Weight loss is a famous side effect of Ozempic, the Type 2 diabetes drug, but patients often find they must avoid certain foods on the medication.
It’s a similar story with Wegovy, the form of Ozempic approved for weight loss. Both contain semaglutide, a synthetic version of a hormone known as GLP-1, which the body releases into the intestine when people eat food, TODAY.com previously reported.
The hormone tells the brain you’ve had a meal, leading to reduced appetite and hunger. But it also slows down stomach emptying, which can lead to uncomfortable symptoms.
“Food remains in the stomach for a longer period of time. This is one mechanism that contributes to weight loss with this class of medications — people using them have a prolonged sense of satiety and greater portion control,” Dr. Christopher McGowan, an obesity medicine physician and founder of True You Weight Loss in Cary, North Carolina, tells TODAY.com.
“(But) this is exactly why many patients experience nausea and even vomiting with the GLP-1 medications.”
Some foods may stay in the stomach for many hours or even days when taking these drugs, he notes.
What foods can make you sick on Ozempic?
Greasy, high-fat foods:
They are slower to digest and tend to stay in the stomach the longest, McGowan says.
The longer food remains in the stomach, the more likely a person is to experience nausea and other unpleasant symptoms, such as belching, excessive fullness and vomiting, he adds.
High-fat foods tend to cause a lot of diarrhea, says Dr. Shauna Levy, a specialist in obesity medicine and medical director of the Tulane Bariatric and Weight Loss Center in New Orleans.
"I’ve seen an almost dumping syndrome-like response in people taking GLP-1s when they eat simple carbohydrates and high-fat foods," Levy tells TODAY.com.
One Ozempic patient previously told TODAY.com she could once eat a whole pizza, but after using the medication, she’d feel “completely sick” after eating two slices because it was too much grease. Another patient could no longer tolerate hoagies.
Fruits and vegetables that contain significant roughage:
Roughage is the indigestible portion of food. McGowan says fruits and vegetables that contain a lot of it are also slow to exit the stomach and can be problematic. The list includes stringy raw fruits and vegetables, such as pineapple or celery, and those with a tough peel, such as an apple.
They include broccoli, cauliflower, cabbage, Brussels sprouts, onions and asparagus can also lead to excessive, unpleasant gas, he adds.
Sweet foods and drinks:
Patients should skip sweet foods if they experience nausea, advises Novo Nordisk, the pharmaceutical company that makes both Ozempic and Wegovy.
Sugary foods can cause stomach aches, Levy says. She also advises skipping sugary drinks.
If a patient has baseline acid reflux, any foods that exacerbate the condition may be more likely to exacerbate reflux on GLP-1s because the medications delay gastric emptying and can cause acid reflux, Levy says. Spicy foods would fit into that category.
Symptoms include heartburn and regurgitation, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
But if you’re somebody who doesn’t have acid reflux, spicy food is probably fine, Levy notes.
What should you avoid while taking Ozempic?
Alcohol is a problem for multiple reasons, Levy cautions.
“One, it’s just empty calories. Two, it tends to make people make decisions that they otherwise might not make,” she notes.
“It could increase hunger, and the whole point of GLP-1s, or at least one of the points, is to decrease hunger. So it sort of negates their purpose.”
Alcohol is probably fine in moderation, but some people may not be able to tolerate it, Levy adds.
The most common side effects of Ozempic and Wegovy include nausea, diarrhea, vomiting, stomach pain and constipation, according to Novo Nordisk.
Overall, figuring out which foods and drinks can cause problems is a trial-and-error process, Levy says.
Registered dietitian Emily Rubin, who works at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, also offered these tips to reduce nausea while on the medication:
Don’t eat or cook strong-smelling food.
Don’t eat too quickly and don’t have a large drink with meals.
Don’t lie down soon after eating.
Don’t wear tight clothes around your waist.
What is safe to eat on Ozempic?
Patients who experience nausea should eat bland, low-fat foods, like crackers, toast and rice; or foods that contain water, such as soups and gelatin, Novo Nordisk advises.
But there’s no official list of “safe” or “unsafe” foods to eat while on the medication — it’s just a matter of figuring out which foods will cause more symptoms for a patient and limiting those, McGowan says.
“Understanding that overall portions are smaller on these medications, we want to optimize nutritional intake and consume the ‘best’ calories available,” he notes. “The focus should be on lean protein, healthy fruits and vegetables, adequate fiber and adequate fluid intake.”
The most ideal situation would be to commit to eating a healthier diet on Ozempic as semaglutide reduces hunger and cravings for unhealthy options, Dr. Zhaoping Li, professor of medicine and chief of the division of clinical nutrition at the University of California, Los Angeles, previously told TODAY.com.
Does Ozempic make you not like food?
Some patients may experience decreased cravings, hunger and pleasure in eating certain foods, especially when they first start taking Ozempic or Wegovy, Dr. Ania Jastreboff, associate professor at Yale School of Medicine and obesity medicine physician-scientist, tells TODAY.com. (Jastreboff is on the scientific advisory board for Novo Nordisk and is in charge of a semaglutide clinical trial at Yale funded by Novo Nordisk.)
That's in part because semaglutide, the active ingredient in Ozempic and Wegovy, makes people feel like they’ve already eaten, Dr. Louis Aronne, an obesity medicine physician and director of the Comprehensive Weight Control Center at Weill Cornell Medicine and NewYork-Presbyterian, previously told TODAY.com.
“It’s kind of like if I gave you Thanksgiving dinner and then I asked you to eat another dinner. You’ll say, ‘I can’t possibly eat it. I just ate a whole dinner,’” Aronne, who is a scientific adviser for Novo Nordisk, says.
But, as the patient approaches a healthier weight for their body, the enjoyment of food may return, Jastreboff says.
Some patients also find that intrusive thoughts about food, sometimes referred to as "food noise," go away on the medication. One patient previously told TODAY.com that they first realized the Ozempic was working when they forgot to have lunch one day.
Then, there’s the impact nausea can have on liking food.
“We call it a side effect, but truly that is how the drug could work — by making you feel you don’t want to eat,” Li said.
Can you eat cheese on Ozempic?
Cheese should be limited to smaller portions because it’s high in fat and calories, which can contribute to feeling excessively full, McGowan says. Cheese can also exacerbate constipation in some people, he adds.
Can you eat bread on Ozempic?
Some patients may experience excessive fullness from bread due to a “degree of expansion” that happens after eating it, McGowan notes.
Can you drink coffee on Ozempic?
“Overall, coffee is perfectly fine to consume, but for some individuals can lead to stomach irritation,” he explains. “Therefore, I recommend drinking coffee in moderation, such as one to two cups a day. Patients should also be mindful of calorie-dense additives, like cream and sugar.”
Can you eat eggs on Ozempic?
Eggs are an excellent source of protein, but their fat and protein content can also lead to slower digestion, so patients should be mindful of portion sizes and the preparation method, McGowan says. Cooking eggs in butter, fatty oils or and bacon grease would obviously create a potential problem, he adds.
Can you eat peanut butter on Ozempic?
Peanut butter can be a great option for a healthy protein-rich snack or small meal, but its fat content means patients could experience problems if they eat too much of it, McGowan says.
This article was originally published on TODAY.com