The semaglutide medications Ozempic, Wegovy, and Rybelsus may lead to some side effects like nausea and diarrhea. For many people, these and other side effects may improve within a few months.
Semaglutide belongs to a class of medications called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). It works by mimicking your body’s natural GLP-1 hormone that’s released when you eat.
GLP-1 makes your body produce more insulin and less glucagon, which helps manage blood sugar levels. In addition, GLP-1 slows down how fast your stomach empties after eating. It makes you feel full quicker and reduces your appetite, the main reason why it helps with weight loss.
The Food and Drug Administration (FDA) has approved three semaglutide products:
Ozempic injections: Approved to lower blood sugar in adults with type 2 diabetes and to lower the risk of heart-related issues in those with type 2 diabetes and heart disease. It is used off-label for weight loss.
Rybelsus tablets: Also approved for type 2 diabetes and may be used off-label for weight loss.
Wegovy injections: Approved for weight loss in adults and children ages 12 years and older with obesity or adults with overweight and weight-related medical conditions.
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Side effects of using Ozempic and Rybelsus for weight loss may include:
stomach pain
diarrhea or constipation
nausea and vomiting
low blood sugar
A 2021 research review noted that the digestive side effects of semaglutide meds may be more likely when using Rybelsus tablets compared to injected versions.
The side effects of using Wegovy for weight loss may be the same as above, with the addition of:
headaches
bloating, flatulence, and burping
acid reflux and indigestion
fatigue
dizziness
The additional side effects of Wegovy may result from a higher dosage of semaglutide.
Most of these side effects are short term and likely to occur within the first 8–12 weeks of treatment. After this time, they may lessen or disappear. Still, some people might experience side effects for longer.
Digestive side effects of semaglutide may improve quicker by adopting or continually following any health-promoting lifestyle recommendations like eating patterns and staying physically active that your prescribing healthcare professional may recommend. For example, eating smaller food portions throughout the day.
Consulting your healthcare professional if you experience persistent side effects or are concerned about how you feel after starting a semaglutide treatment is highly encouraged. They’ll assess your symptoms and treatment and propose a tailored solution. For example. this may include changing your medication or adjusting your dose.
Rare side effects of semaglutide medications
There are some potential rare and long-term side effects linked with semaglutide treatment:
Experts currently do not have clarity on whether semaglutide causes these effects or increases the existing risk. For example, while these medications carry an official box warning for thyroid C-cell tumors, the warning comes from results in studies with rodents.
Still, the warning stands. It’s a good idea to discuss side effects with your healthcare professional, especially if you have a personal or family history of any of these conditions.
Possible side effects of stopping semaglutide for weight loss
When you experience symptoms as a result of stopping a medication, healthcare professionals refer to those as withdrawal symptoms or effects.
A 2022 study gave 327 participants semaglutide or placebo paired with lifestyle interventions for 68 weeks. Then, they stopped treatment, and their health was assessed again after 52 weeks without treatment and lifestyle changes.
The study indicated that stopping semaglutide may lead to the following:
weight gain
elevated blood pressure
high markers of C-reactive protein, an indicator of inflammation
high results for HbA1c, an indicator of blood sugar levels within 3–4 months
elevated cholesterol
That said, except for blood pressure, when researchers compared pretreatment levels with posttreatment levels, they found that markers were still slightly lower 1 year after discontinuing semaglutide. For example, participants regained two-thirds of the weight they had lost, not all of it.
Stopping semaglutide may require a tapering plan that your healthcare professional will tailor to your needs. Discontinuing semaglutide medications suddenly is not recommended.
Contraindications of semaglutide
According to the medication labels, you should not use semaglutide if you have:
a family or personal history of medullary thyroid carcinoma
multiple endocrine neoplasia syndrome type 2
hypersensitivity to semaglutide
This is regardless of whether you want to use semaglutide for weight loss or diabetes management.
Liraglutide (Saxenda): Another GLP-1 RA with similar side effects like stomach pain, nausea, digestive issues, and headache.
Naltrexone-bupropion (Contrave): Common side effects include constipation or diarrhea, increased blood pressure and heart rate, insomnia, nausea and vomiting, dry mouth, and dizziness.
Orlistat (Xenical): Common side effects are oily stools, diarrhea, gassiness, and stomach pain. You can find orlistat as an over-the-counter medication under the name of Alli. However, it contains a lower dose of the active ingredient.
Phentermine-topiramate (Qsymia): Side effects may include dry mouth, taste changes, tingling hands and feet, sleep issues, dizziness, and constipation.
Setmelanotide (Imcivree): Only suitable for people with specific and rare genetic conditions. Side effects can include sexual arousal disturbances, depression, skin darkening, and nausea.
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Summary
Semaglutide for weight loss may cause digestive issues, especially in the first few months of treatment. Serious and long-term effects are rare, and research has not confirmed many of these.
Effects of stopping semaglutide may include weight regain and increased blood pressure.
You can chat with your healthcare professional to learn more about the side effects of semaglutide for weight loss during and after treatment. They can also recommend suitable alternatives if semaglutide is not right for you.
