Key Takeaways

The chief complaint patients have when starting Ozempic, a GLP-1 receptor agonist medication is nausea. So, why is this one of the common Ozempic side effects and what can you do about it?

What Is Ozempic and How Does It Work?

Ozempic, known generically as semaglutide, was approved in 2017 by the U.S. Food and Drug Administration (FDA) for use in adults with type 2 diabetes.

Ozempic is a weekly injection that helps lower blood sugar by helping the pancreas make more insulin. It is not approved for weight loss, but some physicians prescribe it to be used for weight loss.

What is semaglutide?

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It mimics the GLP-1 hormone that is released in the gastrointestinal tract in response to eating. One role of GLP-1 is to prompt the body to produce more insulin, which reduces blood glucose (sugar). GLP-1 in higher amounts also interacts with the parts of the brain that reduce appetite and signal a feeling of fullness.

There are currently three FDA-approved semaglutide products:

• Ozempic injection and Rybelsus tablets are approved to lower blood sugar levels in adults with type 2 diabetes mellitus, in addition to diet and exercise. Ozempic is also approved to reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes mellitus and known heart disease.
• Wegovy injection is approved to help adults and children aged 12 years and older with obesity or some adults with excess weight (overweight), who also have weight-related medical problems, to lose weight and keep the weight off, in addition to diet and exercise.

GLP-1 drugs, also called GLP-1 agonists, are shortened names for glucagon-like peptide-1 receptor agonists. GLP-1 receptor agonists mimic the GLP-1 hormone that is naturally released in the gastrointestinal tract in response to eating.

How do GLP-1 RAs work?

When you eat, your digestive system breaks carbohydrates down into simple sugars that travel through your bloodstream. GLP-1 triggers the release of insulin from your pancreas. Insulin helps usher glucose (sugar) out of the bloodstream and into your cells, where it can be used for nourishment and energy.

In people with type 2 diabetes, the body’s cells are resistant to the effects of insulin, the body does not produce enough insulin, or both. GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon, both of which help control blood sugar levels in people with type 2 diabetes.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

All three medications are only available with a prescription, and there are no approved generic versions.

Ozempic Weight Loss Side Effects

“Ozempic Face”

You may have heard about “Ozempic face” as a side effect of GLP-1 drugs, though the term is misleading because this can be a side effect of any GLP-1 drug or any other cause of rapid weight loss.

The rapid loss of fat in the face can cause:

• a hollowed look to the face
• changes in the size of the lips, cheeks, and chin
• wrinkles on the face
• sunken eyes
• sagging jowls around the jaw and neck.

If weight is lost in a more gradual way, these changes may not be as noticeable. It’s the faster pace of weight loss that occurs with GLP-1 drugs that can make facial changes more obvious.

If “Ozempic face” side effects are significant, they can be treated with plastic surgery.

What are other Ozempic Side Effects?

The most common Ozempic side effects are gastrointestinal symptoms — nausea, vomiting, diarrhea, and constipation.

• Nausea can be managed by avoiding strong smells and eating crackers, mint, or ginger-based food or drinks about a half hour after taking a GLP-1 drug.
• Vomiting can be managed by staying well hydrated and having more frequent meals in smaller amounts.
• Diarrhea can be managed by drinking plenty of water and avoiding dairy products and high-fiber foods until symptoms go away.
• Constipation can be managed by getting enough fiber in your diet and drinking plenty of water.

To help avoid Ozempic side effects:

• Eat slowly and stop when full.
• Have smaller portions.
• Avoid being too active immediately after eating.

Less common but more serious Ozempic side effects include:

• pancreatitis, an inflammation of the pancreas that causes abdominal pain
• gastroparesis, in which movement of food out of the stomach is slowed or stopped
• bowel obstruction, a blockage that keeps food from passing through the intestines
• gallstone attacks and bile duct blockage.

Ozempic Foods to Avoid

While there isn’t a set diet for everyone taking Ozempic, some foods to avoid may help reduce Ozempic side effects and improve your experience:

• High-fat foods: Fried or greasy foods, full-fat dairy, and oil-heavy cooking
• Trans and saturated fats: Whole milk, heavy cream, full-fat cheese, butter, ice cream, and most red meats
• High-sodium foods: Highly processed foods, including canned foods, frozen foods, and grab-and-go snacks like potato chips
• Refined carbohydrates: White bread, boxed pasta, sugary cereals, and starchy bagels
• High glycemic index foods: Foods that can increase blood sugar
• Ultra-processed foods: Highly processed foods, including canned foods, frozen foods, and grab-and-go snacks like potato chips
• High sugar foods and drinks: Sweets, baked goods, sodas, juices, flavored yogurts, candy, honey, agave nectar, maple syrup, jams, fruit smoothies, and dried fruit
• Spicy foods: May cause side effects
• Alcohol: May interfere with blood sugar regulation, especially when combined with GLP-1 medication 

You can read more information about Foods to Avoid here.

When to See a Doctor about Ozempic Side Effects

Most Ozempic side effects are not serious. You should immediately seek medical attention if you have:

• severe vomiting and diarrhea
• severe pain or tenderness in your belly
• inability to pass gas or move your bowels
• jaundice (yellow skin color).

In addition, tell your doctor that you take GLP-1 drugs if you are having surgery or a procedure that involves general anesthesia. Because GLP-1 drugs slow digestion, you may need to stop taking them a few days beforehand to ensure you have an empty stomach before receiving anesthesia.