GLP-1 Medications

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WHAT ARE GLP-1 MEDICATIONS AND HOW DO THEY SUPPORT WEIGHT LOSS?

Currently the main medications we use at the Slimming Clinic are called Wegovy and Mounjaro. They are weekly injections and the doses are gradually increased over a few months. Wegovy mimics a gut hormone called Glucagon- like peptide 1, which makes you feel fuller for longer and reduces cravings. Mounjaro stimulates the release of insulin and glucagon which reduces hunger and promotes a feeling of fullness.

Taking these medications will give you time to pause and reflect on your diet and lifestyle behaviours. Allowing you to focus on altering these habits for healthier ones, to achieve life long weight loss success.

MANAGING YOUR EXPECTATIONS

You may not feel that different when you first start a GLP-1 medication. Some clients I speak to don’t think the medication is working during the first dose phase. This is because it is a starting low dose and will gradually build up over time. It is important to do so, to not shock the body at the start. It is normal to not feel your appetite has changed in the first few weeks so please do not worry about it, you will feel it more as the dose is increased.

You need to have realistic weight loss expectations when taking GLP-1 medications. For instance, clients taking Wegovy tend to lose an average of 15% of their body weight. Research suggests clients on Mounjaro tend to lose an average of 20% of their body weight. So please ensure your target weight sits within these limits to avoid disappointment.

PREGNANCY AND BREASTFEEDING

It is not recommended to fall pregnant whilst taking any of these medications. If you are on Mounjaro there is limited research on oral contraception, pregnancy and breastfeeding. Therefore, the recommendation is to use an additional form of contraception if you take any oral contraception, or swap your oral contraception for a non oral contraception whilst on this medication. If you wish to try to conceive it is recommended to stop these medications 1 month before trying for a baby, so it has completely left your system. Also it is not recommended to take these medications whilst breastfeeding, as they may transfer to the baby in the breast milk.

WHAT SHOULD I EAT WHILST

TAKING GLP-1 MEDICATIONS?

Whilst having these medications, it is important to follow a healthy well balanced diet, including fruit, vegetables, dairy, protein and complex carbohydrates. You should also try to limit your intake of processed and fried foods.

LEAN PROTEINS

Proteins are important for the body to repair and grow. They are low in fat, high in B vitamins and good for your heart health. Examples include chicken, turkey, lean red meat, fish, vegetarian alternatives, Greek yoghurt, cottage cheese, lentils and pulses.

FRUIT AND VEGETABLES

This food group is bursting with vitamins, minerals and fibre. It is recommended to have a minimum of 5 handfuls per day. Try your best to add some to all meals and snacks.

HEALTHY FATS

Healthy fats help the body absorb certain vitamins and minerals. Some foods they are found in include vegetable and olive oil, avocado, oily fish, nuts and seeds.

COMPLEX CARBS

Carbohydrates provide the brain and body with a source of energy. Try to go for wholegrain varieties as they are higher in fibre and will keep you fuller for longer. Whole grain varieties include brown rice, quinoa, wholemeal pasta and plain popcorn. Try to have a small portion of this food group in all 3 meals, as this will help to keep your blood sugars stable throughout the day.

DAIRY

This food group is essential for bone health. We require 2 servings per day. This could include 120mls milk, 30g of cheese or a small pot of yoghurt.

EATING TIPS TO MAXIMISE YOUR WEIGHT LOSS.

REGULAR EATING

The number one thing we get all our clients to do is have a regular meal pattern. I advise having 3 meals per day with no longer than 4 to 5 hours in between each meal. One of the main reasons for this is to keep your blood sugars stable throughout the day, which avoids sugar crashes- leading to cravings and snacking on the wrong foods. Another reason is to prevent your body going into starvation mode. After not eating throughout the night, if we do not give our bodies fuel regularly during the day, it thinks “we are starving it.” This will lead it to go into starvation mode, hold on to our fat reserves and make it harder for weight loss to happen.

