How to minimize nausea while on a GLP-1 weight-loss medication

Hearing about a possible side effect of a medication is one thing — it’s easy to dismiss it as something that could happen. But experiencing a side effect is something completely different. All of a sudden you’re faced with uncertainty over your treatment plan while wondering how to feel better, fast.

This can be true for any medication that comes with the potential for side effects, including the weight-management medications known as glucagon-like-peptide-1 agonists (GLP-1s), like Wegovy and Zepbound. These medications all have possible side effects, with nausea being one of the most common. While nausea is typically mild to moderate, it can reduce your appetite to the point where you aren’t eating enough, which can negatively impact your health. That’s where this advice comes in handy.

Common side effects of GLP-1s

The most common side effects for people taking a GLP-1 weight-loss medication are nausea, indigestion, constipation, and diarrhea. There’s a reason they are all gastrointestinal: GLP-1s impact gut hormones and slow down gastric emptying (or how quickly you digest food), which can trigger the side effects.

There’s a typical pattern to the side effects: They tend to occur when you first start taking the GLP-1 or when you increase your dosage, and they should improve and ultimately go away over time as your body adjusts to your treatment.

For a complete list of potential side effects, visit the drug manufacturer websites for: Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide), the three GLP-1 medications that are FDA-approved for overweight and obesity.

What amount of nausea is normal?

The most common side effects for people taking a GLP-1 weight-loss medication are nausea, indigestion, constipation, and diarrhea. There’s a reason they are all gastrointestinal: GLP-1s impact gut hormones and slow down gastric emptying (or how quickly you digest food), which can trigger the side effects.

There’s a typical pattern to the side effects: They tend to occur when you first start taking the GLP-1 or when you increase your dosage, and they should improve and ultimately go away over time as your body adjusts to your treatment.

For a complete list of potential side effects, visit the drug manufacturer websites for: Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide), the three GLP-1 medications that are FDA-approved for overweight and obesity.

Is nausea a sign that the medicine is working?

Nausea can be a sign that the GLP-1 is impacting your gut hormones and digestion speed, but the best way to tell if your medicine is really working is to consider the following questions:

• Am I feeling less hungry?
• Do I have fewer cravings?
• Do I get full more quickly with less food?
• Am I more satisfied after meals and snacks?

Compared to before starting a GLP-1, you may not be able to finish your favorite pasta dish at a restaurant or realize you’re thinking a lot less about food throughout the day.

3 ways to reduce the risk of nausea

While nausea can happen to anybody, there are some things you can do to help minimize your chances. These steps include:

1. Eat slowly, with smaller portions. GLP-1s slow gastric emptying, so it’s helpful to space out your meals so that your body has enough time to digest the food in your stomach before you eat again.
2. Avoid lying down after you eat and take a walk outside for some fresh air to support digestion.
3. Reduce how much fried, greasy, or very sugary foods you eat, as they can bring on feelings of nausea.

Tips for feeling better when nauseous

If nausea does strike, here are some tried-and-true methods to help you get through it:

• Drink ice-cold or hot beverages instead of room temperature. You’ll feel better if you stay hydrated. Ginger and lemon herbal teas can soothe the stomach, as can ice water or seltzer.

• Pick plain carbohydrates. Eat foods like plain wheat toast or crackers, oatmeal, rice, and pasta. For a bit of added nutrition, you can add small amounts of dips or toppings to these plain carbs, like hummus, nut butter, ricotta, mashed avocado, or cheese.

• Stay away from strong smells. They can make your nausea worse, so try eating cold foods (which have less of an odor) like a fruit plate, cheese sandwich, and chicken salad.

How to eat if your nausea makes you not hungry

When nausea gets really bad, it can make it hard for you to eat — food can become unappealing and you aren’t hungry. But while you may not want to eat or drink anything, it’s important you do so that you are getting the nutrients you need. Here’s what to do:

Focus on fluids and electrolytes

Aim to drink at least 64 ounces of fluids every day to avoid dehydration. This includes water, seltzer, tea, and other beverages. If you are not able to eat very much, go for an electrolyte beverage like coconut water, sports drinks, or orange juice. Electrolyte powders and tablets that are added to water can also be a good option.

For liquids that are a little more filling, try bone broth or soups, which are both nutritious and easily digestible. If you can handle it, go for soups with a bit of protein, like lentil soup, chicken noodle soup, and beef and barley. Avoid creamy soups, which can cause an upset stomach.

Prioritize protein intakerioritize protein intake

Protein is important for maintaining your lean muscle mass when you are losing weight, so if you aren’t eating much, make sure that you’re still consuming protein. Here are some high-protein foods that may be more appealing on a low-hunger day:

• Greek yogurt
• Cottage cheese
• Protein cereal with skim milk
• Peanut butter on whole wheat bread
• Hard-boiled eggs
• A protein shake
• Cooked boneless skinless chicken breast

If you’re a member of the WeightWatchers GLP-1 Program, check out the Go-To Foods List in the app for even more lean high-protein foods.

Eat enough carbohydrates

When you’re feeling unwell, having low blood sugar can make you feel worse. Carbohydrates can help normalize your blood sugar levels, so reach for bread, crackers, noodles, and rice. It’s totally normal to go for more bland, low-fiber foods, as they are easier on the stomach. Once you’re feeling better, aim for increasing your fiber again with the recommended 25 grams per day for women and 38 grams per day for men.

The bottom line

Nausea is a common side effect when taking a GLP-1 because of the way the medication slows down digestion. As your body gets used to your medication, you should experience less nausea, but in the meantime, there are things you can do to feel better. Eating smaller amounts of food and spacing out your meals can help, as can choosing blander foods. If your nausea is more severe or doesn’t seem to be improving, talk to your healthcare provider to see if you need to adjust your dose.