Does semaglutide cause constipation?

Key Points

• Semaglutide slows digestion and reduces muscle contractions in the digestive tract, which can cause constipation
• Mostly, constipation from semaglutide is temporary and improves as your body adjusts to the medication
• Staying hydrated and gradually increasing dietary fiber can help soften stools and promote regular bowel movements
• Aerobic exercise stimulates colon contractions and helps prevent constipation

You finally get that Ozempic or Wegovy prescription and are ready to lose weight and lower your blood sugar levels. Unfortunately, while these meds may help you get better, digestive side effects are common.

These include constipation, nausea, diarrhea, bloating, and gas. Constipation from semaglutide is typically mild to moderate, but it can still impact your daily well-being.

Fortunately, this constipation is often manageable with a few strategies.

Here we explore why semaglutide causes constipation and what to do about it, with insights from experienced Registered Dietitian, Sarah Nash, RD, and physician, Gia Eapen, MD.

What is semaglutide?

Semaglutide is a prescription medication that belongs to a class of drugs called GLP-1 receptor agonists.

It's available under three FDA-approved brand names:

• Ozempic® for type 2 diabetes: a weekly injectable
• Wegovy® for weight loss: a weekly injectable
• Rybelsus® for type 2 diabetes: an oral tablet

Semaglutide is a synthetic version of GLP-1, a natural hormone that regulates appetite and blood glucose. It curbs appetite, helps control blood sugar, and slows digestion so you stay satisfied longer.

Semaglutide results

Studies have shown semaglutide to be highly effective for weight management and metabolic health.

In clinical trials:

• People achieved an average weight loss of 15% in just over a year
• In studies lasting 7 months to just over a year, semaglutide helped most people with type 2 diabetes (66-80%) reach their target HbA1c of less than 7%
• The medication also helped people with heart disease by reducing their risk of heart attacks, strokes, and heart-related deaths by 20%

Side effects

Like most medications, semaglutide can cause side effects. The most frequently reported include nausea, vomiting, diarrhea, stomach pain, and decreased appetite. These gastrointestinal effects are usually mild to moderate and often improve as your body adjusts to the medication.

Additionally, you may experience constipation as a side effect.

Semaglutide and constipation

Nash, RD, says, “Semaglutide can slow down digestion, which means food moves through the gut more slowly. This, along with eating less overall, can sometimes lead to fewer bowel movements and constipation.”

Often, the constipation caused by semaglutide drugs like Ozempic is mild and temporary. In some cases, it can last a month and a half (47 days).

Gia Eapen, MD, notes, “In most cases, the constipation goes away as the body adjusts to the medication and dose. However, if you find yourself straining too much on the toilet, find blood in your stool, or experience pain, please contact a healthcare provider.”

How does semaglutide make you constipated?

The main culprit is slower digestion.

Semaglutide significantly slows gastric emptying, meaning food moves more slowly from your stomach into your intestines. It also reduces muscle contractions throughout your digestive tract, causing waste to move sluggishly through your colon.

When waste sits longer, it gets drier.

As stool spends more time in your colon, your body absorbs more water from it. This makes the stool harder and more difficult to pass, leading to constipation.

You may be eating less fiber and drinking less water. 

Since semaglutide reduces appetite, many people inadvertently consume less dietary fiber and fluids. These two ingredients are extremely important for healthy bowel movements! 

Without them, the bulk and water content in your stool gets too low, making it harder to poop.

The result? A digestive system that's moving in slow motion, creating the ideal conditions for backup and discomfort.

How to stop constipation on semaglutide?

“Add fiber-rich foods like berries, leafy greens, beans, and whole grains, and drink plenty of water throughout the day [to manage constipation],” says Nash, RD. “Including probiotic-rich foods—such as yogurt or kefir—can help support gut health, and gentle movement like walking can also encourage regularity.”

Let’s explore in a little more detail.

1. Drink more water

Typically, the colon absorbs water from waste before eliminating it as poop. However, if you’re dehydrated, once your colon absorbs water, you’re left with harder stools that are difficult to pass.

Staying hydrated helps keep stools soft, making it easier for them to pass through the digestive system. Aim for 8-10 glasses a day.

2. Get enough dietary fiber

The USDA’s Dietary Guidelines for Americans recommends a target of 25-34 grams of fiber daily. However, make sure you introduce fiber in your diet gradually to avoid making constipation worse.

The best natural sources of dietary fiber are:

• Whole vegetables
• Fruit (whole, not fruit juices) like berries and apples
• Whole grains
• Legumes (peas, lentils)

Dietary fiber acts like a natural stool softener and bulking agent:

• Soluble fiber (found in oats, beans, and apples) absorbs water to form a gel-like substance that softens stool
• Insoluble fiber (in whole grains and vegetables) adds bulk and speeds transit through your digestive system

If you need additional support, your doctor may recommend psyllium husk (Metamucil) supplements to provide both sources of fiber.

3. Start walking

The science is in: walk your way to better poop! A minimum of 30 minutes a day can work wonders.

A 2024 study reviewed data from the national databases to understand the effects of diet and exercise on constipation. The study found that people who exercised regularly (at least 150 minutes of moderate exercise like brisk walking per week) had better results in preventing constipation than those who didn’t exercise.

Physical activity helps prevent constipation by stimulating contractions in the colon and increasing the time it takes for waste to move through the digestive system.

Note: the research suggests that exercise works best for constipation relief, together with a high-quality diet.

4. Establish a bathroom routine

Try going to the bathroom at the same time to “train” your gut. This may help you get more regular.

⚠️ When to talk to a doctor

Eapen, MD advises, “Talk to your doctor if you cannot get relief from constipation from these methods, if constipation lasts over two weeks, you feel pain, or if you see blood in your stool.”

Your doctor may ask you to take over-the-counter fiber supplements, magnesium, or even stool softeners and laxatives like MiraLAX to gain some short-term relief.”

If these methods don't provide relief from your constipation, your doctor may consider adjusting your semaglutide dose.

Final thoughts: Managing semaglutide and constipation

Constipation is a common but manageable side effect of semaglutide medications like Ozempic and Wegovy. 

Most people find relief through simple lifestyle adjustments: staying well-hydrated, gradually increasing fiber intake, incorporating regular physical activity, and establishing consistent bathroom routines.

Remember that constipation from semaglutide is typically temporary and often improves as your body adjusts to the medication. 

Contact your healthcare provider if symptoms persist beyond two weeks or become severe, but with the right approach, you can continue benefiting from semaglutide's proven effects without letting digestive discomfort derail your progress.

Manage semaglutide side effects through diet.

Find a weight loss dietitian near you, covered by insurance.

Frequently Asked Questions (FAQs)

Does semaglutide cause constipation?

Yes, constipation is a known and common side effect of semaglutide medications like Ozempic, Wegovy, and Rybelsus.

How long does Ozempic constipation last?

Symptoms may subside as you get used to the medication. Research shows that constipation due to Ozempic can last about 6-7 weeks.

How to prevent constipation from semaglutide?

Stay hydrated, increase your dietary fiber intake gradually, and exercise regularly. If you cannot get enough dietary fiber from your diet, consider psyllium husk (Metamucil) after consulting your doctor. Your doctor may also prescribe laxatives like MiraLAX or stool softeners.

Is constipation common with semaglutide?

Yes, constipation is a well-known side effect of semaglutide drugs like Ozempic, Wegovy, and Rybelsus.

Get your personalized semaglutide diet plan from a weight loss 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.