Does Ozempic cause constipation? Dietitians explain why & how to manage it

Key Points

• Ozempic (semaglutide) commonly causes constipation by slowing down your digestive system, with higher rates at weight-loss doses
• Research shows constipation from Ozempic typically lasts longer (about 7 weeks) than other side effects like nausea
• Simple strategies like staying properly hydrated, gradually increasing fiber, and staying active can help manage constipation while on Ozempic

If you've started Ozempic for diabetes or weight loss and suddenly found yourself dealing with constipation, there’s no reason to be concerned. Constipation is a known side effect of the medication, and while it can be uncomfortable, it often subsides as your body adjusts .

But how long should you expect this side effect to last? Let's dive into what the research actually shows about Ozempic and constipation, how long it typically lasts, and, most importantly, what you can do about it.

How common is constipation with Ozempic?

Constipation is a common side effect of Ozempic. It’s listed as one of the five primary side effects on the medication label.

In clinical trials for type 2 diabetes, about 3-5% of patients taking standard doses of Ozempic reported constipation, compared to only 1-2% of those taking a placebo. While this isn't a majority, it's still significantly higher than the rate without the medication.

If you're taking higher doses of semaglutide (Ozempic's active ingredient) for weight management, you're even more likely to experience constipation. At the 2.4mg dose used for weight loss (as in Wegovy, which contains the same medication), constipation rates jump to roughly 24% of patients.

That's nearly one in four people – a substantial number that explains why constipation is such a common topic in Ozempic user groups and forums.

And if you're taking Ozempic "off-label" for weight loss, you should be aware that the side effects, including constipation, are the same regardless of why you're taking it. Research shows that non-diabetic individuals have the same gastrointestinal side effect profile as those with diabetes.

Why does Ozempic cause constipation?

Understanding why Ozempic causes constipation can help you manage this side effect better.

Slowed digestion is the main cause

“Ozempic slows down how quickly food moves through your digestive system, which can cause constipation,” says Candice Sapp, RD. “It’s a common side effect, especially while your body is adjusting to the medication.”

Ozempic works by mimicking a hormone called GLP-1, which significantly slows down your digestive system. Specifically, it delays "gastric emptying," which is how quickly food moves from your stomach to your intestines.

Here’s just how powerful this effect is: 37% of a solid meal remained in the stomach four hours after eating (compared to 0% in the placebo group!) in patients who had been on semaglutide for 12 weeks. This means food stays in your stomach much longer when you're on Ozempic.

This slower movement impacts your entire digestive tract. When food moves more slowly through your intestines, your body extracts more water from the waste, making stools harder and more difficult to pass.

Reduced fluid intake also contributes 

Another factor that often gets overlooked: Ozempic can make you drink less. Because the medication makes you feel fuller faster and reduces appetite, many people unintentionally reduce both their food and fluid intake.

Experts note that patients on GLP-1 medications like Ozempic often "reduce water intake due to a feeling of fullness," which can predispose them to constipation.

How long does constipation from Ozempic typically last?

One of the most frustrating things about constipation on Ozempic is how long it can last compared to other side effects.

Constipation tends to stick around much longer than other digestive side effects. An analysis found that constipation lasted a median of 47 days (almost 7 weeks) in people taking semaglutide, compared to 35 days for those on placebo.

For comparison, nausea – the most common side effect – typically lasts only about 8 days. So while you might quickly adjust to feeling queasy, constipation could remain an issue for over a month.

Most people notice constipation within the first few weeks of starting Ozempic or after increasing their dose. Experts note that new-onset constipation usually appears within the first 4-16 weeks of GLP-1 therapy, often in the first month.

The good news is that after about 8-10 weeks, constipation symptoms often plateau or begin to improve as your body adapts to the medication's effects on your digestive system.

Is constipation worse with Ozempic than other GLP-1 medications?

All GLP-1 receptor agonists can cause constipation, but there do seem to be differences between them.

An analysis of the FDA's adverse event database found that semaglutide (Ozempic) had the highest odds ratio for reporting constipation among GLP-1 medications.

However, if you experienced GI side effects on one GLP-1 medication, you're likely to experience them on others too – though possibly to different degrees.

How to manage constipation while taking Ozempic

So, if you do experience constipation during your Ozempic treatment, how can you manage it?

“I usually recommend increasing water, fiber, and movement first; small changes like adding chia seeds to yogurt or going for a daily walk can really help,” says Candice Sapp, RD. “If that’s not enough, we can talk about gentle supplements like magnesium or a fiber powder to get things moving more regularly.”

