CONTRIBUTION OF NUTRITIONAL AND LIFESTYLE INTERVENTIONS TO WEIGHT LOSS MAINTENANCE DURING AND AFTER GLP-1-BASED MEDICATION USE: AN INTEGRATIVE REVIEW

Abstract

Obesity is a chronic and multifactorial disease, and weight loss maintenance remains one of the main clinical challenges even with the development of GLP-1-based medications. Although GLP-1 receptor agonists and drugs with combined action involving this pathway promote clinically relevant weight reduction, treatment discontinuation may be followed by weight regain and attenuation of cardiometabolic benefits. This study aimed to analyze the contribution of nutritional and lifestyle interventions with a dietary component to weight loss maintenance during and after the use of GLP-1-based medications in adults with overweight or obesity. This is an integrative literature review with a qualitative and descriptive-analytical approach, organized according to the stages of identification, screening and inclusion adapted from PRISMA 2020. The original broad search identified 2,403 records in PubMed/MEDLINE and the Virtual Health Library; after duplicate removal, 1,312 records were screened, 33 publications were assessed in full text and 26 publications, corresponding to 21 independent studies, composed the evidence set. The findings indicate that nutritional and behavioral interventions are present in most pharmacological protocols, although frequently as background treatment similarly offered to comparison groups, which limits estimation of their independent effect. Withdrawal studies demonstrate relevant weight regain after discontinuation of semaglutide or tirzepatide, whereas evidence on specific nutritional strategies for the post-GLP-1 period remains scarce. It is concluded that nutritional therapy is an essential component of longitudinal care, contributing to diet quality, protein adequacy, management of gastrointestinal symptoms, preservation of body composition and development of sustainable behaviors, although its isolated capacity to prevent weight regain after pharmacological discontinuation still requires further investigation.