Semaglutide Side Effects: What to Know

Key takeaways:

• Common semaglutide side effects include nausea, vomiting, diarrhea, and constipation. These should get better with time.

• Avoid fatty and greasy foods, and eat smaller meals to minimize gastrointestinal side effects.

• Rare side effects are fatigue, hair loss, and issues with the pancreas and gallbladder.

Semaglutide is the active ingredient in Ozempic^®, which is approved by the Food and Drug Administration (FDA) to help people with type 2 diabetes manage their blood sugar levels. Healthcare providers sometimes prescribe Ozempic^® off-label for weight loss.

Semaglutide is also the active ingredient in Wegovy^®, which is FDA-approved for weight loss and long-term weight management in those with obesity or overweight.

Like any drug, semaglutide comes with potential side effects. The most common are gastrointestinal issues, and these typically get better with time as your body adjusts.

Our guide to semaglutide side effects covers the most common side effects of semaglutide, rare issues, and what you can do to minimize your odds of side effects cropping up in the first place.

The most common semaglutide side effects are gastrointestinal issues, like:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Abdominal pain

These side effects are mostly mild to moderate in severity, and they usually get better with time.

Semaglutide Nausea

Nausea is the most common side effect of semaglutide.

In clinical trials on Ozempic^®, nausea was reported in about 20 percent of people taking a 1-milligram (mg) dose.

The higher the dose, the more likely you are to experience nausea. In Wegovy^® clinical trials, 44 percent of people reported nausea — participants were taking a 2.4-mg dose in this case.

Why Does Semaglutide Cause Nausea?

Semaglutide may cause nausea because it slows how quickly food moves from the stomach to the intestines (gastric emptying). This helps you feel fuller, but it can also make you feel nauseous and bloated, especially if you overeat.

How to Minimize Semaglutide Nausea

You can minimize semaglutide nausea by:

• Eating smaller meals more regularly

• Avoiding fatty, greasy, and fried foods

• Drinking enough water (but avoiding drinks 30 to 60 minutes before and after eating)

• Taking prescription anti-nausea medications like ondansetron (Zofran^®)

Ask your provider about anti-nausea medication if you need relief.

→ Read: Semaglutide Nausea

Semaglutide Diarrhea

You might experience diarrhea on semaglutide. Research shows that about 9 percent of people taking Ozempic^® report it, and 30 percent of those taking Wegovy^® report it.

Semaglutide may cause diarrhea because the medication can change how food moves through the digestive system and how the body absorbs fatty compounds (lipids) and sugar (glucose).

You can treat semaglutide diarrhea by:

• Replenishing lost fluids by drinking plenty of water

• Avoiding dairy, coffee, alcohol, and carbonated drinks

• Eating foods that are easy to digest, like chicken, rice, carrots, and peeled fruit

• Taking over-the-counter (OTC) medications like loperamide (Imodium^®)

→ Learn more: GLP-1 Nausea Treatments: How to Stop Feeling Sick

Semaglutide Constipation

On the flip side of diarrhea, constipation is also common with semaglutide.

In trials on Ozempic^®, 5 percent of people reported constipation. About 24 percent of participants in Wegovy^® trials reported it.

Semaglutide may cause constipation because it can slow the movement of food through the digestive system and increase water absorption.

Since semaglutide makes you feel fuller, you might also eat less fiber and drink less water — both of which can contribute to constipation.

To treat semaglutide constipation:

• Get more fiber by eating foods like fruits, veggies, brown rice, beans, and lentils

• Drink more water

• Do more physical activity

• Take OTC stool softeners

→ Read next: What Are the Best Supplements for Bloating and Weight Loss?

Semaglutide side effects tend to crop up when you first start taking the medication and when your dose increases. (Doses typically increase every four weeks.)

