Eleven percent of US adults currently take GLP-1s for weight loss, up significantly from 3% in 2024, according to a new Gallup poll. And 15% of respondents reported having used the pills for weight loss at some point, an increase of nine percentage points.
That still leaves a vast majority of people managing appetite and weight without a prescription, whether by choice, cost, or lack of access. Natural appetite control interventions can support treating these patients, as well as those who are taking the drugs.
Here are seven strategies clinicians can offer patients living with overweight or obesity regardless of where they are in their weight management journey.
1. Prioritize Protein
Protein suppresses appetite more effectively than carbohydrates or fat, and some research suggests 25-30 g of protein per meal can help with appetite control, said Talya Kurzion, RD, clinical dietitian at UCSF Health. Protein-rich meals stimulate the release of the gut hormones GLP-1 and glucose-dependent insulinotropic polypeptide and suppress ghrelin, the hormone that drives hunger, she told Medscape Medical News. Good sources include chicken, turkey, fish, seafood, eggs, Greek yogurt, beans, peas, lentils, soy, nuts, and seeds.
“Higher protein intake at the beginning of a meal can increase fullness and reduce hunger by stimulating natural satiety hormones,” said Beverly Tchang, Comprehensive Weight Control Center, Weill Cornell Medicine, New York City.
“At Cornell, we’ve studied how eating your macronutrients in a specific order — protein or veggies first, carbs last — can suppress ghrelin, the hunger hormone, for longer than if you ate carbs first,” she told Medscape Medical News. Of note, that study did not translate into significant differences in hunger/satiety scores reported by participants; the researchers suggested that finding may reflect both the subjective nature of the tool used to measure satiety and the complexity of appetite regulation.
Caroline Apovian, MD, co-director, Center for Weight Management and Wellness and professor of Medicine, Harvard Medical School, Boston, added that avoiding simple carbohydrates at any point is helpful “because their ability to make you feel full even if you have eaten enough calories is low, and you will be hungry very soon thereafter.” Simple carbs include refined grains, white bread, syrups, and honey.
2. Focus on Fiber
A recent review supports fiber’s role in appetite regulation, Kurzion said. Dietary fiber slows gastric emptying and prolongs fullness through several mechanisms. Viscous fibers, which are found in oats, barley, beans, lentils, chickpeas, flax seeds, chia seeds, berries, apples, citrus, artichokes, and brussels sprouts, form a gel matrix in the stomach that delays digestion, she explained. Soluble fibers are fermented by gut bacteria into short-chain fatty acids that trigger GLP-1 release, as well as peptide YY, which is linked to appetite regulation.
3. Drink Water Before Meals
Drinking about 500 mL (17 oz) of water 30 minutes before meals may also reduce food intake, Tchang noted. Apovian agreed, explaining that doing so “fill[s] your stomach up, and the vagus nerve stretch receptors will register fullness, at least temporarily.”
4. Exercise Regularly, With Realistic Expectations
Studies show that moderate-to-vigorous exercise can help suppress appetite, at least in the short term, Kurzion said. Plasma ghrelin levels temporarily fall after exercise, while exercise also increases circulation of the satiety hormones GLP-1 and PYY. However, she noted, individual hormonal and appetite responses to a single bout of exercise vary considerably from person to person.
Tchang urged clinicians to set realistic expectations. “Many people may feel their appetite is suppressed immediately after exercise, likely due to the production of sympathetic hormones like adrenaline,” she said. “But after the calorie burn, the body has a compensatory mechanism to increase hunger and calorie intake to avoid weight loss from exercise.”
5. Manage Stress; Eat Mindfully
“Reducing stress with meditation or exercise, eating while focusing on your food, and eating slowly are all very helpful strategies to reduce eating due to anxiety,” Apovian said. Indeed, a recent review showed that mindfulness-based approaches may modestly reduce food intake, although they did not affect appetite.
Another study suggested that mindful eating can weaken the connection between negative mood and eating to feel better (eg, emotional eating).
