Chances are you’ve heard of the rising popularity of injectable weight loss drugs like Ozempic, Wegovy, Mounjaro, and Zepbound. These medications have made headlines in recent months for their ability to help people quiet “food noise” in their minds, decrease appetite, and drop excess pounds. What you may not have heard is that these drugs work by slowing down gut motility, also known as “gastroparesis,” to make people feel full for longer. This can cause significant uncomfortable side effects like nausea, bloating, and constipation.
What is gastroparesis?
Gastroparesis, also known as stomach paralysis, is a condition in which the stomach empties very slowly. It happens when the muscles in the stomach and digestive tract do not contract as strongly as they should, leaving food in the stomach and intestines rather than moving it through the digestive system at a normal pace. This slower pace, or “lower motility,” can cause GI symptoms including nausea, vomiting, and abdominal pain. This can happen for a variety of reasons including neurological conditions, uncontrolled diabetes, viral infections, and as a side effect of medications including GLP-1 agonists.
About GLP-1 drugs like Ozempic and Wegovy
Originally developed, and still used, to treat type 2 diabetes, GLP-1 drugs include semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound). They are typically injected weekly or daily and help to control blood sugar levels. The mechanism is by augmenting GI hormone release to empty food from the stomach in small increments to avoid spikes in blood sugar.
The drugs can cause a range of side effects as part of their mechanism of action. In addition to nausea and vomiting, people taking GLP-1 drugs can experience altered bowel habits due to the slowed motility of the gut. Less commonly, patients have reported pancreatitis and gallstones due to sluggish flow of intestinal fluids as well as bowel obstruction due to slowed intestinal motility.
If these effects cause too much discomfort, stopping the drug can usually alleviate almost all of the side effects. Stomach motility that is slowed by a GLP-1 drug will typically return to normal once the individual stops taking the drug.
How to minimize side effects
While the promise and potential of GLP-1 drugs for weight loss is certainly substantial, it’s important to know the mechanism of the drug so that this does not cause unwanted symptoms for you. Eating small, more frequent meals per day can be helpful to achieve weight loss with fewer side effects. It can also be helpful to start a fiber supplement after meals to help keep intestinal contents moving well despite the slower flow of the gut tubes. Finally, while it is important to stay hydrated, drinking fluids in small amounts, more frequently during the day will avoid bloating and nausea that can come with distension of the stomach.
As always, when starting any new medication, it is important to go over the risks, benefits and targets so that you can understand if a medication is right for you.
If you’re experiencing concerning symptoms of gastroparesis for an extended period of time, talk to your doctor or schedule an appointment with one of our GI specialists.