Ozempic: Foods to Avoid to Minimize the Side Effects of Semaglutide Treatment

If years of dieting have failed you and you still don’t have the energy to exercise regularly, you may be considering Ozempic or other semaglutide preparations. But with the internet filled with negative experiences of using prescription weight loss solutions, you’re likely worried about how to minimize the risk of experiencing possible side effects.

The foods you eat (or don’t eat) when taking Ozempic can dramatically influence the side effects you experience. In this article, we’ll discuss the foods to avoid on Ozempic and how to make your own Ozempic diet plan.

What Is Ozempic?

Ozempic contains semaglutide, the same active ingredient in Wegovy and Rybelsus. Developed by Novo Nordisk, semaglutide mimics glucagon-like peptide-1 (GLP-1). This is a substance our bodies naturally produce but may become dysregulated when one is obese.

Semaglutide does not increase metabolism or break down body fat. Instead, it slows down gastric emptying into the intestines. This way, you feel more satisfied with smaller meals. It also stimulates insulin production, which shuttles glucose into some cell types. Ozempic acting on the GLP-1 receptors in your brain means it can reduce cravings and enhance satisfaction [1].

These benefits make Ozempic a highly effective treatment. One study showed a 14.9% weight loss success after 68 weeks for Ozempic users, compared to 2.4% in the placebo group. Even with intensive behavioral therapy to change habits, another research study found that the semaglutide group lost 16% of their body weight while the placebo group lost only 5.7% [1].

Can Foods Worsen Side Effects in People Taking Ozempic?

GLP-1 medications slow down the digestion and transportation of food through the gastrointestinal tract. For this reason, heavier foods can be particularly unpleasant to eat as they take longer to digest. However, many people find that this helps them to start eating healthier meals.

Ozempic Foods to Avoid When Using It

Generally, foods high in fat and refined carbohydrates contribute to side effects. They are both more calorie-dense and can slow gastric emptying time even more than semaglutide alone. Others may sabotage your diet and the benefits of GLP-1 meds.

Sugary Foods and Drinks

Sugary foods and drinks, such as sodas, many commercial fruit juices, candy, ice cream, and baked goods, may not be ideal when you start Ozempic or another semaglutide preparation.

An older study demonstrated that total digestive transit time was significantly slower with high intakes of refined sugar. In fact, one volunteer had their transit time rise by 20 hours, even though two had no change. There were also signs of increased gas production in the intestines [2].

To make things worse, both these and GLP-1 meds may raise the risk of gallstone formation. If you have a family history of gallstones, we advise you to avoid foods with added sugar once you start semaglutide or similar Ozempic alternatives [3].

Additionally, sugary foods and drinks have a short gastric emptying time and cause large insulin spikes. This can undo the benefits of semaglutide by increasing the risk of insulin resistance and making you want to consume more calories.

Common recommendations for people with diarrhea on GLP-1 meds include avoiding foods with sugar alcohols. These will have ingredients that end in -ol, such as sorbitol, mannitol, and xylitol [4].

High-Fat Foods

The fat content of meals can significantly slow down gastric emptying. This often has an additive effect on the properties of semaglutide and could even increase your risk of intestinal blockage.

A study in which volunteers ate mashed potatoes with olive oil or water found that the olive oil groups had a much longer gastric emptying time. Despite their olive oil intake only being 30mL or 60mL, emptying time was anywhere between 15 minutes and three hours longer [5].

On the other hand, the texture of fatty foods may relax the lower esophageal sphincter and contribute to reflux. Not only are reflux and heartburn unpleasant, but long-term exposure of your esophagus to stomach acid can cause long-term damage [6].

People on semaglutide for weight loss and other GLP-1 meds are advised to oven-bake, boil, or use a griddle instead of higher-fat and high-calorie methods such as frying. This rules out french fries, donuts, and all other deep-fried dishes. Other top offenders are burgers, pizza, processed meat such as bacon, and hot dogs.

Refined Carbohydrates

Refined carbohydrates are not much better than sugar. Their low fiber content means they are rapidly absorbed and contribute to blood sugar spikes.

Among GLP-1 users, there is an increased risk of gastrointestinal side effects such as gas, bloating, and diarrhea. A small study where people with these complaints were on a low-starch and sugar diet showed significant relief as well as weight loss [7].

Refined carbohydrates are another risk factor for gallstone development. If you want bread or pasta, choose wholegrain options and avoid desserts such as cakes. Some Ozempic users on Reddit recommend combining cottage cheese or Greek yogurt with jam or lemon curd and fruit instead.

Starchy Vegetables (In Excess)

The carbohydrate content of starchy vegetables takes a longer time to digest, as starches have longer carbon chains. They may also be fermented by intestinal bacteria, which increases gas and the risk of bloating.

However, do not eliminate starchy vegetables unless absolutely necessary. They can be a great source of dietary fiber, which may relieve constipation and lower your risk of gallstones. Potatoes, parsnips, sweet potatoes, squash, and yams are all starchy vegetables that are healthy in moderation.

