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Side Effects of Semaglutide for Managing Type 2 Diabetes and Weight Loss

You may recognize semaglutide as Ozempic, an injectable medication used for people with Type 2 diabetes. Ozempic helps manage blood glucose levels and can also reduce the risk of major cardiovascular events in those with heart disease. It is also available as an oral pill called Rybelsus, and a higher-dose version named Wegovy is approved for weight loss.

Semaglutide mimics a gut hormone, prompting your pancreas to release insulin, preventing your liver from producing glucose, and slowing the rate at which food leaves your stomach. It also acts on brain regions that control appetite and fullness. While these actions are beneficial for managing Type 2 diabetes and promoting weight loss, they can also cause some side effects.

Some side effects of semaglutide may be bothersome and make the medication challenging to tolerate, but they usually subside over time. Although rare, there are some serious side effects to be aware of. Keep reading to learn about 19 side effects of semaglutide and how to manage them.

1. Nausea and Vomiting

Nausea is the most common side effect of semaglutide, affecting up to 20% of those taking it for Type 2 diabetes in clinical trials. It’s even more prevalent at higher doses used for weight loss, while vomiting is less common. The likelihood of experiencing nausea and vomiting increases with higher doses of semaglutide. To minimize these effects, your healthcare provider will gradually increase your dose over several months. For most people, side effects like nausea improve as the body adjusts to the medication. Eating smaller meals, avoiding high-fat foods, and staying upright after eating can also help manage nausea and vomiting. If these symptoms are accompanied by severe pain in the upper or middle abdomen, seek medical attention immediately, as this could indicate pancreatitis, a rare but serious side effect.

2. Diarrhea

Diarrhea is another common side effect of semaglutide. About 9% of people taking it for Type 2 diabetes and 30% of those taking it for weight loss reported diarrhea during clinical trials. Similar to nausea and vomiting, the likelihood of experiencing diarrhea increases with higher doses. To reduce this side effect, your healthcare provider will gradually increase your dose. In the meantime, avoiding foods that can worsen diarrhea, such as fatty or fried foods, dairy products, and caffeinated drinks, may help.

3. Constipation

Constipation can occur with semaglutide, although it is less common than diarrhea. As with other side effects, constipation usually improves over time. To alleviate constipation, try drinking enough water, getting regular exercise, and gradually adding more fiber-rich foods to your diet. If these lifestyle changes are not sufficient, your healthcare provider may recommend an over-the-counter laxative.

4. Gas and Bloating

Gas and bloating are other possible side effects of semaglutide. Dietary and lifestyle changes can help manage these symptoms. Eating smaller meals and choosing foods that are lower in fat can be beneficial. Gradually adding fiber to your diet can also help, but adding it too quickly can worsen gas and bloating. A good starting point is to add two additional servings of fiber per day. If necessary, your healthcare provider may suggest an over-the-counter anti-gas remedy, such as simethicone (Gas-X).

5. Stomach Pain

Mild stomach pain is another common side effect related to semaglutide. Like nausea, vomiting, and diarrhea, this side effect should subside over time. Using the tips mentioned earlier can also help reduce stomach pain. However, severe stomach pain may indicate other serious side effects, such as pancreatitis or gallbladder issues like gallstones. If you experience severe stomach pain, contact your healthcare provider immediately.

6. Fatigue

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Fatigue is a common side effect of Wegovy, affecting 11% of users in clinical trials. It was reported in less than 5% of people taking Ozempic and was not reported with Rybelsus. Semaglutide aids weight loss by reducing hunger, and consuming fewer calories may lead to feelings of tiredness. This fatigue should diminish as your body adjusts to dietary changes.

7. Burping

Some individuals experience acid reflux symptoms, including burping or belching, while taking semaglutide. This is sometimes called the “Ozempic burp” due to its distinct smell and taste. To manage these symptoms, avoid foods that can worsen them, such as greasy, spicy, and fried foods, as well as caffeine and alcohol. For quick relief, your healthcare provider may recommend an over-the-counter antacid. If symptoms persist or worsen, consult your provider.

8. Changes to Your Face (Ozempic Face)

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Some people taking semaglutide may notice less fullness in their face, a phenomenon referred to as “Ozempic face.” Although Ozempic isn’t approved for weight loss, some users experience weight loss, which can lead to facial fat loss, resulting in looser skin and more noticeable wrinkles. The health benefits of semaglutide outweigh these cosmetic effects, but if concerned, discuss treatments to reduce wrinkles or increase facial fullness with your healthcare provider.

