Zepbound sulfur burps: why they happen and how to treat them

Starting a new medication — especially one for weight loss — can be nerve wracking. You may be excited about the potential benefits, but you may also worry about the potential side effects. Unfortunately, all medications can cause side effects, and Zepbound is no exception. Sulfur burps on Zepound can be one of the more embarrassing possible side effects, but why do they occur? And how can you manage them if they happen to you?

Zepbound sulfur burps may happen because of the drug’s effects on your digestive system. These effects make it a great drug for weight loss, but it can also cause several gastrointestinal (GI) side effects, such as diarrhea, vomiting, and sulfur burps. Fortunately, there are several ways to manage Zepbound sulfur burps. 

Keep reading to explore sulfur burps and Zepbound further, including why they occur, how common they are, and how to manage them. 

Sulfur burps are belches that have an unpleasant odor, similar to that of rotten eggs. They occur when hydrogen sulfide gas accumulates in your digestive tract. Gas is a natural by-product of digestion, but certain medications, health conditions, and foods may increase the release of hydrogen sulfide gas, specifically. 

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It’s not entirely clear why Zepbound causes sulfur burps, but it is most likely due to its effects on the digestive system. 

Zepbound is a dual-agonist drug, meaning it works on two different receptors in the body — GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide), mimicking these two hormones. One of the main ways Zepbound works for weight loss is by slowing the movement of food through the digestive tract, so you feel full sooner and longer. This effect, known as delayed gastric emptying, can be associated with upper GI symptoms, including bloating. 

It can also lead to several other GI side effects, including:

• Nausea

• Diarrhea

• Vomiting 

• Constipation

• Abdominal pain

• Indigestion 

• Belching (medical term: eructation)

• Acid reflux

• Flatulence (aka gas)

Side note: Because Zepbound slows stomach emptying, it isn’t recommended if you have a history of serious stomach problems, such as severe gastroparesis. This effect can also cause complications during surgery and raise the risk of aspiration (when stomach contents enter the lungs during anesthesia). If you’re scheduled for a procedure, be sure to tell your surgical team that you take Zepbound so they can plan any necessary precautions to keep you safe.

GI side effects, such as sulfur burps, are among the most common side effects of Zepbound. Clinical trials showed that burping occurred in 4% of people who took the 5 mg dose of Zepbound and 5% of people who used the 10 mg or 15 mg dose. In comparison, only 1% of people taking a placebo reported burping. 

There aren’t any studies that have focused on how long Zepbound sulfur burps last. Therefore, it is difficult to say, and it may vary from person to person. Nevertheless, research has shown that Zepbound GI side effects are usually mild to moderate in severity, temporary, and they tend to improve over the first few months of treatment. The side effects also tend to occur most frequently when your Zepbound dosage increases. 

Fortunately, there are several ways to manage sulfur burps from Zepbound. Your healthcare provider will also likely start you on a lower dose of Zepbound and gradually increase the dose over time to minimize the risk of sulfur burps and other GI side effects. 

Although GI side effects like sulfur burps are usually mild to moderate, they can still be disruptive to your day-to-day life. Luckily, multiple strategies can help manage your symptoms, including avoiding foods that are high in sulfate, staying hydrated, eating smaller and more frequent meals, limiting carbonated drinks, and taking over-the-counter (OTC) medications. 

Avoid foods that can trigger sulfur burps

Gut bacteria naturally release gas during digestion. However, consuming sulfur-rich foods increases the chances of bacteria releasing hydrogen sulfide gas — the gas responsible for foul-smelling burps. Because of this, avoiding foods that are high in sulfur can help reduce the risk of Zepbound sulfur burps. Examples of sulfur-rich foods include: 

• Onions

• Leeks

• Chives

• Kidney beans

• Garlic

• Yogurt

• Mature cheeses

• Pastries

• Lobster

Eat smaller, more frequent meals

Large meals can lead to a build-up of gas in the digestive tract, especially while taking Zepbound. Too much gas can lead to GI side effects, such as bloating, distension, and burping. To avoid this, try eating smaller, more frequent meals. This can make it easier for the digestive system to break down food, reducing the amount of gas produced during digestion. 

Stay hydrated

Drinking lots of water can help reduce the amount of gas in your digestive tract. This can relieve common GI side effects, such as burping, nausea, and bloating. According to the National Academy of Medicine guidelines, it is recommended to drink around 3.7 liters per day for men and 2.7 liters per day for women. 

Limit carbonated drinks

Carbonated beverages can release excessive amounts of gas in the stomach. As mentioned above, this can increase the risk of GI side effects and make burping more frequent. If Zepbound sulfur burps are a problem, try switching to non-carbonated drinks, such as flat water or unsweetened tea. 

Consider OTC remedies

If the above strategies aren’t helping, OTC treatments may help. Probiotics can support healthy digestion, and simethicone is an OTC medication that treats symptoms of gas by breaking up gas in the digestive tract. 

If you decide to try an OTC remedy, be sure to read and follow the dosage instructions on the label, and check with your healthcare provider if you have questions or aren’t getting relief. 

Zepbound sulfur burps can be unpleasant. The good news is that GI side effects of Zepbound, including belching, are usually mild to moderate and go away on their own over time or with some simple lifestyle changes. However, if your symptoms are severe or won’t go away with lifestyle changes or OTC treatments, consult your healthcare provider. They can evaluate you to determine if there is a more serious underlying condition causing your symptoms. They can also discuss different strategies to relieve your sulfur burps, such as adjusting your Zepbound dosage or switching to another treatment. 

Yes, digestive side effects, such as sulfur burps, may occur with other GLP-1 medications. This is because they all work similarly in the body. Therefore, switching to another GLP-1 may not provide the relief you’re hoping for. Nevertheless, everyone reacts differently to medications, and side effects can vary among individuals. Other GLP-1 agonists you may consider (depending on your condition) include:

• Injectable semaglutide (Ozempic, Wegovy)

• Oral semaglutide (Rybelsus)

• Liraglutide (Victoza, Saxenda)

• Exenatide (Byetta)

• Lixisenatide (Adlyxin)

• Dulaglutide (Trulicity)

Bear in mind that some of these medications are only approved for type 2 diabetes, not for weight loss, but may be prescribed off-label for weight management. 

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Zepbound is an effective medication for weight loss. It can, however, cause uncomfortable and sometimes embarrassing side effects like sulfur burps. Here are some key things to remember if you’re experiencing Zepbound sulfur burps: 

• Sulfur burps are belches that have an unpleasant smell, similar to that of rotten eggs. They occur when there is a buildup of hydrogen sulfide gas in the digestive tract. 

• Zepbound likely causes sulfur burps due to its effects on the digestive system. One of its main mechanisms of action is to slow gastric emptying, which can lead to digestive side effects, including belching.

• GI side effects, such as nausea, diarrhea, and belching, are common with GLP-1s like Zepbound. In clinical trials, up to 5% of people taking Zepbound experienced burping.  

• Lifestyle changes can help manage Zepbound sulfur burps. These include avoiding foods that are high in sulfur, staying hydrated, eating smaller and more frequent meals, and limiting carbonated beverages. If these aren’t working, you may consider using OTC treatments. 

• Your healthcare provider can help determine the best course of action if you’re having sulfur burps Zepbound. If lifestyle modifications and OTC treatments aren’t helping, they may switch you to an alternative medication or lower your Zepbound dosage.