GLP-1 Side Effects and How to Manage Them

In recent years, GLP-1 receptor agonists, such as Wegovy and Mounjaro, have gained significant attention as an effective aid for weight loss and weight management. Medications such as semaglutide, liraglutide, and tirzepatide work by mimicking the natural GLP-1 hormone, which helps regulate blood sugar and control appetite. While these medications offer great benefits, like any medication, they have potential side effects. So, what are the common side effects of GLP-1 medications, and how can you manage them?

Common Side Effects of GLP-1 Medications

1. Nausea
   Nausea is by far the most commonly reported side effect, especially when starting a GLP-1 medication. This occurs because GLP-1 medications slow down the emptying of the gastrointestinal tract, which can cause discomfort in the stomach. Some patients report feeling queasy for a few hours after taking the medication, which can sometimes interfere with daily activities.
2. Vomiting
   In more severe cases, nausea can progress to vomiting. This is less common but can occur, particularly when the dose is increased or if the body is adjusting to the medication.
3. Diarrhoea
   Diarrhoea is another potential side effect, as GLP-1 medications can alter the digestive process. This may be uncomfortable at first, but it often improves over time as the body adjusts.
4. Abdominal Discomfort
   Abdominal discomfort, bloating, or indigestion can occur. The slow gastric emptying effect that helps control appetite can sometimes cause discomfort in the digestive tract.

Managing GLP-1 Side Effects

Managing the side effects of GLP-1 medications is essential for maintaining long-term success in treatment. Here are some practical tips to help reduce discomfort and improve your experience:

Start with a Low Dose

One of the most effective ways to reduce the intensity of nausea and other side effects is to use a low dose and only increase as the body is comfortable. When beginning a GLP-1 treatment, it is important to begin on the lowest dose for that specific medication and only increase gradually to give the body time to adjust. It important to not titrate your dose too quickly and only increase the dose if side effects are manageable and you are not noticing appetite suppression on the current dose.

Stay Hydrated

Diarrhoea and vomiting can also cause dehydration, so it’s essential to stay hydrated. Drink plenty of fluids throughout the day to avoid feeling lightheaded or fatigued. Aim to drink at least 2 – 3 litres of water a day to keep hydrated and manage side effects on these medications. Dehydration, can be caused by gastric emptying suppressing the thirst cue as well as the hunger cue, can cause people to not drink fluids throughout the day as they usually would. This dehydration can also increase the risk of kidney injury, especially in those with pre-existing kidney conditions. Water, clear soups, and herbal teas are all great options in staying hydrated and managing side effects. Have you thought to try a peppermint tea? It contains compounds that have a calming effect and positively influence the guts nervous system known as the brain in the gut. 

Eat Smaller, More Frequent Meals

If you experience nausea or loss of appetite from using a GLP-1 medication, consider eating smaller meals more frequently throughout the day. This can help prevent your stomach from feeling too full or empty, which may reduce nausea. Normally, advice is to swap white, starchy carbohydrates for high-fibre, brown complex carbohydrates to manage appetite regulation, promote gut health and manage energy levels. However, if you feel nauseous then try eating bland, simple carbohydrate foods (such as crackers, toast, or rice) that are easier on the stomach.

Fibre is Great. But, Sometimes Less Is More

Yes, it’s beneficial to maintain a high fibre intake whilst taking GLP-1 medications. When first starting out or moving up in dosage instead of having a high fibre intake, for the first few days opt for low residue foods such as cucumbers, carrots, spinach and white potatoes to reduce the risk of nausea. Constipation is another gastrointestinal issue where fibre could work against rather than for you. In this instance, prioritise foods with a lower viscosity, caloric content and higher water content such as watermelon, grapefruit, strawberries, blueberries, raspberries, watermelon or cucumber. 

Warm over cold 

How quickly or slowly your stomach empties is closely linked to feelings of nausea. The longer food takes to digest, the slower the gastric emptying which can exacerbate any adverse gastrointestinal effects. Temperature is a key determinate of how quickly food can be digested and leave the gastrointestinal tract. Colder foods tend to have a higher viscosity meaning it takes longer to breakdown and digest, slowing gastric emptying. Opting for warmer foods drastically cuts down this period, reducing the risk of nausea. 

Avoid Greasy, Spicy, or Heavy Foods

Fatty, spicy, or heavy foods can irritate the digestive system and exacerbate side effects like nausea and indigestion. Stick to simple, easy-to-digest foods while adjusting to the medication. Food is more than just sustenance, it’s mood, social, celebration and culture. If you are eating out, opt for non-fried foods and try grilled or steamed, non-sauce options. If you can eat in, try tackling a fake-a-way recipe to reduce the excess oil and fats that are found in restaurant food without compromising on the ‘treat’ element. 

Monitor Your Symptoms

Keep track of your symptoms, including when nausea or vomiting occurs and whether it’s related to specific foods or activities. This can help you and your healthcare provider make adjustments to your treatment plan.

Consult Your Doctor if Symptoms Persist

If side effects like nausea, vomiting, or diarrhoea persist for more than a few weeks, it’s important to consult your healthcare provider. They may recommend adjusting the dosage or switching to a different GLP-1 medication to better suit your needs.

When to Seek Medical Attention

These medications are generally safe and designed to support weight loss; not to make you feel unwell. If you’re experiencing side effects that become difficult to manage, you shouldn’t suffer through them. Seek help and advice. These medications should work with your body, not against it. Any side effects which become too uncomfortable to manage should be discussed with your healthcare provider to find a solution. There are ways to adjust treatment.

The Bottom Line

GLP-1 medications are an effective aid to supporting weight loss and weight management. While side effects like nausea and gastrointestinal discomfort are common, they are often temporary and manageable with the right strategies. By titrating gradually, adjusting your diet, staying hydrated, and working closely with your healthcare provider, you can effectively manage the side effects and reap the benefits of these medications.