Let's talk about the elephant in the room: GLP-1 medications come with side effects. Nausea, fatigue, digestive issues, and more. The clinical trials mention them. Your doctor warns you. But knowing they exist and knowing how to manage them are two very different things.

After months of trial and error, here are the strategies that actually helped me push through the rough patches without giving up.

Nausea: The Big One

Nausea is probably the most common side effect, especially in the first few weeks and after dose increases. Here's what worked for me:

Ginger Everything

Ginger tea, ginger candies, ginger ale (real ginger, not just ginger flavor). I kept ginger chews in my purse, my car, my desk drawer. When nausea hit, ginger was my first line of defense.

The science backs this up—ginger has been used for nausea for centuries and actually works.

Small, Frequent Meals

Counterintuitive when you're nauseous, but an empty stomach made my nausea worse. Eating small amounts frequently (even just a few crackers or a spoonful of applesauce) kept things more stable.

I set phone reminders to eat every 3-4 hours, even if I wasn't hungry. Just a little bit helped.

Cold and Bland Foods

When nausea was bad, I stuck to the BRAT diet basics: bananas, rice, applesauce, toast. Also: popsicles, plain crackers, cold fruit. Hot, spicy, or greasy foods made everything worse.

Strategic Injection Timing

I do my weekly injection Friday evenings. That way, if I have bad nausea on Saturday, I'm at home and can rest. By Monday, it's usually much better. Find a schedule that works with your life.

Medication Options

My doctor prescribed ondansetron (Zofran) for severe nausea days. I don't use it often, but having it as a backup for really bad days gave me peace of mind. Over-the-counter options like meclizine or dimenhydrinate also help some people.

Important: Always check with your doctor before adding any medications, even over-the-counter ones.

Digestive Issues

GLP-1s slow gastric emptying—that's part of how they work. But it also causes constipation, bloating, and sometimes diarrhea. Fun times.

For Constipation

Water, water, water: I aim for at least 80oz daily. Dehydration makes constipation worse.

Fiber: But introduce it slowly! Too much fiber too fast can make bloating worse. I use a fiber supplement (psyllium husk) and eat lots of vegetables.

Movement: Even a 15-minute walk helps get things moving.

Magnesium: Magnesium citrate or magnesium oxide can help. Start with a low dose and increase as needed. (Again, check with your doctor first.)

Probiotics: Some people swear by them. I take one daily and it seems to help with overall digestive comfort.

For Diarrhea

This was less common for me, but when it happened:

Avoid greasy, fatty foods. Stick to bland, easily digestible foods. Stay hydrated (you're losing fluids). Imodium can help for occasional use, but if it's frequent, talk to your doctor about adjusting your dose.

Acid Reflux and Heartburn

Slower digestion means food sits in your stomach longer, which can cause reflux.

Don't eat close to bedtime: I stop eating 3-4 hours before bed.

Elevate your head: Extra pillow or bed risers helped me.

Avoid trigger foods: Coffee, alcohol, spicy foods, chocolate, tomatoes. Your triggers may vary.

Antacids: Over-the-counter antacids or H2 blockers can help. For persistent reflux, your doctor might prescribe a PPI.

Fatigue

The tiredness hit me hardest in the first month and after dose increases. Here's what helped:

Prioritize Sleep

Your body is adjusting to a significant medication. Give it the rest it needs. I aimed for 8 hours of sleep nightly, took short naps when needed, and didn't push through exhaustion.

Gentle Exercise

Paradoxically, gentle movement helped with fatigue more than rest alone. A 20-minute walk gave me more energy than lying on the couch. Not intense workouts—just gentle movement.

Protein and Hydration

When I'm eating so little, it's easy to not get enough protein or water. Low protein and dehydration both cause fatigue. I track both and make sure I'm hitting minimums.

Vitamin B12

Some evidence suggests GLP-1s can affect B12 absorption. My doctor had me start a B12 supplement, and my energy improved. Could be placebo, could be real—either way, it helped.

Injection Site Reactions

Redness, itching, or lumps at injection sites happen sometimes. What helped:

Rotate sites: I rotate between my stomach (multiple areas), thighs, and upper arms. Never inject in the same spot twice in a row.

Let the medication warm up: Take the pen out of the fridge 30 minutes before injecting. Cold medication hurts more and may cause more reaction.

Ice before and after: Ice the area for a few minutes before injection to numb it, and after if there's redness or swelling.

Don't inject into scar tissue or areas that reacted before: Give those spots time to heal.

Headaches

I get occasional headaches, especially in the first 48 hours after injection:

Hydration: Usually my headaches were dehydration. Drink more water.

Caffeine: A small amount of caffeine can help. I have green tea.

Over-the-counter pain relief: Acetaminophen or ibuprofen when needed. Check with your doctor about what's safe for you.

When to Call Your Doctor

Most side effects are manageable, but some require medical attention. Call your doctor if you experience:

Severe, persistent nausea or vomiting that prevents you from keeping down food or water. Severe abdominal pain (could indicate pancreatitis or gallbladder issues). Vision changes. Signs of allergic reaction (rash, swelling, difficulty breathing). Severe or persistent diarrhea. Symptoms of low blood sugar if you're taking other diabetes medications. Thoughts of self-harm or severe depression.

Don't try to tough it out. These medications are powerful and require medical supervision.

It Gets Better

Here's the good news: for most people, side effects improve significantly after the first month. Your body adjusts. You learn what works for you. You develop strategies.

The first few weeks were rough for me. Weeks 2-4 were the worst. By week 6, things had stabilized dramatically. Now, months in, I barely have side effects except for mild nausea the day after my injection.

If you're in the rough early stages, hang in there. It gets better. The strategies above helped me push through until my body adjusted.

Everyone's Different

These are the strategies that worked for me. Your experience may be different. You might have side effects I didn't mention, or you might not have the ones I had. You might find completely different solutions.

The important thing is to communicate with your healthcare provider, be patient with your body, and remember that side effects are usually temporary.

For me, the side effects were absolutely worth the results. But only you can decide if that's true for you.

Struggling with side effects? Consider talking to a healthcare provider experienced with GLP-1 medications. Check out our list of recommended telehealth services specializing in weight loss. (Affiliate link—we may earn commission.)