Does Zepbound cause constipation?

When starting or considering a weight loss medication like Zepbound (tirzepatide), it’s natural to wonder about possible side effects — especially those that might disrupt your day-to-day life, like constipation. So, does Zepbound cause constipation? It can. 

In this article, we'll explore what the science says about how Zepbound can contribute to constipation, how long it might last, and other common side effects you might experience while taking the drug. 

Yes, Zepbound can cause constipation. 

As a GLP-1/GIP receptor agonist, Zepbound affects the digestive system. It slows gastric emptying, increasing the time food spends in the stomach, which helps you feel full for longer after you eat. While this can be a benefit for those hoping to lose weight, it can also lead to gastrointestinal side effects, such as constipation. 

Constipation is a commonly reported side effect in clinical trials, particularly during the early stages of treatment. 

• In a SURMOUNT-4 clinical trial, 20.7% of participants reported constipation during the initial Zepbound treatment phase (36 weeks or about nine months). Zepbound users generally experienced mild-to-moderate constipation that typically decreased over time as participants continued the medication. 

• In a review of six clinical trials, 2.54% of participants with type 2 diabetes experienced constipation while taking tirzepatide (the active ingredient in Zepbound). The study also found that the likelihood of experiencing constipation increased with higher doses of the medication, such as 10 mg or 15 mg.

While not everyone experiences constipation on Zepbound, it’s a notable side effect for some users, and its likelihood may depend on individual tolerance and dosage. If you experience persistent or severe constipation, consulting a healthcare provider can help address the issue.

Check your coverage for FDA-approved GLP-1s—for free

Check for free

It’s difficult to say with certainty how long constipation on Zepbound lasts, as no studies have focused on this specific issue. However, research shows that most gastrointestinal side effects typically improve over the first few months. So, if you experience Zepbound constipation, know that your bowel movements should likely return to normal as your body adjusts to the medication or increased doses. 

Looking at other weight loss injections might offer more insight. For example, studies on Wegovy (semaglutide) showed that constipation typically lasted around 47 days and leveled off by week 10. 

This doesn’t mean that you have to just wait for constipation to go away on its own. Instead, staying hydrated, eating more fiber, and staying active can help manage symptoms and keep them from interfering with your daily life. If the issue persists, it’s a good idea to talk to your healthcare provider to discuss how to manage Zepbound constipation. 

It’s unclear why Zepbound causes digestive side effects, but it likely relates to how the medication impacts the digestive system. 

As mentioned above, Zepbound slows gastric emptying, the process of food moving from the stomach into the intestines. When food remains in the stomach, it helps you feel fuller for longer after eating, potentially reducing overall calorie intake. However, this delay in digestion may also slow the movement of food through the intestines and contribute to constipation. 

Point being: When the gut slows down, bowel movements can become less frequent.

Healthcare providers often stress the importance of staying hydrated while taking Zepbound because the medication’s appetite-suppressing effects can lead to reduced fluid intake. Dehydration increases the risk of constipation. It causes stool to become harder to pass, compounding the digestive symptoms some people experience on Zepbound.

Dietary changes may also contribute to Zepbound constipation. People taking Zepbound may eat less fiber because they’re consuming less food overall or because high-fiber foods can worsen other side effects, such as bloating or nausea. 

Fiber is essential for adding bulk to stool and promoting regular bowel movements. Inadequate fiber intake can cause or worsen constipation.

Constipation on Zepbound can be frustrating, but it’s usually manageable with a few simple lifestyle adjustments.

Increase your fluid intake

Staying hydrated is one of the best ways to prevent and relieve constipation. As digested food and waste move through the gut, the large intestine absorbs water. Without adequate hydration, stool can become hard, dry, and difficult to pass. 

Since Zepbound reduces appetite, you may be less inclined to keep up with fluids throughout the day. So, it’s important to make a conscious effort to drink more H2O. 

Drinking plenty of water will keep your stool soft and help it move through the intestines. Experts generally recommend drinking 9–13 cups of water daily. If you’re not a fan of plain, still water, consider other calorie-free fluids like herbal teas or sparkling water. 

