Semaglutide, a type of GLP-1 glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonists or GLP-1 RAs), has gained awareness for its role in managing type 2 diabetes and promoting weight loss in some individuals. You’ve likely heard them by brand names like Ozempic and Wegovy or in interviews with celebrities like Oprah talking about their experience with them.
They’re a class of drugs that work by mimicking the action of the GLP-1 hormone in the body. As a reminder from our piece about GLP-1s, the hormone helps regulate blood sugar levels by:
- stimulating insulin secretion in response to high blood glucose
- slowing gastric emptying, which helps with appetite control and weight management
- reducing the liver's glucose production
Side Effects are Easier to Manage with Support
As with any medication, it’s essential to understand its benefits and potential side effects you may experience. They’re not specific just to weight loss drugs. Most medications can have side effects, but they can be easier to manage if you know what to expect and the best ways to mitigate them. With GLP-1 drugs like semaglutide, working with a credentialed expert can help manage side effects and complement your medication protocol for the healthiest outcome!
When taking medications like semaglutide, nutritional support plays a vital role in maximizing benefits and minimizing side effects. These drugs can suppress appetite and slow digestion, so focusing on nutrient-dense and balanced meals is essential to avoid nutrient deficiencies. When we work with members at Nutrisense, our team of registered dietitians and certified nutritionists focuses on personalized nutrition care, side effect management, and metabolic health to ensure you feel confident in the foundation of your nutrition plan for lasting, sustainable weight loss.
As always, a quick reminder to check in with your healthcare provider before starting any new medication, including semaglutide. You have questions, and we have answers, so let’s dive in!
How Will Semaglutide Make Me Feel?
Semaglutide may cause a range of feelings, especially in the early stages of use. Some people may experience nausea, upset stomach, bloating, or other gastrointestinal issues, particularly after meals. Others might feel a reduced appetite or feel fuller faster. While these symptoms can be uncomfortable, they typically reduce over time as the body adjusts to the medication.
On the positive side, many report feeling increased energy and better blood sugar control, which can contribute to improved overall well-being.
Post-Treatment Weight Gain
While this isn’t technically a ‘side effect’ of the medication itself, one of the top concerns people have is regaining weight once they stop taking semaglutide. While some people regain the weight (you’ve likely heard of it as ‘Ozempic rebound’ though this can happen with any ), it can be because of a natural consequence of stopping the medication—an increase in your appetite and fewer feelings of fullness.
But working closely with a dietitian or nutritionist can help! They can create a personalized plan that suits your body’s needs and avoid the rebound weight. From helping you manage stress and physical activity to food experimentation, reading food labels, understanding your unique protein needs, meal sequencing tips, and much more, they’ll be able to help you make sustainable lifestyle changes to manage your weight loss even if you choose to stop taking the semaglutide injections.
Side effects: Compounded Semaglutide vs Ozempic
Semaglutide, the active ingredient in both Ozempic and Wegovy, is often compounded by licensed pharmacies to offer a more affordable alternative with similar weight loss outcomes reported. With the recent shortage of medications like Ozempic, compounded semaglutide may be a more available and affordable solution. For some, compounded semaglutide may have fewer side effects due to its more customizable dosing, although research is still ongoing.
Comparatively, Mounjaro (with the active ingredient tirzepatide) differs from semaglutide and is prescribed at different starting doses, which may contribute to more severe side effects for some individuals. As always, the side effects vary between treatments and individuals.
Most Common Side Effects
A side effect is an unintended reaction when taking medication or undergoing treatment. We know everyone is different, and it’s key to listen to your body and prepare yourself with knowledge to ensure your treatment plan goes as smoothly as possible!
Any successful weight management program requires professional guidance to achieve the best health outcomes and long-term results. That’s why personalized nutrition coaching and support can be crucial to maximize benefits and minimize side effects. Research has shown that people who integrate healthy lifestyle factors and maintain those factors are also less likely to regain weight.
1. Nausea
One of the more common side effects is nausea. Still, like many side effects, it can be minimized by starting with a lower dose and gradually increasing it, as your healthcare provider recommends.
Eating smaller, more frequent meals can help manage nausea. You can work with a nutrition expert to learn how to avoid large, heavy meals without sacrificing nutritional needs, which may exacerbate digestive symptoms.
2. Glucose Imbalances or Low Blood Glucose
This side effect is more common in people with type 2 diabetes, mainly when semaglutide is used with insulin or other glucose-lowering medications. Sudden changes to your nutrition, such as fasting or drastically changing your nutrition intake after you start weight loss drugs, can also cause low blood sugar for some.