9. Headache

Semaglutide doesn’t directly cause headaches, but side effects like dehydration can lead to headaches. It’s essential to stay hydrated, especially if experiencing diarrhea or vomiting. For those taking semaglutide for Type 2 diabetes, low blood glucose levels can cause headaches, along with symptoms like shakiness and sweating.

10. Rebound Weight Gain

Semaglutide is intended for long-term use, with Wegovy specifically approved for chronic weight management. Weight loss is typically maintained while on the medication, but stopping it may lead to regaining some or all of the lost weight. It’s important to pair semaglutide with a nutritious diet and regular exercise to develop sustainable habits. If you’re worried about regaining weight after discontinuing semaglutide, consult your healthcare provider to discuss the pros and cons of continuing or stopping treatment.

11. Low Blood Glucose

Hypoglycemia (low blood glucose) is uncommon when taking semaglutide alone, as it triggers insulin release specifically in response to meals. However, using semaglutide with other glucose-lowering medications, such as insulin and sulfonylureas, increases the risk of hypoglycemia. Your healthcare provider may need to adjust the doses of these medications when you start semaglutide. Symptoms of hypoglycemia include headache, shakiness, and sweating. Regularly monitor your blood glucose levels to prevent hypoglycemia and keep an emergency glucagon or glucagon-like product on hand for severe cases.

12. Vivid Dreams

Some users of Ozempic or Wegovy have reported vivid or abnormal dreams, though the exact cause is unclear and may not be directly linked to semaglutide. Various other medications can also cause vivid dreams. If you experience this side effect while taking Wegovy, Rybelsus, or Ozempic, inform your healthcare provider, especially if it disrupts your sleep or quality of life. They can help identify the cause and recommend next steps.

13. Hair Loss

Rapid weight loss can lead to hair shedding or loss, which may explain reports of hair loss from users of Wegovy or Ozempic. During clinical trials for Wegovy, 3% of participants reported hair loss. This temporary condition, known as telogen effluvium, should improve as your body adjusts, although this process may take several months. Ensure you’re consuming enough vitamins, minerals, and protein, as deficiencies can contribute to hair loss. Your healthcare provider can help you maintain adequate nutrition during treatment.

14. Pancreatitis

Pancreatitis, though rare, has been reported with semaglutide use. The exact cause is not clear, but if pancreatitis occurs, it can be life-threatening. Seek immediate medical attention if you experience severe abdominal pain, nausea and vomiting, or jaundice (yellowing of the skin and eyes). Inform your healthcare provider if you have a history of acute pancreatitis before starting Semaglutide, as they may recommend an alternative medication.

15. Gallbladder Disease

Gallbladder disease, including gallstones, is a potential but uncommon side effect of semaglutide, reported in less than 2% of clinical trial participants. Symptoms of gallbladder issues include upper stomach pain, fever, jaundice, and clay-colored stools. Discuss preventive measures with your healthcare provider, such as dietary changes and regular physical activity, to reduce the risk of gallbladder problems while taking semaglutide.


When should you reach out to your healthcare provider regarding side effects from semaglutide?

Many side effects of semaglutide may improve over time with continued use. If mild stomach-related symptoms persist for several weeks, it’s advisable to contact your healthcare provider. If these symptoms become severe at any point, seek immediate medical attention, as they could indicate a more serious condition.

While hypoglycemia is not common with semaglutide, it’s important to recognize the signs of low blood glucose and how to manage it. Contact your healthcare provider if you notice your blood glucose levels dropping too low. They may need to adjust the dosage of other medications you’re using to lower blood glucose.

The bottom line is that common side effects of semaglutide (Wegovy, Ozempic, Rybelsus) include nausea, vomiting, diarrhea, and stomach pain. Fatigue, constipation, and headaches are also possible. Most digestion-related side effects tend to improve as your body adjusts to the medication.

While more severe side effects like pancreatitis, gallbladder disease, and kidney damage are rare, it’s crucial to be aware of their symptoms and seek medical attention promptly if necessary.

If you have any questions or concerns about potential side effects of semaglutide, talk to your healthcare provider or pharmacist. They can provide guidance on managing specific side effects if you find the medication difficult to tolerate.

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