So you’re on a GLP-1 and things are going great, but you’re experiencing constipation; what do you do?
First, remember that some side effects are common with GLP-1s, including constipation. Constipation can be defined as having three or fewer bowel movements in a week. You may also experience hard and dry stools that can potentially be painful to pass. However, this symptom is just a phase as your body needs time to adjust to medication. As you adapt, side effects will decrease, but notify your clinician if they persist or worsen.
In the meantime, let’s get into some recommendations.
Increase your water intake
Water intake is crucial, whether you’re on medication or not. Aside from a ton of other important roles water plays in the body, it’s also necessary in keeping stool soft. Water even keeps things moving through your digestive tract, pushing stool more effectively. If you’re eating food and lacking water, you can develop hard stools that are painful to pass.
Typically the recommendation is 73 ounces for women and 100 ounces for men (minimum), but you can schedule a call with our dietitians to get a more accurate idea on what’s best for you.
Tip: Keep a large, refillable water bottle on hand and set phone reminders to help reach your water goals. If you don’t love the taste, consider flavor enhancers!
Increase fiber intake through fruits, vegetables and carbohydrates
Fiber is a carbohydrate, but unlike most carbohydrates that are broken down through digestion, fiber can’t be digested. This plays a role in its many functions. First, fiber will slow down digestion, keeping you fuller for a longer period of time. So foods that are higher in fiber - for example, fruits, vegetables, brown rice, whole grain breads and oats - will provide more satiety. Sometimes focusing on just protein goals can take away from other food groups that are also critical.
Fiber comes in two forms - soluble and insoluble fiber. Soluble fiber means it can dissolve in water, forming a gel-like substance and pulling things through the digestive tract. In this way, soluble fiber helps lower both cholesterol and blood glucose levels. On the other hand, insoluble fiber can’t dissolve in water, so it adds bulk to stool to also help move things through. Therefore, both types of fiber are crucial for reducing constipation.
Foods typically contain a combination of the two types of fiber, meaning eating a variety of fruits, vegetables, nuts, seeds, legumes and grains will provide you with adequate amounts of both. When snacking on packaged foods, read the nutrition label and look for fiber content listed under carbohydrates. Typically, you’ll want at least 3 grams of fiber per serving.
The dietary recommendation for fiber is 25 to 35 grams per day for adults. This can be more easily met by having whole fruits/vegetables as opposed to juices; replacing white breads/pastas with whole grains and adding foods such as flaxseeds and chia seeds to your diet.
Tip: Add 1 tablespoon of ground flaxseeds or 1 tablespoon of chia seeds to your breakfast cereal, oats or yogurt to increase fiber.
Add a fiber supplement
It may be difficult to reach fiber goals through food only for some; and while a food-first approach is ideal, a fiber supplement may be beneficial in this case.
Start slow and increase dosage if necessary, but speaking to your clinician or dietitian can be most helpful.
Our top pick for a fiber supplement is psyllium husk. One teaspoon a day is a good way to start, potentially increasing to 2-3 teaspoons per day if necessary.
Tip: If you’re already getting enough fiber from foods, avoid supplementation as excess fiber can also cause constipation.
Add more movement
Exercise is important for overall health, but it can also be helpful if you’re dealing with constipation. The way this works is that exercise stimulates your colon and so food can pass through at a faster rate.
Exercise can look like going for a walk, swimming, practicing yoga, taking a dance class, lifting weights, and more. If you can find something you enjoy, it will be easier to maintain!
Aim to get 150 minutes of moderate-intensity physical activity plus 2 days of muscle strengthening exercise each week. You can also schedule a call with our fitness professional to get personalized recommendations to help reach this goal based on your starting point.
Tip: Going for a morning walk can be an easy way to add exercise to your daily routine.
Use a gentle laxative or stool softener
Laxatives can be used when constipation still occurs despite taking all of previously mentioned measures. They aren’t something to rely on and to use continuously and you should confirm with your clinician before taking any.
The function of laxatives depends on the type; some laxatives directly stimulate the colon to cause movement, while others draw water into the intestinal tract to soften stool. For this reason, it is important to continue drinking to avoid dehydration.
Use Miralax (one cap full) in 4 to 8 oz of water, once a day for up to seven days. Otherwise, try a stool softener such as Colace or Senna.
Tip: There are teas that include Senna leaf and this can taste better than the traditional chewable tablets.
When deciding how to go about treating constipation, you can always ask your clinician or dietitian for best practices. Remember, it’s a common side effect that is treatable and not something to just endure!