Monitoring your glucose is vital for various reasons, even if you don’t have diabetes. That’s where a glucose expert comes in! They can work with your body’s data to make sure your glucose levels are optimized for your unique body.
3. Diarrhea or Constipation
Digestive issues may occur as the body adjusts; in some cases, the slowdown in digestion can lead to constipation. This typically will reduce or disappear as you adjust to the medication. Working with a nutrition expert can help you adapt your fiber intake and hydration levels and see if anything else works best for your body.
4. Allergies or Skin Reactions
Similar to other drugs and medications, semaglutide can cause an allergic reaction in some people. These often occur at the injection site specifically. Symptoms can be mild, like a rash, itchiness, or flushing, or more severe, such as swelling in your skin or mouth. If you react similarly to any medication, not just GLP-1s, it’s best to contact your healthcare provider.
5. Dizziness or Blurred Vision
Research shows that there can be various reasons for dizziness or blurred vision. Since semaglutide is a drug that impacts your appetite and blood sugar levels, it may be indirectly related to hydration and blood glucose levels.
Using the latest health tech, like a continuous glucose monitor, can help you keep track of your blood sugar levels, which may help you prevent this. It’s also essential to be properly hydrated and have adequate electrolyte balance, which a registered dietitian or nutritionist can help you with.
6. Gas, Bloating, or Acid Reflux
Digestive system side effects are common in the first few weeks of your semaglutide journey and are similar to the nausea, diarrhea, and constipation mentioned above. Working with a nutritionist to optimize your dietary and lifestyle factors can help reduce some of these and manage the rest.
7. Headache or Fatigue
While headaches and sudden fatigue are commonly reported, there’s not really evidence of this as a direct side effect of Ozempic and other GLP-1s. Of course, you could still be experiencing it, and it may often be related to the glucose imbalances and hydration issues we mentioned above. A personalized nutrition plan can be key in supporting energy balance through nutrition support and hydration.
8. Muscle Loss
While research is still underway, initial research supports that up to 40 percent of weight lost on these medications could be lean mass.
While this is a common side effect, remember it’s not the semaglutide injection causing it. Muscle loss can occur with weight loss or in a caloric deficit when your body uses its energy stores, including fat and muscle tissue. If protein intake and resistance training aren’t sufficient, your body may break down muscle for energy, contributing to muscle loss. Another factor leading to muscle loss is rapid weight loss, which clinical trials show that people on semaglutide may experience. Rapid weight loss tends to reduce not only fat mass but also lean body mass, which includes muscle.
This is another reason to work 1:1 with a registered dietitian or nutritionist when taking the medication since they can work with you to optimize your diet and lifestyle to ensure you’re losing mostly fat and minimizing any potential muscle loss!
7 Tips to Manage Common Side Effects from a Nutrition Expert
As a nutrition expert focusing on weight loss and helping people optimize their nutrition, here are seven things I help people focus on for a better experience when taking semaglutide.
- Start Low, Go Slow: Many side effects, particularly nausea, can be minimized in the first few weeks by starting with a lower dose and gradually increasing it as your healthcare provider recommends.
- Eat Smaller Meals: Eating smaller, more frequent meals can help manage nausea. Avoid large, heavy meals, which may exacerbate digestive symptoms.
- Stay Hydrated: Vomiting or diarrhea can lead to dehydration, so stay hydrated, especially in the first few weeks.
- Avoid High-Fat Foods: Fatty foods can worsen nausea or abdominal discomfort. Opt for low-fat, nutrient-dense meals.
- Manage Hypoglycemia: If you're at risk for low blood sugar, especially if taking insulin or other medications, monitor your levels closely and be aware of signs like dizziness or sweating. Nutrition support to ensure adequate nutrients and a balanced intake of calories, protein, carbohydrates, and fats.
- Prioritize Activity: Gentle movements, like walking, yoga, or stretching, can help improve digestion and minimize gastrointestinal discomfort.
- Nutrition Support: Take advantage of the nutrition guidance and ensure optimal nutrition intake during and after treatment.
Other Possible Side Effects
Most common side effects are mild and improve over time, especially when you have a team of experts like the dietitians and nutritionists at Nutrisense to help support you. However, it’s a good idea to be aware of the other, less common side effects, too.
9. Ozempic Face
The term “Ozempic face” was coined by Dr. Paul Jarrod Frank, a cosmetic dermatologist in New York City, so it’s not a medical term. It refers to a noticeable change in facial appearance, often characterized by sagging or changes in facial volume, which some individuals experience after significant weight loss while using semaglutide. This is not caused by the medication itself but rather by the rapid weight loss.
10. Hair Loss
While gastrointestinal symptoms like nausea and vomiting are well-known, many people wonder whether semaglutide can cause somewhat uncommon ones, too, like heart disease or hair loss. Hair loss is not a common side effect of semaglutide, but some, especially those using semaglutide for weight loss, report experiencing hair thinning or shedding. This is likely due to temporary hair loss triggered by significant bodily changes, such as rapid weight loss or nutritional deficiencies.
Yes, an expert nutrition professional can help manage symptoms and side effects of semaglutide, such as hair loss! Maintaining a balanced diet with adequate nutrients, especially protein, vitamins, and minerals like zinc and biotin, is crucial for hair health.
11. Stomach pain or Paralysis
In rare cases, semaglutide may cause gastroparesis, in which the stomach empties food more slowly than usual. This can lead to stomach pain, bloating, and nausea.
Although this is a rare side effect, the mechanism is due to semaglutide’s ability to slow gastric emptying, which may improve blood sugar control.
12. Kidney Damage
While kidney problems like kidney disease, acute kidney injury, or other kidney damage are not common side effects, patients with pre-existing kidney conditions should exercise caution when taking semaglutide.
In some cases, dehydration from severe nausea, vomiting, or diarrhea (common early side effects of semaglutide) can strain the kidneys, especially in those with compromised kidney function. It’s best to consult with a healthcare professional before taking semaglutide if you have any preexisting conditions.
13. Nightmares or Vivid Dreams
Though uncommon, some Ozempic and other semaglutide users report vivid dreams or even nightmares while using semaglutide. From more pleasant dreams like shopping with Jeff Goldblum to nightmares, you may see social media sites buzzing about this side effect. However, even though we know dreams can be influenced by everything from stress and anxiety to sleep hygiene to what you eat or drink before bed, research on the connection with semaglutide is limited and ongoing. If you’re experiencing vivid dreams, it’s best to discuss them with your healthcare provider.
14. Pancreatitis
This is a very rare but serious side effect characterized by severe abdominal pain that may radiate to the back. Seek immediate medical attention if this occurs.
15. Thyroid Tumors
GLP-1s, such as semaglutide, include a warning for the risk of thyroid C-cell tumors in the US.
So if you’ve seen all the side effect discussions online, you may be wondering—can semaglutide cause thyroid cancer? However, remember that this caution is based on data from rodent studies. Studies in humans are less clear.
Studies in rodents have shown an increased risk of thyroid tumors with semaglutide use, but the evidence in humans is less clear. However, as recommended by healthcare professionals and research shows, semaglutide should not be used by people who have a personal or family history of a rare type of thyroid cancer called medullary thyroid carcinoma (MTC).
Your Treatment Plan Matters
Avoiding common and serious side effects from any medications, including semaglutide, depends on your dosage, the specifics of your treatment plan, and your personal health history. Since semaglutide is unavailable over the counter, your first step is to work with a healthcare professional to ensure your treatment and dosage are tailored to your unique needs.
It’s also essential to consider working with someone trained to work with weight-related diet and lifestyle factors to help you manage side effects and achieve your health goals more effectively. Expert guidance and support can make all the difference in your long-term success.
Mitigate Side Effects of GLP-1s with a Weight Management Expert
At Nutrisense, we understand that navigating the side effects of weight loss medications like semaglutide can be complex. That’s why personalized support is essential! Whether you want to avoid muscle loss, balance your nutrition, or consider what supplements can help you prevent nutritional deficiencies, it’s best to have a dedicated registered dietitian by your side.
When you sign up for Nutrisense, you can work 1:1 with a weight loss expert via insurance-covered video calls for real-time, face-to-face guidance customized to your needs. This means you get an expert to manage side effects and create a sustainable weight loss plan that works for your body. We’re here to provide the support you need to feel confident and in control of your health journey.
Engage with Your Blood Glucose Levels with Nutrisense
Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.
With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.
When you join the Nutrisense CGM program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.
Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.
Find the right Nutrisense programto help you discover and reach your health potential.
Liz has a Master of Science degree in Clinical Nutrition and Integrative Health and is a board-certified nutrition specialist (CNS) and a licensed dietitian nutritionist (LDN). As a nutritionist, Liz has educated and counseled 100s of clients in areas such as weight loss, hormonal imbalances, and gastrointestinal diseases.