MINDFUL EATING

If we slow down the rate we eat at, and sit at the table with no distractions (for example, no television turned on), we will have more time to recognise when we are full. This can help us to feel satisfied sooner and eat less meal portions.

POST MEAL ACTIVITY

Avoid lying down after a meal. Sitting up right can help aid digestion. If you can fit it in, why not go for a 10 mins walk after a meal. This will aid digestion, burn a few calories and make you feel great.

DRINKS

Try to avoid high calorie soft drinks and alcohol. I call these “empty calories”. Our bodies do not need these products at all and they will just hinder your weight loss success. Swap to “sugar free” or “diet” options instead. Try to reduce your alcohol intake by alternating with a sugar free soft drink.

Make sure you stay hydrated. On average females need 1.5 to 2 litres of fluid per day and males need 2 to 2.5 litres of fluid per day. This will help your body to metabolise fat and keep you feeling fuller for longer.

PORTION PLATE

For your lunch and evening meals aim for 1/4 plate complex carbohydrates, 1/4 plate protein and 1/2 plate vegetables or salad. This will avoid you loading up on too many carbohydrates. It will also ensure you are having plenty of protein for muscle growth.

2 - 2.5 litres per day

1.5 - 2 litres per day

Vegetables & Fruit

SMART SNACKS

You may find whilst taking GLP-1 agonists you start to eat little and often because your appetite is reduced. Try to make sure that your snacks contain some protein and some carbohydrates to help keep you fuller for longer. Good examples of snacks include; oat cakes with protein (cooked meat, peanut butter, cottage cheese), fruit mixed with some Greek yoghurt, high protein yoghurt’s or puddings or handful of nuts mixed with dried fruits.

Try to prepare snacks in advance. That way you should avoid grabbing snacks on the go, which tend to be higher in sugar and fat.

PLAN MEAL AHEAD AND BATCH COOK

Batch cooking is great for time saving. If you don’t particularly enjoy cooking every night, then batch cooking is the way forward. Make a meal for a serving of 4 people, eat one that night and save the other 3 in the freezer for future weeks. This will mean less cooking nightly and more free time to enjoy other things in life.

Each week set a side some time to compete a weekly planner. Write down what you plan on having for your meals and your snacks. Also write out a shopping list to avoid you picking up things in the supermarket you don’t need. Once you have a few plans, you can simply rotate them every few weeks. Planning ahead is a key component of long term success. If we don’t plan the tendency is to fall off track and grab things that aren’t great for our health.

EXERCISE

Try to incorporate more exercise into your lifestyle. Have a think about what your current weekly activity involves. This is your starting point. Then have a think about a way you could add more activity into your day. For instance if you are currently walking for 20 mins twice a week, try increasing this to 25 mins twice a week. Keep reassessing where you are and whether you can push yourself that little bit further every few weeks.

When taking GLP-1 medication you can start to lose muscle mass, which we need to try and prevent. Try to incorporate some resistance training within your routine. This could include weight training at home using your own body weight, tins or bottles of water or you could go to the gym and do some weight training. This will help maintain your muscle mass, which will help you to burn more fat. In turn helping your body have higher muscle mass and lower body fat.

JOURNALING AND BEHAVIOUR CHANGE

Whilst GLP-1s give you time to reflect, try to write down the key behaviours and barriers you struggled with before starting the GLP-1 medications. Then begin to problem solve and think of solutions to these issues. The idea is to come up with a realistic plan, so if you stop the medication you can avoid old habits causing weight regain.

Let me give you an example. A client said the main behaviour that led to weight gain was skipping breakfast. She journaled this was because for years she has not been a breakfast person and did not have time to make breakfast in the morning for work. The solution she came up with was to make her breakfast the night before so she could grab it from the fridge in the morning. She started to have overnight oats or fruit and Greek yoghurt pots each morning. This then led her to feel more satisfied during the day and avoided her overeating during mealtimes.

If you get this right and increase your awareness of old behaviours that don’t suit you and come up with a plan that works, this will increase your long term success.

