This article was originally written by the Sequence clinic team (now known as WeightWatchers Clinic).

How to minimize nausea while on a GLP-1 weight loss medication

Published November 14, 2023 | Updated May 5, 2024

Because of the appetite suppression and delayed gastric emptying that can come with many weight loss medications (mainly GLP-1 medications), one of the most common side effects you may experience is nausea.

In this article, we’ll cover how much nausea you can expect on a GLP-1 medication and how to minimize the nausea you experience.


Nausea and other common side effects

You may experience some side effects with your weight-loss medication. The most common are nausea, indigestion, constipation, and diarrhea.

Typically, these side effects occur when you first start your regimen or when you increase your dosage, and they should go away over time as your body adjusts to your treatment.


What amount of nausea is normal?

Mild-to-moderate nausea and stomach discomfort are normal, but frequent vomiting and severe pain are not.

Nausea may last for a few days and up to a few weeks — it depends on how your body tolerates the medication.

If your side effects impair your ability to do normal daily activities, then reach out to your prescribing healthcare practitioner to see if an anti-nausea medication, like Zofran, would be appropriate.


How to minimize nausea

Nausea should subside over time, and there are a few things you can do to help minimize it, including:

  1. Eat slowly and eat moderate portions with limited snacking. We recommend spacing out meals adequately to leave enough time for digestion to occur.
  2. Drink clear or ice-cold beverages and foods that contain more water, like soups.
  3. Avoid lying down after you eat and take a walk outside for some fresh air.
  4. Avoid fried, greasy, or very sugary foods as these can exacerbate feelings of nausea.

Also keep in mind that this is a temporary phase where your weight-loss eating plan might be put on pause, and that’s totally okay! While experiencing nausea, the main goal is to help you eat enough of anything that helps manage nausea symptoms. Once you are no longer experiencing nausea, you can refocus on your weight-loss eating plan and weight-loss goals.



Tips for reducing nausea when you feel sick

Here are some tried and true methods to help you get through those rough days:

  • Drink ice-cold or hot beverages instead of room temperature. Ginger and lemon herbal teas can soothe the stomach, as can ice water or seltzer.
  • Tart and sour flavors can make food more appealing. Try a good squeeze of lemon on salmon, grapefruit in your salad, and berries in your yogurt.
  • Plain carbohydrates may go down easier when nauseous. Opt for foods like plain wheat toast or crackers, oatmeal, rice, and pasta. For a bit of added nutrition, you can add small amounts of the following dips and toppings to these plain carbs: hummus, nut butter, ricotta, mashed avocado and guacamole, or cheese.
  • Avoid anything too spicy or flavorful.
  • Eat your food cold or chilled. When the smell of food turns you off, try eating cold foods like a fruit plate, cheese sandwich, hard boiled eggs, and tuna and chicken salad.


If you experience lack of appetite…

In some cases, you may experience a significant decrease in your appetite, where you do not feel hungry for many hours, or at all. This is a good sign that your medication is working, but it can be a bit of an adjustment period as you learn your new hunger cues.

If you are finding it difficult to eat — either food isn’t very appealing or you do not feel hungry — try these tips to make sure you are still getting good nutrition:

  1. Focus on fluids and electrolytes
  2. Aim for adequate protein intake
  3. Eat enough carbs to maintain normal blood sugar levels

1. Focus on fluids and electrolytes

You should aim to drink at least 64 ounces of fluids every day to avoid dehydration. This includes water, seltzer, tea, and other beverages. If you are not able to eat very much, then you may choose to have an electrolyte beverage like coconut water, sports drinks, watermelon, or orange juice. Electrolyte powders and tablets that are added to water can also be used when you’re not eating much.

Bone broth and soups are also good options — they are easily digestible and can be very nutritious as well. Go for soups with a bit of protein, like lentil soup, chicken noodle soup, and beef and barley, and avoid creamy soups, which can cause an upset stomach

2. Aim for adequate protein intake

Protein is important for maintaining your lean muscle mass. This is especially important when you are losing weight.

Although protein needs vary from person to person, the general recommendation varies from 1 to 1.5 grams of protein per kilogram of body weight. However, up to 2.1 grams of protein per kilogram of body weight may be considered appropriate for some. If you’re a member of the WeightWatchers GLP-1 Program, you can see your individualized minimum protein target in the app.

