Medical Review by Jennie Stanford, MD, FAAFP, DABOM
Summary:
- Constipation is a common side effect of Ozempic®. It can lead to bloating and discomfort.
- Dietary modifications, such as increasing fiber intake, staying hydrated, and consuming warm liquids can help alleviate symptoms—but excessive fiber intake without enough water can make constipation worse.
- Regular exercise can stimulate digestion and ease constipation. Managing stress through meditation or cognitive behavioral therapy may also help, as stress can negatively impact bowel function.
- If diet and exercise aren’t enough, stool softeners, laxatives, or probiotics may provide relief. Stimulant laxatives should only be used short-term to avoid potential health risks.
- If constipation persists despite lifestyle changes or comes with severe symptoms, like vomiting, fever, unexplained weight loss, blood in stool, or intense abdominal pain, consult a healthcare provider to rule out complications.
Starting Ozempic® can be exciting—but experiencing side effects, such as constipation, can make the process a little uncomfortable. From lifestyle changes and dietary adjustments, to using over-the-counter remedies, there are options to manage constipation so you can pivot your focus back on achieving your weight loss goals.
We’re here to give you insights on how you can best relieve constipation linked to Ozempic® use. From knowing what to expect, to understanding the warning signs for more serious cases, the team at Lemonaid is here to support you with a helpful guide on how to navigate constipation when using this medication.
How common is Ozempic®-induced constipation?
Constipation is a common digestive issue associated with difficult, infrequent, or even painful bowel movements. Constipation can make it hard to go about your normal day-to-day activities, with symptoms of bloating and discomfort that can leave you feeling frustrated, irritable, and embarrassed.
Ozempic® (a branded form of semaglutide) is a GLP-1 receptor agonist, primarily used in the treatment of type 2 diabetes and sometimes prescribed off-label for weight loss in clinically indicated cases. Due to its effect on digestion, Ozempic® can cause constipation.
In fact, constipation is one of the most frequently reported side effects of Ozempic®, along with nausea, diarrhea, and vomiting. However, most gastrointestinal side effects are mild to moderate in severity and won’t require you to stop taking Ozempic®.
According to trials of Ozempic®, constipation occurs in 4–12% of cases but can reach up to 25–35% in people with obesity. Constipation generally starts in the first 28 days and within the first 16 weeks of starting treatment. It can last longer than other gastrointestinal side effects, with a typical duration of 47 days.
How Ozempic® causes constipation
As a GLP-1 receptor agonist, Ozempic® acts by helping to control blood sugar levels and regulate metabolism. One of the ways in which it does this is by slowing gastric emptying, which means your bowel movements might become more difficult or less frequent. This can also come with bloating or discomfort.
Since people taking Ozempic® can also experience a reduced appetite, they may eat less food and drink less water—which can further contribute to the issue. While the occasional bout of constipation is normal, you should speak to your healthcare provider right away if it becomes persistent.
How dietary modifications can help
There are several changes you can make to your diet and lifestyle that may help ease the overall symptoms of gastrointestinal side effects that often occur when starting Ozempic®.
Learn more: What to expect when starting Ozempic®
When it comes to general eating advice, you can improve your eating habits by eating slowly, only when you’re truly hungry, and in smaller portions while avoiding distractions. Eating more often and stopping at the first signs of feeling full can also help make these side effects less disruptive.
Eating a high-fiber diet
To further ease the symptoms of constipation that occur while taking Ozempic®, be sure to get adequate fiber in your diet. Increasing your dietary fiber can work to increase your stool frequency, which can make constipation less of a problem. Here are some examples of what to eat on a high-fiber diet:
- Fiber: Found in fruits (apples, pears, berries), vegetables (broccoli, carrots, sweet potatoes), legumes (lentils, chickpeas, black beans), nuts, seeds (chia, flaxseeds), and whole grains (oats, brown rice, quinoa).
- Cellulose: Commonly found in leafy greens, celery, nuts, seeds, and the skins of fruits and vegetables.
- Plant Extracts: Naturally present in teas (green tea, chamomile), herbs (mint, rosemary), and spices (turmeric, cinnamon).
- Cereals: Including oats, wheat, barley, rye, and corn-based products like cornflakes and whole grain cereals.
- Bran: Found in wheat bran, oat bran, rice bran, and bran-based cereals.
- Psyllium (Plantago husk): Found in psyllium husk supplements, high-fiber cereals, and some fiber-enriched foods.
It is important to maintain a balance with dietary fiber, as too much can actually have the opposite desired effect and make you even more constipated.
Getting adequate hydration
As taking Ozempic® can make it more difficult to drink enough water, it is important to stay on top of your hydration in order to lower your risk of constipation. Drinking generous amounts of water and other sugar-free liquids can help.
In addition to water, you can also try:
- Coffee: It’s no secret that coffee can cause bowel movements. There is evidence showing that coffee stimulates the colon 60% more than water alone, and 23% more than decaffeinated coffee.
