Bloating on GLP-1 Medications: Memo on What to Do

Gas, gassiness and the sensation of stomach fullness can sometimes occur for those using GLP-1 medications like Ozempic, Zepbound, Mounjaro, or Wegovy. This post offers practical tips, based on both social forum insights and scientific studies, to help you manage bloating and improve overall comfort.

Basic Strategies

• Meal size: Eat smaller, more frequent meals instead of large ones

• Eating pace: Chew food thoroughly and eat slowly (20-30 minutes per meal)

• Air swallowing: Avoid drinking through straws, chewing gum, carbonated beverages

• Food journal: Track foods that trigger bloating and create personalized avoid list

• Hydration timing: Drink fluids between meals rather than with meals

• Posture: Maintain upright posture while eating and for 30 minutes after

• Clothing choice: Wear loose-fitting clothes that don't constrict abdomen

By Severity Level

Mild Bloating

• Gentle movement: Short walks after meals to aid digestion

• Herbal support: Peppermint or fennel tea after meals

• Anti-gas foods: Incorporate ginger, turmeric, or pineapple into meals

• Heat therapy: Warm compress on abdomen for 15 minutes

• Yoga poses: Child's pose, cat-cow stretch, or gentle twists

• Abdominal massage: Gentle clockwise circular motions on abdomen

Moderate Bloating

• Gas-forming foods: Limit beans, lentils, cruciferous vegetables, onions

• FODMAP awareness: Consider temporarily reducing high-FODMAP foods

• Digestive enzymes: Take broad-spectrum enzymes with meals

• Activated charcoal: Occasional use after meals (not for regular use)

• OTC relief: Simethicone products (Gas-X, Mylicon) for gas bubbles

• Probiotic support: Daily probiotic supplements or fermented foods

Severe/Persistent Bloating

• Medical evaluation: Rule out small intestinal bacterial overgrowth (SIBO)

• Specialized testing: Food sensitivity testing may identify triggers

• Elimination diet: Structured approach to identify food intolerances

• Prescription options: Doctor may recommend prescription antispasmodics

• Medication adjustment: Discuss GLP-1 dosage or frequency with doctor

• Alternative GLP-1: Consider switching to different GLP-1 medication

Specific Dietary Approaches

• Low-fermentation diet: Reduce foods that ferment rapidly in gut

• Carb adjustment: Monitor carbohydrate quantity and quality

• Soluble fiber focus: Gradually increase soluble fiber (oats, psyllium)

• Salt reduction: Limit sodium to reduce fluid retention

• Food combining: Some find relief by not mixing proteins with starches

• Mindful reintroduction: After elimination, carefully reintroduce foods one at a time

Warning Signs (Consult Healthcare Provider)

• Severe abdominal pain or distension

• Bloating with vomiting or inability to pass gas or stool

• Visible swelling that doesn't improve overnight

• Rapid weight gain with bloating (fluid retention)

• Blood in stool

• Yellowing of skin or eyes

• Significant changes in bowel habits with bloating

Remember that while some bloating can occur with GLP-1 medications, particularly as your digestive system adjusts, severe or persistent bloating should be evaluated by a healthcare professional. Bloating that significantly impacts quality of life deserves medical attention and shouldn't be dismissed as just a side effect.

Scientific References for this article:

• ^{Gastrointestinal tolerability of GLP-1 receptor agonists in type 2 diabetes: A systematic review and meta-analysis — 2018}

• ^{Gastrointestinal adverse events with GLP-1 receptor agonists in type 2 diabetes: A meta-analysis of randomized controlled trials — 2021}

• ^{Effects of GLP-1 receptor agonists on gastric emptying, postprandial glucose, and gastrointestinal symptoms — 2016}

• ^{Semaglutide and gastrointestinal tolerability in patients with type 2 diabetes: Pooled analysis from SUSTAIN trials — 2018}

• ^{Dietary interventions for functional bloating and gas-related symptoms: An evidence-based review — 2017}