Ozempic, a brand name for semaglutide and a type of GLP-1 agonist, is commonly prescribed for diabetes management and weight loss. While effective, it frequently causes gastrointestinal (GI) side effects such as upset stomach, heartburn, nausea, and vomiting. These symptoms can be significantly influenced and often worsened by dietary choices. Understanding which foods to limit and which to prioritize can help mitigate discomfort and enhance the medication's effectiveness.

Certain food types are known to exacerbate the GI side effects associated with Ozempic. High-fat and greasy foods, for instance, slow down the stomach's digestion rate. Since Ozempic already slows digestion, combining it with high-fat items can lead to excessive slowing, increasing the risk of bloating, heartburn, nausea, and constipation. Examples to avoid include fried chicken, French fries, pizza, burgers, donuts, and high-fat dairy products like cheese, ice cream, and butter.

Sugary foods also pose a challenge. They cause rapid spikes in blood sugar, which can counteract Ozempic's efficacy in managing diabetes or hinder weight loss goals. Furthermore, because Ozempic prolongs stomach emptying, sugary foods remain in the digestive system for longer, increasing the likelihood of nausea and upset stomach. Common culprits include baked goods, candy, sugary drinks (juice, energy drinks, soda), and sweetened cereals.

Refined carbohydrates, which have been stripped of fiber, vitamins, and nutrients through processing, can also be problematic. These ultra-processed foods raise blood sugar levels, making it harder to achieve desired results with Ozempic, and can worsen side effects like nausea, constipation, and vomiting. Examples include crackers, certain types of pasta, white bread, white flour, and white rice.

Spicy or acidic foods should be consumed with caution or avoided altogether, as they can irritate the stomach lining and increase acidity. This irritation can lead to issues such as heartburn and diarrhea, intensifying the discomfort experienced while taking Ozempic. Foods in this category include salsa, hot sauce, hot peppers, citrus fruits and juices, vinegar, and tomato-based products.

Highly processed or packaged foods, prevalent in modern diets, contain additives that can negatively affect digestion and raise inflammation. They can also contribute to increased blood sugar, which is particularly concerning for individuals using Ozempic for diabetes. Limiting items like chips, pastries, packaged snack foods, and processed meats is advisable.

Carbonated beverages are another class of drinks that can worsen GI side effects such as nausea, bloating, gas, and heartburn. The "bubbles" from these drinks linger longer in a stomach with slowed emptying, prolonging discomfort. Many carbonated and caffeinated drinks also contain sugar or can raise stomach acidity, further contributing to adverse effects. This includes soda, sparkling water, carbonated juices, and energy drinks.

Regarding alcohol, while generally considered safe in moderation (one to two drinks), excessive consumption can lead to uncomfortable and potentially dangerous side effects. Alcohol irritates the stomach lining and further slows gastric emptying, intensifying GI issues. Additionally, alcohol lowers blood sugar, increasing the risk of hypoglycemia (low blood sugar), especially for individuals with diabetes or those on other blood sugar-lowering medications. The impact can vary based on potency, volume, gender, and individual size.

Conversely, incorporating certain foods and practices can help manage Ozempic's side effects. Hydrating foods like watermelon, cucumber, gelatin, and soup, along with ample water and clear beverages, are encouraged to maintain hydration and mitigate GI issues. Fruits and vegetables provide essential nutrients, fiber, and vitamins; fruits, in particular, are less likely to cause blood sugar spikes.

Whole grains such as oats, quinoa, and brown rice, consumed in moderation, can help regulate appetite and stabilize blood sugar. Lean proteins like fish, chicken, and tofu are beneficial as they promote satiety without typically causing GI upset and support fat burning over muscle loss. Low-fat dairy products, including low-fat milk, cottage cheese, and Greek yogurt, offer nutritional benefits with a reduced risk of exacerbating GI symptoms.

Beyond dietary choices, several strategies can help minimize side effects. Eating slowly and thoroughly chewing food allows for proper digestion and can help individuals feel fuller quicker, preventing overeating. Avoiding lying down immediately after meals and opting for a short walk instead can reduce the risk of GI side effects. Staying well-hydrated is crucial, as dehydration can worsen nausea and overall discomfort.

For persistent symptoms, over-the-counter (OTC) medications like Pepcid (famotidine) for heartburn, Gas-X (simethicone) for gas, and Tums (calcium carbonate) for indigestion can provide relief when used before or after meals. Finally, gradually increasing fiber intake can alleviate constipation, a common side effect, though excessive fiber can lead to gas or bloating, so moderation is key.