The central theses
- GLP-1 agonists such as Ozempic or Wegovy delay gastric emptying and lead to unpleasant symptoms such as nausea, vomiting, constipation and diarrhea.
- Certain foods contribute to constipation and can make these symptoms worse.
- People taking GLP-1 agonists can combat unwanted side effects by eating protein, vegetables, whole grains, and drinking plenty of water every day.
Glucagon-like peptide-1 (GLP-1) agonists are a class of medications that include drugs such as Ozempic and Wegovy. These drugs are effective in treating obesity and diabetes. While many people experience improvements in their health with these medications, some also experience unwanted gastrointestinal side effects.
“These medications work in a two-pronged approach to weight loss, which is why they are so popular,” said Dr. Peminda Cabandugama, an endocrinologist at the Cleveland Clinic, told Verywell. “They reduce cravings and slow gastric emptying,” he explained.
Because the medications delay gastric emptying, they can cause food to remain in the stomach longer, leading to nausea, constipation, and diarrhea. If side effects are particularly bothersome, an over-the-counter fiber supplement may help, Cabandugama said. However, he said not everyone who takes a GLP-1 agonist will need one.
Eating more certain foods (and avoiding others) can help reduce these side effects, including stomach pain and vomiting. Cabandugama said. Still, people taking GLP-1 agonists can and should be able to eat a healthy diet and get all the nutrients they need, he added.
Here, experts explain foods to avoid when taking Ozempic or other GLP-1 agonists to reduce gastrointestinal side effects and what types of foods to choose instead.
Foods to avoid while taking a GLP-1 agonist
Certain types of foods can lead to unwanted side effects, which are often associated with GLP-1 agonists such as Ozempic or Wegovy. If you are struggling with stomach pain, constipation, diarrhea, nausea, or vomiting, avoid the following foods.
Research has shown that a diet high in high-fat foods can lead to constipation and slower gastrointestinal motility and the movement of food out of the mouth, through the digestive system and out of the body. Therefore, consuming fried foods or other high-fat foods may worsen constipation caused by GLP-1 agonists, Cabandugama said.
Foods with added sugar
Whether you take a GLP-1 agonist for diabetes or for weight loss shouldn’t make a difference in your diet, Abby Langer, RD, a Toronto-based nutritionist, told Verywell. “If you take [the medication] Of course, if you have diabetes, you shouldn’t eat a lot of sugar, and that still applies [to people taking the medication for other reasons]said Langer. “I would definitely also pay attention to the consumption of sugary drinks.”
Refined carbohydrates such as white bread and white rice, cookies and pastries can cause constipation and therefore nausea. It’s reasonable to assume that these foods could worsen side effects caused by GLP-1 agonists, Cabandugama said.
Consuming too much alcohol is harmful for everyone, and it’s especially important to watch alcohol consumption when taking a GLP-1 agonist, Cabandugama said. Experts recommend no more than two drinks per day for men and no more than one for women.
However, some people taking the medication may unconsciously find themselves drinking less. “Reports show that this drug [may cause] a reduction in cravings for alcohol and cigarettes,” he explained.
Foods to highlight with GLP-1 agonists
GLP-1 agonists such as Ozempic and Wegovy are prescribed to treat diabetes, overweight, or obesity and should be taken along with a nutrient-rich diet. If you are struggling with the unwanted side effects of GLP-1 agonists, including protein, vegetables, whole grains, and plenty of water in your daily meals can help reduce the unwanted side effects.
GLP-1 agonists help you lose weight, not just fat, Cabandugama explained. This means you may also lose some muscle mass. To stay energetic, you should make sure you consume enough protein. However, large portions of protein can worsen constipation and nausea. Therefore, eat small portions. Be sure to combine protein with vegetables to increase your fiber intake.
When taking a GLP-1 agonist, it’s crucial to eat lots of greens, Cabandugama said. Therefore, including vegetables helps with constipation, and many vegetables can also help maintain fluid balance, he added.