Eat more fiber-rich foods

Dietary fiber is important for maintaining regular bowel movements and stool consistency. There are two types of fiber: 

• Soluble fiber helps soften stool by retaining water, making it easier to pass.

• Insoluble fiber adds bulk to stool and speeds up the passage of food through the gastrointestinal tract. This promotes more frequent and consistent bowel movements. 

Incorporating fiber-rich foods (e.g. fruits, vegetables, whole grains, legumes) into your diet can help relieve constipation and support overall digestive health. If you experience nausea or bloating while increasing your fiber intake, start slowly and choose options that tend to be gentler on the gut, such as cooked vegetables or oatmeal. 

Too much fiber may cause constipation as well. So be sure to seek advice from a healthcare professional, such as a registered dietitian nutritionist, if you want recommendations tailored specifically to you. 

Stay physically active 

Physical activity is an integral part of any weight loss plan, and Zepbound works best when combined with a reduced-calorie diet and regular exercise. Together, these lifestyle changes can help enhance the drug’s weight-related effects while supporting your overall wellbeing. 

Exercise can also help relieve constipation. Engaging in aerobic physical activity, such as walking, swimming, or cycling, can stimulate the muscles in your digestive tract. This can improve intestinal motility (i.e. movement), which encourages bowel movements. 

Incorporating regular movement into your daily routine while taking Zepbound is especially important to counteract the slower gut movement that can contribute to constipation. Starting with short walks after meals or gentle stretches can make a noticeable difference in supporting regularity.

Consider over-the-counter treatments

If lifestyle changes aren’t enough, over-the-counter (OTC) treatments, such as osmotic laxatives, stool softeners, or fiber supplements, can provide relief. 

• Polyethylene glycol powder, like Miralax, is an osmotic laxative that works by drawing water into the intestines to help move stool along. 

• OTC stool softeners, such as Colace (docusate sodium), help by adding moisture to the stool, making bowel movements easier to pass. 

• Fiber supplements, such as Metamucil, can help if you struggle to get enough fiber through diet alone. Metamucil, in particular, psyllium husk, can add bulk to stool and improve bowel movements.  

Always consult a healthcare provider before starting any new medication or supplement to ensure its safety. 

While constipation on Zepbound is often mild and manageable, it’s essential to see a healthcare provider if it’s severe or persistent or when at-home treatments are ineffective. 

Symptoms such as worsening abdominal pain, bloating, or difficulty passing stool for three or more days require medical attention to prevent serious issues, such as intestinal obstruction (when stool gets stuck in the intestine). 

If Zepbound constipation is affecting your quality of life, speak with your healthcare provider. They may suggest adjusting your Zepbound dosage, switching medications altogether, exploring other potential causes of constipation, or, in some cases, offering prescription medication to treat constipation.

Rx weight loss with Ro

Get access to prescription weight loss medication online

Insurance checker

Check now for free

Wegovy pill

Supply available

Get started

Learn more

Important safety information

Zepbound vial

tirzepatide

In stock via LillyDirect®

Get started

Learn more

Ozempic

semaglutide

Supply available

Get started

Learn more

Wegovy pen

semaglutide

Supply available

Get started

Learn more

Zepbound

tirzepatide

Supply available

Get started

Learn more

Like all prescription medications, Zepbound can come with a list of side effects. As for constipation, in particular? Let’s recap: 

• Zepbound may cause constipation, but it tends to be manageable. In clinical trials, up to 20.7% of participants reported experiencing the side effect while taking the medication. And though it can be uncomfortable, symptoms usually improve over time as the body adjusts to the medication.

• Zepbound slows gastric emptying and gut motility (movement), which helps with appetite reduction and weight loss but can lead to less frequent bowel movements. Decreased fluid and fiber intake can also contribute to constipation. 

• Gastrointestinal side effects of Zepbound have been shown to be dose-dependent. They tend to occur most frequently when starting the medication or at higher doses and are typically mild to moderate and temporary. 

• Lifestyle changes can help manage side effects. Drinking more water, eating fiber-rich foods, eating smaller meals, and staying active can ease constipation and other gastrointestinal symptoms.

• If constipation and other Zepbound side effects interfere with daily life or don’t improve with lifestyle changes, talk to a healthcare provider. They may adjust your dosage or recommend additional treatments.