Ozempic and constipation: Tips to alleviate this common side effect

Before you start taking Ozempic or any other medication, it’s completely natural to have questions about potential side effects. If you've heard about the potential side effect of Ozempic constipation, let's explore how to alleviate this common side effect.

What is Ozempic?

Ozempic is a brand name you've likely heard for semaglutide, a class of medication known as glucagon-like peptide-1 (GLP-1) receptor agonists. Ozempic and semaglutide help to lower blood sugar levels and improve overall blood sugar control and they’re used to treat a number of medical conditions.

How is Ozempic used?

Ozempic regulates the blood sugar level of adults and it is primarily used as a treatment for diabetes. It has also been found to lower the risk of a stroke or heart attack, so it is used in treating patients with cardiovascular disease.

The active ingredient in Ozempic – semaglutide – mimics the GLP-1 hormone, which our body naturally releases when we eat. It releases insulin, which regulates blood sugar (which is particularly helpful if you're navigating high or low blood sugar levels).

In the UK, Ozempic is licensed for the treatment for diabetes. Wegovy, on the other hand, also contains semaglutide as it's active ingredient and is licensed for weight loss.

GLP-1 medications, like Wegovy, which is found in Juniper’s Weight Reset Programme, can mimic this natural hormone, helping to regulate your appetite and slow down your 'gastric mobility'. As a result, you consume fewer calories and reduce your body weight. 

Can semaglutide (Ozempic & Wegovy) cause constipation?

Yes, taking Ozempic, Wegovy or other semaglutide medications can cause constipation. As a medication that slows down your digestive system, your stomach takes longer to empty. This helps you feel fuller sooner and for longer, but it can also be responsible for slowing bowel movements, delayed gastric emptying and difficulty passing stools.

In a study on semaglutide published in the National Library of Medicine, the most frequently reported gastrointestinal side effects of Ozempic were found to be nausea, vomiting, diarrhoea, constipation and stomach pain [1]. Other side effects of Ozempic can include acid reflux, burping, gas and flatulence.

While this may sound like a daunting list, it's important to note that these most common side effects are generally mild and temporary as your body adjusts to the treatment. They're also only expected in 1 in 10 (or 10%) Ozempic patients. Side effects, including constipation, may resolve by themselves after a short time and side effects can be minimised by building the dosage up over a number of weeks.

If any of the following symptoms accompany your constipation, then you'll need to seek immediate medical attention from your nearest emergency department: severe abdominal pain, swelling, distention or vomiting, blood in stool, persistent constipation despite treatment, vomiting with bile (green or bright yellow in colour) or significant bleeding.

Why do you often experience constipation when losing weight?

Constipation is an unwelcome but common experience when we start a weight loss programme. There are a couple of reasons for this.

Often, with weight management programmes, you might choose a low-carb diet. In cutting out large groups of vegetables, fruits and grains, you can miss out on the essential fibre that keeps bowel movements regular. This kind of diet can also increase fluid loss, leading to harder stools that are difficult to pass.

Severely restrictive diets can lead to constipation by slowing the metabolic rate. When you consume fewer calories than your body needs for energy, your metabolism can slow down, including the processes in your digestive system. This slowdown can result in fewer bowel movements and potentially constipation.

Ways to relieve Ozempic-induced constipation

Anyone who's experienced constipation knows it can be frustrating, but there are several strategies to effectively relieve Ozempic constipation and get yourself feeling back to your best.

Gradual dosing

Starting Ozempic with a lower dose and then gradually increasing it over time allows your body to adjust to the medication more smoothly, preventing or reducing the severity of constipation.

Hydration

Drink plenty of water throughout the day to soften stools and promote regular bowel movements.

Increase fibre intake

Gradually incorporate high-fibre foods into your meals. These can add bulk to your stool and encourage bowel movements. Try adding 1-2 extra servings of vegetables across 3 days, then increase to 3 servings of veg alongside 1 extra piece of fruit, added to what you are already consuming.

Try a fibre supplement

If you struggle to get enough fibre through food alone, a fibre supplement could be a quick and easy way to boost your fibre intake.

Prune juice

Known for its natural laxative properties, drinking a glass of prune juice daily can help soften stools and encourage bowel movement.

Regular physical activity

Engaging in regular physical activity can aid the digestive process by promoting healthy bowel movements. Even a daily walk or light exercise routine can make a positive difference.

