67: Nausea Relief Strategies for GLP-1 Agonist Medications

Nausea is one of the most frequently reported side effects of GLP-1 agonist medications used in obesity treatment, such as Zepbound, Wegovy, Mounjaro, and Victoza. Although not everyone will experience it, the nature of these anti-obesity medications can often lead to nausea, caused by the slowing of gastric emptying.

Anyone who has experienced nausea before, especially during pregnancies, will understand just how debilitating it can be, impacting your daily life and work. So, what level of nausea should you expect from weight loss medications? And how can we effectively manage this side effect? In this blog, I'm sharing practical strategies to mitigate nausea, advice on when to seek medical advice, and insights on using medications like Zofran to ease discomfort.

How to Mitigate Nausea

• Space out meals

Large meals, even if smaller than usual, can trigger nausea due to the medication's effects on gastric emptying. Eating smaller, more frequent meals throughout the day helps prevent overwhelming your stomach and minimizes the risk of feeling malnourished. 

For morning nausea, try nibbling on bland, easily digestible foods like crackers or bread to alleviate discomfort. Additionally, if you're struggling to meet your protein goals while dealing with nausea, consider snacks like Quest chips or cheddar crackers in moderation to maintain nutritional balance without exacerbating symptoms.

• Monitor Your Diet Closely

Being mindful of your food choices can significantly impact your nausea levels while on anti-obesity medications. Keep a close eye on your diet and consider maintaining a nutrition log to track what you're eating. Often, avoiding fried, greasy, and high-sugar foods can alleviate nausea. 

A common scenario is when people indulge in a seemingly innocent meal at a restaurant, only to experience severe nausea afterward. Pay attention to ingredients and cooking methods, as certain oils and preparation techniques can trigger discomfort. Additionally, be cautious with high-carbohydrate, high-sugar foods like cake or candy, as they may exacerbate nausea symptoms. Even seemingly small indulgences, like a slice of pizza, can lead to discomfort if consumed in excess.

• Hydration and Electrolytes

Staying hydrated is crucial, but when nausea strikes, drinking lots of water may not be appealing. Instead, opt for cold beverages or electrolyte-infused fluids, which can ease discomfort. Experiment with different products like HydroFlex from Devotion or hydration drinks from GHOST® to find what works best for you. Caffeine-free options like those from Ghost are particularly helpful for avoiding additional nausea triggers. By prioritizing hydration and electrolyte balance, you can alleviate nausea symptoms effectively.

Other Tips to Alleviate Nausea

• Ginger and Avoiding Spicy Foods: Some people find relief from nausea by incorporating ginger into their diet or avoiding spicy foods altogether.
• Opt for Easily Digestible Foods: Raw vegetables can sometimes exacerbate nausea due to their difficulty in digestion. Consider steaming, boiling, or baking vegetables to aid digestion. Opt for easier-to-digest options like yogurt and smoothies.
• Alcohol Pad Hack: They have done some studies that show smelling an alcohol pad, like the one you might wipe your skin with to clean it before you do an injection, can help acutely with nausea. However, this method is unlikely to be practical for long-term use.

Using Zofran for Nausea Relief

If you're experiencing severe nausea, especially during the initial stages of treatment or dose adjustments, your doctor may prescribe Zofran (Ondansetron) as needed.

Zofran is typically taken every six to eight hours in either a four or eight milligram dosage. It's available in an under-the-tongue dissolving version, making it suitable even if you're actively vomiting.

It's crucial to address nausea and vomiting promptly before they escalate as waiting until symptoms become severe can make it challenging to control them.

While Zofran can effectively alleviate nausea, continuous long-term use may lead to serious side effects. It's generally recommended for occasional use rather than daily intake as it can contribute to constipation, which can exacerbate existing gastrointestinal issues. Zofran can be a valuable addition to your toolkit, especially for road trips or air travel. However, it's important to make sure you discuss the risks and benefits with your doctor before incorporating it into your treatment plan.

Vomiting and Medication Adjustments

It's crucial to understand that vomiting is not a normal occurrence on these medications. Not only can it lead to significant electrolyte imbalances, but it also signals that something else might be going on. If you're experiencing vomiting, it’s important to reach out to your doctor as it could indicate that your medication dosage needs adjusting. 

Another important point to note is the cumulative effect of these medications over time. Sometimes, what seemed manageable in the first few weeks can become problematic later on due to the stacking effect of the medication's half-lives. 

Sometimes, vomiting can also be attributed to eating too quickly or consuming foods that don't agree with you. Remember to eat slowly and mindfully to avoid unpleasant experiences. If vomiting persists, it's time to take a closer look at your diet and consider keeping a nutrition log. Always involve your doctor in these discussions—they're there to help you navigate these challenges and find the best solution for you.

Remember: This blog provides general educational information. Always consult your doctor and medical team for personalized advice and guidance on any symptoms you’re experiencing.