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Semaglutide Diet Plan (Ozempic/Rybelsus): What to eat and avoid while on GLP-1RAs

NOVI Team

Key takeaways:

  • Semaglutide (Ozempic/Rybelsus) is a GLP-1 receptor agonist that helps improve blood sugar control by stimulating insulin release, slowing gastric emptying, and influencing the brain's "satiety center".

  • A special diet for semaglutide doesn't exist. Instead, the same healthy eating guidelines apply, like prioritizing complex carbohydrates and lean proteins.

  • That said, those taking semaglutide could prevent its associated adverse gastrointestinal symptoms by avoiding fatty foods, eating smaller meals, and staying well-hydrated.

  • Semaglutide works best when paired with healthy lifestyle changes. So, beyond sticking to a healthy diet, remember to make time for exercise, stress management, and high-quality sleep.

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Understanding how to eat when you’re on medication can be tricky. Meal timing, size, and the types of foods and drinks consumed can all affect your body’s response to a medicine. More head-scratching-worthy still, food-related dosing instructions aren’t universally applicable across all medicines. Take ampicillin, for example. As food slows its absorption (decreasing its effectiveness), ampicillin should be taken on an empty stomach. On the other hand, certain diabetes medications—like insulin—should be taken with food to reduce the risk of low blood sugar, stomach upset, and nausea.

 

So, if you’re currently on semaglutide (Ozempic/Rybelsus), you may wonder: is your diet (unwittingly) hurting the drug’s effectiveness and/or increasing your chances of experiencing uncomfortable side effects? Possibly. Below, discover what an ideal diet for semaglutide (Ozempic/Rybelsus) looks like so you could improve blood sugar profiles while minimizing adverse side effects.

How does semaglutide (Ozempic/Rybelsus) work?

To understand the possible interaction between semaglutide and your diet, familiarizing yourself with the former’s mechanism of action will be helpful. And here’s what you need to know: semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. That means it mimics the action of the naturally occurring hormone GLP-1, which:

  • Stimulates insulin release and inhibits glucagon secretion: Insulin helps move glucose from your bloodstream into the body's cells, where it serves as the primary energy source. It thus lowers blood sugar levels. On the other hand, glucagon is a blood-sugar-level-rising hormone that works with the liver to turn stored sugar (i.e., glycogen) into glucose. To that end, by stimulating insulin release and inhibiting glucagon secretion, semaglutide helps a person with diabetes stay within optimal glucose level ranges.     

  • Slows gastric emptying (the process by which the contents of your stomach are moved into the small intestine): As your stomach fills with food or water, its stretch receptors send “satiety signals” to your brain through the vague nerve. So, when semaglutide slows gastric emptying, it prolongs the duration your stretch receptors would send “satiety signals” to your brain (since your stomach is still relatively filled)—enhancing satiety, preventing overeating, and, in turn, promoting better blood glucose control.

  • Stimulates brain areas involved in appetite regulation: Beyond slowing gastric emptying, semaglutide also appears to suppress appetite by acting on the ‘satiety center’ in the hypothalamus.

What’s the difference between Ozempic and Rybelsus?

Semaglutide. Ozempic. Rybelsus. While this article has repeatedly mentioned them in the same sentence, they're not technically the same. See, Rybelsus and Ozempic are both brand names of the drug semaglutide:

  • Rybelsus: An oral form of semaglutide that comes in tablets of 3 mg, 7 mg, and 14 mg

  • Ozempic: An injectable form of semaglutide usually taken once a week

Okay, but is there truly a need to distinguish between these two? Yes, because their dosing regimen (one is oral and taken daily, the other is injectable and taken weekly) differs. Still, you don't need to worry too much about that right now. We'll cover how you should tweak your diet for the two semaglutide types (Ozempic and Rybelsus) in just a bit.

What should a diet for semaglutide (Ozempic/Rybelsus) look like?

Or, in other words, does a “special diet” for semaglutide (Ozempic/Rybelsus) users exist? Not really. As mentioned earlier, semaglutide basically simulates the action of a naturally occurring hormone, GLP-1, in your body. So, in that sense, there’s little risk of a food-drug interaction like what you’d see with grapefruit paired with statins, vitamin-K-rich leafy vegetables with warfarin, or cheese with monoamine oxidase inhibitors.

