Constipation on GLP-1: what usually helps

Why it happens

GLP-1 medications like semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro) slow digestion down: the stomach empties more slowly, and food stays longer along the way.

With less appetite, meals get smaller, and with less food there’s less fiber coming through and little left for the bowels to move along. Each day’s water often drops too, and that’s missed here.

What usually helps

These are simple steps, and they work better together:

• Water throughout the day, in sips, not large amounts at once.
• Fiber added gradually, always along with fluids: fruit, vegetables, oats, beans and other legumes. If nausea is strong, wait for it to ease before adding more.
• Movement: a walk each day helps the bowels.
• A set time to use the bathroom, without holding it in.

Before drinking more water

If you have heart failure or kidney disease (including if you’re on dialysis), or your care team has given you a fluid or salt limit, follow that limit, not a general water goal.

Medication for your bowels

Take medication for your bowels, including over-the-counter ones, only with guidance from the people who care for you. The same goes for teas and supplements: some interact with medications or are hard on the kidneys or the heart.

When to talk to your care team

If your bowels go more than a few days without moving, talk to the people who care for you without waiting for your appointment. A swollen belly with pain that isn’t severe, with gas still passing and no vomiting, calls for that conversation as soon as possible. So does blood in the stool.

When your bowels are slow on several days of the week, even without stopping for many days in a row, it’s worth telling the people who care for you, and keeping up the water, fiber and walking in the meantime.