If you are experiencing loss of appetite, we recommend aiming for a minimum of 60 to 80 grams of protein per day. Here are some foods that may be more appealing on a low-hunger day, and how much protein they contain:

  • 6 oz of Greek Yogurt: 15 grams of protein
  • 1 serving of Special K Protein cereal with 8 oz skim milk: 23 grams of protein
  • 2 tablespoons of peanut butter on 1 slice of whole wheat bread: 11 grams of protein
  • 2 eggs: 13 grams of protein
  • 1 protein shake: 20-30 grams of protein for most shakes, check your specific brand’s Nutrition Facts for the protein value of the brand you’re consuming
  • 4 ounces of cooked boneless skinless chicken breast: 35 grams of protein
  • 4 ounces of cooked salmon: 28 grams of protein

If you’re a member of the WeightWatchers GLP-1 Program, check out the Go-to foods list in the app for even more lean high-protein foods.

To meet your day’s minimum protein needs on a low-hunger day, you could start with a slice of whole wheat toast with 2 tablespoons of peanut butter for breakfast, a Greek yogurt parfait for a light lunch, and a dinner of 4 oz of grilled chicken breast and 1 cup of brown rice.

3. Eat enough carbohydrates to maintain normal blood sugar levels

When you’re feeling unwell, reach for bread, crackers, noodles, and rice. It’s totally normal to go for more bland, low-fiber foods, as they are easier on the stomach.

It’s also important to have enough carbs to prevent symptoms of low blood sugar, such as dizziness, feeling lightheaded, headaches, fatigue, and even fainting. It’s important to pay attention to these symptoms and be careful not to do strenuous exercise when you aren’t eating much.

4. Choose easily digestible foods

If your stomach isn’t feeling well, choosing foods that are easily digested can give it a break. Blended or cooked foods like soups, stews, yogurt, applesauce, and smoothies are great examples.

Avoid raw, fibrous vegetables like cabbages and kale — save that Brussels sprout salad for another day!

Our secret weapon: Protein smoothies

All right, they’re not so secret, but they are a great way to get a lot of essential nutrients in a delicious icy beverage!

Making a protein smoothie is one of our favorite tricks for sick days since it’s nutritious, hydrating, and easily sippable. Simply blend a protein source (like protein powder, greek yogurt, silken tofu, cow’s milk, or soy milk) with 1 small fruit and/or 1-2 cups of vegetables and your liquid of choice. Here are some of our favorite combinations:

  • 2 Tablespoons almond butter + 1 cup pear + 1 cup/handful of kale + 1 cup soy milk
  • 1 container vanilla greek yogurt + 1 cup frozen pineapple + 1 handful of spinach + 1 cup coconut water
  • 1 scoop of protein powder + 1 cup cow’s milk or soy milk or water + 1 cup blueberries + 1 cup/handful spinach


Is nausea a sign that the medicine is working?

Sort of — but side effects are more like growing pains. Weight loss is great, but not if it’s the result is you being too uncomfortable to eat!

The best way to tell if your medicine is really working is to consider the following questions:

  • Am I feeling less hungry?
  • Do I have fewer cravings?
  • Do I get full more quickly with less food?
  • Am I more satisfied after meals and snacks?

Compared to before, you may not be able to finish your favorite pasta dish at a restaurant, or you may feel like you don’t need to! Maybe you’re not craving and polishing off a roll of cookies in one sitting.

But if you’re experiencing nausea that impacts your ability to eat a healthy, sustainable diet or get the nutrients you need to feel full and satisfied, check in with your clinician.


Constipation

In addition to nausea, many people experience mild constipation while on a GLP-1 medication.

If you experience constipation, here are a few recommendations that can help:

  1. Increase your water intake.
  2. Add a fiber supplement, such as psyllium husk. You can take 1 teaspoon daily, increasing to 2-3 teaspoons per day if necessary. When adding a fiber supplement, it’s that much more important for you to also increase your water intake.
  3. Add more movement, such as a morning walk.
  4. Consult with your prescribing healthcare practitioner about using an over-the-counter gentle laxative, such as Miralax or other medications.

Remember, it’s all a phase! As your body gets used to your medication, you should experience less nausea. Let your prescribing healthcare practitioner know if your nausea persists or worsens.

If you need more tips or advice, your Care Team is always available for help!