The Top Foods To Limit When You're on Drugs Like Ozempic, According to Obesity Doctors
Semaglutide injecting pen in an empty bowl
Drugs like Ozempic, Wegovy and newly-approved Zepbound have become part of the public lexicon in 2023. Though Ozempic is FDA-approved for diabetes management, Wegovy and Zepbound are sought-after for obesity treatment. Overweight patients with an underlying condition like hypertension also qualify for a prescription.
Clinical trials published in 2021 indicated that Wegovy could help patients lose an average of nearly 15% of body weight. Another trial for Zepbound demonstrated patients lost 18% of their body weight while taking the drug.
However, GLP-1s like Zepbound and Wegovy also have side effects, and experts share it's crucial patients understand them.
"Patients must understand that the GLP-1 medications have side effects—they are common and expected, and that particular foods may trigger them," says Dr. Christopher McGowan, MD, a gastroenterologist, obesity medicine specialist and founder of True You Weight Loss. "Nearly everyone will experience nausea when starting Ozempic, Wegovy or related medications."
The drugs are also meant for long-term use, but Dr.McGowan says these unpleasant side effects cause people to stop.
"The more unpleasant side effects patients have, the more likely they are to stop the medication," McGowan says. "That’s a problem."
Another trial showed people who stopped taking Wegovy regained two-thirds of their lost weight within a year. However, McGowan and other doctors say that dietary tweaks can reduce discomfort, especially by minimizing the consumption of certain foods.
Related: Thinking About Trying Ozempic? Here's What You Can Expect Week by Week
What Food Should You Avoid When Taking Ozempic and Similar Drugs?
"Avoid" is a complicated way to phrase the question—we'll get to that in a second. However, experts share it's best to limit the consumption of foods in a specific category. "There's no single food to avoid, but really, it would be very fatty, very heavy foods, which fortunately plays into the same advice that every patient will be given in terms of nutrition," says Dr. Wajahat Mehal, MD, DPhil, the director of the Yale Weight Loss Program.
Here for the concrete examples? "Recent food culprits we’ve received calls about include steak and a pastrami sandwich," says Dr. Katherine H. Saunders, MD, DABOM, an obesity expert, the co-founder of Intellihealth and a clinical assistant professor of medicine at Weill Cornell Medicine.
Dr. McGowan adds a few more: "Fatty meats, high-fat processed foods, cheese-laden pizza and, frankly, most traditional fast foods."
That said, experts generally don't recommend completely avoiding any food (unless you want to).
"We don’t want our patients to feel too restricted," Dr. Saunders says.
However, Dr. Saunders agrees that the recommendation is to consume rich, fatty and heavy foods in small quantities.
Why Experts Recommend Consuming These Foods In Moderation
The recommendation to limit consumption of high-fat, heavy foods isn't about shaming. Instead, experts say the foods can exacerbate an already-common side effect: GI discomfort, including stomach aches and nausea.
What is it about the food?
"One of the primary mechanisms by which the GLP-1 medications work is by delaying stomach emptying," Dr. McGowan says. "They directly slow the rate at which foods leave the stomach. In fact, they can increase the time that food spends in the stomach by many hours and potentially days."
As a result, patients feel more satisfied with less food. However, Dr. McGowan says high-fat foods are already slow to digest without a GLP-1.
"That's why that greasy cheeseburger can sit like a rock in your stomach for hours," Dr. McGowan says. "Unfortunately, this feeling is only amplified for patients on Ozempic or Wegovy. That burger may try to hang around for days. That's not a pleasant experience."
Related: What Happens When You Stop Taking Ozempic?
How to Handle GI Discomfort on Ozempic and GLP-1s
Eat nutritious meals
Some foods exacerbate symptoms of GI discomfort on GLP-1s, but experts share that others often help patients feel their best.
"Lean proteins like chicken, turkey and fish are go-to options," McGowan says. "These are satisfying and nutritious, and they aren't likely to make you feel sick. If you have the choice, these meats will be better than beef, pork or lamb."
Other protein-packed options McGowan recommends include eggs and tofu.
Dr. Mehal says the standard advice to eat plenty of veggies also holds true for patients on a drug like Ozempic. The key is to find something you like."If you don't like them and you don't eat them, they won't do you any good, so I would say eat the vegetables that you like," Dr. Mehal says.
Consume small, frequent meals
It's not just what you eat. Portions and frequency of meals are also significant.
"Breaking it up into smaller meals probably would be a big help with emptying, just because there's less mass there," Dr. Mehal says.
Talk to a doctor
Side effects like GI discomfort are common, but that doesn't mean you have to grin and bear it without help.
"Speak with your prescribing provider because your medication dosage and/or schedule might," Dr. Saunders explains, adding that dieticians trained to work with patients taking GLP-1s can also be clutch.
"It can take a while for some people to get used to eating differently on these medications, so definitely ask for help if you need it," Dr. Saunders says.
Next up: The Best Snack for Heart Disease Patients, According to a Cardiologist
Sources
Dr. Christopher McGowan, MD, a gastroenterologist, obesity medicine specialist and founder of True You Weight Loss
Dr. Wajahat Mehal, MD, DPhil, the director of the Yale Weight Loss Program
Dr. Katherine H. Saunders, MD, DABOM, an obesity expert, the co-founder of Intellihealth and a clinical assistant professor of medicine at Weill Cornell Medicine.
