(What to Expect and What Actually Helps)
So, you started a GLP-1 med, and now you’re dealing with side effects. Fun, right? Hopefully, you get lucky and they pass quickly, but chances are they will reappear every time you give yourself an injection or you increase the dosage of the medication. Those are the most common causes of side effects.
What do you have to look forward to? It’s an unpleasant laundry list of symptoms.
- Abdominal discomfort
- Acid Reflux
- Bloating
- Constipation
- Diarrhea
- Dizziness
- Fatigue
- Headaches
- Nausea
- Vomiting
It’s enough to make one have second thoughts.
My Experience with Side Effects
I must admit, the night before I started the medication, I pulled up the Zepbound homepage and spent some quality time reading their hit list of side effects. It freaked me out. Of course, it starts off in the worst way. “Zepbound may cause tumors in the thyroid, including thyroid cancer.” What a way to introduce your product. Of course, the list just kept going, and by the time I got done reading, I questioned what I had gotten myself into.
Despite my trepidation, I moved forward and gave myself my first injection, and then waited with bated breath to see what would transpire. At first, nothing. But within two days I was dealing with indigestion and mild symptoms of acid reflux. I took Pepto Bismol and some antacids and ate smaller portions. Then, after a few days, I had nausea and fatigue, which I later realized was from not eating enough.
My appetite had disappeared, and my food cues were gone, so I wasn’t consuming enough calories. I ate some toast and drank some peppermint tea. Ultimately, I made it a point to eat regular, small meals throughout the day. And then fun, fun, fun, constipation hit. I drank water and added Metamucil to my daily routine.
Serious Potential Risks
In hindsight, I was fortunate. All my symptoms were treatable with over-the-counter medications and home remedies. I now know of people who had such severe nausea that their doctors wrote them a prescription to address it. There are others who developed kidney problems because of severe dehydration from vomiting and diarrhea.
All alarming outcomes for a medication that is supposed to be doing you good. So, if those are the most common side effects, what are the rare but scary ones?
Pancreatitis: Inflammation of the pancreas.
Gallbladder Problems: Gallstones or gallbladder inflammation.
Gastroparesis: Severe stomach paralysis or significantly delayed emptying.
Bowel Obstructions: Blockages in the intestines.
Kidney Issues: Potential for kidney injury or failure from dehydration.
Thyroid C-cell Tumors: A risk associated with some GLP-1s, making them unsuitable for those with a family history of medullary thyroid cancer.
On all the manufacturers’ websites, they caution that severe, persistent vomiting or intense abdominal pain should be reported to a healthcare provider at once. And if you follow the news, patients who suffered severe side effects have filed lawsuits. Which is evidence that the severe side effects do happen.
Some Good News
Luckily, the most common side effects dissipate. For instance, nausea strikes half of those taking the medication, intensifying during the initial 2 to 6 weeks of treatment or immediately after a dose increase. So, if you can wait it out, nausea does improve.
Fortunately, numerous strategies exist to manage GLP-1 side effects. Besides starting the medication at a low dose so your body can adjust, things like staying hydrated and eating smaller, but frequent meals top the list of recommendations.
Managing Symptoms
What are your day-to-day treatment options for side effects?
Nausea: Pepto Bismal, Dramamine, or Emetrol. Drink ginger or peppermint tea, eat bland foods like whole-grain toast or cereal, avoid high-fat foods, processed meats, and spices. Even if you’re not hungry, don’t skip meals, as often nausea will only worsen the longer you go without eating.
Diarrhea: Imodium AD or other over-the-counter antidiarrheal medication. Drink water. Eat bland, low-fiber foods like bananas, rice, and toast. Avoid dairy products, fatty, high-fiber, or spicy foods. Avoid artificial sweeteners, caffeine, and alcohol.
Heartburn: Pepto Bismal, antacids. Eat smaller portions, avoid spices, and don’t lie down for two or three hours after eating. Don’t drink carbonated beverages, as it will aggravate the problem, even if it might seem to offer some relief.
Constipation: A stool softer, laxatives, probiotics or Metamucil. Drink plenty of water. Increase soluble fiber, like oats and apples; also increase insoluble fiber, like vegetable skins and nuts.