Remember that individual responses to medications can vary, so consult your healthcare provider for personalised guidance and to discuss any persistent side effects.

Can semaglutide cause diarrhoea?

Diarrhoea is another potential side effect of taking semaglutide, the active ingredient in Ozempic and Wegovy. It affects 31% of people taking a higher 2.4 mg dose of semaglutide for weight management [2]. It tends to improve after you've been using the medication for a few weeks.

If you do happen to experience diarrhoea while taking Ozempic or Wegovy, be sure to stay hydrated, as diarrhoea can result in dehydration. Opt for water, herbal teas, or clear broths to help replenish the lost fluids.

Regarding your diet, easily digestible bland foods can help soothe your stomach and reduce the frequency of diarrhoea. Try to avoid spicy, greasy, or high-fibre foods, as they can sometimes exacerbate digestive issues.

How long do semaglutide side effects generally last?

When you start taking Ozempic or Wegovy, you might experience some unwelcome side effects for a short period. For the vast majority of people starting Ozempic, these tend to go away within the first few days or weeks as your body quickly adjusts to the medication.

Generally, Ozempic (or Wegovy) constipation can be managed quickly with some diet and lifestyle changes. But if any of the other side effects are persistent or particularly bothering you, then be sure to seek advice from your prescriber.

What are the more serious side effects of semaglutide?

While the common side effects of taking Ozempic are short-term digestive issues, there are some rare but serious side effects and medical conditions to be aware of before starting treatment. Allergic reactions, thyroid cancer and pancreatitis are some of the more serious side effects that are linked to Ozempic and Wegovy.

Thyroid cancer

It's unknown whether taking Ozempic causes thyroid tumours or a type of thyroid cancer called medullary thyroid carcinoma (MTC). Symptoms of this can be a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

In studies with rodents, Ozempic (and medicines that work like Ozempic) caused thyroid tumours. However, we know that rodents are more sensitive to this [5]. The relevance for humans is considered low but can't be excluded entirely.

It's generally advised that you shouldn't use Ozempic or Wegovy if you have a personal or family history of MTC, or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) as you may have an increased risk.

Pancreatitis

In rare cases, Ozempic or Wegovy users can develop pancreatitis, which can be life-threatening. If you're experiencing severe persistent abdominal pain or stomach cramps, call your doctor or seek medical attention immediately from your nearest emergency healthcare provider.

You should only take Ozempic if it has been prescribed for you by a clinician or healthcare provider who is competent and trained to prescribe it for blood sugar control.

Are there foods to avoid while taking Ozempic?

There are no specific foods that need to be avoided while taking Ozempic. However, if you're experiencing side effects such as Ozempic constipation, diarrhoea or even experience nausea, you’ll want to steer clear of fast food and high-sugar foods, which can worsen these symptoms.

Plus, there are a few things you can do to manage Ozempic constipation and curb side effects of semaglutide like nausea, diarrhoea, vomiting, bloating, mild stomach pain and gas.

• Eat smaller meals slowly
• Eat foods with high water content (like soup)
• Eat foods that are light and bland and low fat (such as crackers, whole wheat toast and brown rice)
• Drink clear or ice-cold drinks
• Slowly introduce fibre-rich foods and incorporate healthy fats
• Limit heavily processed foods and sugary foods to avoid high blood sugar levels

Can you drink alcohol while taking Ozempic?

Whilst alcohol is permitted, some patients do find that it can make some side effects worse, especially if they might be dehydrated or have low blood sugar due to not eating enough calories.

This is because both Ozempic and drinking alcohol can have the effect of lowering blood sugar levels. So, limiting alcohol consumption may be a good idea to help control blood sugar and any potential kidney problems.

Start your weight loss journey with semaglutide

Juniper’s Weight Reset Programme is a weight loss programme that helps you achieve your healthy weight alongside ongoing consultation and guidance.

We prescribe Wegovy, which contains the same active ingredient as Ozempic – semaglutide – and is a clinically proven weight loss medication. By mimicking the GLP-1 hormone, it helps to regulate blood sugar levels, increase satiety and keep you feeling fuller for longer.

Our clinical team also provides you with the tools you need to create (and stick to) a healthy lifestyle, which will help you kick your weight loss goals long after you stop taking medication.