How to minimize nausea while on a weight loss medication

Dr. Daniel Hodge

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 Sequence Care Team to see if an anti-nausea medication, like Zofran, would be appropriate.

How to minimize nausea

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

  1. Eat slowly and eat moderate portions with limited snacking, spacing out meal frequency.
  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.

Also keep in mind that this is a temporary phase where your healthy eating plan might be put on pause, and that’s totally okay! Once you are no longer experiencing side effects, you can refocus on your weight loss goals.

If your nausea persists despite trying these methods, we have some other recommendations that should help. Please reach out to your Sequence Care Team for personalized recommendations.

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 carbs may go down nicer, like wheat toast or crackers, oatmeal, rice, and pasta. For a bit of nutrition, you can add dips and toppings like 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, you do not feel hungry, or you feel other discomfort — 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
  4. Choose easily-digestible foods (like the BRAT diet)

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.

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 0.8 up to 2 grams per kilogram of body weight.

If you are experiencing loss of appetite, we recommend aiming for a minimum of 60 grams per day for females and 70 grams per day for males. Here are some foods and how much protein they contain that may be more appealing on a low-hunger day:

●    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 wheat bread: 13 grams of protein

●    2 eggs: 14 grams of protein

●    1 protein shake: 20-30 grams of protein

●    4 ounces of chicken: 31 grams of protein

●    4 ounces of salmon: 23 grams of protein

To hit your day’s protein needs, you could start with a slice of toast with peanut butter for breakfast, a yogurt parfait for a light lunch, and a dinner of grilled chicken and brown rice.

3. Eat enough carbohydrates to maintain normal blood sugar levels

When you’re feeling unwell, don’t feel bad about reaching for bread, crackers, noodles, and rice. It’s totally normal to go for more processed foods, as these bland foods are soothing to the stomach.

It’s also important to have enough carbs to prevent symptoms of low blood sugar—including 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[1] are great examples.

Avoid raw, fibrous vegetables like cabbage sand kale — save that brussel 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!

Incorporating a protein smoothie is one of our favorites for sick days since it’s nutritious, hydrating, and so sippable. Simply blend a protein source (like protein powder, greek yogurt, silken tofu, milk / soy milk, or nut butter) with fruit and/or vegetables and your liquid of choice. Here are some of our favorite combinations:

●    2 Tablespoons almond butter + 1 cup pear + 1 handful of kale + 1 cup soy milk

●    1 container vanilla greek yogurt + 1 cup frozen pineapple + 1 handful of spinach + 1 cup coconut water

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 you’re 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 per day if necessary.
  3. Add more movement, such as a morning walk.
  4. Use an over-the-counter gentle laxative, such as Miralax. (Please confirm with your clinician before taking.)

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

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

You can also track your side effects right in your Sequence account.

Dr. Daniel Hodge

About the Author

Dr. Daniel Hodge is board-certified in both internal medicine and obesity medicine with an expertise in chronic disease management, medical weight loss, and urgent care. Dr. Hodge aims to provide a personalized approach to health and wellness that works for our Sequence members.

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