Taking GLP-1s can come with a myriad of adverse side effects and nutritional gaps. Here’s what we think you should know and how to feel good as you lose weight. 

Semglutide Sickness

Semaglutide Sickness refers to the negative symptoms that most commonly occur as someone takes semaglutide, or GLP-1s, commonly sold as Ozempic, Wegovy, Mounjaro, and other compounds. For most people, this can include nausea, diarrhea, constipation, gas, bloating, fatigue, and more.  

This might not be surprising. A quick look at social chatter reveals that many people feel sick when they start these medications and struggle with eating and keeping food down. To some extent, calorie reduction is the point, but with fewer calories comes less (literal) energy to metabolize, and nutritional gaps can start to occur that can have serious short- and long-term effects on your muscles, bones, and risk of injury. 

We’re taking this constellation of symptoms and calling it semaglutide sickness. 

Of note, some degree of discomfort is expected but can be especially prevalent if your dosage is too high. Talk with your provider if you’re concerned. 

The Negative Side-effects of Taking GLP-1s

Most people we’ve talked to know some of the negative side effects of taking semaglutide, but, in our opinion, we’d hope for better education. The effects can be serious and long-lasting on your muscles and bones, immune system, and overall well-being. 

Short-term

In the short term you might be feeling nauseous, tired, fatigued. Many of these symptoms are directly related to the fact that you’re eating way less, often around 1,000 calories a day. 

• Less Energy & Calorie Deficit. If you have less energy, it’s because you’re eating about half of the recommended daily amount of calories, so there’s simply less available fuel for your body to burn. In addition, fewer calories may lead to key vitamin & mineral deficiencies such as vitamin B12 (Ryan & Acosta, 2015). 

• Fatigue & Dehydration GLP-1 medications have been shown to increase sodium excretion by up to 30%, which can lead to sodium depletion and imbalances in electrolytes such as magnesium and potassium. (Tonneijck et al., 2019)

• Nausea & Slower Digestion GLP-1s increase the time that food and liquid stay in your stomach, which can help you feel full, but it also can create a feeling of nausea and malaise. This becomes troublesome when you need to increase your protein intake to meet nutritional needs, but this type of food becomes slow or uncomfortable to digest. 

Long-term

We hope that patients taking GLP-1s learn about their long-term risks of muscle loss bone density, and the danger that poses for debilitating injuries. While Ozempic Face is widely talked about, what we personally find more serious is the risk of injury and how that impacts lifelong mobility. 

Let’s talk about it. 

• Appearance & Muscle Loss: When you lose lean muscle, you’re not just losing the aesthetic shape of muscle; you’re losing your body’s main mechanism for regulating blood sugar, which maintains metabolic health to keep you trim over the rest of your life. 

• Fractures & Reduced Bone Density: GLP-1 medications have been linked to increased bone turnover and reduced bone mineral density (BMD), leading to a fourfold increase in bone mineral content (BMC) loss in some patients. (Iepsen et al., 2015).

• Loss of Mobility & Injury: The combination of reduced stability in the soft tissue (muscle) department leads to more weight being borne by the skeletal system (bones) leaving patients prone to injury (UVM Health). Yes, you’ll burn fat, but 40% of weight loss also comes from lean mass (muscle, bones, organs). (NCBI)

In Support of GLP-1s

We’ve spent much of this paper discussing the negative side effects of GLP-1s, but there’s a reason they’re prescribed as often as they are. These drugs are powerful, and they work at addressing many very relevant, pressing issues in our society today.

Despite some side effects, these medications have been successful in helping people lose weight and decrease their risk of other illnesses. So, if you’re on GLP-1s, you’re making the choices to make yourself healthier and happier, and you have our full support. We simply want to keep all of your systems balanced as your body rapidly changes. 

What we want to add along the way is the nutritional knowledge you need to make this weight loss journey sustainable. We want to make sure that as you start treatment, you’re getting the dietary advice to smooth out negative symptoms. Maintaining muscle doesn’t just make you look good; it keeps your body healthy so you can keep your metabolism up and move more to come off of these medications. 

Supplementing your GLP-1 Treatment for Long-Term Health

Having a careful nutritional and exercise plan can help avoid many of the side effects and risks that come with GLP-1s. These supplements should include good quality protein to combat lean mass loss, a means of ensuring balance in hydration levels to prevent nausea and energy fluctuations, and a solid multivitamin to ensure all other essential nutrient needs are being met on a daily basis no matter what you are or aren't able to get down for the day.

Can’t I just eat more chicken? 

GLP-1 medications are very powerful, so in our opinion, you can’t bring a knife to a gunfight. Here’s why: for women, the recommended amount of protein (30% of total caloric intake) equates to about 112g of protein or more per day (The American Journal of Clinical Nutrition).  That’s equivalent to 18+ eggs per day...or a full pound of ground turkey.

And while you technically could eat these macros, when you are nauseous from the medication, that can be very difficult. We love chicken and eggs and recommend them wholeheartedly, but we suggest a shake from a protein source - it's easier to get down – you’re already going through a lot.

Why We Created FlexRX

An orthopedic surgeon isn’t the first person you’d think would get interested in GLP-1s, but that speaks to the severity of bone loss during this treatment. Our team looked at the data, and then looked at our loved ones. Our family members, partners, and friends were taking semaglutides and not getting the education and nutrition they needed to stay safe. 

That’s why we put together FlexRx. We developed protein and supplements to offset semaglutide sickness while still helping you lose weight. Our supplements were designed by doctors & nutritionists to combat negative side effects by balancing your diet so you feel better now and stay strong, healthy, and lean later. 

It’s unfortunate that the supplement industry is always under a lot of scrutiny. Most of the time these supplements are unproven and new on the market. FlexRX supplements are straightforward and time-tested without novel ingredients. What we’re doing that’s different is providing these supplements in flexible powders you can add to whatever you feel like eating. Your appetite is changing; you don’t need or want to choke down the same smoothie once a day. And in addition, education. We’re investing in educational content and materials we think patients need. 

If you’d like to check out our supplements, you can do so at FlexRx.com. If you have any comments or questions, please reach out to the team at  info@getflexrx.com.

With care,

Dr. Ryan Miller & Katie Miller RDN

and the FlexRx Team