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GLP-1 medications bring incredible results like lower blood sugar and weight loss for people living with type 2 diabetes or obesity. But if you’re not prepared, these revolutionary medications can also bring some uncomfortable side effects.
Not everyone experiences side effects from a GLP-1 medication such as Ozempic, Wegovy, and Trulicity. For those who do, symptoms are usually mild to moderate and gradually decrease as your body adapts to the medication. The most common side effects include:
- Abdominal pain
Guidelines on how to prevent and manage these gastrointestinal side effects were recently published in the Journal of Clinical Medicine. An expert panel of endocrinologists, nephrologists, primary care physicians, cardiologists, internists, and diabetes nurse educators put together these recommendations across the areas of eating habits, food composition, and lifestyle.
We dig into each of them to give you the knowledge you need to make your GLP-1 experience smooth, comfortable, and most of all, successful.
1. Eat slowly.
By eating slowly, you give the hormone, GLP-1, more time to take effect. GLP-1 levels peak in the blood about 20-30 minutes after eating. If you eat quickly, you may not give GLP-1 enough time to reach its peak levels, which can limit its effectiveness in reducing appetite and lowering blood sugar levels.
Even if you’re not taking a GLP-1 medication, eating slowly is beneficial for your health. Eating slowly gives your stomach more time to break down food and helps you recognize when you’re feeling full, so you can avoid overeating.
2. Be aware of how hungry you actually are at meal times.
When you’re hungry, your body releases hormones that signal to your brain that you need to eat. If you continue to eat during a mealtime when you aren’t hungry, you’re ignoring these signals and can disrupt your body's natural hunger and satiety cues. Try practicing intuitive eating to tune in to your body’s needs.
3. Eat smaller portions.
When you eat a large meal, it can overwhelm the body's ability to process it and can lead to side effects such as nausea, vomiting, and diarrhea. Eating smaller portions can help to reduce the amount of food that the body has to process at once, helping to minimize these side effects.
When you eat a large meal, it can be difficult to listen to your body's cues of fullness. Eating smaller portions can help you to pay attention to your body's cues and to eat only when you are truly hungry.
4. Avoid drinking with a straw.
Using a straw to drink liquids can introduce excess air into your digestive system, leading to bloating and discomfort. You’re essentially bypassing the stomach and sending the liquid directly to the small intestine. This can cause the liquid to move through the digestive system too quickly.
Drinking liquids without a straw allows the liquid to mix with saliva more thoroughly. Saliva contains enzymes that help to break down food and protect the lining of the stomach. When you drink liquids through a straw, the liquid does not have as much time to mix with saliva, increasing the risk of side effects.
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5. Limit distractions while eating.
Mindful eating, without distractions like TV or smartphones, can aid digestion and improve your tolerance of GLP-1 medications. When you’re distracted while eating, your body's ability to process food can become overwhelmed and this can lead to side effects such as nausea, vomiting, and diarrhea.
Distractions can also lead to overeating. Mindful eating helps you pay attention to your body's cues of satiety, so you can finish eating when you’re full.
6. Stop eating when you’re full.
Overeating can worsen GLP-1 side effects, so it's crucial to recognize when you’re satisfied and stop eating accordingly. When you eat more food than you need, it can overwhelm the body's ability to process it and can lead to side effects such as nausea, vomiting, and diarrhea.
Stopping eating when you're full can help you to listen to your body's cues, too. When you’re full, your body releases hormones, including leptin, that signal to your brain that you need to stop eating. If you ignore these signals and continue to eat, you’re more likely to experience side effects.
7. Don’t lie down after a meal.
Maintaining a relatively upright position after eating can promote better digestion and prevent acid reflux, a common side effect of GLP-1 medications. Acid reflux is when stomach acid backs up into the esophagus. This can be a painful condition.
GLP-1 medications have a number of effects on the body, including slowing down the rate of gastric emptying. When you lie down after a meal, it can slow down the rate of gastric emptying even further, which can lead to nausea, vomiting, and diarrhea.
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8. Don’t be too active after a meal.
