Semaglutide, known by various brand names, is a groundbreaking medication used in the treatment of type 2 diabetes (and obesity off-label). Developed by Novo Nordisk, a leading pharmaceutical company, semaglutide belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists.

Initially approved by the U.S. Food and Drug Administration (FDA) in December 2017, semaglutide has quickly gained recognition for its efficacy in controlling blood sugar levels and for aiding in weight management for individuals with type 2 diabetes. Its popularity stems from its unique mechanism of action, which mimics the effects of a naturally occurring hormone called GLP-1.

Can Semaglutide Cause Constipation?

Yes, semaglutide can cause constipation, and it's quite common. In studies, about 3% to 5% of people experienced constipation while taking semaglutide. Higher doses were correlated with higher rates of constipation, while lower doses saw fewer cases of side effects. Recent research suggests this could be even higher, ranging from 4% to 12%, again proportionate with dosages. But here's the good news: constipation occurs less frequently than other digestive side effects. Only about 4% of people with gut-related side effects discontinue semaglutide, which indicates that while these side effects can be bothersome, they're usually not severe.

Other common side effects include:

• Nausea
• Vomiting
• Diarrhea
• Heartburn
• Stomach pain

However, as mentioned, most side effects of semaglutide are mild in nature and tolerable.

Why Does Semaglutide Lead to Constipation?

Research indicates it relates to its impact on the digestive system through several avenues.

Semaglutide works by slowing down the rate at which the stomach empties, resulting in individuals feeling full for longer periods and eating less. This can also decrease fluid intake throughout the day, potentially causing constipation by making stools harder and more difficult to pass. Being more mindful of hydration can help mitigate unwanted side effects.

Additionally, people taking semaglutide may consume less fiber due to feeling full, and because fiber can exacerbate other side effects like nausea, gas, and bloating associated with semaglutide, they might avoid it even more. However, insufficient fiber intake is a significant contributor to constipation. Fiber adds bulk to stool, facilitating easier passage. Without enough fiber, stool becomes hard and less likely to pass. Choosing foods high in fiber can help, such as avocados, oats, and beans.

Furthermore, semaglutide stimulates the body to produce more insulin, which effectively manages blood sugar levels but also slows down gut motility, leading to less frequent bowel movements. In combination, these factors can result in infrequent, hard, and painful stools for individuals taking semaglutide.

What Can I Do if I Have Side Effects?

Fortunately, there are several small habitual changes that can help alleviate constipation. Here are some things to try:

1. Drink more water! A general rule of thumb is 1 ounce of water per 2 pounds of body weight. For someone weighing 200 pounds, this would mean 100 ounces of water per day. Exercising would require more.
2. Get some exercise. Even as little as 10 minutes of exercise a day can be enough to help bowel movements.
3. Eat more fiber with foods like fruits, vegetables, and whole grains.
4. Try to go to the bathroom at the same time every day. Simple conditioning can help your gut get into a good rhythm.
5. Use a toilet stool for your feet (also known as a squatty potty), which can make having a bowel movement easier.

Talking to Your Provider

As always, any serious concerns should be directed to your healthcare provider. Do not hesitate to ask questions or seek advice! If you are already on a program with MD Exam, you can always reach out to us in the Patient Portal. If you are not, consider taking our 5-minute quiz or reaching out to your own physician. We offer semaglutide and tirzepatide at as little as $225 a month and provide a holistic approach to weight management.

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