The Surprising Ozempic Side Effects You Need To Know About, According To A Doctor

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Ozempic side effects are getting almost as much attention as the drug itself (maybe you’ve heard of “Ozempic face.”) Intended for those with type 2 diabetes, Ozempic (which lists semaglutide as its main active ingredient) is an injectable drug that helps manage blood sugar. The medication, which is part of a drug class glucagon-like peptide 1 (GLP-1), can reduce the risk of a stroke, heart attack, or death in adults who have type 2 diabetes, along with heart and blood vessel disease.

Some patients on the medication experience side effects when taking the drug. One of the most common side effects of Ozempic is weight loss, though it is not intended for weight loss, per its manufacturer, Novo Nordisk. Ozempic’s side effects can make it difficult for patients to stay on their treatment regimen. “About 20% of my patients will discontinue use as they have difficulty tolerating Ozempic due to these side effects,” says Florence Comite, M.D., founder of the Comite Center for Precision Medicine & Health.

But, for the other 80% of Dr. Comite’s patients, the drug’s side effects are much more mild. Ahead, find everything you need to know about Ozempic side effects.

Common Ozempic side effects

“The most common side effects of Ozempic derive from slowing peristalsis (rippling GI waves that push contents through the gut),” explains Dr. Comite.

She says common Ozempic side effects include:

  • Gastrointestinal upset (upset stomach)

  • Nausea

  • Reflux

  • Vomiting

  • Diarrhea

  • Constipation

  • Stomach pain

“These symptoms will occur initially in most people, then resolve. However, symptoms may persist in a significant number of individuals,” she says, even right after taking the first dose. “Others will see an uptick with any increase in dose, which should subside after taking the medication for two to three weeks.”

Dr. Comite says another side effect of Ozempic is the loss of muscle mass, which could have negative health implications. “Multiple factors contribute to sarcopenia (reduced muscle), including weight loss, inadequate dietary protein, lack of desire to eat, minimal or no resistance exercise, or less than optimal hormones, in particular testosterone,” she says. “Muscle is the fountain of youth because it is vital to your metabolic health, your strength, and prevents aging disorders, such as [type 2 diabetes], heart disease, stroke, osteopenia, memory and cognitive decline as you age.” She says that when taking Ozempic, patients lose fat and muscle unless they take action to preserve muscle mass by strength training, eating enough protein, and ensuring they’re producing enough testosterone. “Sufficient testosterone, an essential hormone which begins to decline by 1-3% in our 30’s, is critical to muscle,” she says.

Another side effect that’s received a lot of attention lately is “Ozempic face,” a sagging of the skin that occurs because of weight loss that affects the face. This is not specific to Ozempic, due to any weight loss that will impact facial skin.

Uncommon Ozempic side effects

While typical side effects skew on the milder side, Novo Nordisk lists a number of Ozempic side effects, including possible thyroid tumors, thyroid cancer, and vision changes.

Dr. Comite also notes: “Less common side effects include excess air or gas in the stomach, burping, heartburn, indigestion, fast heartbeat, low blood sugar, low energy, fatigue, and gallstones.”

Uncommon yet severe side effects also include:

  • Pancreatitis

  • Appendicitis

  • Thyroid cancer

  • Decreased kidney function

  • Allergic reactions

  • Anaphylaxis

  • Angioedema

“If you experience any severe or unexpected symptoms, consult the clinician who prescribed the medication,” Dr. Comite says.

Drugs to avoid when taking Ozempic

When in doubt, it’s always best to consult your doctor. But, there are some medications that don’t go well with Ozempic. “Drugs to avoid include insulin and sulfonylurea medications as they can lower blood sugar levels. Explore with your practitioner if you are on these drugs, as they may be adjusted if Ozempic is an option for you. Careful monitoring is important,” Dr. Comite says.

Are there any foods to avoid when taking Ozempic?

In short, no. But, there are foods you can forego to avoid exacerbating Ozempic side effects. “No foods are ‘off-limits’ per se when taking Ozempic, but there are foods to avoid, which can compound stomach upset and make it difficult to manage [blood] sugar levels, including fried or greasy foods, sugary foods and drinks, highly processed foods and refined carbs,” explains Dr. Comite. “Limit high sugar content intake of fruits and veggies and decrease alcohol use. It’s best to maintain a varied diet that is high in protein and unprocessed foods, without extra sugars.”

Can those pregnant or breastfeeding take Ozempic?

Ozempic is not recommended while pregnant or breastfeeding, as it can potentially impact fetal growth and development, Dr. Comite says. “Typically, we advise our patients to stop Ozempic at least two months prior to attempting to conceive. If you are diabetic, there are alternative medications that are safe to take while pregnant or breastfeeding.”

Tips for managing Ozempic side effects

Trying crackers or pita chips to settle your stomach is a good way to manage an upset stomach, Dr. Comite says. “Be sure to drink a lot of water, eat your meals slowly, and use over-the-counter medications like Tums or Gas-X to ease any nausea or gas pains. Eating small amounts of food, even if not hungry, can make a difference,” she says.

As for muscle loss, Dr. Comite says it’s all about strength-training exercises and diet. “To avoid muscle loss, start every meal with lean protein, such as chicken, fish, lean beef, tofu, beans, and nuts (walnuts, almonds, cashews, macadamia, Brazilian, but not peanuts which are legumes). Protein, the essential building block of muscle, has a more favorable impact on your metabolism,” she says.

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