Semaglutide, a medication primarily used for type 2 diabetes and weight loss management, has been associated with various side effects, including constipation. Marketed under brand names such as Ozempic, Wegovy, and Rybelsus, semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that aids in insulin production post-meal, helping to maintain blood sugar levels. However, its impact on digestive processes can lead to slower gastrointestinal transit, potentially causing constipation.
It is recommended for use in adults with at least one weight-related health condition, as well as those who have a body mass index (BMI) of at least 35 kg/m2 or a BMI between 30-34.9kg/m2 with one weight-related comorbidity. The drug is delivered via an injection into the skin once a week and is intended to be used alongside a reduced-calorie diet and increased physical activity.
Understanding Semaglutide-Induced Constipation
The research article "Gastrointestinal adverse events associated with semaglutide" suggests that the mechanism of semaglutide-associated constipation, nausea, vomiting and diarrhoea is not fully understood. These gastrointestinal symptoms are thought to be related to GLP-1RA activating central and peripheral GLP-1 receptors and slowing down gastrointestinal motility.
The one possible mechanism behind semaglutide's constipating effect lies in its activation of the GLP-1 receptor, which can slow down the movement of food through the digestive system. This deceleration may result in delayed stomach emptying, known as gastroparesis, and reduced intestinal muscle contractions, leading to stool accumulation and subsequent constipation.
Duration of Constipation with Semaglutide
The persistence of constipation while on semaglutide varies based on dietary and lifestyle factors. Adequate hydration and fibre intake can alleviate symptoms within days, but some individuals may experience constipation for several weeks. A study highlighted that participants on semaglutide experienced constipation for a median of 47 days, compared to 35 days for those on a placebo.
Managing Constipation Caused by Semaglutide
To mitigate constipation, consider the following strategies:
- Start with a Low Dose: Begin semaglutide treatment at a lower dose to monitor for adverse effects, gradually increasing as tolerated.
- Hydration: Drink approximately 11.5–15.5 cups of water daily to maintain soft stools and ease their passage.
- Fibre Intake: Consume at least 25–34 grams of fibre daily to facilitate digestive transit.
- Regular Exercise: Engage in at least 150 minutes of moderate aerobic activity per week to promote gastrointestinal motility.
Other Potential Side Effects
In addition to constipation, semaglutide may cause:
- Diarrhoea
- Nausea
- Abdominal pain
- Vomiting
When to Seek Medical Advice
Consult a healthcare professional if you experience severe symptoms such as intense abdominal pain, vision changes, hypoglycemia, anaphylaxis, or signs suggestive of thyroid cancer.
Common Queries Regarding Semaglutide and Constipation
- Do Ozempic and Wegovy cause constipation?
Yes, both brand-name formulations of semaglutide can lead to constipation, affecting approximately 5% of users. - Can Ozempic or Wegovy cause bowel obstruction?
Prolonged constipation from these medications may result in intestinal blockage. In 2023, the FDA updated semaglutide's label to include intestinal obstruction as a potential risk.
Manage Constipation with eMed Healthcare's Weight Loss Programme
While semaglutide is an effective treatment for type 2 diabetes, its use for weight loss should be approached with caution due to the risk of constipation and other side effects. It is essential to weigh the benefits against potential complications and to consult with a healthcare specialist for personalised advice.
eMed Healthcare's comprehensive weight loss programme can help you effectively manage constipation. Our team of specialists will work closely with you to address any digestive issues that arise during your weight loss journey. With regular check-ins and personalised guidance, you can stay on track towards your goals while minimising disruptive side effects.
Don't let constipation derail your progress. Consult with eMed Healthcare today and take control of your weight loss journey.
References
- NICE. (2023). NICE recommended weight-loss drug to be made available in specialist NHS services. Link
- Theses, H. (2024). Injectable GLP-1 analogues. Even if GLP-1 receptor agonists result in superior glycemic control and weight loss benefits, DPP-4 inhibitors are still preferred by the patients for a long- term medication. Link
- Wilding, J. P., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., ... & Tran, M. T. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002. Link
- Wadden, T. A., Bailey, T. S., Billings, L. K., Davies, M., Frias, J. P., Koroleva, A., ... & Rubino, D. M. (2021). Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. Jama, 325(14), 1403-1413. Link
- Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., ... & Kushner, R. F. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. Jama, 325(14), 1414-1425. Link
- Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., ... & Wilding, J. P. (2020). Semaglutide 2.4 mg for the treatment of obesity: key elements of the STEP trials 1 to 5. Obesity, 28, S451-S461. Link
- Capehorn, M. S., Catarig, A. M., Furberg, J. K., Janez, A., Price, H. C., Tadayon, S., & Poulsen, P. (2020). Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes & Metabolism, 46(2), 100-109. Link
