Domenic Pisanelli, BHSc Naturopathy | ATMS Registered | Vital Health & Natural Medicine, Melbourne
25+ Years Clinical Experience · Metabolic Health, Hormonal Health, Gut Health | Updated July 2026
Important: This page is for people who are already prescribed GLP-1 medications by their GP or specialist. It does not constitute a recommendation to start, stop, or change any medication. Always follow your prescribing doctor's guidance.
Ozempic and Mounjaro are genuinely effective medications. For people who have spent years struggling with weight, blood sugar control, or insulin resistance, GLP-1 agonists can change things significantly. That is not in dispute.
What often gets left out of the conversation is what happens to the rest of your body while the medication does its job. Muscle loss. Nutrient depletion. Gut motility changes. Fatigue that doesn't fit the narrative of "feeling great because you're losing weight." And the bigger question that most prescribers don't have time to address: what happens when you stop?
I'm not here to talk people out of GLP-1 medications. I work alongside them. The question I help people answer is: how do you protect your muscle, your nutrient status, your gut, and your metabolic health while you're on the medication, so that when you come off it, you're actually better off than before?
"The medication is a tool. My job is to make sure people use it in a way that leaves them better off when it finishes, not just lighter temporarily."
Heard in clinic
"My doctor was thrilled with my results on Ozempic. I'd lost 14 kilos in five months. But I felt awful. Exhausted, losing hair, my digestion was a mess. I asked about it and was told it was probably just the adjustment period. At month seven I was still exhausted and still losing hair."
Melbourne patient, 2025
Another patient, six months in
"I'd lost 22 kilos. My GP was happy. But I couldn't climb a flight of stairs without stopping. I assumed I was just unfit. Turned out I'd lost a significant amount of muscle mass and my ferritin was at 11."
Melbourne patient, 2025
People often tell me they expected to feel healthier because they were losing weight. Instead they're struggling to get through the workday, skipping exercise because they're exhausted, or wondering why their hair is coming out in the shower. That disconnect between the number on the scale and how they actually feel is the gap I work in.
The medication was working exactly as intended. The problem was that nobody was looking at what was happening alongside the weight loss. Muscle mass declining. Ferritin dropping. Gut motility crawling. These are predictable, manageable consequences of GLP-1 therapy. They just need someone paying attention to them.
25–40%
Of weight lost on GLP-1 medications may be lean muscle mass rather than fat. That's one reason some people feel weaker despite weighing significantly less.
66%
Of patients regained significant weight within a year of stopping GLP-1 medication without lifestyle support. The medication suppresses appetite. It doesn't fix what caused the problem.
B12, D, Zn
Three of the most commonly depleted nutrients in GLP-1 patients. All three are associated with fatigue, hair loss, and mood changes that patients often attribute to other causes.
Why GLP-1 Medications Need Naturopathic Support Alongside Them
GLP-1 agonists work by slowing gastric emptying, suppressing appetite, and improving insulin signalling. They are not selective about what you lose weight from. They do not automatically preserve muscle. They do not optimise your nutrient intake. And they do not address the underlying metabolic drivers that led to insulin resistance or weight gain in the first place.
None of that is a criticism. It's just the reality of how the medication works, and why it needs to be supported properly.
The muscle loss problem
Muscle tissue is metabolically active. It burns calories at rest, regulates blood sugar, supports insulin sensitivity, and protects bone density. When you lose weight rapidly, especially without adequate dietary protein and resistance training, a significant portion of that loss comes from muscle, not fat. GLP-1 medications reduce appetite significantly, which often means reduced protein intake at exactly the time when protein requirements are highest. Without specific attention to this, patients can end up lighter but metabolically worse off than before they started.
The good news is that muscle loss on GLP-1 medications is largely preventable with the right dietary protein intake and resistance training. It is not a given. But it doesn't happen automatically either. It needs specific attention from the start, not once the damage is already done.
Nutrient depletion
Reduced food intake means reduced nutrient intake. Slowed gastric motility affects absorption. The nutrients that suffer most consistently in GLP-1 patients include B12, vitamin D, zinc, magnesium, and iron. Most of these deficiencies are asymptomatic early on and then produce fatigue, hair loss, mood changes, and cognitive slowing that patients often attribute to other causes. Testing before, during, and after GLP-1 therapy is one of the most straightforward and highest-value interventions available.
