GLP-1 Constipation? Here’s How to Keep Things Moving

Why Do GLP-1 Medications Cause Constipation?

GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) slow gastric emptying — the rate at which food leaves your stomach. This helps you feel fuller longer, but it also reduces bowel motility. The result? Sluggish digestion and constipation.

For some patients, this starts within the first week. Others experience it after dose increases or if water or fiber intake is low.

What Does GLP-1–Related Constipation Feel Like?

It varies, but common symptoms include:

• Infrequent bowel movements (fewer than 3 per week)
• Hard, dry stools
• Bloating or abdominal discomfort
• A feeling of incomplete evacuation

Even mild constipation can affect appetite, energy, and comfort — and may tempt you to stop your medication prematurely. But with a few adjustments, most cases can be managed effectively.

What Can You Do to Stay Regular?

Here’s what I recommend to my patients:

1. Hydrate More Than You Think You Need

GLP-1s can reduce thirst signals. Aim for at least 8–10 cups of water daily — more if you're physically active or increasing fiber. Warm lemon water in the morning may also help stimulate motility.

2. Focus on Soluble and Insoluble Fiber

Fiber helps bulk and soften stool. Soluble fiber (like oats, chia, flax, beans) feeds gut bacteria and holds water. Insoluble fiber (like leafy greens, veggies, seeds) adds physical bulk. Aim for 25–35 grams per day total, slowly increasing to avoid bloating.

3. Don’t Skip Meals Entirely

Even if your appetite is low, small meals help signal your digestive system to move. Skipping meals can worsen constipation by reducing motility cues.

4. Move Your Body Daily

Even gentle movement like walking, stretching, or yoga supports peristalsis — the wave-like motion of your intestines. Try 10–20 minutes after meals to kickstart digestion.

5. Consider Magnesium Citrate

Many patients respond well to magnesium citrate or magnesium oxide, taken before bed. It draws water into the colon and promotes bowel movements. Always check with your provider before starting a supplement.

6. Try a Probiotic

A well-formulated probiotic can support microbiome balance, reduce bloating, and improve motility. Choose one with diverse strains — especially bifidobacteria — and give it at least 2–4 weeks to work.

What About Laxatives?

Short-term use of gentle laxatives like polyethylene glycol (MiraLAX) can help, especially during dose escalation. Avoid stimulant laxatives (like senna) for regular use, as they can lead to dependence.

Your provider can help guide which options are best based on severity and other medications.

When Should You Be Concerned?

Call your provider if you experience:

• No bowel movement for 5+ days
• Severe abdominal pain or bloating
• Vomiting or signs of intestinal blockage

In rare cases, GLP-1s may cause severe gastrointestinal side effects that require medication adjustments.

Can You Still Reach Your Goals if This Happens?

Yes. Constipation is common but manageable. The key is proactive support — hydration, fiber, movement, and supplement guidance. Don’t suffer in silence or stop your medication without exploring options.

Final Thoughts

GLP-1 medications can be life-changing for weight management and metabolic health — but side effects like constipation can make them feel unsustainable. Fortunately, this is one of the most treatable issues with the right tools.

By staying hydrated, nourishing your gut, and moving regularly, you can support your digestion while still reaping the full benefits of your medication. As always, personalized support from your doctor is essential.