10-item list

10 GLP-1 side effects to know before you start

Most GLP-1 side effects appear in the first 4-8 weeks and resolve as the body adapts. Knowing which ones are normal vs. red-flag prevents abandoned prescriptions and unnecessary ER visits.

1. 1

   Nausea (44%)

   Common

   Peaks in the first 2 weeks of each dose step-up. Eat smaller meals; avoid fatty and fried foods; ginger or peppermint tea helps about half of patients.

2. 2

   Constipation (24%)

   Common

   8 oz water with each meal; 25-30 g fiber daily; magnesium citrate at night if needed; probiotic.

3. 3

   Diarrhea (30%)

   Common

   Usually short-lived (2-4 days). Bland diet (BRAT — banana, rice, applesauce, toast) until it passes.

4. 4

   Vomiting (24%)

   Common

   Most often after eating too much or too fast. If persistent >24 hrs, contact your prescriber — dehydration is a real risk.

5. 5

   Sulfur burps

   Common

   A signature complaint. Linked to slowed gastric emptying. Limit cruciferous vegetables and red meat during dose changes; bismuth subsalicylate helps acute episodes.

6. 6

   Fatigue

   Common

   Often tied to undereating or rapid weight loss. Hit protein targets, sleep 7-8 hrs, add electrolytes if blood pressure runs low.

7. 7

   Hair shedding

   Less common

   Telogen effluvium from rapid loss. Peaks 3-4 months in, resolves within 6 months. Biotin doesn't help; adequate protein and iron do.

8. 8

   Gallbladder issues (~2%)

   Serious

   Rapid weight loss is the primary risk factor, not the drug itself. Symptom: right-upper-quadrant pain after fatty meals. Imaging if symptoms persist.

9. 9

   Acute pancreatitis (<1%)

   Serious

   Severe abdominal pain radiating to the back. Stop the medication and seek emergency care immediately.

10. 10

    Mood changes (3-7%)

    Less common

    Most common during titration. Often resolves at stable doses. Pre-existing depression warrants closer monitoring.