Semaglutide Constipation & Diarrhea: Causes & What Helps

Does Semaglutide Cause Constipation and Diarrhea?

Gastrointestinal symptoms are among the most common side effects when using GLP-1 medications, such as FDA-approved Ozempic®, Wegovy®, and Rybelsus®.  For some people, semaglutide diarrhea after eating is a frequent early complaint. Others notice the opposite—semaglutide and constipation often go hand in hand as the digestive system adjusts.

While these digestive changes can feel frustrating and uncomfortable, they’re usually temporary and manageable with the right approach. But why do these side effects happen in the first place?

As a GLP-1 receptor agonist, semaglutide mimics glucagon-like peptide-1, a natural hormone your body releases after eating. GLP-1 helps regulate appetite, supports insulin secretion, and also influences how your digestive system works. As such, it slows gastric emptying (how quickly food leaves your stomach), affects nutrient movement through the intestines, and changes the signaling between your gut and brain.

Ultimately, your body needs time to adapt to these changes. And for some, this may mean initial constipation or diarrhea.

How Long Does Semaglutide Diarrhea Last?

Most gastrointestinal side effects peak within the first few weeks of treatment and tend to improve as your body adapts. 

However, individual experiences may vary. You may notice relief within just a few days, but others may need several weeks for their digestive system to fully adapt. 

It’s also common to experience a temporary return of symptoms after a dose increase; this is normal and usually settles down as your body again adjusts.

If diarrhea persists beyond four to six weeks, becomes severe, or is accompanied by other concerning symptoms such as dehydration, blood in the stool, or severe abdominal pain, contact your healthcare provider. They can determine whether a dosage adjustment or additional support is needed.

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How To Reduce Semaglutide Constipation and Diarrhea

With semaglutide side effects, diarrhea and constipation can be some of the most disruptive and uncomfortable ones. You might notice a lingering sense of heaviness, or feel like you need to rush to the bathroom after each meal—neither of which is ideal.

But a few lifestyle changes and tips may help support you and your body through this transitional time.

Discuss Any Side Effects With Your Doctor

A licensed healthcare provider is your best resource when navigating any side effects. Be open about what you’re experiencing—even if it feels awkward to talk about. Your doctor can help determine whether any changes need to be made based on your individual situation.

It also helps to keep track of your symptoms (such as frequency, severity, or timing). This way, you have specific details to share with your physician, which can help them determine whether what you’re experiencing is normal or not.

Drink Plenty of Water

When you’re constipated, water may help soften your stool and keep things moving. And when you have diarrhea, you’re likely losing fluids that need to be replaced. This means it’s important to ensure you’re drinking at least 9–13 cups of water each day, unless your healthcare provider has given you different guidance. Consider adding electrolytes if diarrhea is frequent.

Eat Enough Daily Fiber

Fiber supports healthy digestion by adding bulk to stool and promoting regular bowel movements. 

This means it may be beneficial to incorporate more fruits, vegetables, whole grains, and legumes. For constipation, fiber helps move things along. For diarrhea, soluble fiber (found in oats, bananas, and apples) can help absorb excess water.

However, ensure you increase your intake slowly—adding too much fiber too quickly may worsen gastrointestinal distress.

Limit Caffeine and Alcohol

Caffeine speeds up gut motility, which may aggravate diarrhea. In contrast, alcohol can contribute to dehydration and disrupt normal digestion. This means you may want to consider cutting back, especially during the early weeks of treatment.

Move Your Body Regularly

Gentle physical activity—such as walking or stretching—supports healthy digestion and may help relieve constipation by stimulating the muscles in your intestines and encouraging regular bowel function. Even a short 15-20 minute walk after meals can be beneficial.

Eat Smaller, More Frequent Meals

Large meals can overwhelm your digestive system, especially when it’s busy adjusting to a new medication. Thus, eating smaller portions spread throughout the day gives your gut less to process at once, which may reduce both constipation and diarrhea. 

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Other Semaglutide Side Effects

With semaglutide, side effects such as diarrhea and constipation tend to get the most attention, but they’re not the only digestive symptoms you might encounter. Many individuals also experience other semaglutide side effects, like stomach pain, nausea, vomiting, and decreased appetite—particularly during the first few weeks of treatment or after a dose increase.

Nausea is actually the most commonly reported side effect, but it also typically improves as your body adjusts.

Beyond digestive symptoms, some people report fatigue, headaches, or dizziness—especially early in treatment when the body is adapting to changes in appetite and food intake. 

Less common but more serious side effects may include pancreatitis, gallbladder problems, and kidney issues. Warning signs to watch for include severe or persistent stomach pain (especially if it radiates to your back), persistent vomiting, or signs of dehydration. If you experience any of these, contact your healthcare provider right away.

At the end of the day, most side effects are mild to moderate and tend to decrease over time. Staying in close contact with your licensed healthcare provider helps ensure your treatment plan is working safely and effectively for your individual needs.

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Final Thoughts

Digestive side effects, such as diarrhea and constipation, are often your body’s way of adjusting to this new medication. For most people, symptoms improve within the first few weeks as the body adapts.

In the meantime, simple strategies like staying hydrated, eating enough fiber, moving regularly, and choosing smaller meals may help. And if symptoms persist or become severe, don’t hesitate to reach out to your healthcare provider—they can help determine whether adjustments to your treatment plan might be necessary.

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Ozempic®, Wegovy®, and Rybelsus® are registered trademarks of Novo Nordisk A/S, and we do not claim any affiliation with or endorsement by Novo Nordisk.

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