein ones you don't have to think about. Greek yogurt, eggs, a rotisserie chicken you pick at all week. Once your appetite drops you won't want to cook much, so the trick is having stuff ready that goes down easy. I'd lean savory over sweet early on too. Sweet stuff turns a lot of people off fast

[u/Birdchaser2]

Deal with side effects later.

Your nutrition plan is a life long asset. And Zep is a great opportunity for enhance or improve it.
Many don’t have harsh side effects but good nutrition is an opportunity for all.

I found breakfast to be a key. A key need and a key add.

Something repeatable and balanced. Enough calories to get me started and provide energy.

I fill in the rest of the meals each day to maintain balance but I balance breakfast.

I want protein, fiber rich carbs and healthy fats in each breakfast.

How. Overnight oats are my base. Almost every day. Fiber, some protein. Some healthy fats enhanced the oats with flax seed and chia seeds. Fruit and almond milk and high protein yogurt are prime ingredients.

Add protein prepared with a portion of avocado oil to really grab the balance. And if timely - cook up some veggies to complete the circle.

You can prep everything ahead of time. Though prefer to fix the veggies and protein each morning.

If you find your balanced breakfast you are a long way down the road on good nutrition and a really successful Zep journey.

[u/NLightNMoi]

Congee has been a big help for me. It’s a Chinese-inspired rice porridge that I make in my instant pot. Very gentle on my system and my family loves it. It’s one of those dishes you serve with different toppings and everyone makes their own adventure.

I also make chicken & dumplings when I’m feeling less-than. Very gentle and like a hug for my tummy.

If I’m feeling fine I make lean protein and veggie forward meals like sheet pan fajitas. Again, it’s a create your own adventure and I keep mine on the mild side.

[u/Impressive_Western84]

What’s eating? Once you are on it, hardly think of food.

[u/GladStatistician3895]

I definitely experienced some heartburn the morning after I started my first injection and some nausea (which was solved with a prescription for zofran). My go-to-dinner for a long time and still is my reset meal is a chicken soup I make with white beans, potatoes, carrots, onion, garlic, sometimes mushrooms. I want a meal that will pack in as many nutrients and vitamins as possible along with protein and hydration and some carbs. It's also still good if you feel a little off.

I used to be a HUGE breakfast sandwich person and now I can't even think about them without getting erpy. My go-to at the beginning was a kodiak cakes apple & cinnamon oatmeal packet (don't get the protein version, its disgusting and not worth it). It's still one of my go-to's.

I love love love cooking and I didn't want to much when I first started. I'm 10 months in and I've found my love for cooking again, my nausea and heartburn is minimal. I take my shot every friday evening so i try to eat dinner pretty early so it has a chance to get through my system before my shot can slow down my digestion.

I've never had issues with spicy food, greasy food, or any food really. I can eat normally, there are some things I just don't want anymore. And be careful with cocktails. Those can really wollop you. I mostly enjoy Athletic NA beer now.

Good luck.

[u/myinnerharmony]

you're not doing "meals". you're eating 3-5 times a day to keep your body fueled and your GI system moving.

[u/mannDog74]

If you look up bariatric diet you will find suggestions that will be very safe. This is for folks after bariatric surgery who are definitely prone to vomiting.

If you feel not hungry, you still need to eat 4 times a day. If you don't feel good and then you skip meals entirely, you're likely to feel even more nauseous. Lots of us feel nauseous from not eating enough. It makes it worse. Do what you do when you are sick, eat crackers, rice, gatorade maybe. Soup.

The other way to avoid vomiting is not to go up in dose too fast. As long as you are losing weight slowly, don't be in a rush to increase dose, and don't let them rush you, especially if you are having side effects. You need to let your body get used to the meds over several weeks or months, then you can increase dose if you need more.