SLEEP HYGIENE

Sleep duration is linked to the body’s production of appetite regulating hormones. Lack of sleep is linked to a higher production of a hormone called grelin, which increases our appetite. So the less we sleep the more hungry we feel the next day and the more weight we might gain.

When we were children we may have had better sleep habits. The adult looking after us may have turned off screens at a certain time, ran us a warm bath, read us a story and put us into a lovely warm bed. These routines would have helped us get to sleep easily and have a deep sleep. But as we get older these routines gradually come to a halt. We need a routine back in our lives again. Here our a few tips they could improve the quality of your sleep.

✓ Try to turn screens off 1 hour before bed, this includes mobile phones

✓ If you do need to look at a screen try and reduce the light and reduce to dimmer settings

✓ Have a soak in the bath

✓ Read a book, newspaper or magazine

✓ Try a relaxing herbal tea like chamomile

✓ Put some lavender on your pillow

✓ Make sure your bedroom is dark enough and a comfortable temperature

✓ Stop having caffeine drinks after 6pm to avoid you feeling hyper before bed

✓ Listen to meditation in bed- noises on you tube or headspace free mobile applications

✓ If something is on your mind try to write this down to off load before bed.

FOOD TO AVOID WHILST ON GLP-1 MEDICATIONS

1) FRIED FOODS

Fried foods are high in saturated fats which can cause upset stomach and nausea while taking GLP-1 medication. Additionally, fried foods should be limited in a healthy diet as they can increase the risk of obesity, heart disease, and cancer.

2) SUGARY FOODS AND BEVERAGES

Sugary foods and drinks are linked to obesity, type 2 diabetes, heart disease, and many other chronic conditions. Sugary foods and drinks also increase blood sugar levels and can counteract the effects of GLP-1s.

3) HIGHLY PROCESSED FOODS

Processed foods tend to be high in sugar and fats which, as mentioned above, can worsen uncomfortable side effects and potentially counteract the effects of GLP-1s. Heavily processed foods such as frozen meals, packaged snack foods, and packaged baked goods are also associated with adverse health implications if consumed in excess. Instead, limit these foods.

4) HIGH-FAT MEATS

High-fat cuts of meat, particularly processed meats, should be limited on a healthy diet, especially while on GLP-1s as it can exacerbate certain side effects. A high intake of high-fat meats may also increase your risk of various cancers.

5) ALCOHOL

While there are currently no disclaimers for alcohol intake while taking GLP-1s, it is encouraged to limit your intake of alcohol to avoid a potential low blood sugar event..

WHAT TO DO IF I GET SYMPTOMS?

Below are some common symptoms people can experience when taking GLP-1 medication. I have written down some solutions you could try to see if this helps. From experience most clients experience the symptoms at the start of new medications or for the first few days after an increased dosage is prescribed. Although we have provided some suggestions below, if your symptoms feel severe please call our office and speak to one of our doctors and discontinue medication until the doctor has spoken to you. If needed speak to your GP or visit your local accident and emergency services.

NAUSEA OR VOMITING

✓ It’s best to avoid skipping meals, so if you can’t eat an entire meal in one go, split it into two smaller meals eaten two to three hours apart.

✓ Eat little and often

✓ Try to eat dinner early, giving your body at least two hours to digest the food before going to bed.

✓ Slow down your rate of eating and chew your food well

✓ Try to move around after eating, as this will help digestion

✓ Try separating your eating and drinking and see if this helps

✓ Have more bland cold meals if the smell of cooking is triggering nausea

✓ Stay hydrated

✓ If you are dehydrated or constipated this can make nausea and vomiting worse- see below for tips

✓ If all the above has been attempted and symptoms have not improved you could speak to a pharmacist or your GP about being prescribed anti- sickness medication.

