Ozempic and Wegovy Can Cause Constipation, Diarrhea, and More—But Can Fiber Help?

Fact checked by Nick Blackmer

• Ozempic and Wegovy can cause a number of gastrointestinal side effects, and fiber may help alleviate some, but not all.

• Fiber can relieve constipation and keep bowel movements regular, but likely won’t improve other common side effects such as diarrhea or nausea.

• People taking these drugs can try increasing their fiber and water intake or can try other solutions, such as eating smaller portions to mitigate side effects.

Ozempic and Wegovy can help people manage type 2 diabetes or lose weight, but they can also cause a number of uncomfortable gastrointestinal symptoms. Could increasing your fiber intake help?

Like other prescription medications, Ozempic, Wegovy, and similar drugs come with a list of possible side effects, including nausea, diarrhea, vomiting, constipation, and abdominal pain.

When people experience these gastrointestinal (GI) issues—regardless of whether they’re taking Ozempic or Wegovy—fiber may be the first fix to come to mind.

Whether in food or supplements, fiber is an essential part of people’s diets. It also has a wide range of health benefits—it’s known primarily for supporting digestion, but it may also help people lower cholesterol and manage their weight.

Despite this, however, fiber isn’t a one-size-fits-all solution for people experiencing side effects from Ozempic or Wegovy, said Steven Batash, MD, gastroenterologist and founder of the Batash Endoscopic Weight Loss Center.

“Taking more fiber will not necessarily ease GI issues associated with Ozempic,” he told Health. “In fact, it can make it worse for some, especially while their bodies adjust to medication.”

It won’t work for everyone, but in certain situations, fiber can actually be useful for people taking these drugs, added Kimberly Gudzune, MD, MPH, medical director of the American Board of Obesity Medicine and associate professor of medicine at Johns Hopkins Medicine.

“It depends on the GI symptoms that the patient is having,” Gudzune told Health.

How Ozempic and Wegovy Can Affect Your Gut

Ozempic and Wegovy, or semaglutide, can take a toll on a person’s gastrointestinal system due to how the drug functions in the body.

Semaglutide mimics glucagon-like peptide 1, or GLP-1. This hormone is responsible for releasing insulin and lowers blood sugar after you eat, and GLP-1 receptors in the brain help control appetite. Other GLP-1 agonist drugs include Rybelsus, Victoza, and Trulicity.

Beyond suppressing appetite and lowering blood sugar, these drugs also make food travel more slowly through the stomach and intestines. As a result, patients can develop constipation or other GI concerns.

According to Food and Drug Administration (FDA) data from 2023, nausea, vomiting, and diarrhea were the most common gastrointestinal symptoms reported by semaglutide users, followed by constipation and abdominal pain. Less common GI symptoms included excess gas, bloating, indigestion, and heartburn. And a study from the fall of 2023 also linked GLP-1 drugs to severe GI side effects, including pancreatitis, bowel obstruction, and gastroparesis (stomach paralysis).

Most of the time, these common side effects aren't serious, but can still be frustrating for patients.

“Some of the discomfort in patients comes from constipation, which can be very uncomfortable,” William Yancy Jr., MD, MHS, medical director of the Lifestyle and Weight Management Center at Duke Health, told Health.

Uncomfortable GI symptoms tend to subside over time, but they can be worse when a patient first starts the medication or if they increase the dose, Eduardo Grunvald, MD, director of obesity medicine at the Bariatric and Metabolic Institute at UC San Diego Health, told Health.

“However, individual responses can vary, and some patients may continue to experience GI issues despite long term use,” Batash added.

Related: Drugs Like Ozempic, Wegovy Linked to Greater Risk of Severe Gastrointestinal Side Effects

When Fiber Is and Isn’t Helpful

Fiber is necessary for health, and everyone is supposed to get around 25 to 30 grams per day to support digestion, said Batash. (One study found only 4% of men and 8% of women with type 2 diabetes are getting enough fiber).

It is true that fiber can relieve some GI side effects associated with taking semaglutide—increasing fiber intake can help with constipation, Gudzune said. It can also help keep bowel movements regular, Yancy added.

But that may be as far as fiber can go.

Fiber isn’t going to help with nausea from taking Ozempic or Wegovy, Gudzune said. And in some people, high fiber intake can even spark bloating, gas, and discomfort, Grunvald explained.

A 2022 report gave specific recommendations to ease nausea, vomiting, diarrhea, and constipation associated with GLP-1 drugs. Researchers recommended adding more fiber for those who had constipation but said high-fiber foods should be avoided for diarrhea until symptoms improve.

Instead of relying solely on fiber, how you deal with GI symptoms should depend on which ones you have.

“Constipation may require stool softeners and laxatives,” said Grunvald. “Nausea may require anti-nausea medications. Heartburn may require acid-blocking medications.”

Doctors may also adjust a patient’s semaglutide dose to mitigate some of these if managing side effects individually isn’t working.

“Every person is different, and it may be helpful for some and uncomfortable for others,” said Grunvald.

Related: Are You Eating Too Much Fiber? These Are The Signs and Symptoms

Managing Ozempic and Wegovy’s Side Effects

If you do choose to deal with constipation or other side effects by increasing your fiber intake, first try getting it from fiber-rich foods, Batash recommended. Start with smaller increments and gradually increase it over time to allow the body to adjust, he said.

However, meeting your fiber goals may not be totally doable—GLP-1 agonist medications cause you to eat less, making it potentially harder to get the recommended amount of fiber in your diet, added Grunvald.

If people want to turn to a fiber supplement in these cases, Yancy said supplements such as psyllium husk are fine, so long as people follow instructions on the label. Fiber can be taken more than once a day if needed, but again, it’s better to start once a day or every other day, he said.

In addition to starting slow, “it’s also critical to stay well-hydrated when consuming more fiber to help prevent constipation,” Batash added.

When taking a fiber supplement, people should take it with about eight ounces of fluid, Yancy recommended.

“This can be increased by an ounce or two if stools remain hard, or decreased by that amount if they are too loose,” he said. “People should avoid taking fiber capsules with just a sip of liquid. They need to be taken with a full glass.”

If the additional fiber is making your GI system upset, try one day of a liquid diet and then reduce fiber intake, Batash recommended.

Beyond just adding fiber, there are other things people can do to help ease possible side effects while taking Ozempic and Wegovy.

For patients just starting the medication, they can try adopting a plant-based diet, drinking plenty of water, and exercising regularly, Grunvald suggested.

Another key recommendation is to slow down while eating and listen to fullness cues, said Yancy. “Small portions are a must,” Batash added.

What a person eats is also important—opt for low-fat options while avoiding greasy and sugary foods, and limit carbonated beverages, he said.

If side effects are impacting your daily life or are otherwise severe, talk to your doctor about managing symptoms or deciding if the medicine is right for you, Gudzune noted.

Related: Psyllium Husk Is Being Called the 'Poor Man's Ozempic'—Can It Really Help You Lose Weight?

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