Gut motility and digestive function
GLP-1 agonists slow gastric emptying. This is part of how they work. It also means nausea, constipation, bloating, and reflux are common, particularly in the early months. For people who already have gut dysbiosis, SIBO, or compromised gut barrier function, slowed motility can worsen the underlying picture significantly. Addressing gut function is not just about managing side effects. It matters for nutrient absorption, immune regulation, and how well the medication actually works.
What happens when the medication stops
This is the question most people don't ask early enough. GLP-1 medications are increasingly being taken long-term, but for those who stop, the weight regain data is sobering. The medication suppresses appetite. The underlying insulin resistance, metabolic dysfunction, gut dysbiosis, and hormonal contributors that drove the original problem are still there. Without addressing those during the medication course, stopping is essentially a return to the same starting conditions, often with less muscle mass than before.
None of this is inevitable. The weight regain, the nutrient depletion, the muscle loss — these are predictable consequences that can be addressed with the right support during the medication course. Most patients I work with who go into the exit having done this properly maintain the majority of their results. That outcome is achievable. It just needs planning.
If you are on Ozempic or Mounjaro and experiencing fatigue, hair loss, or digestive issues that haven't been addressed, a free discovery call is a good starting point.
Book a free discovery call →
What We Test and Address
Every GLP-1 support consultation starts with understanding what's actually happening in your body, not just on the scale. The following are the areas I assess in every patient on Ozempic or Mounjaro.
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Muscle Mass and Body Composition
The first question I ask every GLP-1 patient isn't how much weight they've lost. It's how much of that was muscle. Weight loss without tracking body composition tells you very little clinically. We assess lean mass versus fat mass, look at dietary protein adequacy, and structure an approach that protects muscle through the medication course. Preserving muscle is the single most important thing you can do for your long-term metabolic health on a GLP-1.
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Nutrient Status
We run a targeted nutritional assessment covering B12, vitamin D, ferritin, zinc, magnesium, folate, and key metabolic markers. Deficiencies are common, predictable, and often missed because symptoms are attributed to the medication or the weight loss process. Testing is the only way to know what's actually happening.
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Gut Motility and Microbiome Health
Slowed gastric emptying affects more than digestion. It affects nutrient absorption, microbiome composition, immune function, and how well the medication works. Where gut symptoms are significant, we assess the microbiome and gut barrier function directly using the GI Microbiome Map and address the specific drivers, not just the symptoms.
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Fatigue and Energy
Fatigue is probably the complaint I hear most often from people on GLP-1 medications. Sometimes it's low ferritin. Sometimes it's inadequate protein and muscle loss. Occasionally it's thyroid function shifting in response to rapid weight change. Until we test, we're guessing. One patient assumed her constant exhaustion was just part of the adjustment period. Eight months in, testing revealed ferritin of 9 µg/L and B12 at the bottom of range. Neither showed up on her standard blood panel.
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Metabolic Markers and Insulin Sensitivity
Fasting insulin, HOMA-IR, triglycerides, HDL, and inflammatory markers tell us how the underlying metabolic picture is actually changing. These are the markers that determine whether the medication is creating durable metabolic improvement or just transient weight loss. We track them throughout.
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Hormonal Health
Something I've noticed over the past few years: a significant number of women on GLP-1 medications are also in perimenopause or have PCOS, and neither was formally addressed before the prescription was written. The medication helps with weight and glucose. It doesn't fix the hormonal drivers that were feeding the metabolic dysfunction in the first place. Thyroid function, cortisol patterns, and reproductive hormones all need to be in the picture.
Our Approach: The ROOT Method for GLP-1 Patients
The ROOT Method is the clinical framework I use in practice. It was developed over 25 years of working with complex, multi-system presentations. For GLP-1 patients, each step has a specific purpose.
R
Review
We review your full health history, medication timeline, current symptoms, dietary intake, and any existing blood results. We want to understand what was driving the metabolic dysfunction before the medication, not just what the medication is doing now. That context determines everything else.
O
Order
We order targeted functional testing based on your specific presentation. For most GLP-1 patients this includes: a full iron studies panel, complete nutritional assessment, fasting insulin and HOMA-IR, full thyroid panel, inflammatory markers, and a gut health assessment where symptoms indicate. We measure what matters, not everything at once.
O
Observe
Results are read against functional optimal ranges, not just laboratory reference ranges. A ferritin of 16 µg/L looks fine on a standard report. At that level, hair loss and fatigue are entirely expected. We interpret results in clinical context and track them across your medication course so we can see what's improving and what needs attention.
T
Treat
Treatment is targeted, not generic. That might mean a specific protein and resistance training protocol to protect muscle mass, targeted nutrient repletion based on your test results, gut motility support, adaptogenic herbs for stress physiology, or a structured exit strategy for when the medication course ends. The goal is for you to be metabolically stronger when the medication finishes, not just lighter.
A note on the exit strategy
One of the most common reasons people regain weight after stopping GLP-1 medications is that the medication was doing all the work. The appetite suppression, the glucose regulation, the reduced food intake. When those effects stop, and nothing else has changed, the underlying drivers reassert themselves.
Planning the exit from the start, not six weeks before stopping, is one of the most important things we do. That means building the dietary habits, the muscle mass, the metabolic flexibility, and the gut health that can maintain results independently. It takes longer. It is worth doing.
What to Expect at Your First Consult
The first consultation is 60 minutes. It is a proper clinical assessment, not a supplement sales pitch. Here is how it runs.
Before you arrive
We review what you send us
When you book, we send a pre-consult questionnaire covering your medication history, current symptoms, dietary intake, and any existing test results. Reading these before we meet means we spend the consultation on your actual situation, not on background history you've already told a dozen practitioners.
First 20 minutes
Clinical history and symptom review
We go through your history: what was driving the original metabolic dysfunction, how long you've been on the medication, what's improved, what hasn't, and what's causing the most concern right now. This is where context is built. No two GLP-1 patients present the same way.
Middle 20 minutes
Test results and testing plan
We go through any existing results you've brought in. We explain what they show, what's been missed, and what additional testing would change the clinical picture. Testing is recommended where it will actually influence the protocol, not ordered reflexively.
Final 20 minutes
Your protocol and next steps
You leave with a written protocol covering diet, movement, supplementation where indicated, and a clear tracking plan. You also leave knowing what we are monitoring, why, and how we will assess whether it is working. A follow-up is scheduled for 8 to 12 weeks, or sooner if test results warrant it.
Ongoing
Support through the medication course and exit
We stay involved for as long as the medication course runs. Protocol adjustments are made based on test results, side effect changes, and medication dosing. Exit planning starts well before the medication stops. Telehealth is available nationally so geographic location is not a barrier.
You can book a full first consultation directly, or start with a free 20-minute discovery call if you want to talk through whether this is the right fit first.
Book your free discovery call →
Why Choose Vital Health and Natural Medicine
There are a lot of practitioners offering GLP-1 support right now. A lot of it is generic, supplement-heavy, and not grounded in actual testing. Here is what's different here.
Over the past 25 years I've specialised in the exact systems that GLP-1 medications put under most pressure: metabolic health, insulin resistance, hormonal conditions, gut function, and chronic fatigue. I didn't set out to work in this area specifically. It happened because the patients coming through the door with unexplained fatigue, hair loss, and weight that wouldn't budge kept having the same underlying drivers. GLP-1 medications have changed the population I see, but not the clinical problems I'm solving.
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25+ Years Clinical Experience
Metabolic health, hormonal conditions, gut health, and autoimmune disease. Not a generalist. Specific expertise in the systems that GLP-1 medications affect most.
🔬
Testing-First Approach
Every protocol is built on actual results, not assumptions. We use NutriPath (NATA #20770) for functional pathology not available on standard Medicare panels.
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ATMS Registered
BHSc Naturopathy. Registered member of the Australian Traditional-Medicine Society. Professional standards, clinical accountability.
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Works Alongside Your GP
Naturopathic support complements your prescribing doctor's care. We communicate with your GP where relevant and never recommend medication changes.
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Melbourne + Telehealth
In-clinic in Kealba, Melbourne's northwest. Telehealth available nationally. Test kits posted to your door through NutriPath.
🎯
ROOT Method Framework
A systematic four-phase clinical approach developed over 25 years: Review, Order, Observe, Treat. No guesswork. No generic protocols.
What we don't do
We don't prescribe or recommend GLP-1 medications. We don't tell you to stop taking them. We don't replace your GP or specialist. We don't sell you a supplement bundle and call it support. Naturopathic care in this context is genuine clinical support for the side effects, nutrient consequences, and long-term metabolic strategy that GLP-1 prescribers often don't have time to address. It works alongside your existing medical care, not instead of it.
Book Your GLP-1 Support Consultation
If you're on Ozempic or Mounjaro and you want to make sure you're protecting your muscle, your nutrients, your gut, and your long-term metabolic health, this is what the consultation is for.
You can start with a free 20-minute discovery call if you want to talk through your situation before committing to a full consult. No pressure. No script. Just a conversation about whether this is the right fit.
In-clinic Kealba Melbourne and telehealth nationally
Make Sure Your GLP-1 Medication Is Actually Building Better Metabolic Health, Not Just Temporary Weight Loss
Muscle protection, nutrient testing, gut motility support, metabolic tracking, and a proper exit strategy. This is what GLP-1 support should look like. Start with a free 20-minute discovery call.
✓ Free for new patients
✓ No obligation
✓ Domenic calls you
✓ Telehealth nationally
Frequently Asked Questions
Can a naturopath help while I'm on Ozempic or Mounjaro?
Yes. Naturopathic support works alongside your prescribing doctor's care. We address the things GLP-1 medications don't manage directly: muscle preservation, nutrient depletion, gut function, fatigue, and the underlying metabolic drivers that led to the problem in the first place. We don't change your medication or advise you to stop it.
Why am I losing hair on Ozempic?
Hair loss on GLP-1 medications is common and usually has two contributing factors: telogen effluvium from rapid weight loss, where the body sheds hair 2 to 4 months after a significant physiological stressor; and nutrient depletion, particularly low ferritin, zinc, and protein intake. Both are addressable. Neither will resolve on its own without specific attention. Testing ferritin, full iron studies, and zinc before attributing hair loss to "just the medication" is the right first step.
How do I prevent weight regain after stopping GLP-1 medication?
The research is clear that most people who stop GLP-1 medications without lifestyle support regain a significant portion of lost weight. The medication suppresses appetite. The underlying drivers of weight gain, including insulin resistance, gut dysbiosis, hormonal imbalance, and poor metabolic flexibility, are not addressed by the medication. Preventing regain means addressing those drivers during the medication course, building muscle mass, establishing sustainable dietary habits, and planning the exit properly well before stopping. This is exactly what naturopathic GLP-1 support is designed to do.
What is the difference between Ozempic and Mounjaro?
Both are GLP-1 receptor agonists but they work on different receptors. Ozempic (semaglutide) targets only GLP-1 receptors. Mounjaro (tirzepatide) targets both GLP-1 and GIP receptors, which is why it tends to produce more significant weight loss in trials. The naturopathic support principles are the same for both: protect muscle, address nutrient depletion, support gut function, track metabolic markers, and build the foundations for long-term metabolic health.
Do you offer telehealth for GLP-1 support?
Yes. All consultations are available via telehealth. Test kits for functional pathology through NutriPath are posted directly to you. You don't need to be in Melbourne. Most GLP-1 support patients outside of Melbourne manage their entire care via telehealth without any compromise in the quality of assessment or follow-up.
How much protein should I eat on Ozempic or Mounjaro?
General guidance is a minimum of 1.2 to 1.6 grams of protein per kilogram of body weight daily when on GLP-1 medications, with the higher end applying to those doing resistance training. When appetite is significantly suppressed, reaching this target becomes difficult and is one of the main reasons muscle loss occurs. We address protein adequacy specifically in the dietary component of the protocol, often including targeted protein supplementation when food intake alone is insufficient.
About the Author
Domenic Pisanelli, BHSc Naturopathy, is a Melbourne naturopath with 25 years of clinical experience. His practice focuses on metabolic health, insulin resistance, hormonal health, gut function, and chronic fatigue. He developed the ROOT Method — a systematic four-phase clinical framework for identifying and addressing the functional drivers of chronic illness. He practises at Vital Health and Natural Medicine, 195A Sunshine Ave, Kealba VIC 3021, and offers telehealth nationally. ATMS registered. This article is for educational purposes only. It does not constitute medical advice and does not replace the guidance of your prescribing doctor.
