What a Long-Term GLP-1 Plan Really Looks Like

GLP-1 medications for weight loss aren’t designed as a one-and-done solution—they work best when viewed as part of a longer-term approach. “GLP-1s are a catalyst to kickstart change, but it’s proven lifestyle habits that will allow you to maintain a healthy weight and good nutrition for the long haul,” says Tara Schmidt, the lead registered dietitian for the Mayo Clinic Diet in Rochester, MN. “The most successful patients are those who use their time on GLP-1s to master the so-called ‘boring’ but very essential skills: meal planning, tracking and increasing muscle strength.”

With that in mind, building a GLP-1 game plan can help set you up for long-term success. Ahead, we’re breaking down a clear framework for what that looks like, with expert insight.

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Featured Experts

• Tara Schmidt is the lead registered dietitian for the Mayo Clinic Diet in Rochester, MN
• Rocio Salas-Whalen, MD is a board-certified endocrinologist in New York

Step 1: Define What ‘Long-Term’ Means for You on a GLP-1

“Long-term use is about viewing the medication as a partner to your lifestyle, not a replacement for it,” says Schmidt. “It’s important to note that the FDA approved GLP-1 medications specifically as a companion to an accompanying lifestyle and nutrition program like the Mayo Clinic Diet. This means the medication was never intended to work in a vacuum. Obesity needs to be seen in a similar way to other chronic diseases, with the assumption that some tools and medications are going to be needed long-term.”

New York endocrinologist Rocio Salas-Whalen, MD, adds that long-term care should feel realistic and livable. “From a nutrition and lifestyle standpoint, it’s about building sustainable habits that support muscle mass, blood sugar regulation and overall health—not chronic restriction,” she says. “The goal is a way of eating and living that someone could realistically maintain for years, with enough protein, adequate calories, regular movement and flexibility for real life.”

Step 2: Settle Into a Maintenance Rhythm

“You may have found your ‘sweet spot’ when you reach a weight that you and your medical provider are happy with, your health has improved, you feel confident in maintaining your lifestyle and you are able to nourish yourself,” says Schmidt. She says that signs you’ve hit a healthy rhythm may include one, some or all of the following:

“Nutrition Confidence: You still feel the effects of the medication, but you’re confident in reaching your nutrition goals.
Steady Strength: You’ve established regular workouts and can engage in activities without fatigue.
Stable Health Markers: Your lab results (like blood sugar and cholesterol) are in a healthy range, or have improved.”

Step 3: Protect Muscle and Support Metabolism

“The biggest risk is losing the ‘wrong weight,’” says Schmidt. What that means is “you want to lose fat, not the lean muscle that keeps our metabolism humming.” While some lean mass loss is inevitable, she says, “protecting metabolic health comes down to two non-negotiables:

Protein Throughout the Day: Don’t try to eat all your protein at dinner. Spacing it out helps your body repair and maintain muscle.
Strength Training: You don’t need to be a bodybuilder, but lifting weights or doing resistance moves at least two to three times a week is essential for maintaining healthy muscle mass.”

Step 4: Build a Sustainable Nutrition Baseline

Medication can influence appetite, but eating patterns still need intention. “A sustainable baseline is a way of eating that you can actually enjoy for the rest of your life,” says Schmidt. “It’s built on protein, fiber and healthy fats, which is called the satiety trifecta. Analysis of Mayo Clinic Diet member data shows that structured meal planning plays a key role in weight-loss outcomes, so it’s imperative that you’re actually enjoying what you’re eating while on your personal health journey.”

A common mistake Schmidt sees in practice is what she calls the “eating-as-little-as-possible trap.” “When appetite suppression is high, patients often skip meals or rely on low-nutrient convenience snacks,” she says. “This leads to under-fueling, which actually backfires as it can result in extreme fatigue and muscle loss. Even if you aren’t ravenous, your body still needs high-quality fuel to function.”

It’s a concern Salas-Whalen encounters regularly, too. “One of the biggest mistakes I see is prolonged under-eating, which can stall progress, worsen fatigue, and increase muscle loss,” she says. “Weight loss should feel supportive, not depleting. I emphasize this in Weightless, where I walk patients through how to fuel their bodies in a way that supports long-term metabolic health rather than short-term restriction.”

Step 5: Plan for Adjustments Over Time

“We need to reframe plateaus: they aren’t failures; they are data points,” says Schmidt. “If the scale stops moving, it’s simply your body’s way of taking a rest from initial, more dramatic weight loss, or asking for a tweak. Maybe it’s time to reassess your sleep, manage stress, adjust your workout routine or slightly increase your protein. It may also just be your body and metabolism adapting to your new weight.”