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If you’re taking a glucagon-like peptide-1 (GLP-1), you’re probably excited to see positive changes. Unwanted side effects, like an upset stomach or constipation, can be discouraging.
However, some digestive issues are common when you start a GLP-1 or increase your dose. Your doctor can help you know what’s normal and what’s not. They can also suggest ways to keep these symptoms under control.
Here’s what you should know about GLP-1s, digestion, and how to feel your best during treatment.
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GLP-1 medications affect digestion in several ways. They help regulate blood sugar and appetite, keep you feeling full longer, and slow food movement through the stomach. This slower stomach emptying is part of how these medications work.
In some cases, that feeling of fullness is too much. You may feel sick to your stomach, especially after eating certain foods.
GLP-1s slow digestion. They also affect the brain in ways that help people eat less food. Some people also end up drinking less water while on GLP-1s. All of these changes might make you constipated.
Although everyone’s bathroom habits differ, constipation is usually defined as having fewer than three bowel movements a week. Keep these basic tips in mind to help lower your risk of constipation while on GLP-1 treatment.
Staying hydrated can help soften stool and make it easier to pass. Sip fluids throughout the day rather than waiting until you feel very thirsty.
Your fluid needs may vary based on your health, activity level, the weather, and other medical conditions. If you’ve been told to limit fluids because of a kidney, heart, or other health condition, ask your healthcare professional how much you should drink.
Fiber can help with constipation. Yet, too much, too fast, can make constipation feel worse before it gets better.
Instead, gradually add fiber-rich foods to your diet, especially if you’re not used to them. Examples include:
Don’t start a fiber supplement or make any major diet changes without talking to your healthcare team first.
Gentle physical activity can encourage your digestive system to keep moving. A walk after a meal may be enough. Light stretching, swimming, or easy cycling may also help.
You don’t need to do an intense workout to support regular bowel movements. Just moving more throughout the day may do the trick.
When you feel the need to have a bowel movement, try to use the bathroom right away. Give yourself enough time and privacy if you’re stressed about constipation.
If constipation continues despite these steps, talk with your healthcare professional. They can recommend products like stool softeners, if needed. You may also need a full medical evaluation to be sure your symptoms aren’t caused by another condition.
If your stomach feels a little off since starting GLP-1s, try a few simple strategies to help it feel more settled.
GLP-1 medications can slow stomach emptying and increase fullness. As a result, large meals may leave you feeling uncomfortable.
Try eating smaller portions. Stop as soon as you start to feel satisfied. A few smaller meals or snacks may work better for you than large meals.
Take your time when eating. Eating slowly gives you more time to notice your fullness cues.
Eating fast can lead to overeating and poor digestion. It can leave you feeling overly full, bloated, and uncomfortable.
Fatty or greasy meals can be harder to tolerate on GLP-1s. In general, fat takes longer to empty from the stomach. GLP-1s can intensify this effect.
Everyone is different. As you adjust to your medication, pay attention to how you feel after certain foods. You may find that heavy sauces, cream, fried foods, or high-fat meats and cheeses just don’t sit well with you anymore.
Lying down too soon after a meal can make symptoms worse for some people. You might have reflux, meaning stomach acid comes up your throat (heartburn).
Instead of resting after meals, try a light walk or doing some housework. This movement can help digestion run more smoothly.
Most digestive symptoms associated with GLP-1 medications are mild and temporary. Not every stomach symptom is automatically a medication side effect.
Severe or persistent abdominal pain should be taken seriously. Pancreatitis, or inflammation of the pancreas, can cause significant abdominal pain. Pancreatitis is a medical emergency.
You should also be aware of serious digestive problems that can happen while taking GLP-1 medications. One condition doctors watch for is gastroparesis, which means the stomach empties food more slowly than normal even though there’s no physical blockage. GLP-1s can also slow stomach emptying, so severe or persistent symptoms should be checked by a healthcare professional.
Gastroparesis may cause:
Conditions like bowel obstruction and severe delayed stomach emptying are different from the mild fullness or occasional constipation that many people experience while taking GLP-1s. Watch for symptoms that are severe, persistent, worsening, or significantly different from what you normally have.
For mild or ongoing side effects, don’t change your dose, skip doses, pause treatment, or stop your GLP-1 medication without talking to your healthcare provider. However, if you develop symptoms of a serious reaction, such as severe and persistent abdominal pain that could signal pancreatitis, seek medical care right away and follow the instructions for your specific medication. Some GLP-1 medication labels advise stopping the drug if pancreatitis is suspected.
If digestive issues are severe or ongoing, your provider can consider making a change. They may add a new medication or supplement to treat your side effects or adjust your dose or type of GLP-1.
If you use a compounded GLP-1 medication (not a brand-name), make sure you understand exactly how much medication you’re supposed to take and how to measure it. Ask your prescriber or pharmacist if you have any questions. You might qualify for brand-name versions of GLP-1 medications that deliver a steadier, more reliable dose.
This is especially important if symptoms began after a dose increase. The U.S. Food and Drug Administration (FDA) has received reports of serious adverse events related to dosing errors with some compounded semaglutide GLP-1 products. Some people have developed serious side effects that needed hospitalization.
Constipation and stomach discomfort don’t mean you can never take GLP-1 medications. You may just need a small adjustment or more time to get used to treatment.
Try the tips listed above, and get support from your healthcare team. You can ask for a referral to a registered dietitian nutritionist. They can help you plan meals and snacks that are easier to tolerate and less likely to upset your stomach.
At the same time, don’t feel pressured to “push through” feeling bad. Your healthcare team can help you find a treatment approach that fits your health needs and goals, without leaving you in pain or discomfort.
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