GLP-1s Part 4: Side effects and how to manage them

Key Takeaways

• Side effects are common with all medications, including GLP-1s.
• The most common side effects include nausea, constipation, and loss of appetite.
• Eating smaller portions, avoiding high-fat and high-sugar foods, consuming cold foods instead of hot foods can all help decrease nausea.
• Ensuring adequate fiber intake or adding fiber supplements or stool softeners can help with constipation.
• You should eat intentionally, even if you aren’t very hungry. Inadequate food consumption can result in nutrient deficiencies, low energy, decreased mood, decreases in muscle mass, rapid weight loss, and hair loss.
• Talk to your registered dietitian or nutritionist for help managing side effects.

We’ve come to the fourth and final part of our GLP-1 series. 

In part one of this series, Dr. Laura Davisson, director of the WVU Medicine Medical Weight Management Clinic in Morgantown, discussed the differences between the various GLP-1s on the market and how to know which one is right for you. 

In part two, she talked about the safety of using an online retailer. 

In part three, I gave you tips on how to use diet and exercise to maximize the results of your weight loss from taking GLP-1s, as well as how to manage the return of cravings. 

For our last blog, we’re going to talk about the side effects that accompany GLP-1 usage and how to manage them. 

Anyone who has ever seen a television commercial knows that all drugs carry a risk of some sort of side effects, which can range from mild to emergent. 

Not everyone experiences side effects but managing them can be a challenge. 

Let’s talk about the most common side effects GLP-1 users experience and what to do when they arise. 

Nausea and vomiting 

Nausea, often the day of and maybe the day after your injection for the week, is probably one of the most common things we see. 

Usually, eating smaller portions – half to two-thirds of your normal portion – can help. Avoiding a lot of high fat and high sugar foods can help with nausea, too. 

Cold foods might be tolerated better than hot foods. Liquids are sometimes tolerated better than solids, so using something like a smoothie or a protein shake to sip on might be helpful.  

Make sure you are not lying down on a full stomach before you go to bed. You also may want to try drinking some ginger or peppermint tea to help settle your stomach. 

If you make these adjustments at the beginning of the week, the nausea normally dissipates by the middle of the week and definitely by the end of the week. 

If for some reason the nausea remains persistent, we recommend you talk to your doctor. You may need to do take anti-nausea medication, at least for a little while, until your body gets used to it.  

Vomiting can be a side effect, though many times it may be due to the way you are eating.  

For example, eating too large a portion or eating too fast can lead to vomiting. You need to be sure to listen to your body, slow down, and stop eating when you feel satisfied.   

Also eating high-fat or high-sugar meals may not sit well with you at all. This can lead to vomiting in some people.  

When our patients present with vomiting, we always discuss what they’ve been eating, and whether they’ve been managing their intake properly to make sure vomiting isn’t related to a more serious cause. 

Constipation 

Constipation is one of the other most common side effects we see, and it can happen for a lot of reasons.  

With these medications, digestion does slow down just a little bit, and we’re not eating as much. We need to focus on making sure people are getting adequate fiber and fluids in their diet. 

If we’ve got enough fiber, and we’re well hydrated, exercise can help with constipation as well.  

All three of those things can be very helpful, but if for some reason you still have persistent constipation, you can talk to your doctor about starting a regular regimen of things like stool softeners to help keep you regular. 

Poor appetite 

The last, but not least, side effect of these medications is poor appetite. This is probably one of the biggest worries for your registered dietitian. 

Often on the day of your injection or the day after, your appetite just really isn’t there. You may notice just a big decline in your appetite overall with the use of these medications. And even though you might not be hungry, you still need to eat. 

Adequate nutrition becomes a big challenge because you’re just not as hungry, and you’re eating a lot less.  

If you are skipping meals and not eating much, you can set yourself up for a higher risk of nutrient deficiencies, low energy, decreased mood, decrease in muscle mass, rapid weight loss, and hair loss. 

There are a lot of things that accompany a general decrease in appetite and intake.  

It’s very important that you work with your registered dietitian to make sure you have an optimal plan, that you’re eating intentionally for nutrition, and that you’re getting your three meals a day. 

If you are at the point where you really don’t want to eat at all, or you have no desire to eat, then you need to talk to us because we can probably make some adjustments in your nutrition plan or medication dose to help improve that. 

The benefits of a comprehensive program 

Making and maintaining lifelong lifestyle changes to your diet and exercise can be daunting. Adding medication side effects can make it more difficult. But you don’t have to figure it out alone.  

At WVU Medicine Medical Weight Management, we offer a non-surgical, individualized program that addresses the physical, behavioral, and medical causes of obesity. It combines nutrition counseling, exercise planning, behavior change support, and medical management delivered by a multidisciplinary team. 

Let our team be your team. 

For more information, visit WVUMedicine.org/WeightMgmt.