Starting weight loss medication but not sure what side effects to expect? Here, our Levity experts unpack the common and serious side effects as well as how to manage them.
Semaglutide is the active ingredient in popular weight loss treatments such as Wegovy, Ozempic* and Compounded Semaglutide** and belongs to a class of medications called GLP-1 receptor agonists.
It was initially developed for the treatment of type 2 diabetes but has been proven to be useful for chronic weight management, helping obese patients to lose up to 15% of their body weight in just over a year. It promotes weight loss by helping you feel fuller for longer by acting on your brain’s hunger receptors, slowing gastric emptying (digestion) and curbing cravings for sugary foods by regulating your blood sugar levels. [1]
Like all prescription drugs, semaglutide comes with potential risks and side effects but the good news is that these are normally mild and manageable. Most patients experience side effects either when they first start treatment or after a dosage increase.
Some of the most common side effects caused by semaglutide are gastrointestinal issues, meaning they impact the digestive tract from the mouth to the anus. Studies have shown that 43.9% of patients on 2.4mg semaglutide experienced nausea, 29.7% experienced diarrhea, 24.5% experienced vomiting, and 24.2% experienced constipation. [2]
Here’s what our experts recommend doing to manage and prevent gastrointestinal side effects:
Semaglutide-containing medications like Wegovy, Ozempic* and Compounded Semaglutide** are administered via subcutaneous injection (into the fatty tissue just under your skin) and sometimes this can result in reactions localised around the injection site. A reaction may present as pain, itching, swelling or redness around the site of injection and we recommend using non-drowsy antihistamines or local antihistamine creams to help symptoms. To prevent inflammation altogether, rotate injection sites each week.
Other common side effects of semaglutide may include heartburn, headaches, fatigue or dehydration. Here’s what we recommend to help manage them.
It is important to note that there are more serious side effects and risks of semaglutide and while these are rare you should be aware of warning signs and seek medical attention if you notice any symptoms. More serious side effects and risks include increased heart rate, kidney injury, pancreatitis and thyroid tumours.
The pancreas is located behind the stomach and is crucial for healthy digestion and blood sugar control and acute pancreatitis is characterised as inflammation of the pancreas. Symptoms can include persistent and severe abdominal pain, which sometimes radiates to the back, which may or may not present with vomiting. [3] You must stop semaglutide treatment immediately if pancreatitis is suspected and seek urgent medical attention.
While semaglutide has been shown to decrease the risk of heart disease in trials [4] there is a risk of it increasing your resting heart rate. You should seek medical attention if you notice a racing heartbeat at rest or heart palpitations while on your treatment. [3]
Studies of semaglutide treatment in rodents have noted the formation of thyroid C-cell tumors. While this effect has not been studied in humans, semaglutide cannot be prescribed to patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN2). [3] Remember to keep your healthcare provider updated with your family history throughout your treatment and stop treatment if there are any changes to your history of MTC or MEN2.
GLP-1 agonists like semaglutide have been linked to acute kidney injury which can happen if you become dehydrated causing reduced blood flow to your kidneys. Symptoms of sudden changes in kidney function include decreased urine output and swelling in the legs. [3] You should seek medical attention if you notice any symptoms while on your treatment.
Like any prescription medication, semaglutide can cause severe allergic reactions or anaphylaxis. Symptoms of anaphylaxis may include shortness of breath or wheezing, swelling of your throat or tongue, hives, difficulty swallowing, and a red rash. [3] If you’re experiencing a severe allergic reaction, call 911 and seek immediate medical attention.
If you’re interested in using Compounded Semaglutide injections for weight loss, Levity can help. Weight loss injections need to be prescribed by a healthcare professional, who assesses whether these medications are suitable for you. Find out if you’re eligible by starting a consultation today.
*Ozempic is FDA-approved for type 2 diabetes, but may be prescribed off-label for obesity at the discretion of the prescribing physician.
**Compounded drugs are permitted to be prescribed under federal law but are not FDA-approved and do not undergo FDA safety, effectiveness, or quality review.
[1] Wilding JPH, Batterham RL, Calanna S. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine [Internet]. 2021 Feb 10;384(11):989–1002. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
[2] Wharton S, Calanna S, Davies M, Dicker D, Goldman B, Lingvay I, Mosenzon O, Rubino DM, Thomsen M, Wadden TA, Pedersen SD. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab. 2022 Jan;24(1):94-105. doi: 10.1111/dom.14551. Epub 2021 Oct 4. PMID: 34514682; PMCID: PMC9293236.
[3] HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256s007lbl.pdf
[4] Phizackerley D. Semaglutide reduces the absolute risk of major cardiovascular events by 1.5%. BMJ. 2024 Jan 15;q53–3.
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