Novo Nordisk is the manufacturer of the semaglutide injections Ozempic^® and Wegovy^®, as well as the oral semaglutide drug Rybelsus^®. Novo Nordisk-sponsored research found that semaglutide side effects tend to happen in the first eight to 12 weeks with Ozempic^® and Rybelsus^®.

Here are a few more findings from Novo Nordisk-sponsored research:

• Nausea might last up to eight days on Ozempic^® and Wegovy^®.

• Diarrhea may last about three days on Wegovy^®.

• Constipation might last an average of 47 days on Wegovy^®.

Losing weight can lead to many improvements in your health and well-being. But weight loss itself can also cause a few unwanted side effects, including:

• Fatigue

• “Semaglutide face”

• Muscle loss

Keep scrolling for details.

Semaglutide Fatigue

Does semaglutide make you tired? It can. In Wegovy^® clinical trials, 11 percent of people reported fatigue.

You might feel tired because you’re eating fewer calories, exercising more, or experiencing dehydration due to side effects like vomiting and diarrhea.

To get more energy while taking semaglutide, try:

• Improving your sleep quality by cutting down on caffeine and keeping a consistent sleep schedule

• Doing regular physical activity and taking rest days

• Eating a variety of whole foods, including fruits, veggies, healthy fats, and lean proteins

• Drinking enough water

→ Get some rest: Sleep Hygiene Tips

“Semaglutide Face”

“Semaglutide face” or “Ozempic^® face” are terms used to describe the fat and muscle loss that can happen in the face with rapid or substantial weight loss.

Losing fat and muscle in your face can change your appearance slightly or lead to sagging skin and more visible fine lines. This can happen with any type of weight loss — whether semaglutide is involved or not.

Losing weight gradually and eating plenty of protein can help you avoid muscle loss. And you might find that your skin naturally retracts as you maintain your new weight.

Semaglutide Muscle Loss

There’s a risk you’ll lose some muscle as you lose body fat. Again, this can happen with any type of weight loss, whether you’re using semaglutide or not.

To avoid muscle loss:

• Eat plenty of protein. Go for lean protein sources like chicken, turkey, fish, eggs, and tofu.

• Strength train. Do bodyweight exercises, use dumbbells, or get on the resistance machines at the gym. Aim for at least two strength-training sessions a week.

• Make the most of tools in the Hims app. When you access weight loss medication through Hims, you’ll get access to the Hims app. The mobile app includes personalized protein recommendations, protein and workout trackers, and high-protein recipes developed by nutritionists.

You can also purchase doctor-recommended meal-replacement bars and shakes. These contain up to 27 grams of protein per serving — ideal for topping up your protein intake on busy days.

→ Get your daily goal: Hims Protein Calculator for Weight Loss and Muscle Gain

Hair loss may be a rare side effect of semaglutide. Participants in Ozempic^® clinical trials didn’t report hair loss, but 3 percent of people in Wegovy^® trials reported it. There are also anecdotal reports online of semaglutide hair loss.

It’s not clear how semaglutide might affect your hairline. One theory is that the medication could disrupt the natural hair growth cycle. But there are also theories that semaglutide could improve hair health, so more research is needed.

Hair loss could also come down to stress, aging, or rapid weight loss.

If you’re experiencing hair loss, reach out to your Care Team through the Hims app. A range of hair loss treatments available through Hims can help.

Treatments include:

• Hair loss medications like minoxidil or finasteride

• Supplements like biotin

• Reducing stress levels

• Eating a variety of nutrients, including enough protein

→ Read: Diffuse Thinning: What It Is and How to Treat It

Currently, there’s no evidence suggesting that semaglutide negatively affects fertility. In fact, it may even improve fertility. How so? Obesity can negatively impact male fertility, and semaglutide can help you reach a healthy weight.

More research is needed on this front, though.

There are some potential long-term, serious side effects of semaglutide. Although rare, they’re worth knowing about so you know what to watch for.