✓ Have an ice pop as patient’s find this soothing and relieves nausea. (Maybe you could make home made ginger, lemon and honey ice pops)

CONSTIPATION

Constipation can be a side effect of taking a GLP-1 medication, your bowels should return to normal after a few days. Here are a few tips to support you:

✓ Please ensure you are drinking plenty of fluid and recording the amount you are managing

✓ Fluid can include water, milk, sugar free drinks, herbal teas, decaffeinated drinks

✓ Be careful not to have too much caffeinated coffee and tea as these cause dehydration. (maximum of 3 per day)

✓ Increase fibre in your diet by adding in fruit, veg, salad and wholemeal carbohydrate products

✓ Exercise more- can help increase bowel movements

✓ If the above does not help speak to pharmacist, gp or slimming clinic doctor to get prescribed a medication to relieve this symptom. (please inform healthcare professional you are taking GLP-1 medication)

DIARRHOEA

It is extremely important to stay hydrated if you are suffering with diarrhoea. So please ensure you are sipping fluid throughout the whole day. This fluid should not involve caffeine, sugary drinks or alcohol as these can make your symptoms worse.

✓ Eat small meals more frequently

✓ Ensure meals are low in fat and fibre- as if too high these will make diarrhoea symptoms worse

✓ Avoid spicy foods

✓ Try to include a drink to replace electrolytes you have lost such as stock cube in hot water, Bovril or a sachet of dioralyte

✓ If none of the above helps, speak to your pharmacist about taking some Imodium to relieve this symptom. Ensure the health care professional knows you are taking the GLP-1 medication.

HEARTBURN/ ACID REFLUX

This symptom can be common amongst clients having GLP-1 medications. Reflux triggers can vary across the board, so it may be useful to keep a food and symptom diary for a few days to try and figure out if certain foods are exacerbating this symptom. Tips to reduce this symptom:

✓ Eat small meals little and often

✓ Avoid alcohol as this can cause acid build up

✓ Foods that tend to make heartburn worse include- fried food, high fat foods, spicy and citrus foods

✓ Reduce caffeinated beverages

✓ Avoid fizzy drinks

✓ Avoid lying down 2 to 3 hours after eating

✓ Sleeping on left hand side can reduce risk of acid reflux

✓ Sleep at 45 degree angle

✓ Go for a walk after eating to aid digestion

✓ Try eating and drinking separately

✓ Have Rennies or Gaviscon before each meal and snack to coat the lining of the stomach

✓ If reflux continues or is happening during the night speak to your pharmacist or GP about being prescribed a Protein pump inhibitor (please notify the healthcare professional that you are taking a GLP-1 medication)

✓ Swap your meals for lunch and dinner, so you are having your heaviest meal for lunch and a lighter meal for dinner. This may help to reduce acid reflux during the evening and night time.

BLOATING AND ABDOMINAL DISCOMFORT

This symptom is likely to be due to slow gastric emptying whilst you are taking the GLP-1 medication. You can reduce this symptom by:

✓ Staying well hydrated

✓ Going for short walk after meals to aid digestion, can be around your house or down the road

✓ Avoid alcohol and caffeine so you don’t become dehydrated

✓ Avoid carbonated drinks as these will cause bloating

✓ Avoid lentil, beans and high fibre foods as they can cause extra gas.

MENU PLAN AND RECIPE IDEAS

During your journey on GLP-1 medication you will experience different symptoms and different degrees of appetite suppression at different stages. Even during stages of low appetite you must continue to try and eat little and often throughout the day. This will keep your metabolism going and aid weight loss. Use the table below for meal ideas and adjust accordingly depending on your appetite. For example at the start of your journey you may still feel quite hungry, so some people may have 3 main meals and 3 snacks whereas others may feel satisfied with 3 main meals. During the higher doses of GLP-1 medication, some people start to have smaller meals and may therefore have 3 small main meals and a couple of snacks- so a more “little and often” approach.

Monday

Breakfast

Lunch

Overnight porridge oats (see recipe 1)

Tuesday Wednesday

Snack

Evening meal

Snack

Dairy

Small to medium jacket potato with half tin tuna and 20g grated reduced fat cheese with side salad.

