GLP-1 RA medications: What are they and how do they work

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) like Wegovy, Ozempic, and Saxenda, are a class of medications indicated for type 2 diabetes and obesity. They work by slowing digestion, increasing insulin release, and inhibiting the release of glucose from storage which can help lower blood sugar levels and promote weight loss.

Like any medication, there is an inherent risk of adverse effects, and unfortunately, with this class of medications, they are quite common. Studies suggest side effects can occur in 40-70% of patients receiving a GLP-1 RA. The most common adverse effects include gastrointestinal symptoms like nausea, vomiting, diarrhea, and/or constipation. Side effects are often dose-dependent; most prevalent at the initiation of medication and as you increase the dosage. Fortunately, in most individuals, these symptoms are temporary and can be remedied with a few practical lifestyle changes.

• Drink more water. Hydration is key and can help prevent nausea, constipation, and dehydration. We recommend at least 64 oz per day for most individuals.
• Eat when you are hungry and stop when you are full. Bring mindfulness to your eating (avoid eating with distractions; phone, TV, while working etc.) and check in with your hunger/fullness levels throughout your meal to prevent overeating.
• Eat slowly. Slowing down the speed of eating can help you stay more attuned to your body and prevent uncomfortable fullness.
• Eat smaller, more frequent meals. This will help reduce the likelihood of overeating while still ensuring you are eating enough
• Avoid eating too close to bedtime or lying down after meals as this can trigger reflux and other GI symptoms
• Limit physical activity after meals as vigorous movement can trigger nausea, cramping, reflux and vomiting
• Be mindful of foods that may worsen these symptoms: high-fat foods, high-sugar foods, spicy foods, and alcohol
• Consider ginger or peppermint tea 30 minutes after injection and throughout the week to help with nausea

• Focus on hydration. Staying hydrated is key to prevent dehydration when experiencing diarrhea
• Stick to bland foods that have binding properties including:
• Soft binding fruits like unsweetened applesauce or a banana
• Broth-based soups with soft, well-cooked vegetables and chicken
• Plain brown rice, wild rice, and/or sourdough toast
  
  
• Consider tracking GI symptoms and meals to identify potential trigger foods that may exacerbate symptoms. Common triggers include dairy, caffeine, alcohol, gluten, and artificial sweeteners

• Hydration! Staying hydrated helps things move more smoothly and can help bring water back into the intestines to help stool pass more easily.
• Increase fiber intake. Fiber can be extremely helpful in mitigating symptoms of constipation. Fiber increases the weight and size of your stool and softens it allowing it to pass easier through the intestines. The daily recommendation for dietary fiber is 25 grams for women and 31 grams for men per day. High-fiber foods include whole fruits and vegetables, whole grains, and legumes
• Physical activity. Daily movement can help stimulate gastric motility, which allows stool to move easier through the digestive tract.
  
  

Although side effects from GLP-1 RA medications are quite common, they are usually transient and can resolve as our bodies adjust to the new medication over time. If symptoms persist or worsen it is important to discuss with your healthcare provider as you may benefit from reducing your current dose or trying an alternative medication.

If you are interested in learning more about metabolic health and weight loss, please consult us at Dignity Weight Center! We would be honored to meet you, and we take most insurances!

If you are interested in learning more about metabolic health and weight loss, please consult us at Dignity Weight Center. We would be honored to meet you, and we accept most insurances.

https://www.dignityweightcenter.com/book-online

• Filippatos TD, Panagiotopoulou TV, Elisaf MS. Adverse Effects of GLP-1 Receptor Agonists. Rev Diabet Stud. 2014;11(3-4):202-230. doi:10.1900/RDS.2014.11.202
• Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, et al. Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. J Clin Med. 2022;12(1):145. Published 2022 Dec 24. doi:10.3390/jcm12010145
• Wharton S, Davies M, Dicker D, et al. Managing the gastrointestinal side effects of GLP-1 receptor agonists in obesity: recommendations for clinical practice. Postgrad Med. 2022;134(1):14-19. doi:10.1080/00325481.2021.2002616
• Wharton S, Calanna S, Davies M, et al. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab. 2022;24(1):94-105. doi:10.1111/dom.14551