Introduction
If you’ve jumped on the weight loss drugs bandwagon, Ozempic and Wegovy may probably be no longer new to you. The two semaglutide brands are some of the hottest drugs on the market. This is because of their efficacy in not just lowering blood sugar levels, but also promoting weight loss. Even Hollywood personalities swear by its pound-shedding benefits.
But just like any drug, semaglutide also has its share of side effects, which are mostly gastrointestinal in nature. Why does semaglutide cause nausea? How long does it last and what can you do to deal with it? In this article, we cover what semaglutide is, how it works, and the possible reasons why it triggers nausea.
What is semaglutide?
In our gut is a hormone called glucagon-like peptide-1, or GLP-1 for short. Whenever we finish eating and our blood sugar levels spike, GLP-1 triggers the pancreas to release insulin, which normalizes these.
Semaglutide, meanwhile, is a glucagon-like peptide-1 receptor agonist, or GLP-1 Ra. Whenever blood sugar levels are high, it responds in the same way, performing the same action.
Simultaneously, semaglutide also delays gastric emptying, or that process where food exits the gut and enters the small intestine. Because digestion slows down, you don’t think about food as much and feel full most of the time. With fewer food cravings and a weaker appetite, people on semaglutide lose a significant amount of weight. It also signals to the brain that you’re already full.
Who can take semaglutide?
Although clinical studies have proven that semgalutide is safe and tolerable, this doesn’t mean that just anyone can take it. They first have to meet certain diagnostic criteria, upon the determination of a healthcare provider.
For Ozempic and Rybelsus, which both treat type 2 diabetes, patients must naturally have a diagnosis for type 2 diabetes. Doctors may also prescribe Ozempic for heart disease because it has additional approval for lowering the risk of cardiovascular problems. Healthcare providers may also at times prescribe it for those dealing with insulin resistance.
Wegovy, on the other hand, has FDA approval to treat obesity. Wegovy users need to have a body mass index (BMI) of at least 27 or greater. Additionally, they must also have one weight-related health condition (ex: high blood pressure), or a BMI of 30 or greater.
Even if companies market Ozempic, Wegovy, and Rybelsus for different uses, they are all made of semaglutide. In addition, they offer the same therapeutic benefits of blood sugar regulation and weight management. It’s no wonder many doctors choose to prescribe Ozempic or Rybelsus off-label for weight loss.
Oral and subcutaneous semaglutide
Some people choose to inject semaglutide, while others prefer to drink it in tablet form.
Ozempic and Wegovy are called subcutaneous semaglutide as they come in injectable dosing pens and are injected under the skin.
Rybelsus, meanwhile, is referred to as oral semaglutide because it comes in tablet form and people take it orally.
Dosage and administration
Your doctor will typically start you off on a low dose, gradually increasing this until you reach a maintenance dose. This is to allow your body to get used to the drug. This is called gradual dosing.
People inject Ozempic and Wegovy once weekly regardless of meals. They can inject these in any of the following injection sites: the 1) upper arm, 2) thigh, or 3) abdomen.
Meanwhile, people must take Rybelsus once daily on an empty stomach.
Is semaglutide safe and effective?
If you’re concerned about semaglutide’s safety, you can rest assured that it received FDA approval after extensive clinical studies. The following are highlights from the research that proves semaglutide’s safety, efficacy, and tolerability.
In the STEP 5 trial, researchers investigated the two-year effects of semaglutide in adults who were overweight or with obesity. Participants lost on average 15 percent of their body weight. On the other hand, those in the placebo group lost approximately 2.6 percent of their body weight.
Participants on semaglutide also lost 14.4 centimeters or 5.7 inches off their waistline. In addition, their systolic blood pressure improved by 5.7 mmHg. Participants in the semaglutide group also experienced better diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
A December 2022 study, meanwhile, found that participants on semaglutide lost more body fat than body mass. Additionally, they consumed less because of a weaker appetite, had better food control, and had less cravings, especially for greasy foods.
Semaglutide and its side effects
Knowing what semaglutide’s adverse effects can help manage your expectations if it’s your first time taking the drug. Here’s an overview of its most common side effects and how many experienced them during studies:
Gastrointestinal reactions account for 10% or more of semaglutide’s side effects. These include:
- nausea (up to 44% of cases),
- diarrhea (up to 30%),
- vomiting (up to 24%),
- constipation (up to 24%),
- abdominal pain (up to 20%),
Other common semaglutide side effects that occur in 1 to 10% of cases include indigestion, belching, gassiness, gastroenteritis, and gastritis. Gastroenteritis is the short-term infection and inflammation of the digestive system, while gastritis is the inflammation of the stomach lining.