Berries mixed with 100g low fat Greek yoghurt.

Cottage pie with any boiled vegetables you enjoy. (see recipe 6)

2 oat cakes with low fat pesto and goats cheese.

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

1 or 2 slices wholemeal toast with 1 or 2 poached eggs and half an avocado

Chicken Caesar salad (see recipe 3)

Half an apple chopped with 1 teaspoon of nut butter

Salmon served with new potatoes. (see recipe 7)

125g tinned fruit cocktail mixed with 100g low fat Greek yoghurt.

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

1 to 2 weetabix served with 100g Greek yoghurt, handful of berries and drizzle of honey

Chicken noodle soup with a bread roll. (see recipe 4). Place some in the fridge to have on Friday and freeze the rest for another week.

Chocolate protein pudding.

Medium jacket potato with 200g baked beans and 25g grated cheese and side salad.

One apple sliced with 1 tablespoon peanut butter.

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

Thursday Friday Saturday Sunday

1 or 2 slices of wholemeal toast with 200g baked beans

Chicken Caesar salad (see recipe 3)

Handful of nuts.

Chilli con carne. (see recipe 8). Save some in fridge for Sunday.

Chocolate chia pudding (see recipe 10)

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

30g or 40g high protein granola with a handful of fruit and 200mls semi skimmed milk.

Same soup and bread roll as Wednesday (see recipe 4)

Protein balls (see recipe 5)

Chicken Carbonara (see recipe 9)

2 rice cakes with ¼ pot reduced fat cottage cheese on top.

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

Full English frittata (see recipe 2)

Half a tin of mackeral in tomato sauce on 2 slices of wholemeal toast.

Protein yoghurt

230g Sirloin steak with 90g black peppercorn sauce, with any boiled vegetables that you enjoy. 640 kcals.

2 tablespoons reduced fat humus with veg sticks.

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

1 to 2 weetabix spread with reduced sugar strawberry jam with 200ml semi skimmed milk and handful of blueberries.

Tortilla wrap pizza. Spread wrap with tomato puree add 50g cooked chicken ripped up, any veg and 20g reduced fat grated cheese. Grill until cheese melted. Serve with salad.

2 oat cakes with ½ tin tuna in spring water.

Chilli con carne. (see recipe 8)

Protein balls (see recipe 5)

250mls of semi skimmed milk to use in hot or cold drinks. 125 kcals.

Ingredients

• ½ teaspoon ground cinnamon

• 40g rolled porridge oats.

• 2 tablespoons natural yoghurt

• 50g any berries you like.

• 1 teaspoon nut butter

Recipe 1 Overnight Oats

Method

• The night before serving mix together the porridge oats, cinnamon and 100mls of water or milk and leave in the fridge overnight.

• The next day loosen the mixture with a little bit more water or milk if needed. Then top with the remaining ingredients.

N.B. You can use different types of fruit and yoghurt in this recipe.

• Drizzle of honey (optional)

• 100ml of water or milk

Ingredients

• 8 eggs

• 50g soured cream

• 2 tsp olive oil, plus extra for greasing

• 4 rashers bacon, cut into strips

• 12 button mushrooms, sliced

• 4 leftover roast potatoes, cut into bite-size chunks

• 4 leftover cooked chipolatas, cut into bite-size portions

• fresh bread and brown sauce, to serve

Recipe 2 Full English Frittata

Method

• Heat oven to 180C/160C fan/gas 4. First of all, beat the eggs with a whisk in a bowl, then whisk in the soured cream and seasoning. Heat a non-stick pan, add the oil, then fry the bacon and mushrooms until caramelised and cooked through. Towards the end, toss in the leftover sausages and roast potato chunks and allow them to heat up in the pan alongside the bacon and mushrooms.

• Tip the contents of the pan into a small, lightly greased roasting tin, then pour over the egg mixture. Bake until the egg has risen slightly and set. Serve with fresh bread and brown sauce (or tomato sauce to add a splash of colour).

