How to Manage Possible GLP-1 Side Effects
You’re super excited to be enrolled in the Ro Body Program and start rewriting your Body Story—and we’re excited for you!
Amongst that excitement, we also know that if there’s anything that can rain on the parade—even if only temporarily—it’s anxiety about side effects. Most medications can have them, and the GLP-1 medications prescribed as part of the Body Program are no exception.
While not everyone will experience side effects, we know that you’ll want to knock them out quickly if you do. That’s why we’ve compiled this handy tip sheet full of info on what to do if you feel some of the most common side effects associated with GLP-1s—all to ensure you’re feeling great as you take the inspiring step to rewrite your Body Story.
What to expect
Before we dig into what to do if you experience any of the things below, let’s first lay out some straightforward answers on side effects, why they occur, and what to expect.
What is a side effect?
What we call a “side effect” is really anything that wasn’t the main goal of something we’ve taken, usually a medication or food. Technically, anything that we put into or onto our bodies can potentially cause a side effect if it makes us feel something we didn’t intend.
For example, you might eat some cheese with the main goal of simply enjoying cheese, but an unintended consequence—a side effect—might be gas or bloating, especially if you’re lactose intolerant. Any unintended symptom can be called a side effect.
Why might side effects occur with GLP-1s?
Side effects are usually the result of how a medication or food interacts with our bodies. Sometimes, it’s actually the very same process that causes the main effect we want that also happens to cause side effects.
This is the case for some of the most common side effects of GLP-1s. Because these medications slow down how quickly your stomach empties—one of the main ways GLP-1s help with weight loss—many of their side effects are related to your digestive system.
You can find a complete list of possible side effects in the package inserts for each medication (linked in the Sources section at the end of this article), but we’ll cover the most common ones here.
How many people experience side effects with GLP-1s?
Everyone responds to medications differently, and we can’t compare side effect rates between different medications. But in general, gastrointestinal side effects are fairly common with many GLP-1s. For example, clinical trials found that 73% of people taking Wegovy experienced some type of gastrointestinal symptom, with nausea being the most common (Novo Nordisk, 2021-a). Other side effects are possible, as well, but usually at a much lower rate.
What are the side effects like?
Those percentages might sound pretty high. Reassuringly, clinical trials also found that most people who reported the most common side effects said they were mild. Those common symptoms tended to start around the time that a dose is first increased, then they typically resolved on their own over time. Very few participants in clinical trials stopped their medication because of side effects, which implies that the symptoms were manageable.
Serious side effects were very rare, but we’ll tell you what to watch for below.
Ideally, by using the tips below and working with your Ro-affiliated provider, you’ll be able to manage any side effects that do come up and get to rewriting your Body Story comfortably very soon.
Common side effects
Nausea is one of the most common side effects of GLP-1s. If people taking a GLP-1 do develop nausea, it tends to arise within a few days of an injection. Vomiting is less common, but some people may experience it. The feeling of nausea usually passes on its own.
To try and prevent nausea, listen to your body more closely during the first few days after taking your injection. There is often a lag between when we are full after eating and when we actually feel full. You may find that eating smaller portions or eating more slowly after an injection may help to alleviate or even prevent nausea. You may also find that eating certain foods on these days makes your symptoms better or worse. Your food journal can help you identify what to eat and what to avoid.
Never hesitate to reach out to your Ro-affiliated provider if you have questions or concerns, especially if you cannot keep any food or water down, or if you are not interested in eating at all.
Some people taking GLP-1s have reported experiencing diarrhea at times. Should you experience this, there are a handful of things you could try to feel better.
Avoid dairy products while you have symptoms, as both lactose and cow milk protein can make diarrhea worse. Eating things like bananas and whole grains, such as brown rice or oatmeal, for the first day of symptoms may help to slow things down—but return to your normal diet after a day to ensure you get the nutrition you need. You may also consider an over-the-counter medication like Pepto-Bismol. If diarrhea lasts more than several days, be sure to reach out to your Ro-affiliated provider.
While some people may experience diarrhea, others may develop constipation. If your bowel movements are usually regular and soft but you’re now feeling constipated, there are a few things you can try.
First and foremost, make sure you’re drinking plenty of water throughout the day. You can also aim to eat a wide variety of fruits and vegetables, plus high-fiber foods like oats and chickpeas. These are all part of a healthy diet and fall right into the nutritional goals of our program, so these are always great steps to take.
If diet alone doesn’t help, you may consider adding over-the-counter Miralax or Colace to your regimen. Follow the instructions on the package.
Whatever solution you try, aim to stick with it daily until your bowel movements have the same consistency as toothpaste, and you have one to two bowel movements a day.
If you’ve been constipated for several weeks, it can be helpful to stick with whatever helped—whether diet or over-the-counter medication—for at least two weeks after your symptoms have improved. That may help prevent constipation from coming back. If you do develop recurrent constipation, or if you’re having a hard time fixing it in the first place, reach out to your Ro-affiliated provider.
Like many other possible side effects of GLP-1s, heartburn may be caused by the slowdown in how quickly your stomach empties. Why? If a food can potentially cause heartburn—think things like spicy foods, fried foods, tomatoes, coffee, bubbly drinks, and more—then having it stick around in your stomach for more time can increase its chances of giving you heartburn.
You can try to prevent this by avoiding heartburn-causing foods around the time that you take your medication. If you do develop heartburn, over-the-counter medications like TUMS may help. Chewing gum or ginger are additional home remedies that may be helpful. And if your symptoms are worse when trying to sleep, you can elevate your head with a second pillow or try sleeping on your left side.
Most commonly, abdominal pain associated with GLP-1s is a result of one of the other things we’ve already mentioned—nausea, heartburn, diarrhea, or constipation. You can try some of the remedies we’ve discussed above to see if your discomfort improves.