Note that these common side effects of semaglutide are mild and you can manage these with your healthcare provider. Semaglutide’s more serious adverse effects, meanwhile, are rare.
Why does semaglutide cause nausea?
It’s not clear why semaglutide causes nausea, but it may be because it is a GLP-1 receptor agonist. Also, how your brain tells you you’re full and how the medicine delays gastric emptying.
Because food hangs out in the tummy longer, it creates additional pressure inside. As a result, it stretches the nerves around the stomach and causes common gastrointestinal side effects like nausea, vomiting, and diarrhea. This is likely why most of the drug’s common side effects are gastrointestinal in nature.
If you’re taking the higher dosages of semaglutide, the higher the chance that you’ll experience nausea and vomiting, too. This is why gradual dosing is important.
Note that more research is still needed to determine the exact cause of nausea while taking semaglutide.
Duration of nausea
Nausea typically subsides as your body adjusts to taking semaglutide. However, note that it can resurface every time you increase your dosage of semaglutide.
If you notice no improvement after longer use or continue to experience mild gastrointestinal side effects, inform your healthcare provider. If these get worse, seek emergency medical attention as they may be a symptom of something more serious.
Dealing with nausea
The key to managing nausea is to make changes to your diet and incorporating certain eating habits as well. Eating smaller meals and refraining from lying down after eating also helps prevent nausea and vomiting. You should also avoid oily or sugary foods.
Read on for more specific tips on what you can do to manage nausea.
Go on the lowest dose first.
Research shows that patients with higher doses of Ozempic tend to experience nausea more. It helps to stay on a low dose first.
Although patients typically increase their dosage as they progress along their treatment plan, it doesn’t always apply to every patient. If your blood sugar levels are responding well to a low dose of semaglutide, it may be possible to stay on it. Consult your healthcare provider.
Slow down as you go up to a higher dose.
Once you increase your dose of semaglutide, do it slowly. This will minimize any unpleasant side effects such as nausea.
Limit or eliminate your intake of certain foods.
Greasy, oily, or sugary foods are common triggers for upset stomachs and can worsen your semaglutide side effects. These include:
- High-fat foods (fatty cuts of meat, whole milk, heavy cream, full-fat cheese, butter, and ice cream)
- High-sugar foods (candy, cakes, pastries)
- Sugar-sweetened drinks (juices, soft drinks)
- Highly processed foods (chips, packaged soups, hotdogs, canned foods, etc.)
- Refined carbohydrates (white pasta, white rice, pizza, etc.)
- Salty or spicy foods
- Alcohol
Alternatively, choose low-fat, bland foods that contain a lot of water such as crackers, toast, English muffins, brown rice, or soups. In addition to these are baked fish, baked chicken, carrots, popsicles, and gelatin. Ginger, apples, and mint are also foods that can help relieve nausea.
Change the way you eat.
Consume smaller portions of food, chewing food slowly and savoring each bite. Be mindful of when you feel full and end your meal.
Stay upright and do not lie down right after eating. Try not to eat anything too right before going to bed.
Stay hydrated.
Drink a lot of ice-cold, clear drinks such as water and fresh fruit juices. Just be sure to drink in sips so you don’t tend to feel full. Drink straight from a glass instead of using a straw. It also helps to get some fresh air after eating.
Avoid nausea triggers.
You may find that certain foods and smells may make you nauseous. Knowing this, steer clear of these.
Going out for fresh air also helps a lot in managing nausea. Although experts don’t recommend physical activity after eating, taking a quick walk around the neighborhood after eating is fine.
Consider other GLP-1 drugs.
Although nausea is a common side effect of GLP-1 medications, research shows that nausea was most common in tirzepatide. Tirzepatide is a rival of semaglutide and the active ingredient in the brand Mounjaro.
Given these findings, consider that another drug may be more suitable for you. When in doubt, talk to your healthcare provider.
It’s not clear why semaglutide causes nausea, but it may be because of how semaglutide is a GLP-1 receptor agonist. GLP-1 Ras delay gastric emptying and sends signals to the brain that you’re full. It will take more studies to determine the exact cause of nausea among semaglutide users.
Additionally, nausea commonly subsides the longer you use semaglutide.
Although nausea is one of semaglutide’s most common adverse effects, fortunately, it is typically mild and manageable. Patients can deal with nausea by making changes to their diet and eating habits.
Glossary of terms:
- GLP-1: Glucagon-like peptide-1 is a gut-based hormone involved in the secretion of insulin to lower blood sugar levels typically elevated after meals.
- GLP-1 Ra: Glucagon-like peptide-1 receptor agonist. It mimics the actions of GLP-1.