On the other hand, being extremely physically active immediately after eating may interfere with digestion and exacerbate side effects, too. Opt for light activities, such as a short walk, to aid digestion instead.
When you’re too active after a meal, it can speed up the rate of gastric emptying, which can lead to nausea, vomiting, and diarrhea.
Being too active after a meal can also increase the risk of hypoglycemia. Hypoglycemia is when blood sugar levels drop too low. Being too active after a meal can increase the risk of hypoglycemia because it can make the body use up more glucose.
9. Finish eating a few hours before bedtime.
Giving your body sufficient time to digest food before going to bed can reduce the risk of acid reflux and other nocturnal GLP-1 side effects.
Eating a large meal before bed can also make it more difficult to fall asleep. This is because the body is focused on digesting the food, so it may not have as much energy to rest.
When you eat a large meal before bed, it can overwhelm the body's ability to process the food and can lead to side effects such as nausea, vomiting, and diarrhea.
10. Maintain a low-fat diet.
Foods that are greasy, fried, and high in fat are high in calories and hard to digest. Opt for a diet lower in saturated fats and focus on healthier fats found in avocados, nuts, and olive oil.
11. Cook by boiling, baking, or grilling.
Healthier cooking methods, such as boiling, baking, or grilling, can reduce the fat content in your meals and aid digestion. These cooking methods do not require the use of added oils or fats, helping to reduce the overall fat in your meals.
Fats are difficult to digest, and they can slow down the rate of gastric emptying. This can lead to side effects such as nausea, vomiting, and diarrhea. These cooking methods also tend to preserve the nutrients in foods.
12. Drink clear liquids with small sips.
Opt for clear and non-carbonated options. Take small sips to minimize the risk of bloating and gas-related side effects. Clear liquids are easy to digest and absorb. This means that they will not put a strain on your digestive system, which can help to prevent side effects.
Drinking clear liquids with small sips can help to keep you hydrated. This is important because GLP-1 medications can sometimes lead to dehydration.
If you’re experiencing nausea, try adding ginger root to hot water or eat crystalized ginger.
13. Enjoy water-rich foods.
Incorporate water-rich foods like cucumbers, watermelon, and leafy greens into your diet. These foods can help keep you hydrated and aid in digestion, reducing the likelihood of GLP-1 side effects.
Water-rich foods are easy to digest and absorb, which means that they won’t put a strain on your digestive system. These types of foods can also help to keep your bowel movements regular. This is important because GLP-1 medications can sometimes cause constipation. Constipation can make side effects such as abdominal pain and bloating worse.
14. Avoid sweets, dressings, or spicy foods.
Foods high in sugar, spicy ingredients, or preservatives can trigger gastrointestinal discomfort, particularly in combination with GLP-1 medications. Opt for fresh, whole foods and limit your intake of processed items.
15. Get plenty of fresh air and light exercise.
Fresh air can help to improve mood and reduce stress. Stress can worsen side effects of GLP-1 medications such as nausea, vomiting, and diarrhea.
Spending some time outside can support the immune system, too. A strong immune system can help to fight off infections, which can sometimes be a side effect of GLP-1 medications.
16. Log your food.
Logging your food can help you to track what you’re eating and drinking, which can help you identify foods that may be triggering side effects.
Food logging can help you to make sure that you’re getting enough calories and nutrients. GLP-1 medications reduce appetite, so it’s important to make sure that you’re getting enough to eat.
Logging your food can help you to identify patterns in your eating habits. This can help you to see if there are certain times of day or certain foods that are more likely to trigger side effects. Once you’ve identified these patterns, you can make changes to your diet to help minimize side effects. Try the free food logging feature in the One Drop app to get started.
When to Contact Your Clinician
Let your weight management clinician know if you are experiencing any side effects from your medication. Your clinician may:
- Recommend an over-the-counter or prescription medication to help with your symptoms
- Recommend switching to a different type of GLP-1 medication
- Reduce your dosage or delay further dose increases
- Discontinue your GLP-1 medication if other options haven’t worked
This article has been clinically reviewed by Hanna Rifkin, RD, CDCES, clinical health coach at One Drop.