By Amelia Sponseller, FNP-C, Menopause Society Certified Practitioner
GLP-1 weight-loss medications such as Wegovy or Zepbound have helped many Marshview patients lose weight, improve metabolic health, and feel more in control of their relationship with food. Medications like semaglutide- and tirzepatide-based treatments can be incredibly effective—but they’re not magic, and they’re not one-size-fits-all. Side effects are common, especially early on or after dose increases. The good news? Most side effects are mild, temporary, and very manageable with the right support. Here’s how we help Marshview patients stay comfortable and successful on GLP-1 therapy.
Nausea (and Sometimes Vomiting)
This is the most common side effect we see and the one patients worry about most. GLP-1 medications slow stomach emptying and reduce appetite. Eating too much, too quickly, or choosing heavier foods can overwhelm your system.
- Eat smaller portions and stop eating at the first sign of fullness
- Eat slower
- Eat foods that contain water, like soups and gelatin
- Avoid greasy, fried, or very rich foods
- Stick with bland foods if symptoms flare (eggs, yogurt, toast, rice)
- Avoid lying down after you eat
- Go outdoors for fresh air
- Drink clear, ice-cold drinks
Many patients feel best making breakfast or lunch their largest meal and keeping dinner lighter.
Constipation
This is very common. You’re eating less and hydration often drops unintentionally.
- Hydration is key—most people need more fluids than they realize
- Add fiber slowly through foods like berries, oats, chia seeds, and vegetables. Over-the-counter psyllium (such as Metamucil) can also help.
- Magnesium (glycinate or citrate) in the evening can be helpful
- Daily movement—even a walk around the block helps stimulate the gut
We avoid “overcorrecting” with harsh laxatives unless absolutely necessary.
Diarrhea, Bloating, or GI Upset
These symptoms are often food-related.
- Reduce fatty, greasy, or highly processed foods
- Watch sugar alcohols and large carb-heavy meals
- Avoid dairy if you’re lactose sensitive
- Eat regularly—skipping meals can actually worsen symptoms
At Marshview, we often identify personal trigger foods and adjust around them rather than stopping medication altogether.
Fatigue or Low Energy
This is common early on. Calorie intake drops quickly, and your body is adjusting.
- Ensure adequate protein intake to preserve muscle and energy
- Don’t undereat—fueling your body still matters
- Add electrolytes if you’re lightheaded or fatigued
- Strength training 2–3 times per week helps maintain metabolism and energy
We monitor weight loss pace closely—losing too fast isn’t the goal.
Heartburn or Acid Reflux
Often related to timing and portion size.
- Avoid eating 2–3 hours before bedtime
- Keep evening meals smaller
- Limit spicy or acidic foods
- Elevate the head of the bed if needed
Injection Site Issues
Minor bruising or irritation can happen.
- Rotate injection sites weekly
- Let medication come to room temperature before injecting
- Avoid injecting into scar tissue or irritated skin
The Most Important Strategy: Go Slow
Many side effects happen when doses are increased too quickly.
- Individualize titration schedules
- Hold doses longer if side effects appear
- Adjust nutrition and hydration before changing medication
- Check in frequently—no waiting weeks for advice
There is no benefit to rushing. Sustainable weight loss always wins.
Amelia Sponseller is a Scarborough resident, Family Nurse Practitioner, Menopause Society Certified Practitioner, and owner of Marshview Direct Primary Care.
Photo: Solving Healthcare
