How to beat constipation on Mounjaro

Key Points:

• Constipation is a common side effect that often resolves with time. Tirzepatide causes constipation because it slows the movement of food through your entire digestive tract.
• Constipation does not mean the medication isn’t working. It simply means your body is adjusting to a slower pace, and small changes to your routine can bring significant relief.
• Both dietary changes, like fiber and hydration, and laxatives can help ease symptoms as your body adjusts to the medication.

Starting Mounjaro® (tirzepatide) is an exciting moment and an important milestone in taking control of your health.

But for many, this journey includes an uncomfortable and frustrating side effect: constipation. Dealing with bloating, hard stools, and general digestive discomfort can feel isolating.

While these symptoms are frustrating, they’re very normal. Gastrointestinal symptoms, including constipation, are one of the most common side effects reported in clinical trials.

The good news is that this is often a temporary issue. Other than giving your body time to adjust to the medication, there are specific, evidence-backed diet and lifestyle changes you can make to mitigate the symptoms.

Read on to learn why Mounjaro causes constipation and, more importantly, give you a registered dietitian's plan to solve it with simple, powerful steps.

Is Mounjaro constipation normal? The science behind the slowdown

Yes, Mounjaro (tirzepatide) is known to cause constipation as a side effect. One large-scale analysis of studies found that up to 10% of users experienced constipation with tirzepatide.

It happens because the medication is doing exactly what it’s designed to do – slow your digestion down.

The dual action of tirzepatide (GIP & GLP-1)

Tirzepatide, the active ingredient in Mounjaro, is unique because it mimics two different natural gut hormones: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Both of these hormones play a key role in slowing down your digestive system and regulating your appetite. When the medication activates these two receptors, it does two important things in your digestive tract:

1. It slows gastric emptying. This means the food stays in your stomach longer, which helps you feel fuller sooner and for a longer time.
2. It slows the transit time of waste through the rest of your intestines.

Why a slower gut means harder stools

When everything is moving slower through your digestive tract, your body has much more time to absorb water from the waste material.

This unfortunately leaves you with stool that is dry, hard, and significantly more difficult to pass. This issue is often made worse because the appetite-suppressing effect of Mounjaro can lead to you eating less food and drinking less fluid throughout the day. Less fluid means less water is available to soften the stool.

It’s also important to know that while constipation is a frustrating side effect, studies suggest that it often tends to decrease gradually over time as your body adjusts to the medication. These side effects are most common when you first start Mounjaro or when your dosage is increased.

How to get immediate relief from constipation on Mounjaro

If you are struggling right now, focus on immediate, gentle relief before moving on to a long-term strategy. The following steps should be your first line of defense.

Priori

This is, arguably, the single most important step for immediate relief. Because Mounjaro actively slows your gut and removes more water from your stools, you have to compensate with fluid intake.

This is especially true if you are adding more fiber to your diet, as fiber acts like a sponge and can make the issue worse if it doesn't have enough water to absorb.

• Make water your priority: Sip on water consistently throughout the day, even if you don't feel thirsty. Your goal should be to drink water alongside every dose of food and fiber.
• Add electrolytes: Consider adding a non-sugary electrolyte drink to one or two glasses of water daily. This can help improve fluid absorption and balance any potential dehydration.
• Try warm fluids: A cup of warm herbal tea or low-sodium broth in the morning can sometimes help gently stimulate the gut and get things moving.

Over-the-counter options

When lifestyle changes aren't enough, over-the-counter (OTC) options can provide necessary relief. You should always discuss these options with your doctor first.

For constipation caused by a slowed gut and dry stool, experts usually recommend an osmotic laxative first. An osmotic laxative directly treats the dryness and hardness of the stool caused by the slow transit time.

• Osmotic laxatives (like polyethylene glycol/Miralax, or magnesium oxide) work by drawing water from the body into the bowel, which softens the stool and makes it easier to pass. Polyethylene glycol is a safe and effective first-line laxative that doesn’t cause dependency.
• Stimulant laxatives (like senna or bisacodyl) should be reserved for occasional use only. They forcefully stimulate the muscles of the intestines, which can cause cramping and may lead to dependency if used long-term.

Building a long-term anti-constipation strategy

The best way to manage Mounjaro constipation long-term is to integrate a diet and movement strategy that focuses on prevention.

Focus on the right type of fiber

If you’re struggling with a slowed gut, a sudden, significant increase in fiber can actually cause more issues of discomfort.

To manage a slow digestive system, your focus should be on a gentle, gradual increase in fiber – but you have to pay close attention to the type you consume.

• Prioritize soluble fiber: This type of fiber dissolves in water, creating a soft, gel-like substance that keeps stools smooth and easy to pass. This is crucial for a slow gut. You can find this in foods like oats, apples, beans, and the supplement psyllium husk.
• Balance with insoluble fiber: This type of fiber adds bulk to your stool, which is important for triggering the final push. Without enough water, though, it can make stools even bulkier and harder. You find it in nuts, seeds, and the skins of vegetables.