Ingredients

• 4 rindless streaky bacon rashers

• 225g bag ready-to-eat Caesar salad (with croûtons, dressing)

• 1 ripe avocado

• 2 cooked chicken breasts, any skin and bones removed

Recipe 3 Chicken Caesar Salad

Method

• Stir fry the bacon in a frying pan for 2-3 minutes on each side. Remove, then sprinkle the croûtons into the fat in the pan and toss over a medium heat for a minute or two to give them flavour and crisp them up.

• Divide the leaves between 2 plates. Halve the avocado and dig out the stone; peel and cut into chunks and scatter over the leaves. Tear the chicken into pieces on top. Finally, snap the bacon into chunky pieces over the chicken and top with the croûtons.

• Drizzle the dressing over the whole salad and finish with a good dusting of parmesan and a grind of pepper.

Ingredients

• 2 large carrots, chopped

• 2 large leeks, trimmed and finely sliced

• 2 corn on the cobs, corn kernels cut off

• 200g vermicelli noodles

• small bunch parsley, finely chopped

For the stock

• 2 onions, quartered

• 1 leek, cut into chunks

• 2 carrots, thickly sliced

• 2 bay leaves

• 6 black peppercorns

• parsley stalks

• 4 celery sticks, roughly chopped

• 2 tbsp low-sodium vegetable bouillon or 1 vegetable stock cube

• 1.3kg chicken

Recipe 4 Chicken Noodle Soup

Method

• Put all the stock ingredients and the chicken in a very large saucepan, then cover everything with about 3 litres cold water. Bring to the boil, then lower to a simmer and cook for 1 hr-1½ hrs, until the chicken is cooked through. Skim off any froth every 20 mins or so. Remove the chicken to a plate to cool. Strain the stock through a sieve, skimming off as much fat as you can.

• Rinse out the pan and put the stock back in, then simmer on a high heat until reduced a little – you need about 2 litres in total. Add the carrots and leeks, then simmer for 10 mins.

• Meanwhile, shred the meat from the chicken, discarding the skin and bones. Add to the pan with the sweetcorn. Add the vermicelli noodles, unless you want to freeze the soup, and simmer for about 7 mins more, until the corn and pasta is cooked. Ladle into bowls, sprinkled with the parsley. To freeze, allow the soup to cool completely before freezing, and when you’re ready to eat, allow the soup to defrost before bringing it back to a gentle simmer in a pan. Add the noodles and simmer until cooked.

Ingredients

• 150g porridge oats

• 50g flavoured protein powder of your choice

• 1 tbsp ground flaxseeds

• pinch of ground cinnamon

• 1 tsp vanilla extract

• 2 tbsp maple syrup

• 150g nut butter of your choice

• 4 tbsp milk

• 25g chocolate chips or raisins (optional)

Recipe 5 Protein Balls

Method

• Combine the oats, protein powder, flaxseed, and cinnamon in a large bowl. Stir in the maple syrup, vanilla extract, nut butter, milk, and chocolate chips.

• Stir well to combine the mixture, then, using damp hands, roll it into 15 balls (they should be about 30g each). Arrange on a plate and chill for 30 mins until firm, then serve.

Ingredients

• 1kg potatoes, chopped into chunks

• 350g extra-lean minced beef

• 1 small onion, finely chopped

• 1 medium carrot, finely chopped

• 1 courgette, finely chopped

• 100g green beans, washed and chopped

• 1 teaspoon dried mixed herbs

• 1 pinch ground black pepper

• 450ml cold water

• 4 teaspoons reduced-salt gravy granules

• 50g sweetcorn (fresh, frozen or tinned)

Recipe 6 Cottage Pie

Method

• Cook the potatoes in a large saucepan of boiling water for about 20 minutes until tender.

• While the potatoes are cooking, heat a large saucepan. Add the minced beef a handful at a time, cooking until browned.

• Stir in the onion, carrot, courgette, green beans and mixed herbs, then add 450ml water. Bring to the boil, then turn down the heat and simmer without a lid for about 20 minutes, until the veg has softened.

