Navigating Common Weight Loss Medication Side Effects

Managing Side Effects of GLP-1 Weight Loss Medications

Weight loss medications, especially GLP-1 receptor agonists like semaglutide (Wegovy/Ozempic) and tirzepatide (Zepbound/Mounjaro), have revolutionized the way we approach weight management. These medications offer life-changing benefits, including improved blood pressure, reduced blood sugar levels, decreased risk of cardiovascular disease, and enhanced longevity. But occasionally, they may also come with bothersome side effects. This article aims to provide you with useful advice on how to best manage these side effects.

Constipation

Constipation is a common issue, affecting up to 30% of patients on GLP-1 medications. It may be uncomfortable, but there are several strategies to manage it effectively.

Management Tips:

1. Increase Dietary Fiber Intake: Incorporate more fruits, vegetables, whole grains, and legumes into your diet. Foods high in fiber can help regulate bowel movements.
2. Stay Hydrated: Drink plenty of water throughout the day to help soften stools and promote regularity.
3. Exercise Regularly: Physical activity stimulates intestinal activity. Aim for at least 30 minutes of moderate exercise most days of the week.
4. Psyllium Husk: Taking psyllium husk daily (the active ingredient in Metamucil) can be highly effective. It is available in powder or capsule form and helps you go regularly. We often recommend the Now brand on Amazon due to its affordability.
5. Mag07, Miralax, and Senna: For more severe constipation, these supplements and medications can be taken safely on a regular or as-needed basis. Our patients particularly seem to love Mag07, which is available on Amazon, stating that it quickly helps to alleviate constipation.
6. Severe Cases: If constipation persists more than 3-4 days, consult your Shapely provider. For the most severe cases, we may recommend Magnesium Citrate (oral solution), which is used for colonoscopy prep, or an enema for relief.

Nausea

Nausea is fairly common with GLP-1 medications as they slow down stomach emptying and help you feel full faster. While this can be beneficial for weight loss, it can also cause discomfort.

Management Tips:

1. Smaller, More Frequent Meals: Eating smaller portions more frequently throughout the day can help reduce nausea.
2. Stay Hydrated: Drink plenty of fluids, but avoid large amounts at once. Ensuring that you are hydrated is important to avoiding dehydration and aiding digestion.
3. Have warm or cold drinks: Hot teas like ginger, peppermint, chamomile, and lemon, as well as cold drinks such as water with lemon can have a soothing effect on your belly and reduce nausea. 
4. Ask your provider for nausea medications: if the above steps aren’t enough, message your Shapely provider and we will happily prescribe you a medication for nausea, such as ondansetron. 
5. Severe nausea or vomiting: If you are having severe nausea or vomiting, you should be evaluated by a medical provider. If you have intractable vomiting and cannot keep fluids down, you should be promptly evaluated in person at urgent care or an ER.

Diarrhea

In our experience, diarrhea is usually a short-term side effect when starting GLP-1 medications and often resolves within a few days. However, if it persists or becomes bothersome, there are ways to manage it.

Management Tips:

1. Psyllium Husk: Similar to its use for constipation, psyllium husk can also help manage diarrhea by bulking up stools.
2. Over-the-Counter Imodium (Loperamide): This medication can be used to control diarrhea if it becomes bothersome.‍
3. Consult Your Provider: If your diarrhea lasts longer than 3-4 days, or becomes severe, reach out to your Shapely provider for additional recommendations. Recommendations may include dosage adjustments of your medication, additional tips to manage the diarrhea, and a reminder to stay hydrated while having diarrhea.

Heartburn

Heartburn, a burning sensation in the chest caused by stomach acid rising into the esophagus, affects about 4-5% of people on GLP-1 medications. Though it can be uncomfortable, heartburn is manageable with the right strategies. Here are detailed tips on how to effectively manage heartburn:

Management Tips:

1. Avoid trigger foods: Spicy foods, acidic foods/drinks, fatty foods, caffeinated beverages, and carbonated beverages can all trigger heartburn. Instead, you may benefit from heartburn-friendly foods like non-citrus fruits, veggies, lean proteins, and whole grains. 
2. Eat Smaller, More Frequent Meals: Large meals can increase stomach pressure and cause acid reflux. Eating smaller portions more frequently can help.
3. Avoid Lying Down After Eating: Wait at least 2-3 hours before lying down to give your stomach time to digest and reduce the risk of acid reflux.
4. Over-the-Counter Medications: Antacids like Tums, Rolaids, and Maalox help neutralize stomach acid quickly but provide short-term relief. Medications like Pepcid (famotidine) reduce acid production and provide longer-lasting relief than antacids. Prilosec (omeprazole) and Nexium (esomeprazole) are highly effective at reducing stomach acid production and providing longer-term relief.
5. Consult Your Provider: If heartburn persists or becomes severe, reach out to your Shapely provider for additional recommendations or prescription options.

Fatigue

Fatigue can occur due to low blood sugar levels when starting GLP-1 medications or increasing the medication doses. It tends to improve over time as your body adjusts to the medication.

Management Tips:

1. Frequent, Regular Meals: Eating regular meals throughout the day can help maintain stable blood sugar levels and reduce fatigue.
2. Stay Active: Moderate exercise can boost your energy levels and help combat fatigue.
3. Be Patient: Fatigue as a side effect of GLP-1 medications tends to self resolve. If persistent, discuss it with your Shapely provider to see if any other causes may be at play, or if the medication dose needs to be adjusted.

Conclusion

Navigating the side effects of GLP-1 weight loss medications can be challenging, but with the right strategies, you can manage these side effects effectively and continue to reap the benefits of your weight loss journey. Always consult with your Shapely provider before making any changes to your medication regimen or if you experience any severe or persistent side effects. With proper management, GLP-1 medications can be a valuable tool in achieving your weight loss goals and improving your overall health.

Remember, every individual's experience with medication can vary. What works for one person may not work for another. Stay in close communication with your Shapely provider, be patient with yourself, and give your body time to adjust to the medication. With support and perseverance, you can overcome these challenges and enjoy the numerous health benefits that come with weight loss medications.