 

Although there isn’t a “special diet” for semaglutide (Ozempic/Rybelsus)—i.e., no one, universal, strict set of must-follow dietary rules—there are a few tips that could:

Types of foods to avoid while taking semaglutide (Ozempic/Rybelsus)

What type of food should you avoid while taking semaglutide (Ozempic/Rybelsus)? Fatty foods. That’s because dietary fat, in and of itself, slows gastric emptying. Combine that with semaglutide’s effect on your digestion, and you run the risk of food moving through your digestive tract too slowly. You may then experience a slew of uncomfortable and downright painful gastrointestinal symptoms, like nausea, vomiting, bloating, and upper abdominal cramping.

If you’re a fan of local hawker delights (who isn’t?), high-fat dishes to avoid—note: limit, not eliminate—include Roti Prata, Char Kway Teow, and Laksa. Frowning because those are all your go-to foods? Don't worry; as outlined in this article, you’ve got plenty of healthier, lower-in-fat options.

Types of foods to eat while taking semaglutide (Ozempic/Rybelsus)

Limit consumption of fatty foods. Wait … that’s it? How else should a diet for semaglutide (Ozempic/Rybelsus) look? There’s got to be more guidance, right? Well, unfortunately, or fortunately, just as there’s no one best eating pattern for diabetes, there isn’t a “best diet for semaglutide”, too. Instead, stick to general healthy eating guidelines. They would help you maximize the medication’s effectiveness in helping you manage your blood sugar levels. That means, ideally, you should:

  • Prioritize complex carbohydrates: Complex carbohydrates, like brown rice, oats, quinoa, and wholemeal spaghetti, are digested and absorbed more slowly (than refined carbohydrates) into the bloodstream, producing an associated slower, lower rise in blood sugar levels. Fill ¼ of your plate with complex carbohydrates.

  • Eat protein at every meal: Adding protein to a meal could reduce blood sugar spikes by blunting post-meal glycemic response and enhancing satiety (which prevents overeating). Protein should make up roughly 10 to 35% of your total daily calorie intake; a good guideline is to fill ¼ of your plate with protein. Choose lean proteins like plant proteins, pork loin, lean beef, skinless chicken breast, and white fish. These have the highest protein but the lowest saturated fat and calorie content.

  • Consume more vegetables and fruits: Vegetables and fruits provide fiber, which helps slow the breakdown and absorption of carbohydrates into your bloodstream. It also boosts satiety. Try to fill half your plate with vegetables and fruits.

  • Limit highly processed foods: Highly processed foods are jam-packed with blood-sugar-hiking refined sugar, unhealthy saturated fats, and salt. According to a new 2022 animal study by scientists at Nanyang Technological University (NTU) Singapore’s Lee Kong Chian School of Medicine, saturated fat could worsen diabetes. On the other hand, an excessive intake of salt could raise blood pressure—significantly raising your risk of having a heart attack or stroke.

More helpful diet tips for semaglutide (Ozempic/Rybelsus)

Other than specific types of food to eat and avoid while taking semaglutide (Ozempic/Rybelsus), are there any other diet-related tips you should note? Well, yes:

  • Do not overeat and when you eat, take smaller meals: Once again, semaglutide slows down the digestive process. So, limiting the amount of food you take in any one single meal could prevent you from running into uncomfortable gastrointestinal symptoms like bloating and indigestion. Break up your meals into smaller, “mini-meals” and spread your intake over the day if needed. 

  • Stay well-hydrated: Since your small and large intestines help absorb water from your food, the longer gastric emptying takes, the "drier" the resulting solid waste will be. Dry, hard stools are difficult to pass. So, to prevent constipation while taking semaglutide, take plenty of fluids. While fluid requirements vary among individuals based on factors like age, sex, and activity level, a general guideline is to get in 30 mL of fluids per kilogram of body weight (i.e., 30 mL/kg bodyweight or roughly 0.5 oz/lbs bodyweight). 

  • Wait for at least three to four hours after meals before lying down: Lying down when your stomach is still full could cause reflux and indigestion.

  • Take Rybelsus on an empty stomach when you first wake up: Remember how Rybelsus is an oral medication? Yep. That means you should give Rybelsus at least 30 minutes to "kick in" before eating, drinking, or taking other oral medications. Note: this doesn't apply to Ozempic, which is injected into your body.

Don’t let other healthy habits slide just because you’re on semaglutide (Ozempic/Rybelsus)

Semaglutide paired with a healthy diet can help you better manage diabetes. That said, you shouldn’t stop there. The following healthy lifestyle habits could also improve the effectiveness of semaglutide (Ozempic/Rybelsus) in controlling your blood sugar levels: