Breaking Down the New GLP-1 Advisory with Lara Zakaria, IFMCP

In this episode, Dr. Kate Kresge unpacks the 2025 joint advisory on nutrition and GLP-1 therapy with Lara Zakaria, PharmD, MS, CNS, CDN, IFMCP. Lara reframes GLP-1 medications as a window of opportunity for lifestyle change, not a stand-alone solution. She explains why screening for disordered eating and baseline diet quality matters before starting, how to protect muscle with protein and resistance training, which nutrients to monitor as intake drops, and how to manage common GI side effects proactively. (Mozaffarian 2025) You'll also hear how to build visit templates, lab panels, and care teams that make guideline-based GLP-1 care realistic in everyday practice.

3 Key Takeaways

• Screen before you start. The advisory recommends baseline screening of usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions before GLP-1 initiation. (Mozaffarian 2025)
• Protein alone won't protect muscle. Clinicians should emphasize that higher protein intake is likely inadequate to preserve muscle without structured resistance training. (Mozaffarian 2025). Lara pairs both, aiming for strength training two to three times per week.
• Watch nutrient status as intake drops. Lara monitors iron, vitamin D, RBC magnesium, zinc, and fat-soluble vitamins, and favors nutrient-dense, minimally processed foods to fill gaps. (Mozaffarian 2025)

Guest: Lara Zakaria, PharmD, MS, CNS, CDN, IFMCP, is a licensed pharmacist and functional medicine practitioner specializing in metabolic health, neuroinflammation, and chronic disease. As faculty for the Institute for Functional Medicine, she teaches clinicians how to integrate pharmacology with nutrition and lifestyle medicine. Learn more at larazakaria.com.

Clinical FAQ

Which labs does Lara consider for patients on GLP-1s?

A CMP, CBC with iron studies, RBC magnesium, vitamin D, and a full thyroid panel, with functional testing such as organic acids or stool testing when indicated.

How does she approach GLP-1-related constipation?

She considers hydration, magnesium citrate, buffered vitamin C, gradual fiber, ginger, triphala, or digestive bitters, plus stool positioning and morning routines that support parasympathetic tone. (Mozaffarian 2025)

Why track body composition instead of weight?

Visceral fat, lean mass, and muscle density reveal whether weight loss is coming from fat or muscle, which matters for long-term metabolic health. (Wilding 2021)

Timestamps

00:00 – Episode introduction and prescribing considerations

03:28 – GLP-1 development and off-label use for weight loss

05:54 – The consensus statement and implications for practice

06:43 – Muscle loss, fat distribution, and diet quality

09:05 – Nutrition counseling and the gut-brain axis

12:05 – Screening, biomarkers, and functional testing

14:10 – Fiber and gut health

17:50 – Screening for nutrient deficiencies

22:07 – Preventing sarcopenic obesity

27:54 – Liver, thyroid, and metabolic labs

47:02 – Managing GI side effects

54:43 – Titrating and off-boarding GLP-1s

55:30 – Resources

Ready to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript helps clinicians bring supplement dispensing, lab ordering, and patient education into one centralized workflow. For more practitioner education on supplements, nutrition, and evidence-informed clinical care, visit Fullscript Academy at academy.fullscript.com.

Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.