• Turn the grill on to preheat, and warm a large baking dish under it for a couple of minutes. While the grill is heating, drain and mash the potatoes, seasoning them with some pepper.

• Add the sweetcorn to the mince mixture, then sprinkle in the gravy granules and stir until thickened. Season if needed, then tip into the baking dish. Spoon the mash on top, spreading it out to cover the mince, then pop under the grill.

• Once the top has browned, remove from the grill and leave to cool for a couple of minutes. Dish up and enjoy!

Ingredients

• 4 skin-on salmon fillets

• 1 head broccoli, broken into florets

• juice ½ lemon, ½ lemon quartered

• small bunch spring onions, sliced

• 2 tbsp soy sauce

• 750g new potatoes

Recipe 7 Salmon With New Potatoes

Method

• Boil the new potatoes in a large pan of boiling water for 30 minutes.

• Heat oven to 180C/160C fan/gas 4. Put the salmon in a large roasting tin, leaving space between each fillet.

• Wash and drain the broccoli and, while still a little wet, arrange in the tray around the fillets. Pour the lemon juice over everything, then add the lemon quarters.

• Top with half the spring onions, drizzle with a little olive oil and put in the oven for 14 mins. Remove from the oven, sprinkle everything with the soy, then return to the oven for 4 mins more until the salmon is cooked through. Sprinkle with the remaining spring onions just before serving.

• Drain the potatoes and serve on the side.

Ingredients

• 1 large onion

• 1 red pepper

• 2 garlic cloves

• 1 tbsp oil

• 1 heaped tsp hot chilli powder (or 1 level tbsp if you only have mild)

• 1 tsp paprika

• 1 tsp ground cumin

• 500g lean minced beef

• 1 beef stock cube

• 400g can chopped tomatoes

• ½ tsp dried marjoram

• 1 tsp sugar (or add a thumbnailsized piece of dark chocolate along with the beans instead, see tip)

• 2 tbsp tomato purée

• 410g can red kidney beans

• plain boiled long grain rice, to serve

• soured cream, to serve

Recipe 8 Chilli Con Carne

Method

• Dice up all the vegetables.

• Start cooking. Put your pan on the hob over a medium heat. Add 1 tbsp oil and leave it for 1-2 minutes until hot.

• Add the onion and cook, stirring fairly frequently, for about 5 minutes, or until the onion is soft, squidgy and slightly translucent.

• Tip in the garlic, red pepper, 1 heaped tsp hot chilli powder or 1 level tbsp mild chilli powder, 1 tsp paprika and 1 tsp ground cumin.

• Give it a good stir, then leave it to cook for another 5 minutes, stirring occasionally.

• Brown 500g lean minced beef. Turn the heat up a bit, add the meat to the pan and break it up with your spoon or spatula. The mix should sizzle a bit when you add the mince.

• Keep stirring and prodding for at least 5 minutes, until all the mince is in uniform, mince-sized lumps and there are no more pink bits. Make sure you keep the heat hot enough for the meat to fry and become brown, rather than just stew.

• Make the sauce. Crumble 1 beef stock cube into 300ml hot water. Pour this into the pan with the mince mixture.

• Add a 400g can of chopped tomatoes. Tip in ½ tsp dried marjoram, 1 tsp sugar and add a good shake of salt and pepper. Squirt in about 2 tbsp tomato purée and stir the sauce well.

• Simmer it gently. Bring the whole thing to the boil, give it a good stir and put a lid on the pan. Turn down the heat until it is gently bubbling and leave it for 20 minutes.

• Check on the pan occasionally to stir it and make sure the sauce doesn’t catch on the bottom of the pan or isn’t drying out. If it is, add a couple of tablespoons of water and make sure that the heat really is low enough. After simmering gently, the saucy mince mixture should look thick, moist and juicy.

• Drain and rinse a 410g can of red kidney beans in a sieve and stir them into the chilli pot. Bring to the boil again, and gently bubble without the lid for another 10 minutes, adding a little more water if it looks too dry.