- Warm water: One study showed in a group of people recovering from surgery that people who drank warm water started passing gas sooner than those who did not.
Lifestyle changes to combat constipation
In addition to dietary modifications, here are some lifestyle changes you may want to consider when starting Ozempic®:
Regular exercise
While the exact reasons why are still unclear, exercise seems to stimulate your gut by speeding up digestion and keeping everything flowing smoothly. That means increasing your physical activity can help with symptoms of constipation.
Aerobic exercise, such as walking and physical movement, has been shown to have a positive effect on constipation. It may come down to simple mechanics—bouncing, gravity, and core muscle contractions can all help speed this process along.
Stress management techniques
Believe it or not, stress plays a role in bowel function. When you’re feeling stressed, your body releases hormones that can sometimes lead to occasional constipation. Stress can also alter your daily routines, leading you to skip sleep, opt for unhealthy food options, or skip a workout, undoing all the good habits you had put in place.
Some forms of therapy, including biofeedback and cognitive behavioral therapy, can help. They may be particularly useful at easing constipation when stress or anxiety has made your symptoms worse.
Over-the-counter remedies
If you’re looking for relief from constipation, and diet and exercise haven’t moved things along, there may be other options. Check with your pharmacist and healthcare professional to see which of the methods below might work best for your symptoms.
Stool softeners
Stool softeners are a gentle, preventative option that works by increasing the water in your stool, making it softer and easier to pass.
- Colace® (Docusate Sodium) is a stimulant-free stool softener, with no harsh side effects. It works differently from harsh laxatives and is even recommended for use during pregnancy and for those recovering from surgery.
Osmotic laxatives
Typically used as a first step in the treatment of constipation, osmotic laxatives draw water from the body into your bowel to soften stool, making it easier to pass. Options include:
- Polyethylene glycol (MiraLAX®)
- Magnesium hydroxide (Milk of magnesia)
- Lactulose—a prescription option that helps soften stools)
Stimulant Laxatives
Stimulant laxatives work by activating nerves and muscles in the intestines. This helps increase movement and fluid secretion in the gut. Stimulant laxatives also help keep water in the bowel, preventing it from being absorbed back into the body. Options are:
- Bisacodyl (Dulcolax®, Correctol®)—available as tablets or suppositories
- Senna (Senokot®, Ex-Lax®)—a natural plant-based laxative
- Cascara sagrada—a milder herbal option
Stimulant laxatives should only be a short-term solution, as they do pose health risks when taken long-term.
Probiotics
There is evidence that probiotics can stimulate movement in the gut and help stool move along faster.
Probiotic compounds can improve gut movement and increase stool movement–helping ease symptoms of constipation. They also support a healthier microbiome by balancing Lactobacillus and Bifidobacterium levels. These are beneficial bacteria that remain in the gut and continue to promote digestion after you have taken probiotics.
When to seek medical advice
If the diet and lifestyle changes haven’t helped your bowel movements, it may be time to speak to your healthcare professional. The following warning signs are serious and should not be ignored:
- Vomiting
- Fever
- Lower back pain
- Constant abdominal pain
- Weight loss without trying
- Inability to pass gas
- Blood in your stool
- Bleeding from your rectum
Contact your healthcare provider if you are experiencing any of these symptoms.
Complications from constipation
It is imperative to make the necessary diet and lifestyle changes in order to manage constipation the best you can. The potential long-term effects from the symptoms of constipation can include:
- Abdominal cramps and discomfort
- Poor quality of life
- Hemorrhoids
- Anal fissures
- Pelvic floor damage
- Loss of bowel control
- Difficulty emptying the bladder
- Intestinal tears from hardened stool
- Prolapsed rectum
- Intestinal twisting
- Infected opening near the rectum
Managing symptoms of Ozempic®-induced constipation
Starting Ozempic® can be an important step in managing your weight loss goals, and knowing how to handle side effects like constipation can make the journey smoother. By keeping on top of your hydration, adjusting your diet, staying active, and considering gentle remedies when needed, you can help keep things moving along comfortably.
Lemonaid Health is here to answer your questions about Ozempic® and help you create a plan for achieving your weight loss goals that may include medication if clinically indicated. Book an online consultation with one of our US-based healthcare providers, and get the facts you need to feel confident about how you approach your health.
Ozempic® is a registered trademark of Novo Nordisk A/S. MiraLAX® is a registered trademark of Bayer. Ducolax® is a trademark of Boehringer Ingelheim International GmbH. Correctol® is a trademark of Schering-Plough HealthCare Products, Inc.. Senokot® is a trademark of AVRIO HEALTH L.P. Ex-Lax® is a registered trademark of GlaxoSmithKline Consumer Healthcare Holdings (US) LLC. Colace® is a registered trademark of Norwell Consumer Healthcare Inc.
