Can Ozempic Cause Constipation: Understanding the Side Effects

Ozempic, made using the active ingredient semaglutide, is gaining popularity for its effectiveness in treating type 2 diabetes and assisting in weight loss (1). While it is renowned for its efficacy in blood sugar control and potential weight loss benefits, some users report gastrointestinal issues, such as constipation, as a side effect (1). This article explores whether Ozempic can lead to constipation, the causes, prevention strategies, and if similar issues are found with other GLP-1 receptor agonists.

Can Ozempic Lead to Constipation?

Ozempic can lead to constipation in some individuals (1). Although not everyone will experience this side effect, it is crucial to be aware of the possibility. The incidence of gastrointestinal side effects, including constipation, has been documented in clinical trials and user reports. One such trial, published in the New England Journal of Medicine, examined 1961 adults living with obesity or who were overweight with a weight-related condition (i.e., high blood pressure, heart disease). They randomly divided participants into two groups. One group was given once-weekly semaglutide injections; the other was given a placebo injection. Over 68 weeks of treatment (treatment = semaglutide or placebo in addition to lifestyle intervention), they found that 23.4% of all participants on semaglutide experienced constipation. In contrast, only 9.5% of all participants in the placebo group reported constipation It’s crucial for patients to understand that while Ozempic is effective in controlling diabetes and aiding in weight loss, changes in bowel habits may occur.

Why Does Ozempic Cause Constipation? 

The reasons behind constipation induced by Ozempic are multifaceted and may include:

• Slowed gastrointestinal motility: One of the reasons Ozempic is so effective at helping people lose weight is because it slows down gastric (stomach) emptying and possibly even gastrointestinal motility (2). This can slow the movement throughout the digestive system, resulting in constipation.
• Dehydration: Medications, like Ozempic can decrease appetite and potentially reduce fluid intake, which worsens constipation (1).
• Changes in diet or appetite: Ozempic’  often leads to changes in eating patterns. These dietary adjustments may also contribute to constipation. For example, reduced calorie consumption may result in decreased fiber intake, a primary cause of constipation. 

How To Treat Constipation From Ozempic

Fortunately, constipation from Ozempic is often manageable with some practical steps. Here are ways to alleviate or prevent constipation:

• Increase dietary fiber intake: Foods rich in fiber, such as fruits, vegetables, and whole grains, can help improve bowel movements (3). If getting enough fiber in natural foods is not feasible, fiber supplementation may also improve symptoms. The recommended amount of dietary fiber is 20-35 grams per day. Note that consuming large amounts of fiber can lead to bloating and/or flatulence, so it’s best to increase fiber intake gradually.
• Prunes: This sweet fruit has been shown to help with constipation. Try dried prunes or prune juice next time you feel backed up (4). 
• Stay hydrated: Drinking water throughout the day is crucial for softening the stool and promoting regular bowel movements (5).
• Regular exercise: Physical activity can stimulate intestinal motility and improve digestive health, helping to relieve constipation (5,6).

Constipation can be an unpleasant side effect of Ozempic. Fortunately, most cases of constipation will resolve over time after your body gets used to the new medication. One study found that among thousands of patients on semaglutide, the median duration of constipation was about 47 days (7).  

Discuss any side effects with a healthcare provider. They may suggest additional strategies tailored to individual health needs or adjust the medication regimen accordingly. With the Mochi Health program, you can get virtual appointments with a board-certified provider and individualized weight loss guidance tailored to you. 

Do Other GLP-1 Medications Cause Constipation?

Ozempic is not alone among GLP-1 receptor agonists in potentially causing constipation. Other medications in this class, such as Trulicity (dulaglutide) and Victoza (liraglutide), may also have similar gastrointestinal side effects (8,9). All GLP-1 medications are known to cause gastrointestinal side effects such as constipation as well as diarrhea, nausea, and/or vomiting (10). However, it's important to note that individual responses to these medications can vary widely. Some patients may experience constipation with one GLP-1 receptor agonist but not another. It highlights the importance of personalized medical care and finding the best medication for the individual's health profile and treatment goals.

Explore other medications here: https://joinmochi.com/medications

Final Tips For Managing Ozempic Side Effects

In conclusion, while Ozempic and other GLP-1 medications can cause constipation in some individuals, this side effect is often manageable through dietary and lifestyle modifications. If you're experiencing constipation or other side effects while on these medications, it's vital to consult with your healthcare provider for personalized advice and management strategies. Remember, the goal is to manage your diabetes effectively without compromising your overall quality of life.

If you want personalized guidance from an obesity medicine physician, consider joining Mochi Health’s comprehensive weight care program. Find out if you’re eligible today!

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Sources:

1. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002. https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
2. Marathe, C. S., Rayner, C. K., Jones, K. L., & Horowitz, M. (2011). Effects of GLP-1 and incretin-based therapies on gastrointestinal motor function. Experimental diabetes research, 2011, 279530. https://onlinelibrary.wiley.com/doi/10.1155/2011/279530
3. Tramonte, S. M., Brand, M. B., Mulrow, C. D., Amato, M. G., O'Keefe, M. E., & Ramirez, G. (1997). The treatment of chronic constipation in adults. A systematic review. Journal of general internal medicine, 12(1), 15–24. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/9034942/
4. Attaluri, A., Donahoe, R., Valestin, J., Brown, K., & Rao, S. S. (2011). Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Alimentary pharmacology & therapeutics, 33(7), 822–828. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04594.x
5. Arnaud M. J. (2003). Mild dehydration: a risk factor of constipation?. European journal of clinical nutrition, 57 Suppl 2, S88–S95. https://doi.org/10.1038/sj.ejcn.1601907
6. Gao, R., Tao, Y., Zhou, C., Li, J., Wang, X., Chen, L., Li, F., & Guo, L. (2019). Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scandinavian journal of gastroenterology, 54(2), 169–177. https://doi.org/10.1080/00365521.2019.1568544
7. Wharton, S., Calanna, S., Davies, M., Dicker, D., Goldman, B., Lingvay, I., Mosenzon, O., Rubino, D. M., Thomsen, M., Wadden, T. A., & Pedersen, S. D. (2022). Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes, obesity & metabolism, 24(1), 94–105. https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14551
8. Smith, L. L., Mosley, J. F., 2nd, Parke, C., Brown, J., Barris, L. S., & Phan, L. D. (2016). Dulaglutide (Trulicity): The Third Once-Weekly GLP-1 Agonist. P & T : a peer-reviewed journal for formulary management, 41(6), 357–360. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27313432/
9. Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., Andreasen, A. H., Jensen, C. B., DeFronzo, R. A., & NN8022-1922 Study Group (2015). Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA, 314(7), 687–699. https://doi.org/10.1001/jama.2015.9676‍
10. Madsbad S. (2016). Review of head-to-head comparisons of glucagon-like peptide-1 receptor agonists. Diabetes, obesity & metabolism, 18(4), 317–332. https://doi.org/10.1111/dom.12596