Semaglutide, the active ingredient in medications like Ozempic, Wegovy, and Rybelsus, has gained widespread popularity for managing type 2 diabetes and supporting substantial weight loss. By mimicking the GLP-1 hormone, it helps control blood sugar, slows digestion, and reduces appetite, making it easier for many to achieve healthier body weight. While the benefits are often life-changing, digestive side effects remain a common topic of discussion among users.
Constipation frequently appears as one of these side effects, especially in the early stages of treatment. It can cause discomfort, bloating, and a sense of sluggishness that affects daily life. The slowed digestive process that helps with fullness and portion control can sometimes lead to less frequent bowel movements.
The encouraging part is that constipation is usually mild to moderate and tends to improve as the body adjusts. With practical lifestyle changes and medical guidance, most people manage it effectively and continue enjoying the long-term advantages of semaglutide for health and wellness.
What Is Semaglutide and Why Does It Cause Constipation?
Semaglutide works as a GLP-1 receptor agonist, copying a natural hormone released after eating. This action stimulates insulin release, suppresses glucagon, and slows gastric emptying, which keeps food in the stomach longer for better satiety. These mechanisms are central to its success in diabetes control and weight management.
The same slowing of digestion that reduces hunger can also affect the entire gastrointestinal tract. Food moves more slowly through the intestines, allowing more water to be absorbed from stool, which makes it harder and less frequent to pass. Reduced overall food intake from appetite suppression can further contribute to fewer bowel movements.
This effect is dose-dependent, meaning higher doses often increase the likelihood or intensity of constipation. The body typically adapts over time, leading to fewer issues with continued use.
Does Semaglutide Cause Constipation? The Facts and Statistics
Yes, semaglutide commonly causes constipation, particularly with higher doses used for weight loss. In the STEP trials for Wegovy (2.4 mg weekly), constipation was reported by about 24-25% of participants, compared to around 11% on placebo. For Ozempic at lower doses (up to 2 mg), rates are generally lower, around 5-10% in diabetes-focused studies.
Most cases are mild to moderate and classified as non-serious. Constipation often lasts longer than other GI symptoms like nausea, with median durations reported around 35-47 days in pooled data. Discontinuation due to constipation alone remains low, typically under 5%.
Real-world reports and recent 2025-2026 reviews confirm similar patterns, with symptoms most prominent during dose escalation and improving significantly afterward.
Here is an overview of constipation prevalence from major clinical data:
| Medication / Dose | Constipation Prevalence | Key Notes on Timing and Severity |
|---|---|---|
| Wegovy (2.4 mg weekly) | 24-25% | Common during escalation; often mild-moderate, longer duration |
| Ozempic (up to 2 mg weekly) | 5-10% | Lower at diabetes doses; improves with adaptation |
| General STEP Trials Pooled | ~24% vs ~11% placebo | Peaks early, plateaus then declines after weeks 10-20 |
These statistics draw from STEP 1-5 trials, SUSTAIN programs, and updated safety analyses.
Timeline of Constipation: When It Starts and How Long It Lasts
Constipation usually starts within the first few weeks of treatment or soon after a dose increase. It tends to become noticeable after nausea or diarrhea, often emerging around weeks 4-12 as the medication accumulates.
Individual episodes can persist longer than other GI effects, with some people experiencing ongoing mild symptoms for several weeks to months. Prevalence typically plateaus around week 10 and then decreases steadily. By 3-6 months, most continuing users report much less frequent or resolved constipation.
Long-term studies show that with consistent use, the body adapts, making constipation rare beyond the initial adjustment phase.
Practical Tips to Reduce and Manage Constipation
Simple daily habits often provide the best relief. Increase water intake significantly—aim for at least 8-10 glasses daily—to keep stool softer and easier to pass. Gradually add more fiber-rich foods like fruits (prunes, apples, pears), vegetables, whole grains, and legumes to promote regular bowel movements.
Incorporate regular physical activity, such as a 20-30 minute walk each day, to stimulate intestinal movement. Eat smaller, more frequent meals to avoid overloading the slowed digestive system. Avoid processed, low-fiber, or high-fat foods that can worsen symptoms.
Over-the-counter options like stool softeners (docusate), osmotic laxatives (polyethylene glycol/MiraLAX), or gentle fiber supplements (psyllium) can help when needed, but always consult your doctor first. Probiotics may support gut balance for some individuals.
Here are effective strategies many find useful:
- Drink plenty of water and herbal teas throughout the day
- Add fiber slowly to prevent gas or bloating
- Stay active with daily movement like walking or light exercise
- Establish a regular bathroom routine
- Consider magnesium supplements (with medical approval) for added relief
These approaches support digestive health while maintaining semaglutide benefits.
Other Related Side Effects to Know About
Semaglutide often causes a range of gastrointestinal effects that appear together early on. Nausea affects up to 44% on higher doses, diarrhea around 30%, vomiting 20-25%, and abdominal pain 15-20%. These usually follow a similar early-peak pattern and fade with time.
Less common issues include fatigue, headaches, or burping. Rare but serious concerns like severe abdominal pain, persistent vomiting, or gallbladder problems require immediate medical attention.
Monitoring and reporting symptoms ensures safe ongoing treatment.
When to Contact Your Doctor About Constipation
Talk to your healthcare provider if constipation lasts more than a few weeks without improvement, becomes severe (fewer than three bowel movements per week with pain), or includes symptoms like blood in stool, intense cramping, or vomiting.
Seek urgent care for signs of complications such as sudden severe pain, fever, or inability to pass gas/stool. Your doctor may adjust the dose, recommend specific remedies, or evaluate for other causes.
Regular follow-ups help tailor treatment for the best results.
Summary
Semaglutide does cause constipation in a notable percentage of users, with rates around 24-25% on higher-dose Wegovy and lower on Ozempic. This side effect results from slowed digestion and reduced intake, is typically mild to moderate, and improves substantially over weeks to months as the body adapts.
Lifestyle adjustments like increased water, fiber, exercise, and strategic remedies make it manageable for most. The significant benefits for weight loss, blood sugar control, and overall health often outweigh temporary discomfort.
Consult your healthcare provider for personalized strategies and monitoring to make semaglutide work effectively and comfortably.
FAQ
How common is constipation with semaglutide?
Constipation affects about 24-25% of people on the 2.4 mg Wegovy dose, and 5-10% on lower Ozempic doses. It’s a recognized but usually mild side effect. Most cases occur early and improve with time and management.
How long does semaglutide-related constipation typically last?
Symptoms often start in the first few weeks and can persist for several weeks to months, with longer individual episodes than nausea. Overall, it peaks early, plateaus around week 10, and fades significantly by 3-6 months for most users.
What helps relieve constipation while taking semaglutide?
Increase water intake, add fiber-rich foods gradually, exercise daily, and eat smaller meals. Over-the-counter stool softeners or laxatives may help with doctor approval. These steps soften stool and promote regularity without interfering with treatment.
Is constipation worse with higher doses?
Yes, higher doses like 2.4 mg in Wegovy lead to more constipation than lower ones used in Ozempic. It often intensifies briefly during dose increases but improves as tolerance develops over time.
When should I worry about constipation on semaglutide?
Contact your doctor if it’s severe, lasts weeks without relief, includes blood, intense pain, vomiting, or no bowel movements for several days. These may indicate complications needing prompt attention. Regular check-ins keep treatment safe.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.