• Taste a bit of the chilli and season. It will probably take a lot more seasoning than you think.

• Now replace the lid, turn off the heat and leave your chilli to stand for 10 minutes before serving. This is really important as it allows the flavours to mingle.

• Serve with soured cream and plain boiled long grain rice.

Ingredients

• 300g dried spaghetti (but any pasta shape is fine)

• 400g diced chicken breast

• 4 slices lean back-bacon rashers, cut into pieces

• 5 spring onions, trimmed and finely chopped

• 150g lower-fat soft cheese with garlic and herbs

• 1 egg

• 150ml semi-skimmed milk

• 40g reduced-fat hard cheese, finely grated

• 1 teaspoon vegetable oil

• 2 tablespoons fresh parsley, chopped

• 1 pinch ground black pepper

Recipe 9 Chicken Carbonara

Method

• Cook the diced chicken breast by frying in light oil for 14 to 16 minutes until cooked through. Then set aside.

• Bring a large saucepan of water to the boil. Add the pasta and cook for 8 to 12 minutes, according to packet instructions.

• Meanwhile, heat the oil in a large non-stick frying pan. Add the bacon and spring onions, and cook for about 5 minutes, stirring often. Remove from the heat.

• Beat together the soft cheese and egg in a mixing bowl, then stir in the cooked bacon, cooked chicken and spring onions. Add the milk, half the hard cheese and the parsley (if using). Season with pepper.

• Drain the pasta and return it to the saucepan. Add the egg mixture and heat gently for 2 to 3 minutes, stirring constantly until the mixture thickens. Serve sprinkled with the remaining hard cheese.

N.B. you could use pre cooked chicken instead of uncooked chicken for a quicker recipe.

Serves: 4 to 6 people

Ingredients

• 60g chia seeds

• 400ml unsweetened almond milk or hazelnut milk

• 3 tbsp cacao powder

• 2 tbsp maple syrup

• ½ tsp vanilla extract

• cacao nibs, mixed

• frozen berries, to serve

Recipe 10 Chocolate Chia Seed Pudding

Method

• Put all the ingredients in a large bowl with a generous pinch of sea salt and whisk to combine. Cover with cling film then leave to thicken in the fridge for at least 4 hours, or overnight.

• Spoon the pudding into four glasses, then top with the frozen berries and cacao nibs.

DOSE TITRATION

The way your dose will be titrated each month will be individual and will be discussed in detail with the doctor. Typically you will start with the lowest dose, then every 4 weeks the dose will gradually be increased until to you reach the maximum dose. However, if your appetite is successfully suppressed sooner or if you experience any symptoms, it may be better to stay on your current dose for an extra month. This is not a negative outcome, as it allows you to focus on reducing your symptoms, making you more comfortable when moving up to the next dose. Evidence has shown that people who increase their dose too quickly may have to stop the treatment because they are unable to cope. Then their weight loss journey ends. So please seek support from our team if needed.

WHY YOU SHOULD CONSIDER WORKING WITH A DIETITIAN

WHILE TAKING GLP-1

MEDICATION

GLP-1 medication is not meant to be a magic wand leading to weight loss, but rather a tool for weight loss. It should be used in combination with diet and lifestyle changes. If GLP-1 medication is used on its own without making diet and lifestyle changes, you will simply regain most, if not all, the weight you have lost back once you stop the medication. If you are looking for long term weight loss success you need to work alongside a dietitian for support to improve your diet and lifestyle behaviours.

Taking GLP-1 medications will also give you challenges including poor appetite, food aversions, and other side effects that can make eating more difficult. The dietitian will be able to give you ideas to reduce these symptoms.

To better navigate your weight loss journey and ensure long-term success, consider working with a Registered Dietitian at the Slimming Clinic. Dietitians are nutrition professionals who can help guide you direction. They can answer your questions, help you manage your side effects, and provide you with tailored recommendations to help you maximise your results with long term sustainability in mind.

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