Wegovy diarrhoea: Why it happens and how to manage it

With the increasing access and availability of weight loss drugs, it can be easy to focus on the often miraculous-seeming results rather than any side effects you may experience along the way.

After all, feeling fitter, healthier and looking great in that new dress can be a much more fun dinner-time conversation than talking about your upset stomach or the nature of your bowel movements.

Unfortunately, the pleasantness of a conversation doesn't make one any more or less important to talk about than the other.

While you should feel proud of every achievement on your weight loss journey, understanding the other things that may be happening in or to your body along the way is vital to ensuring you stay healthy, and know when to speak to your healthcare provider about any potential side effects.

The side effects of Wegovy treatment in particular have been a hot topic recently, and while the more serious risks are important to discuss, here, we'd like to talk about Wegovy diarrhoea. What is it, how long does it last, and how can you avoid an episode.

But first, let's have a look at what, exactly, Wegovy is.

What is Wegovy?

Wegovy is an injectible prescription medication containing semaglutide.

It's prescribed to people who are overweight and obese to not only help them lose weight but also reduce the risk of major cardiovascular events such as heart disease, heart attack or stroke, and can assist with other weight-related medical problems [1].

Medical professionals will generally prescribe Wegovy alongside a reduced-calorie diet and increased physical activity [1], making it a part of a broader lifestyle change to help support weight loss and weight maintenance.

For more information on Wegovy, or to find out if its right for you, check out Juniper's Weight Reset Programme.

Does Wegovy cause diarrhoea?

In short, it can. Wegovy has been found to cause a range of gastrointestinal adverse effects, and diarrhoea is the second most common side effect after nausea.

One study found that approximately 30% of people experience diarrhoea while taking the medication, resulting in the term Wegovy diarrhoea, but it also found that 99.5% of side effects were non-serious, mild-to-moderate, passed quickly and occurred most frequently during or shortly after dose escalation [3].

In other words, you shouldn't have diarrhoea for the entirety of your Wegovy treatment.

How long does Wegovy diarrhoea last?

How long it lasts, like many things when it comes to health, really depends on your particular body, with research suggesting that age and body weight can have an impact on the side effects of Wegovy, including gastrointestinal effects such as diarrhoea [2].

Recent studies though have found that these effects decrease over time and with use, and you are unlikely to suddenly start experiencing side effects late into treatment.

In other words, for mild and moderate cases, you'll likely find yourself experiencing abdominal pain and diarrhoea between 6 and 7 days after starting treatment, although for people with more serious reactions, it could start at around the day 23 mark [2].

How long that then lasts again varies from person to person, but one study did find that the prevalence of nausea, diarrhoea and vomiting from Wegovy treatment peaked at about week 20, so at about the 5-month mark, and was found to decrease thereafter.

The same study also found that episodes of diarrhoea on average lasted just 3 days at a time [3].

Does Wegovy cause other gastrointestinal side effects?

Depending on your body, it can. In fact, the most common side effects of Wegovy are typically gastrointestinal reactions.

The 3 you are most likely to experience are nausea, diarrhoea and vomiting; however, people have also reported experiencing constipation, abdominal pain, upset stomach, feeling bloated, burping, low blood sugar in people with type 2 diabetes, gas, stomach flu and heartburn.

Commonly reported symptoms outside of your digestive system include headaches, tiredness and fatigue, dizziness, and a runny nose or a sore throat [1].

Rarer, more serious side effects

While rarer, Wegovy treatment has also been linked to some more serious side effects, and understanding the symptoms can help you to identify when it's time to speak to your healthcare provider.

One is the possible increased risk of thyroid tumours and thyroid cancer.

Monitoring your neck for a lump or swelling, hoarseness, difficulties swallowing or shortness of breath is vital as these can be symptoms of thyroid cancer, thyroid tumours, or a type of thyroid cancer known as medullary thyroid carcinoma.

If you find yourself experiencing any of these symptoms, see your healthcare provider immediately, and do not take Wegovy if you or anyone in your family has ever had thyroid cancer or an endocrine system condition such as multiple endocrine neoplasia syndrome.

Another rarer side effect is the inflammation of the pancreas, otherwise known as pancreatitis.

If your upset stomach or abdominal pain starts to become a severe pain that will not go away, or if you start to vomit with the pain, this could be pancreatitis. In this case, stop using Wegovy, and speak immediately to a licensed healthcare professional.

Some research has found that Wegovy may cause gallbladder problems or gallstones, the latter of which sometimes requires surgery.

If you have pain in your upper stomach area, fever, yellowing of the skin or eyes, or clay-coloured stool, book an appointment with your healthcare provider.

There is a potential increased risk of low blood sugar, particularly in those taking a drug combination that includes medicines for medical conditions such as diabetes. This can be a serious side effect and should be brought up with your healthcare provider.

Symptoms of low blood sugar may include dizziness, blurred vision, anxiety, irritability or mood changes, slurred speech, confusion, sweating, shaking, fast heartbeat or jittery feelings.

Finally, there's also the potential for kidney problems and, in extreme cases, kidney failure caused by dehydration from diarrhoea, vomiting and nausea; increased heart rate or high blood pressure; and depression or thoughts of suicide.

If you have pre-existing medical conditions, and/or are on medication for those conditions, speak to your doctor as soon as you can. Some drug interactions with Wegovy can be life-threatening.

There is also a risk of having a serious allergic reaction to Wegovy. [1] Symptoms of allergic reactions can include swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, feeling dizzy, fainting, or a very rapid heartbeat.

If you experience any of these side effects, stop taking Wegovy immediately, and speak to a medical professional.

Foods to eat and avoid while taking Wegovy

Wegovy will usually be prescribed alongside a low-calorie diet and physical activity.

To limit the side effects of Wegovy, dietitians recommend a healthy diet full of high-fibre and low-fat foods like leafy greens, fruits like apples, pears and berries, nuts and seeds such as almonds and chia seeds, beans and whole grains.

It's also recommended to prioritise high-protein foods such as lean meat, fish and poultry, as well as vegetarian alternatives such as tofu, lentils and beans.

You should always ensure you are drinking enough water, especially if you are experiencing diarrhoea as diarrhoea can and does dehydrate you.

To get the best out of your Wegovy treatment and reach your weight loss and health goals, avoid fatty foods, fried foods, anything too spicy that might aggravate an upset stomach, and alcohol.

Tips for stopping Wegovy diarrhoea

Ultimately, stopping Wegovy diarrhoea is just like stopping any other episode of it. Drink plenty of fluids where you can, particularly water, fruit juices, herbal teas, and even salty broths, as the latter has been found to help replenish your system.

Avoid caffeine, alcohol and soft drinks, eat small meals, get fresh air and try to stick with bland foods such as those on the BRAT diet — banana, rice, applesauce and toast.

If you are experiencing multiple side effects of Wegovy, keeping track of your symptoms in a journal can help you to identify patterns and work out if you might be at an increased risk for one of the more serious side effects such as thyroid cancer Wegovy has been linked to.

If you have any concerns about the drug interactions with your body, speak to a licensed medical professional.

Image credit: Pexels / Sora Shimazaki