Sometimes, abdominal pain with GLP-1s is due to indigestion—that feeling of bloating or general discomfort in the belly after eating too much or too quickly. Once again, the culprit is the slowing down of how fast your stomach empties. You can try to prevent this feeling by taking small bites, chewing thoroughly and mindfully (you’ll see a lesson on this later in your curriculum), and eating smaller portions. If indigestion comes up while you’re eating, stop and take a break for a few minutes.
On very rare occasions, severe abdominal pain can be a sign of a serious side effect called pancreatitis, or inflammation of the pancreas. If you develop severe abdominal pain, pain that won’t go away, pain that seems to radiate toward your back, or pain that’s associated with intractable vomiting, seek urgent in-person medical care right away.
Issues at the injection site
When medication is injected into the skin, it’s possible for irritation and other issues to develop at the site of injection. A small amount of tenderness, mild redness, or very mild swelling at the injection site are not unusual and will typically resolve on their own. You can decrease the odds of experiencing these symptoms by cleaning the skin well before the injection, and by injecting the medication at a 90-degree angle to the skin. If you do develop mild tenderness or irritation, applying a cool compress (a cool, damp towel or washcloth) to the area can help. If needed, and if you don’t have any medical conditions that prevent you from doing so, you can also take a dose of ibuprofen.
Some people taking GLP-1s have infrequently reported small, raised bumps near the injection site. This is usually a self-limited reaction, resolving on its own within a few weeks.
Headache is often found on the list of possible side effects for many medications, and GLP-1s are no exception. There are many possible reasons some people may experience headaches when taking a GLP-1, including the fact that the medication is likely to affect your eating and drinking habits. You may help prevent headaches by ensuring that you are well-hydrated—and drinking plenty of water can also help alleviate a headache should you experience one. You may also consider taking over-the-counter medications, such as Tylenol (acetaminophen) or Advil (ibuprofen).
Should headaches become severe, persistent, or associated with vomiting or changes in vision, stop taking your medication and contact your healthcare provider.
Like headaches, fatigue is a general, nonspecific side effect common to many medications. And like the case with headaches, one possible cause of fatigue when taking a GLP-1 is the change in your eating and drinking habits. As a result, to help prevent or treat feelings of fatigue, be sure to eat and drink enough throughout the day. Getting enough quality sleep can also help prevent and treat fatigue.
Less common side effects
Increased heart rate
An increase in your heart rate is one of the less common side effects of GLP-1 medications. On average, people who experienced a change in heart rate in clinical trials had an increase of 1–4 beats per minute (bpm) from their resting heart rate. You may or may not notice this small change unless you are checking your heart rate regularly, as was done in the studies. Some people may notice a larger increase in heart rate, closer to 10–20 bpm or more from their resting heart rate. Be sure to let your provider know if you are experiencing palpitations or a feeling of racing heartbeat while resting. If your heart rate goes up too much for too long, your provider may recommend that you stop the medication.
Serious allergic reactions, like swelling of the face, lips, throat, or tongue can occur with GLP-1s. Other symptoms include problems breathing or swallowing, a severe rash or itching, feeling faint or dizzy, and a very rapid heartbeat.
If you develop any of these symptoms, stop using the medication and seek emergency medical care.
Depression or suicidal thoughts
In clinical trials for other weight management medications, some people reported feelings of depression, worsening depression, thoughts of harming oneself, or other unusual changes in mood or behavior. This could potentially happen with GLP-1s as well. If you or your loved ones notice you are showing any of these unusual changes in mood or behavior, stop the medication immediately and seek medical advice.
Yellowing of the skin or eyes
Gallbladder issues are a rare, but potentially serious side effect of GLP-1s. Your gallbladder is a small organ in your abdomen that stores and releases bile to help with fat digestion. If you are developing a gallbladder problem, you may notice that your skin and the whites of your eyes are taking on a yellowish color—the medical term for this is jaundice. You may also experience upper abdominal pain, fever, and clay-colored stools. If you experience any of these symptoms, stop using the medication and contact your healthcare provider.
When to seek in-person care
Severe or urgent side effects tend to be quite uncommon with GLP-1s. However, it’s worth knowing what to watch for and what signs should lead you to seek in-person medical care.
Seek in-person medical care if you experience:
Changes in your mood that are new and uncharacteristic for you
Persistent hoarseness, persistent trouble swallowing, or a persistent feeling of fullness in the neck
And seek urgent in-person medical care if you experience:
Abdominal pain that is severe, won’t go away, or keeps coming back
Swelling in the face, tongue, or throat
Shortness of breath
Blood in vomit
Black tarry stools
Writing your next chapters, together
On your path to rewrite your Body Story, there are bound to be bumps along the way. There will be times that a goal feels just out of reach; days when exercise just isn’t in the cards; and yes, there may be side effects at times.
But each of these bumps will just be a page in your new Body Story—and you’re writing chapters. And between your step-by-step curriculum and the wise, empathetic words of your Ro-affiliated coach and provider, you’ve got support every day, every page, every step of the way.
Novo Nordisk. 2021-a. Wegovy Prescribing Information. Retrieved April 05, 2022 from https://www.novo-pi.com/wegovy.pdf
Novo Nordisk. 2021-b. Saxenda Prescribing Information. Retrieved May 26, 2022 from https://www.novo-pi.com/saxenda.pdf
Novo Nordisk. 2021-c. Victoza Prescribing Information. Retrieved May 27, 2022 from https://www.novo-pi.com/victoza.pdf
Novo Nordisk. 2022. Ozempic Prescribing Information. Retrieved April 05, 2022 from https://www.novo-pi.com/ozempic.pdf