Stay hydrated

Since Ozempic can reduce your sense of thirst and fluid intake, you need to be intentional about drinking enough water:

• Aim for 8-10 cups of fluid daily, even if you don't feel particularly thirsty
• Keep water visible and accessible throughout your day as a reminder
• Try setting reminders on your phone if you tend to forget

Remember that adequate hydration is especially crucial when increasing your fiber intake. Without enough water, added fiber can actually make constipation worse.

Increase fiber gradually

Fiber is one of the top recommendations to manage GLP-1-related constipation. It adds bulk to your stool and helps keep things moving, but it's important to approach it correctly:

• Start slow and work your way up to avoid bloating and discomfort
• Focus on soluble fiber from foods like oats, fruits, and vegetables, which tends to be gentler
• Always pair increased fiber with extra fluids
• Consider easy additions like adding berries to breakfast, snacking on an apple, or including a side salad with dinner

Stay physically active

Exercise stimulates the natural contractions of your intestines, helping move stool through your digestive tract.

Even a 10-minute walk after meals can help stimulate your digestive system. Another low-impact option is gentle yoga poses; those that involve twisting or compressing the abdomen can be particularly effective

Consistency matters more than intensity – short daily activity is better than one intense weekly session.

Over-the-counter remedies that may help

If lifestyle changes aren't enough, there are safe over-the-counter options to consider:

• Osmotic laxatives like polyethylene glycol (Miralax) draw water into the bowel to soften stool
• Magnesium citrate works similarly and is often recommended by experts for GLP-1-related constipation
• Stool softeners like docusate sodium can make stools easier to pass without stimulating the intestines
• Fiber supplements can help, but start with a low dose and increase gradually while drinking plenty of water

Talk to your doctor or dietitian before trying any supplements. With the Ozempic already making so many changes within your digestive system, you want to approach further tweaks thoughtfully.

Medication adjustments might be necessary

Sometimes, constipation can be severe enough to warrant adjusting your Ozempic treatment:

• Slower dose escalation may help – staying longer at a lower dose before increasing can give your body more time to adapt
• Temporary dose reduction might be considered for significant constipation that doesn't respond to other measures

Constipation itself usually isn’t reason enough to stop Ozempic treatment altogether. However, if you’re really finding your side effects intolerable, talk to your doctor about your options.

When to talk to your doctor about constipation on Ozempic

While constipation is common and often manageable, there are cases where you should definitely consult your healthcare provider.

Contact your doctor if you experience:

• No bowel movement for 3 or more days accompanied by discomfort
• Severe abdominal pain that persists or worsens
• Vomiting alongside constipation
• Blood in your stool
• Abdominal swelling or bloating that seems extreme

While uncommon, GLP-1 medications like Ozempic have been associated with rare but serious gastrointestinal complications. A 2023 study found that GLP-1 weight-loss therapy was linked to a small but increased risk of serious GI events, including a higher risk of intestinal obstruction compared to other weight-loss drugs.

The absolute risk is still very low (around 1% or less), but it's important to be aware of these potential complications and seek immediate medical attention if you notice severe symptoms.

Common questions about Ozempic & constipation

Does constipation mean Ozempic is working better for weight loss?

No, constipation is not a sign that Ozempic is working better. You can lose just as much weight without experiencing constipation or other digestive issues. Everyone responds to the medication differently.

Will constipation go away if I continue taking Ozempic?

For most people, constipation improves over time as your body adjusts to the medication. Studies show that 98% of GI events with semaglutide were "mild-to-moderate and transient," mostly occurring during or shortly after dose increases.

However, since constipation can last longer than other side effects, you may need to actively manage it while your body adapts.

Can Ozempic cause severe gastrointestinal problems?

While most constipation from Ozempic is manageable and not serious, in rare cases, GLP-1 medications have been associated with more severe complications. The risk is very small but increases slightly compared to other weight loss medications.

If you experience severe abdominal pain, persistent vomiting, or significant bloating, seek medical attention promptly.

Final thoughts

Constipation is a common side effect of Ozempic that many users experience, especially at higher doses used for weight loss. While it typically lasts longer than other side effects (about 7 weeks on average), it's usually manageable with proper hydration, gradual fiber increases, physical activity, and over-the-counter remedies if necessary.

Remember that experiencing constipation doesn't mean anything about how the medication is working. People have success with both weight loss and blood sugar control whether they experience side effects or not. That said, if constipation becomes severe or is significantly affecting your quality of life, don't hesitate to discuss it with your healthcare provider, as dose adjustments may help.

Want personalized guidance on managing Ozempic side effects? Find a registered dietitian to help you create a nutrition plan that works with your medication.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.