For example, the long-term side effects of Wegovy^® might include:

• Inflammation of the pancreas (pancreatitis)

• Gallbladder problems like gallstones and gallbladder disease

• Acute kidney injury — when the kidneys stop working properly

• Mental health issues

• Low blood sugar (hypoglycemia) when used with certain diabetes medications

• Complications with an eye condition called diabetic retinopathy in people with type 2 diabetes

There’s also a boxed warning from the FDA stating that semaglutide causes thyroid tumors in rodents. So far, research suggests semaglutide isn’t linked to an increased risk of cancer in humans, including thyroid cancer.

For many people, the health benefits of losing weight and treating obesity outweigh any potential long-term adverse events. But a healthcare professional can look at your current health and medical history to determine if semaglutide is safe for you to take long-term.

→ Learn more: Long-Term Effects of Wegovy^®

Semaglutide was originally a diabetes medication, meaning it’s designed for long-term use — or even life-long use.

How long to stay on semaglutide for weight loss depends on:

• Your goals

• How well you’re tolerating the medication

• Whether you develop any new health conditions

• Your overall health

You might be able to stay on semaglutide to help maintain weight loss in the long run. A healthcare provider can give you personalized medical advice to help you decide if staying on semaglutide is the best choice.

Some foods can make the gastrointestinal side effects of semaglutide worse.

To minimize side effects, limit or avoid:

• Spicy foods

• Fatty foods

• Fried foods

• Sugary foods and drinks

• Acidic foods like tomatoes and citrus fruits

• Garlic and onions

Bland foods may help when side effects like nausea crop up. Try rice, applesauce, plain toast, tofu, and cooked vegetables like carrots and spinach.

Not sure what’s triggering side effects? Keep a food diary to track patterns. Of course, if nutritious foods like tomatoes and onions don’t trigger side effects for you, you can keep on eating them.

As for what to eat on semaglutide, prioritize whole foods, and aim to get a variety of nutrients. Go for:

• Fruits and veggies

• Lean proteins, like chicken, fish, and tofu

• Low-fat dairy products

• Legumes, including lentils, chickpeas, and beans

• Whole grains, like brown rice, quinoa, whole-wheat bread, and oatmeal

→ Learn more: GLP-1 Diet Plan

Semaglutide and Alcohol

You can technically drink alcohol on semaglutide. But if you drink regularly (or excessively), you might find it harder to stick to healthy habits. Alcohol can slow weight loss, and it may make semaglutide side effects worse.

Consider drinking alcohol in moderation now and again, or cutting it out altogether.

It can be daunting looking at the side effects of any medication. But know that semaglutide side effects are usually very manageable.

Here are the key facts one more time:

• Semaglutide side effects are mostly gastrointestinal. You might experience nausea, vomiting, diarrhea, or stomach pain, particularly at the start of treatment and with dose increases.

• Side effects should improve with time. As your body adjusts, you may feel better and better. If you don't, contact your prescribing healthcare provider. They may recommend lowering your dose of semaglutide.

• The health benefits may outweigh the risks. A healthcare provider can help you with this one. But for many people, the health benefits of losing weight outweigh the potential long-term risks of semaglutide.

If you get weight loss medication through Hims, remember you have unlimited access to your Care Team. You can reach out about concerning side effects and get tweaks to your treatment plan to help you feel better, if needed.

Still looking into your options? Take our free online weight loss assessment to see which weight loss medication could work best for you.

Get answers to frequently asked questions about semaglutide side effects below.

What happens if you stop taking semaglutide?

If you stop taking semaglutide, your hunger levels will gradually return to what they were before you started the medication. This can lead to weight regain if you don’t compensate with lifestyle changes.

What are the dangers of semaglutide?

The dangers of semaglutide include pancreas, gallbladder, and kidney problems. These possible adverse effects are rare, though. A healthcare provider can determine if semaglutide is safe for you personally.

How to minimize semaglutide side effects?

You can minimize semaglutide side effects by eating smaller meals more often, avoiding fatty and greasy foods, and staying hydrated.