- GLP-1 agonists like Ozempic or Wegovy delay gastric emptying, leading to uncomfortable symptoms such as nausea, vomiting, constipation, and diarrhea.
- Certain foods contribute to constipation and can worsen these symptoms.
- People taking GLP-1 agonists can combat adverse side effects by emphasizing protein, vegetables, whole grains, and plenty of water daily.
Glucagon-like peptide-1 (GLP-1) agonists are a class of drugs that include medications such as Ozempic and Wegovy. These medications are effective in treating obesity and diabetes. While many people are seeing improvements in their health as a result of these medications, some also experience undesirable gastrointestinal (GI) side effects.
“These medications work in a two-pronged approach for weight loss, and that is why they’re so popular,” Peminda Cabandugama, MD, an endocrinologist at Cleveland Clinic, told Verywell. “They cut down cravings and slow down gastric emptying,” he explained.
Because the medications delay gastric emptying, they can cause food to sit in the stomach for more extended periods, leading to nausea, constipation, and diarrhea. If the side effects are especially disruptive, an over-the-counter fiber supplement may help, Cabandugama said. However, he said, not everyone taking a GLP-1 agonist will need one.
Eating more of certain foods (and avoiding others) may help reduce these side effects, including abdominal pain and vomiting, said Cabandugama. Even still, people taking GLP-1 agonists can—and should—be able to maintain a healthy diet and get all the nutrients they need, he added.
Here, experts explain foods to avoid on Ozempic or other GLP-1 agonists to reduce GI side effects and what kinds of foods to choose instead.
Foods to Avoid While Taking a GLP-1 Agonist
Certain types of foods can contribute to adverse side effects often associated with GLP-1 agonists like Ozempic or Wegovy. If you’re struggling with abdominal pain, constipation, diarrhea, nausea, or vomiting avoid the following foods.
Research has shown that a diet containing a lot of high-fat foods can lead to constipation and slower gastrointestinal motility, movement of food from the mouth, through the digestive system, and out of the body. Thus, eating fried foods or other high-fat foods may worsen constipation caused by GLP-1 agonists, Cabandugama said.
Foods With Added Sugar
Whether you’re taking a GLP-1 agonist for diabetes or weight loss shouldn’t make a difference in how you’re eating, Abby Langer, RD, a Toronto-based dietician, told Verywell. “If you’re taking [the medication] for diabetes, you obviously should not be eating a lot of sugar, and that still applies [to people taking the medication for other reasons],” Langer said. “I would definitely watch the intake of sugar-sweetened beverages as well.”
Refined carbohydrates, such as white bread and white rice, cookies, and pastries, can cause constipation and, in turn, nausea. It’s reasonable to assume these foods may worsen the side effects caused by GLP-1 agonists, Cabandugama said.
Consuming too much alcohol is bad for everyone, and it’s especially important to be mindful of your alcohol intake when you’re 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 subconsciously start drinking less. “Reports show that this medication [may cause] a reduction of cravings for alcohol and cigarettes,” he explained.
Foods to Emphasize with GLP-1 Agonists
GLP-1 agonists, like Ozempic and Wegovy, are prescribed to treat diabetes, overweight, or obesity and should be used alongside a nutrient-dense diet. If you’re dealing with the adverse side effects of GLP-1 agonists, incorporating protein, vegetables, whole grains, and plenty of water into your daily meals could help reduce the unwanted side effects.
GLP-1 agonists help you lose weight, not just fat, Cabandugama explained. This means you may lose some muscle mass as well. To stay energized, you should make sure to get enough protein. However, large servings of protein may worsen constipation and nausea, so eat small portions. Be sure to pair protein with vegetables to increase your fiber intake.
Eating a lot of greens is crucial when taking a GLP-1 agonist, Cabandugama said. So, including greens will help with constipation, and many vegetables can also help you stay hydrated, he added.
Leafy greens, such as kale and spinach, are a form of insoluble fiber that cannot be broken down in water and absorbed by the body. Instead, these fibrous foods move through your digestive system, encouraging gastric emptying and reducing constipation.
Though refined carbohydrates can worsen constipation, whole grains—such as brown rice, whole-grain bread, and oatmeal—contain fiber and help alleviate it. If you plan to incorporate more fiber into your diet, do so slowly. Adding too much fiber too quickly can lead to symptoms like gas, cramping, and bloating.
Higher Water Intake
It’s easy to get dehydrated while taking a GLP-1 agonist, Cabandugama said. So, it’s a good idea to keep track of your daily water intake and pay attention to your thirst. Getting enough water can help with some gastrointestinal issues, like constipation.
There is no standard recommendation for water intake (it varies based on age, sex, pregnancy, and breastfeeding status). Women should aim for nine 8-ounce glasses of water daily and men 13 glasses. However, the color of your urine may help you identify whether you should up your water intake. If your urine is dark yellow and has a strong odor, it’s time for a glass of water.
Appetite Changes While Taking a GLP-1 Agonist
Some research has shown that semaglutide—the active ingredient in Ozempic, Wegovy, and Rybelsus—may reduce your cravings for salty and spicy foods, starchy foods, and dairy. This is because GLP-1 agonists can change a part of the brain responsible for cravings, Cabandugama said.
If you start taking a GLP-1 agonist and find your appetite for certain foods reduced, you should speak with a healthcare provider about how to make sure you’re still getting 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 prescribing healthcare provider will recommend that you exercise regularly—at least 150 minutes of moderate-intensity exercise weekly—while taking a GLP-1 agonist.
A randomized, double-blind, placebo-controlled study published in 2023 found that people who combined exercise with their GLP-1 agonist medication reduced the severity of metabolic syndrome, abdominal obesity, and inflammation compared to those taking the medication alone.
These medications are just the tool we add on to diet and exercise.
PEMINDA CABANDUGAMA, MD
Cabandugama added that some people taking the medication for weight loss instead of diabetes ask if they can skip a dose ahead of special occasions, such as Thanksgiving, so they may be able to eat more.
The answer, he said, is always no because these medications shouldn’t be used for aesthetic purposes to help someone achieve a certain pant size. Instead, they should be used to help people who are at risk of disease or death due to their weight better manage it.
Take GLP-1 Agonists Under the Supervision of a Healthcare Provider
Many people access GLP-1 agonists through online programs that don’t require a proper physical examination. But doing so can cause detrimental health effects, Langer said. “It’s dangerous because it’s a medication. You’re putting something into your body, and even if you do qualify—while these medications are amazing and they have the potential to save lives—they have side effects,” she explained. “You really need to be followed closely by a physician or a nurse practitioner who knows you.”
Cabandugama added that people in the following categories qualify for a GLP-1 agonist:
- Those with a body mass index (BMI) of 30 or higher
- Those with a BMI of at least 27 who also have a comorbidity, such as type 2 diabetes, high blood pressure, or high cholesterol
Though BMI isn’t an ideal measurement, it’s what’s currently used to assess GLP-1 criteria, Cabandugama explained. People outside of those groups should not try to access the medications to lose a few pounds quickly, he added.
What This Means for You
GLP-1 agonists can be very helpful for people who qualify for them, such as those with diabetes or obesity. But they can cause debilitating side effects like constipation, nausea, and diarrhea. Eating enough greens, whole grains, and small portions of protein can help with these side effects, as can drinking plenty of water. Avoiding foods high in fat, refined carbohydrates, and foods with added sugar may also help.