What to do about Ozempic constipation

In this article:

• Does Ozempic cause constipation?
• Why does Ozempic cause constipation?
• Ozempic constipation treatment
• How to avoid constipation on Ozempic
• Bottom line

In this article

• Does Ozempic cause constipation?
• Why does Ozempic cause constipation?
• Ozempic constipation treatment
• How to avoid constipation on Ozempic
• Bottom line

Ozempic (active ingredient semaglutide) is a prescription medication manufactured by Novo Nordisk that is FDA approved to improve glycemic control in adults with Type 2 diabetes. It’s also commonly prescribed off-label as a weight loss drug. Like Wegovy and Trulicity, Ozempic belongs to a class of drugs known as glucagon-like peptide-1 agonists, or GLP-1 receptor agonists. These medications reduce blood sugar levels and can assist with weight management by regulating food intake and slowing gastric emptying.

While it’s common to have a decreased appetite on Ozempic, that’s not the only side effect you may experience. For example, Ozempic can cause constipation, changes in bowel movements, bloating, and stomach pain. If using Ozempic makes it hard to “go,” check out these expert tips to get things moving.

Does Ozempic cause constipation?

According to placebo-controlled clinical trials, about 26% to 32% of individuals treated with Ozempic experienced gastrointestinal side effects, such as nausea, vomiting, diarrhea, abdominal pain, and constipation. Most of these symptoms increased with higher doses of Ozempic—except for constipation. Among patients taking a 0.5 mg dose of Ozempic, 5% reported constipation versus 3.1% of those taking a 1.0 mg dose.

A 2022 research review found that constipation may occur in up to 13.0% of those taking Ozempic. What’s more, the symptom may be more common among those taking the drug for off-label uses not approved by the U.S. Food and Drug Administration.

According to Jonathan Kaplan, MD, a board-certified plastic surgeon and GLP-1 expert at Pacific Heights Plastic Surgery in San Francisco, while constipation is not the most common side effect of Ozempic, some patients may experience less frequent bowel movements than usual while on the medication.

How long does Ozempic constipation last? That depends on how long it takes for your body to adjust to the medication, says Carmen Fong, MD, a double board-certified general and colorectal surgeon and author of Constipation Nation. While constipation generally resolves in as little as a few days or up to six weeks, Dr. Fong notes that in some of her patients, constipation has lasted for months (usually worsened or prolonged by poor eating habits).

Rare, but serious side effects include:

• Pancreatitis (inflammation of the pancreas)
• Diabetic retinopathy complications
• Hypoglycemia (low blood sugar)
• Acute kidney injury
• Serious allergic reactions
• Acute gallbladder disease
• Thyroid cancer

Although rare, adverse events like severe gastroparesis (stomach paralysis) and bowel obstruction are possible when taking GLP-1 medications, whether for diabetes or weight loss.

RELATED: How long does constipation last?

Why does Ozempic cause constipation?

Constipation from Ozempic may be attributed to several factors. For example, the medication can lead to decreased fluid and fiber intake due to changes in appetite and food preferences. Another reason is delayed gastric emptying, Dr. Kaplan points out. He explains that while Ozempic’s primary action is to stimulate insulin secretion and lower glucagon secretion, it also has a secondary effect of slowing digestion.

“This means food stays in the stomach longer than usual, allowing for more water to be absorbed from the food, leading to harder, drier stools that are difficult to pass, contributing to constipation,” Dr. Kaplan says.

RELATED: What will make you poop fast?

Ozempic constipation treatment

To relieve constipation caused by Ozempic, our experts recommend the following strategies:

1. Drink up

Dr. Kaplan recommends increasing fluid intake to soften stools and promote easier bowel movements. Penn State College of Medicine researchers recommend drinking at least eight 8-ounce glasses of liquids per day. In addition to water, you can try prune juice, fruit juices, and herbal tea—hot beverages may stimulate your colon to produce a bowel movement.

2. Eat more fiber

“Fiber adds bulk to the stool, aiding its passage through the digestive tract,” notes Dr. Kaplan. He suggests incorporating fiber-rich foods like fruits, vegetables, and whole grains into your diet to help get things moving. Increase your fiber intake gradually until you get up to 25 to 30 grams daily for women and 30 to 38 grams for men. Just be aware that high-fiber foods do tend to take longer to digest, which may increase upper GI symptoms such as nausea and bloating.

3. Get moving

Regular physical activity increases GI motility, relieving constipation, says Dr. Fong. Aim for at least 30 minutes of moderate exercise most days of the week, such as walking, cycling, or swimming.

4. Try an OTC medication

If diet and exercise aren’t helping, over-the-counter laxatives may help. Dr. Kaplan says that stool softeners like Colace work by drawing water into the stool, making it softer, and are generally safe for long-term use. You can also try osmotic laxatives such as MiraLAX, which draw water into the colon to stimulate bowel movements and are safe for occasional use. Just be sure to check with your healthcare provider before using laxatives long-term or taking a stimulant laxative like Dulcolax or Senna.

5. Establish a regular bathroom routine

When it comes to bowel movements, it pays to become a creature of habit. Set aside time each day to use the bathroom, ideally 20 to 40 minutes after a meal, when the digestive system is most active. This routine can help train your body to respond more effectively. Dr. Fong emphasizes going when you have to go rather than ignoring your body’s signals and holding it in.

6. Avoid certain foods

In addition to eating the right foods, you want to avoid the wrong ones. For example, high-fat meats, eggs, dairy products, processed foods, and sweets can contribute to constipation. Focus on a balanced diet rich in whole foods to support your diabetes management or weight-loss goals.

7. Take a probiotic supplement

Probiotics can help maintain gut health and regularity, and recent clinical trials show they can achieve significant results when it comes to constipation relief. Consider taking a daily probiotic supplement or consuming fermented foods like yogurt and kefir to support your microbiome and promote healthy digestion.

8. Speak to your provider

Dr. Kaplan advises consulting a healthcare professional about dosage adjustments or potential drug interactions that may contribute to constipation—they can help determine the best course of action. Fong adds that higher Ozempic doses are more likely to cause diarrhea while lower doses are more likely to cause constipation, however, different people may react differently to Ozempic and the other GLP-1 receptor agonists.

RELATED: 7 foods to avoid when constipated

How to avoid constipation on Ozempic

To minimize constipation on Ozmepic, the following lifestyle modifications may help:

• Stay hydrated by drinking plenty of water.
• Maintain a regular exercise routine.
• Make sure you’re getting enough fiber in your diet.
• Limit processed foods, red meat, and dairy products.
• Establish a consistent bathroom routine.

Bottom line

Gastrointestinal side effects from Ozempic, including constipation, can last from days to weeks. These side effects are often mild and tend to worsen with increasing Ozempic doses. However, some people may experience more severe symptoms. “If you experience prolonged vomiting lasting more than a day or two, or inability to keep down fluids, seek immediate medical advice as these could indicate serious conditions like pancreatitis or other gastrointestinal issues,” urges Dr. Kaplan.