Tips For Managing Semaglutide Side Effects

Taking semaglutide for weight loss can deliver incredible weight loss results, but it may cause side effects as well. Knowing what side effects you might experience and understanding how to manage them can help you follow your treatment plan, have a more pleasant experience, and achieve your weight loss goals. 

What is semaglutide?

Semaglutide, also known by the brand names of Ozempic® and Wegovy®, is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps achieve significant weight loss and better blood sugar control. The class of GLP-1 receptor agonist medications works by increasing the effects of a GLP-1, a neuroendocrine hormone released in the intestines in response to food intake.

GLP-1 is anorexigenic, meaning it promotes weight loss. GLP-1 also helps reduce blood glucose by directing it to organs and tissues to be used for energy. One way GLP-1 helps with weight loss is it slows gastric emptying. Delayed gastric emptying helps sustain fullness over time, reducing appetite and leading to a reduced overall calorie intake.

High-dose semaglutide (2 mg weekly) has been shown to lead to a 15% loss of body weight in patients with obesity and a 2% reduction in hemoglobin A1c (HbA1c) in patients with type 2 diabetes mellitus.

Side effects of semaglutide

At least 80% of patients with obesity who take semaglutide experience at least a 5% loss of body weight. So, while semaglutide is effective, it can also cause many different adverse effects, which vary in likelihood and severity.

Less severe side effects

• Gastrointestinal upset occurs most frequently. Nausea, vomiting, diarrhea and constipation are common with semaglutide treatment, sometimes leading to discontinuation of treatment. 

• Decreased appetite occurs with all GLP-1 receptor agonists, as it is necessary to achieve the desired effects. Decreased appetite usually results in lower calorie intake, supporting the overall goals of improved blood glucose and weight loss.

• Injection site reactions may occur with injectable semaglutide. Swelling, redness, and pain at the injection site are usually temporary, resolving within 1-2 days.

• Fatigue is common with patients taking semaglutide, likely related to a lower appetite and decreased overall nutrient intake. Patients usually report this is worse at first, and it improves slowly as they acclimate to semaglutide treatment.

More severe side effects

• Semaglutide can rarely cause pancreatitis. However, it is vital to promptly diagnose and treat pancreatitis to avoid potentially serious complications. Signs and symptoms may include severe abdominal pain that radiates to the back, nausea, and vomiting. Don't take semaglutide if you have had pancreatitis in the past.

• Hypoglycemia is a more common, but possibly severe, side effect of semaglutide treatment, especially if it is taken in combination with other diabetes medications that lower blood glucose, like insulin, thiazolidinediones, or sulfonylureas. Symptoms of hypoglycemia may include fatigue, sleepiness, mental fogginess and shakiness. Hypoglycemia can have devastating complications (loss of consciousness, coma and seizures) if it is not promptly corrected.

• Acute kidney injury is possible (but rare) with semaglutide treatment, usually in patients with preexisting kidney disease. Use semaglutide with caution if you have chronic kidney disease.

• Acute cholecystitis is possible, related to weight loss and reduced gallbladder emptying. Watch for pain in the right upper quadrant of the abdomen, nausea, or vomiting after eating high-fat foods.

• Semaglutide is associated with an increased risk of a specific type of thyroid cancer, called medullary thyroid carcinoma. Don’t take semaglutide if you have a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

Tips for managing semaglutide’s side effects

Now that you know the possible side effects of GLP-1 receptor agonists, let’s discuss some tips on how to effectively manage them. 

1. Gastrointestinal upset can be reduced by starting treatment at a low dose and titrating (increasing) the dose up slowly.

GLP-1 receptor agonists have specific dosing recommendations, which are designed not only to promote maximum efficacy but also to improve their tolerability. When dosages are increased too quickly, unpleasant gastrointestinal side effects are more likely to occur.

2. Eating smaller, more frequent meals can reduce nausea and vomiting.

Part of how semaglutide helps lower appetite is by slowing down gastric emptying, which means that food stays in the stomach longer and keeps you feeling full. However, if you consume more food before the stomach is empty, you will likely experience nausea and vomiting.

3. Drink plenty of water and eat high-fiber foods.

For semaglutide-associated constipation, drinking a lot of water and ensuring you take in enough fiber will both promote good digestion and help move stool through the gastrointestinal tract with regular bowel movements.

4. Fight fatigue by ensuring you have a nutrient-dense diet to avoid nutritional deficiencies.

Eating whole, real foods that offer the macronutrients, vitamins, and minerals you need is not only important to improve fatigue but also to promote overall health. Drinking enough water is vital to help reduce fatigue too.

5. Rotate your injection sites.

To prevent injection site reactions, rotate the injection sites you use between your thighs, abdomen, and upper arms. Be sure to use proper administration techniques as instructed on the package.

6. Follow the prescribed regimen of semaglutide and communicate openly with your healthcare team.

Open, regular communication is an important strategy to reduce side effects and improve tolerance. If you have concerns about side effects you may be experiencing, discuss these promptly with your physician (continued next).

Regular follow-up appointments with your provider.

Having regular follow-up appointments with a knowledgeable healthcare professional helps monitor your weight, laboratory results, vital signs, and status of other health conditions to ensure the effectiveness and tolerability of semaglutide. Physicians may recognize warning signs or patterns of unwanted side effects. They may require dosage adjustments, drug holidays, switching between GLP-1 receptor agonist drugs, or even discontinuing treatment in some cases to promote your health and safety.

Are the side effects worth it?

GLP-1 receptor agonist medications like semaglutide are some of the most effective weight loss medications in modern history, and they are truly changing the game in the treatment of obesity! However, semaglutide can cause significant side effects in some patients, and for that reason, they may not be the best option for everyone. This is where open, clear communication with your healthcare team is incredibly important. 

If you’re interested in learning more about medical weight loss, you can schedule a no-cost consultation with one of Agile Telehealth’s expert providers. They’ll take a look at your health history, answer any questions and determine if GLP-1s are the right treatment plan. Ready to get started? See if you qualify here!