The general advice for people who develop diarrhea on Ozempic and similar medications is to reduce their intake of high-fiber or starchy foods, such as grain products, cauliflower, cabbage, and beans [4].

Alcohol

Alcohol can either speed up or slow down gastric emptying. Lower concentrations, such as that of beer and wine, typically speed up gastric emptying and may stimulate digestion. Levels over 15%, which you usually find in spirits, slow down digestion and can add to semaglutide’s side effects [8]. On the other hand, research shows that alcohol may slow motility [9].

The diuretic effects of alcohol could contribute to dehydration, too. This may further increase your risk of severe constipation and intestinal blockages. If you do drink, it’s best to stick to one and have a glass of water for every alcoholic beverage. It’s also important to remember that alcoholic drinks are often very high in calories and sugar, especially cocktails.

What to Eat on Semaglutide Contained in Ozempic Treatments

The best “Ozempic meals” are smaller in size but rich in protein and minimally processed ingredients like cooked non-starchy vegetables. Fruit, nuts, beans, legumes, and whole grains can all be included, too. Leaner cuts of meat are best, but we recommend eating oily fish in moderation for omega-3 fatty acids.

Ozempic users on the web recommend ideas such as smoked salmon in salads or on bagels with cream cheese, hardboiled eggs, and chicken salad in bell pepper “boats” instead of on bread. Greek yogurt and protein powder in fruit smoothies are popular breakfast options [10]. Although these can have a considerable fat content, they are far less greasy than fried dishes.

Protein may be an essential measure to prevent muscle loss. A sharp drop in calorie intake can not only lead to fat loss but also loss of lean mass. Combining a higher-protein diet with regular exercise, including strength training, may help shift your body composition [11]. Muscle also burns more calories at rest.

Can I Drink Coffee and Diet Soda?

There is no negative interaction between Ozempic and coffee. However, as caffeine is a diuretic, we recommend prioritizing water to stay hydrated and avoid constipation.

Ozempic and diet soda, however, can be a different story. A study on European-American and Mexican-American adults found that diet sodas were linked to increasing obesity. Despite containing fewer calories, they may contribute to metabolic dysregulation [12].

Can I Eat Cheese and Eggs?

Cheese and eggs can be part of a healthy diet in moderation. Many Ozempic users on sites such as Reddit advise others on which Ozempic foods to avoid and that they should try and stick to meals that include foods high in protein. On r/prescription_drugs, users advise avoiding greasy, fatty foods.

The high-fat content in cheese and eggs may increase the risk of side effects. Consider a few slices of cheese on crackers or bread, used as a garnish, or one fried egg with cooked vegetables. Avoid greasy pizzas or omelets.

Other Tips to Reduce GI Upset While Taking Semaglutide

Besides the types of food you eat, here are some other ways to reduce Ozempic side effects and reduce common gastrointestinal (GI) symptoms [4]:

• Eat smaller portions, even if you have to eat more often.

• Do not eat too close to bedtime, and do not eat in bed.

• Avoid lying down soon after eating or lying when eating.

• Only eat if you are hungry, and do not eat if you already feel full.

• Eat slowly and take time to savor your food to prevent overeating and build a healthier relationship with food.

• Do not drink with a straw if you can avoid it.

• Do not be too active after eating; wait for an hour or more between any exercise and meals. However, walking or other gentle physical activities may help dial down “food noise” and build healthier habits.

• Avoid drinking with meals as it can dilute stomach acids and digestive enzymes, especially if you experience nausea.

• Keep a food diary if you suspect any additional triggers. This may also prevent malnutrition, as you can see if your diet has enough protein, vitamins, and minerals.

• It is essential to keep track of bowel movements to avoid obstruction. Monitor your water intake and consider a magnesium or fiber supplement if necessary.

Is There a Recommended Meal Plan to Follow While Taking Ozempic?

There is no one set Ozempic diet plan. However, it is best to prioritize protein and lower-calorie foods that are easier to digest. Diet plans are often personalized to the individual’s requirements and preferences.

One case study detailed a vegetarian meal plan designed to be approximately 1,200 calories per day and taken alongside weight loss injections. Meals included stir-fried tofu with vegetables and cottage cheese, kidney beans with Greek yogurt, and black-eyed beans cooked with onions and tomatoes. Snacks included protein bars, hummus with vegetables, and almonds with raisins [13].

For your own meal plan, you can consult a dietician or subscribe to a meal plan online. Many options are available aimed at helping people build muscle, including those on low-calorie diets.

FAQs on Ozempic and Food

Here are some questions you may have when researching Ozempic foods to avoid and those to keep in your diet.

What Should I Eat While Taking Ozempic?

In summary, the ideal semaglutide diet prioritizes small, protein-rich meals with higher concentrations of vitamins and minerals. Minimally processed foods that feature vegetables and lean meat or vegetarian protein sources are best.