6. Don’t Skimp on Sleep
Sleep deprivation drives appetite and promoting cravings for calorie-dense, highly palatable foods, said Kurzion, pointing to a study showing that partial sleep deprivation increased food intake, which was accompanied by significantly higher fat and lower protein intake. The American Academy of Sleep Medicine states that sleeping less than 7 hours a night is associated with weight gain, obesity, and related comorbidities.
7. Avoid Certain Processed Foods
Limiting ultraprocessed foods is also important, Kurzion said. She pointed to a 2019 randomized controlled trial that found that participants eating an ultraprocessed diet consumed about 500 more calories a day and gained weight vs an unprocessed diet matched for calories, sugar, fat, sodium, fiber, and macronutrients. “Highly processed food requires minimal chewing and is ingested faster, allowing calories to be consumed before hormonal satiety cues can register,” she explained.
However, current research suggests that not all processed foods are alike. Some are high in added sugars, sodium and refined carbohydrates, all of which are associated with poor dietary quality. On the other hand, ultraprocessed foods such as fortified breakfast cereals, whole grain products, canned beans, or plant-based dairy can still provide important nutrients, fiber, antioxidants and other beneficial compounds, contributing to a healthy diet.
Worth Watching
Tchang cautioned that “most over-the-counter ‘natural appetite suppressants’ lack convincing evidence of effectiveness, and some have been linked to serious side effects, including liver and kidney injury.” In addition, a recent review concluded, “Overall, natural strategies for appetite suppression may be considered biologically plausible adjuncts, but current evidence supports cautious integration rather than stand-alone use.”
Despite the caveats, the search for natural substances that can reduce weight and/or body fat continues unabated. Here’s a look at some of what’s under investigation.
Food Aromas. A recent proof-of-concept study tested whether the smell of certain food-derived aromas could reduce appetite in 45 adults with a BMI ≥ 25. Compounds containing vanillin and phenylpropanoid groups showed the most promise for influencing appetite through smell alone. The authors concluded, “By linking consumer perceptions to chemical analyses, we identified effective prototypes for further investigation, including studies measuring actual food intake.”
Lac-Phe. Ongoing research on this exercise-induced metabolite suggests that it could play a role in hypophagia. A 2022 study showed that N-lactoyl-phenylalanine (Lac-Phe), suppressed feeding and reduced obesity in mice, and chronic administration decreased body fat and improved glucose control. A more recent study found that metformin, as well as exercise, also raises Lac-Phe levels. A trial in people has finished recruiting, and a recent review suggests further research is underway.
Ketone Bodies. Preclinical work with various ketone bodies suggests this is a promising area of research. A Spotlight article in Nature Metabolism concluded that the most recent findings “provide new insights into how ketogenic diets may influence appetite and body weight.”
pTOS. Researchers studying Burmese pythons — large, venomous snakes that can eat an enormous meal and then go months without eating again — found a blood metabolite called para-tyramine-O-sulfate (pTOS) that spikes more than 1000-fold after feeding. In both pythons and mice, pTOS activated appetite-suppressing neurons in the hypothalamus, and chronic administration reduced food intake and body weight in obese mice. Notably, pTOS is also present in human blood and rises modestly after a meal, though far less dramatically than in pythons. Human trials have not yet launched.
Apovian reported having advisory board relationships with Aardvark Therapeutics, AbbVie, Altimmune, Arrowhead Pharmaceuticals, BioAge, Biolinq, Caribou Biosciences, Covidien, Cowen and Company, Currax Pharmaceuticals, Form Health, Fractyl Health, Keros Therapeutics, Lilly USA, L-Nutra, Mediflix, Metsera, Neurocrine Biosciences, Nutrisystem, OptumRx, Pain Script Corporation, Redesign Health, ReShape Lifesciences, Scholar Rock, Terns, Verily Life Sciences, Veru, Vida Health, Viking Therapeutics, Wave Life Sciences, Wondr Health, and Zyversa Therapeutics. Tchang reported receiving current or past consulting/advisor fees from Novo Nordisk, Roman Health Ventures, Skye Bioscience, Circadian Care, Amgen, Lilly, Boehringer-Ingelheim, Gelesis, Cloud Health Systems, SAI MedPartners, Tern Pharmaceuticals, Alnu Health, and Intellihealth/Flyte Health. Kurzion declared no conflicts of interest.
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