Dehydration: Drink 8-12 cups of fluid daily, predominately water. Eat fruits and vegetables that have a high-water content, like watermelon and cucumbers. Avoid alcohol, caffeine, and sweetened beverages.
Muscle Loss and Nutrition
Other side effects are being discussed online, but manufacturers’ websites do not address them. The medication does not directly cause these side effects; they are byproducts of weight loss.
One side effect that everyone must deal with is muscle loss. Up to 30% of weight loss can come from muscle mass rather than fat. One way to avoid this, is eating enough protein. Based on your body weight and activity level, it’s recommended that you eat 0.8–1.2 grams of protein per pound daily.
Also advised is consuming 20–30g of protein per meal and spreading your protein out throughout the day to avoid consuming it all at once. A weight loss doctor or nutritionist would be the best resource to determine how much protein you should consume daily. If you want to at least get an idea of how much protein you should aim for, check out this protein calculator.
You can also add supplements to your diet to help preserve muscle. Protein powder is a way to add a significant amount of protein while keeping your calorie count down. Creatine monohydrate is another option, as it can increase muscle mass if used appropriately.
Connected to muscle preservation is bone health, as they can become fragile with muscle loss. Adding a multivitamin is often suggested as you might be missing essential vitamins like A, B12, C, D, and E, and minerals like calcium, iron, magnesium, and potassium from your diet.
In all instances, it’s recommended that before you start using supplements, you speak with a doctor or nutritionist, as they will be familiar with your specific situation.
Exercise is also strongly recommended, especially weight-bearing exercise. Lift weights, use resistance bands, or do bodyweight exercises 2-3 times per week to stimulate muscle protein synthesis. It is the best way to maintain existing muscle and possibly build more.
Hair Loss and “Ozempic Face”
Temporary hair loss is also known to occur, primarily from rapid weight loss, metabolic stress, and nutritional deficiencies. Symptoms include increased shedding, thinning at the crown, and brittle hair, usually peaking 3–6 months after starting the medication. Fortunately, the problem usually resolves when weight stabilizes.
Another much-discussed byproduct of rapid weight loss is saggy skin, which comes with pronounced wrinkles caused by the loss of natural padding, especially in the face and feet. This is known as “Ozempic Face” and “Ozempic Feet.”
When the fat pads that normally support the cheeks, temples, and jawline shrink, the face loses volume, skin elasticity, and youthfulness, leaving the skin hollowed out and deflated. Feet encounter a similar scenario in that the fat padding on the soles of the feet shrink which leads to pain, blisters, and bunion issues.
Expensive surgical and dermatological treatments exist to correct facial problems after the fact. There are no medical treatments for the feet except for targeted exercises to strengthen the feet and legs. You can do it at home or with a physical therapist. Otherwise, custom orthotics, gel pads, and supportive footwear can help.
Looking for more information about life on a GLP-1 medication? You may also find my article on Food Noise Explained helpful.
When to Call Your Doctor
As you can see most times GLP-1 medication side effects are treatable at home with over-the-counter medicines or home remedies. And, maybe it wasn’t clear, but staying hydrated is the number one thing you can do to stave off and cope, after the fact with side effects. Also, you can address many symptoms by adjusting what you eat, and most side effects taper off as your body adjusts to the medication.
If symptoms worsen or do not subside, call your doctor because serious side effects require immediate attention. While rare, they can be life-threatening.
Common Side Effects
- Abdominal discomfort
- Acid Reflux
- Bloating
- Constipation
- Diarrhea
- Dizziness
- Fatigue
- Hair Loss
- Headaches
- Muscle Loss
- Nausea
- Vomiting
Serious Potential Risks
Significant pain and discomfort that is not responsive to over-the-counter medication accompanies almost all of the following. Medical intervention is required.
- Pancreatitis: Inflammation of the pancreas.
- Gallbladder Problems: Gallstones or gallbladder inflammation.
- Gastroparesis: Severe stomach paralysis or significantly delayed emptying.
- Bowel Obstructions: Blockages in the intestines.
- Kidney Issues: Potential for kidney injury or failure.
- Thyroid C-cell Tumors: A risk associated with some GLP-1s, making them unsuitable for those with a family history of medullary thyroid cancer.
Leave a Reply