Who Shouldn’t Take Ozempic?

People with Multiple Endocrine Neoplasia Type 2 (MEN2) or a personal or family history of medullary thyroid carcinoma cannot take Ozempic. This is because semaglutide may increase the risk of these cancers [14]. If you’re searching for an alternative to Ozempic, there are other options, such as Mounjaro (tirzepatide).

Can You Eat Fruit on Ozempic?

Yes. Fruit can not only be easy to digest, but it’s also rich in vitamins and “non-essential” nutrients with a range of health benefits, such as polyphenols. Desserts based on fruit are a better alternative to sugary cakes, too.

What Are the Side Effects of Semaglutide?

The most common side effects of semaglutide are nausea, diarrhea, vomiting, and constipation [14]. They usually appear when you increase the dose and are typically temporary. More severe problems include gallstones and intestinal blockages but are less common.

Ozempic Foods to Avoid or Add to Your Diet: Final Thoughts

If you take Ozempic, it’s best to minimize or avoid foods with added sugar, refined carbohydrates, high amounts of fat, and alcohol. These can slow gastric emptying to risky levels, irritate the digestive tract, and sabotage the benefits of GLP-1 meds.

However, the best foods to eat on Ozempic and other GLP-1 drugs include lean protein, plant-based protein sources, and a range of minimally processed vegetable and wholegrain foods. You can also eat healthy fat sources such as salmon, cottage cheese, nuts, and avocado in moderation.

References

1. Bergmann, Natasha Chidekel et al. “Semaglutide for the treatment of overweight and obesity: A review.” Diabetes, obesity & metabolism vol. 25,1 (2023): 18-35. doi:10.1111/dom.14863

2. Kruis, W et al. “Effect of diets low and high in refined sugars on gut transit, bile acid metabolism, and bacterial fermentation.” Gut vol. 32,4 (1991): 367-71. doi:10.1136/gut.32.4.367

3. Di Ciaula, Agostino et al. “The Role of Diet in the Pathogenesis of Cholesterol Gallstones.” Current medicinal chemistry vol. 26,19 (2019): 3620-3638. doi:10.2174/0929867324666170530080636

4. Gorgojo-Martínez, Juan J et al. “Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus.” Journal of clinical medicine vol. 12,1 145. 24 Dec. 2022, doi:10.3390/jcm12010145

5. Gentilcore, Diana et al. “Effects of fat on gastric emptying of and the glycemic, insulin, and incretin responses to a carbohydrate meal in type 2 diabetes.” The Journal of clinical endocrinology and metabolism vol. 91,6 (2006): 2062-7. doi:10.1210/jc.2005-2644

6. Fox, Mark et al. “The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms.” Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association vol. 5,4 (2007): 439-44. doi:10.1016/j.cgh.2006.12.013

7. Roth, Bodil, and Bodil Ohlsson. “A starch- and sucrose-reduced diet may lead to improvement of intestinal and extraintestinal symptoms in more conditions than irritable bowel syndrome and congenital sucrase-isomaltase deficiency.” Nutrition (Burbank, Los Angeles County, Calif.) vol. 117 (2024): 112254. doi:10.1016/j.nut.2023.112254

8. Gonzalez, Zorisadday et al. “Alcohol and gastric motility: pathophysiological and therapeutic implications.” Journal of investigative medicine: the official publication of the American Federation for Clinical Research vol. 68,5 (2020): 965-971. doi:10.1136/jim-2020-001327

9. Usai-Satta, Paolo et al. “Gastroparesis: New insights into an old disease.” World journal of gastroenterology vol. 26,19 (2020): 2333-2348. doi:10.3748/wjg.v26.i19.2333

10. “Reddit – Dive into Anything.” Reddit.com, 2024, www.reddit.com/r/Ozempic/comments/1ewzuqc/husband_here_need_recipe_suggestions_for_higher/. Accessed 24 Nov. 2024.

11. Neeland, Ian J, et al. “Changes in Lean Body Mass with Glucagon‐like Peptide‐1‐Based Therapies and Mitigation Strategies.” Diabetes Obesity and Metabolism, 27 June 2024, https://doi.org/10.1111/dom.15728.

12. Fowler, Sharon P G et al. “Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging.” Journal of the American Geriatrics Society vol. 63,4 (2015): 708-15. doi:10.1111/jgs.13376

13. Niranjan, Varalakshmi, and Jennifer Ozimek. “Case report of a female western Indian vegetarian with obesity.” Obesity pillars vol. 12 100137. 1 Oct. 2024, doi:10.1016/j.obpill.2024.100137

14. Chao, Ariana M et al. “Clinical Insight on Semaglutide for Chronic Weight Management in Adults: Patient Selection and Special Considerations.” Drug design, development and therapy vol. 16 4449-4461. 29 Dec. 2022, doi:10.2147/DDDT.S365416

This article appears in New Year’s Eve double issue.