When increasing your fiber intake, remember to do so slowly. For instance, start by adding just half a cup of beans or a tablespoon of ground flaxseed to your existing meals. The total recommended amount for most adults is about 25 to 30 grams of fiber per day.

The best foods to promote motility on Mounjaro

The best approach is to select foods rich in soluble fiber and those with a high water content.

Here are the top categories to focus on:

• Fruits: Ripe bananas, berries, apples (with the skin on), pears, prunes, and figs. Prunes and figs are especially potent due to their fiber and natural sugar alcohol content.
• Vegetables: Cooked vegetables like Brussels sprouts, broccoli, and carrots, as well as high-water options like leafy greens and cucumbers. Cooking vegetables slightly can make them easier for a slowed gut to process.
• Grains and legumes: Oats, barley, lentils, black beans, chia seeds, and flax seeds. Oats and beans are excellent sources of soluble fiber. You can sprinkle chia or flax seeds into yogurt or a smoothie for a gentle fiber boost.

“You don’t need to transform your entire diet overnight,” says Rita Faycurry, RD. “In fact, too many changes at once could be just as detrimental. But focusing on nutritious foods with high water content can make a big difference.”

Movement to get your gut moving

While Mounjaro slows down the internal movement of your digestive system, external movement helps counteract it.

Physical activity stimulates intestinal contractions, which is key to improving gut motility and relieving symptoms like bloating and gas. Exercise helps strengthen your gut muscles and promotes the necessary wave-like contractions (peristalsis) to move waste out of your body.

You don't need a high-intensity workout. Even moderate activities can make a difference:

• Walk after meals: A gentle 10 to 15-minute walk after breakfast or dinner can immediately help stimulate your bowel.
• Try gentle yoga: Poses that involve twisting or folding can physically stimulate your digestive organs.
• Stretching: Simply getting up and stretching several times a day will help.

Regular, moderate movement is a powerful, drug-free tool in your anti-constipation toolkit. Consistency is also key if you want to break through a weight loss plateau in the future.

When to call your healthcare provider

While most Mounjaro constipation is manageable at home, it is vital to know the warning signs that indicate a more serious problem. Because the medication slows the digestive tract, there is a rare, but serious, risk of complications.

The FDA’s prescribing information for Mounjaro notes that the medication has not been studied in patients with severe gastrointestinal disease and is not recommended in these patients.

Seek immediate medical attention if you experience any of the following:

• Severe, persistent abdominal pain
• Abdominal pain accompanied by vomiting
• Severe bloating that does not go away
• Fever or chills
• Signs of severe dehydration (like dizziness or dry mouth)

Always check in with your healthcare provider if you have gone more than a few days without a bowel movement or if the constipation is accompanied by new, concerning symptoms.

A personalized path to gut comfort

“Constipation on Mounjaro is a common and often temporary hurdle,” says Rita Faycurry, RD.  “It’s a sign that the medication is actively working to slow your digestion, and it is something we can manage together.”

You don’t have to figure out the perfect formula for fiber and fluid intake on your own. A registered dietitian who specializes in GLP-1 therapy can bring valuable expertise to your journey.

They will assess your entire diet, pinpoint where your specific challenges lie, and build a personalized anti-constipation plan that fits your lifestyle. This ensures you maximize the health benefits of Mounjaro while minimizing digestive discomfort. A registered dietitian (RD) can provide the customized guidance you need.

Frequently asked questions (FAQs)

How long does constipation last when taking Mounjaro?

Constipation, like other gastrointestinal side effects, is generally transient. It is most common when you first start Mounjaro or when your dosage is increased, as your body is adjusting to the medication. For many people, the side effect will lessen as your body becomes accustomed to the treatment. Studies suggest these symptoms tend to decrease gradually over time.

What is the difference between Mounjaro & Ozempic side effects?

Both Mounjaro (tirzepatide) and Ozempic (semaglutide) work similarly to slow digestion and reduce appetite, which is why both medications share similar common gastrointestinal side effects, including nausea, diarrhea, vomiting, and constipation. The difference is that Mounjaro is a dual agonist (GLP-1 and GIP), while Ozempic is a single agonist (GLP-1).

What foods should I avoid with Mounjaro constipation?

While you don't need to eliminate entire food groups, try to limit or temporarily reduce foods that are known to slow down the gut or have little to no fiber, especially if you are actively constipated. This includes highly processed foods, large amounts of red meat, and refined starches (like white bread or white rice). Instead, focus on foods with high-water and high-soluble fiber content, such as berries, cooked vegetables, and oats.

Get personalized nutrition guidance to reach your health goals. Find a registered dietitian who accepts your insurance.

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.