Does Wegovy cause diarrhea?

If you're considering Wegovy for weight loss, you're probably already aware that it affects your appetite. But what about other digestive changes? 

For instance: Can Wegovy cause diarrhea? Absolutely. But does Wegovy cause diarrhea for everyone? No. Diarrhea on Wegovy is common, but it's not guaranteed.

Read on to learn why Wegovy diarrhea happens, how long it lasts, what you can do to manage it, and when to contact a healthcare provider.

Yes, diarrhea is a common side effect of semaglutide, the active ingredient in Wegovy — available in both oral and injectable forms.

In clinical trials of 2.4 mg Wegovy injections:

• 30% of adults experienced diarrhea

• 22% of adolescents experienced diarrhea

 Oral Wegovy is also associated with gastrointestinal side effects — the drug label notes that severe gastrointestinal reactions occurred in 2% of people taking the tablet, compared to 0% on placebo, but does not specify an overall diarrhea rate for the oral formulation the way it does for injectable Wegovy.

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It’s not completely clear why Wegovy can cause diarrhea. Semaglutide actually slows digestion, which is why it causes constipation in some people. 

Here are some possible reasons Wegovy might cause diarrhea:

• GLP-1 action can be region-specific. Although GLP-1 medications like semaglutide slow stomach emptying, they can also speed up movement in the colon— which may help explain why some people develop diarrhea.

• Changes in gut bacteria. Research in animals suggests that GLP-1s can alter gut bacteria — and diarrhea has been linked to changes in the gut microbiome. That said, we don’t yet know whether these microbiome-related shifts directly cause diarrhea in people, or if they’re simply one piece of a bigger picture.

• Gastrocolic reflex. Ever had to use the bathroom right after a meal? When your stomachfills up, your lower digestive tract activates to make room. Because Wegovy slows stomach emptying, prolonged stomach stretching after a meal may continue to activate the gastrocolic reflex — potentially increasing colon activity and contributing to diarrhea in some people.

The duration of Wegovy diarrhea varies from person to person. In one study, researchers found that Wegovy diarrhea typically lasts about three days. 

That said, Wegovy side effects are dose-dependent. Diarrhea is more likely to occur just after a dose increase, and is generally more common at higher doses of Wegovy. So while each episode of diarrhea should only last a few days, you might experience a recurrence of diarrhea with each dose increase.

Managing diarrhea on Wegovy usually involves adjusting your diet and drinking plenty of fluids so that you don’t get dehydrated. 

Just remember: this side effect is usually temporary. Here are some strategies to manage it until it subsides.

Drink plenty of fluids

When you have diarrhea, you’re losing more fluid than normal. If you have diarrhea frequently or for several days in a row, you can get dehydrated. 

So, staying hydrated is key. Drink more water, and try to replenish with electrolyte-rich fluids like broth, fruit juice, and coconut water. Just watch the sugar content in some of these drinks so it doesn’t work against your weight management goals on Wegovy.

Dehydration can sneak up on you, so watch for signs like thirst, tiredness, headache, and dizziness — and keep sipping fluids throughout the day, especially if you’re having frequent or loose stools.

Limit caffeine

Your morning cup of tea or coffee doesn’t just wake you up — it also stimulates your colon. If you’re already experiencing diarrhea, caffeine can make it worse. If you can, try to limit or avoid caffeine until the worst has passed. Most Wegovy diarrhea only lasts a few days.

Take a break from alcohol

Like caffeine, alcohol can cause or worsen diarrhea. If you’re dealing with diarrhea, it’s a good idea to hold off on drinking until your digestive system has had a chance to settle.

In general, mixing Wegovy and alcohol in moderation is OK for most people  — but it’s worth being cautious, especially because both can upset your stomach. 

Eat a bland diet

If you experience Wegovy diarrhea after eating, temporarily sticking to a bland diet could help. Limiting fiber intake in the short term can also help firm up your stool. The BRAT diet — bananas, rice, applesauce, and toast — is a common example of a bland diet that may help settle your stomach. 

Temporarily avoid spicy, fried, and high-fat dairy foods — all known to worsen diarrhea. 

Consider an over-the-counter antidiarrheal medication

Over-the-counter antidiarrheals include:

• Loperamide (Imodium). This medication slows intestinal movement, resulting in slightly firmer stool and fewer bowel movements.

• Bismuth subsalicylate (Pepto-Bismol). This medication works by reducing certain diarrhea-causing bacteria, calming intestinal inflammation, and decreasing fluid secretion in the bowel. Note that Pepto-Bismol can sometimes cause black stools.

Even over-the-counter medications come with risks. Follow the product instructions carefully, and do not take them for longer than the label recommends. Contact your healthcare provider if your diarrhea persists despite trying an antidiarrheal medication.

Contact your healthcare provider if Wegovy diarrhea is severe or doesn’t improve after three days.

Also contact your healthcare provider or seek emergency medical attention if your diarrhea is accompanied by:

• Signs of dehydration (including dark urine, lightheadedness)

• Severe abdominal pain

• Fever

• Bloody stools

• Black, tarry stools (note that Pepto-Bismol can also cause black stools, so mention this to your provider)

Wegovy diarrhea is common and treatable, but it can become dangerous if dehydration sets in. 

Wegovy is more likely to cause diarrhea than constipation. Neither is the most common Wegovy side effect — that title goes to nausea.

In clinical trials, 30% of adults on Wegovy experienced diarrhea, and about 24% experienced constipation. Adolescents — those ages 12 and up — were less likely to experience both side effects: about 22% reported diarrhea, and only 6% reported constipation. 

Fortunately, both side effects tend to improve over time. According to one study, bouts of diarrhea tend to occur after dose increases and last about three days. Constipation tends to last longer — about 47 days.

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Can Wegovy cause diarrhea? Yes. Here’s what to keep in mind if it happens to you:

• Wegovy diarrhea is common. In clinical trials, approximately 3 in 10 people on Wegovy reported diarrhea. 

• Wegovy diarrhea happens due to semaglutide’s effects on the digestive system. Wegovy might cause diarrhea by delaying gastric emptying, altering the gut microbiome, and triggering colon activity.

• Wegovy diarrhea is usually temporary. You might experience diarrhea when starting Wegovy or increasing your dose — but most people only deal with it for a few days at a time.

• Wegovy diarrhea can usually be managed with lifestyle changes. Drinking plenty of fluids, avoiding caffeine and alcohol, and eating bland, low-fiber foods can help relieve discomfort until the diarrhea resolves.

• Don’t hesitate to reach out to your healthcare provider. If diarrhea is severe or lasts more than a few days, they can help determine if Wegovy is the cause and how you can best manage your symptoms — including whether a lower dose might help while your body adjusts.