Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are medications commonly prescribed for treating diabetes and supporting weight loss. Drugs in this class include semaglutide (Ozempic, Rybelsus, Wegovy), liraglutide (Saxenda, Victoza), dulaglutide (Trulicity), and tirzepatide (Mounjaro).

While these medications are generally safe and effective, some people may experience side effects. Fortunately, most of these side effects are manageable, and severe reactions are rare. Knowing what to expect and how to minimize discomfort can help you continue your treatment successfully.

Common Side Effects of GLP-1 RAs

The most frequently reported side effects include:

• Nausea and vomiting

• Abdominal pain

• Indigestion or heartburn

• Constipation or diarrhea

• Weakness during exercise

• Headaches

While these symptoms may be unpleasant, they are generally not dangerous.

How Common Are Side Effects?

Digestive side effects are quite common with GLP-1 RAs, with studies showing that at least 20% of users experience them. In some cases, over 50% of patients report gastrointestinal issues when starting these medications. This is because GLP-1 RAs slow down digestion, keeping the stomach full longer to aid in weight loss but sometimes causing bloating, nausea, and discomfort. The intestines also move more slowly, leading to constipation in some people.

Weakness during exercise can result from how GLP-1 RAs reduce glucose release from the liver, leaving muscles with less fuel during physical activity.

Managing Side Effects

Most side effects from GLP-1 RAs lessen over time as your body adjusts. Here are some strategies to minimize discomfort:

• Start low and go slow. Side effects are often dose-dependent, meaning they are more likely to occur at higher doses. Starting with a low dose and gradually increasing it allows your body time to adjust. At NOVI Health, we always begin with the lowest dose and slowly build up over weeks to minimize side effects.

• Lifestyle adjustments

• Eat smaller, more frequent meals to prevent feelings of fullness and bloating.

• Avoid high-fat and oily foods, as they can worsen nausea and indigestion.

• Stay hydrated to combat constipation.

• Remain upright after meals to reduce heartburn and indigestion.

• If you experience exercise-related weakness, eat a small carbohydrate-rich snack before working out to give your muscles the energy they need.

If your side effects persist or worsen, reach out to your healthcare team. They can offer additional support and may adjust your treatment plan to help you feel more comfortable.

Serious Side Effects: When to Seek Medical Help

Studies of people taking GLP-1 RAs for several years have revealed no major safety concerns, and these are considered to be very safe medications. Although serious side effects are rare, it's essential to be aware of potential risks. If you experience any of the following, seek medical attention immediately:

• Low Blood Sugar (Hypoglycemia). Especially if taking GLP-1 RAs with other diabetes medications like insulin. Symptoms include shaking, sweating, dizziness, and confusion. If your blood sugar drops, take glucose tablets, juice, or soda to raise it.

• Pancreatitis. Symptoms include severe abdominal pain, vomiting, rapid heart rate, and fever. This is a medical emergency, and immediate care is needed. Some studies have shown that GLP-1 RAs don’t cause an increase in the risk of pancreatitis, while other studies have shown a very small increase in risk. 

• Gallbladder Disease. Pain in the upper abdomen, pale stools, dark urine, and jaundice (yellowing of the skin) could indicate a gallbladder issue.

• Acute Kidney Injury. Watch for reduced urine output, changes in urine color, swelling in your legs, or pain in your back. Seek medical attention if these symptoms arise. Not all studies have shown this effect, but some studies have indicated that it can occur.

• Allergic Reactions. Anaphylaxis can occur in rare cases. Symptoms include difficulty breathing, swelling of the face or throat, and hives. This requires immediate medical attention. Milder allergic reactions, such as redness or itching at the injection site, should also be reported.

Different GLP-1 RAs and Side Effects

Most GLP-1 RAs share similar side effects, though some differences exist. For instance, the oral form of semaglutide (Rybelsus) may cause more digestive side effects than injectable forms. However, these side effects typically lessen as your body adjusts to the medication.

GLP-1 RAs are effective, but they work best when used along with healthy lifestyle changes, like diet and exercise. 

When seeking healthcare providers, prioritize those who take the time to understand your unique health status and tailor dosages specifically to your individual needs. Look for a holistic care team that includes doctors, dieticians, and health coaches who will continuously monitor your progress. This collaborative approach ensures that every aspect of your well-being is addressed. Choose providers who emphasize personalized lifestyle changes, helping you adjust to your medication while minimizing or avoiding side effects. 

Our NOVI Optimum Plus medical weight loss program includes:

• GLP-1 RA medication such as semaglutide

• Guidance from a doctor who’s specialized in weight management

• Digital diet and fitness coaching 

Clients in our NOVI Optimum Plus medical weight loss program are guided by our team and are encouraged to tell us about their discomfort, if there’s any.