Leafy greens like kale and spinach are insoluble fiber that does not break down in water and cannot be absorbed by the body. Instead, these fibrous foods travel through your digestive system, promoting gastric emptying and reducing constipation.
Although refined carbohydrates can worsen constipation, whole grains such as brown rice, whole-wheat bread, and oatmeal contain fiber and help relieve constipation. If you plan to add more fiber to your diet, do so slowly. Adding too much fiber too quickly can lead to symptoms such as bloating, cramps and bloating.
Higher water absorption
It’s easy to become dehydrated while taking a GLP-1 agonist, Cabandugama said. Therefore, it’s a good idea to keep track of your daily water intake and pay attention to your thirst. Drinking enough water can help with some gastrointestinal problems such as constipation.
There is no standard recommendation for water intake (this varies depending on age, gender, pregnancy and breastfeeding status). Women should drink nine 8-ounce glasses of water daily and men should drink 13 glasses. However, you may be able to tell whether you should increase your water intake by looking at the color of your urine. If your urine is dark yellow and smells strong, it’s time for a glass of water.
Changes in appetite while taking a GLP-1 agonist
Some research has shown this Semaglutide– the active ingredient in Ozempic, Wegovy and Rybelsus – can reduce your cravings for salty and spicy foods, starchy foods and dairy products. This is because GLP-1 agonists can change a part of the brain responsible for food cravings, Cabandugama said.
If you start taking a GLP-1 agonist and notice that your appetite for certain foods decreases, you should talk to a doctor about how to make sure you continue to get proper nutrition, Langer said. “When people have side effects, it’s important to eat what you can tolerate and try to get enough protein,” she explained.
Incorporate exercise alongside GLP-1 agonists
In addition to emphasizing protein, vegetables, whole grains, and hydration, your prescriber will also require you to exercise regularly—at least 150 minutes of moderate-intensity exercise per week—while taking a GLP-1 agonist.
A randomized, double-blind, placebo-controlled trial published in 2023 found that people who combined exercise with their GLP-1 agonist drug reduced the severity of metabolic syndrome, abdominal obesity, and inflammation compared to those who took the drug alone revenue, reduced.
These medications are just the tools we add to diet and exercise.
PEMINDA CABANDUGAMA, MD
Cabandugama added that some people who take the drug for weight loss instead of diabetes ask if they can skip a dose before special occasions like Thanksgiving so they may be able to eat more.
The answer, he said, is always no, because these drugs should not be used for aesthetic reasons to help someone get a certain pant size. Rather, they are intended to help people who are at risk of becoming ill or dying because of their weight to cope better.
Take GLP-1 agonists under the supervision of a healthcare provider
Many people access GLP-1 agonists through online programs that do not require a proper physical examination. However, this could have harmful health effects, said Langer. “It is dangerous because it is a drug. “You’re putting something into your body, and even if you’re eligible for it – while these drugs are amazing and have the potential to save lives – they have side effects,” she explained. “You really need to be closely followed by a doctor or nurse who knows you.”
Cabandugama added that people in the following categories are eligible for a GLP-1 agonist:
- People with a body mass index (BMI) of 30 or higher
- People with a BMI of at least 27 who also have comorbidities such as type 2 diabetes, high blood pressure or high cholesterol
Although BMI is not an ideal measurement, it is currently used to assess GLP-1 criteria, Cabandugama explained. People outside of these groups shouldn’t try to access the medication to quickly lose a few pounds, he added.
What this means for you
GLP-1 agonists can be very helpful for people who are eligible for them, such as people with diabetes or obesity. However, they can cause debilitating side effects such as constipation, nausea, and diarrhea. Eating enough vegetables, whole grains, and small portions of protein can help with these side effects, as can drinking plenty of water. It may also be helpful to avoid foods high in fat, refined carbohydrates, and foods with added sugar.