If you're taking Ozempic, Wegovy, Mounjaro, or other GLP-1 medications, you may have noticed that bathroom visits have become... less frequent. Constipation is one of the most common side effects, affecting up to 24% of users. Here's why it happens and what you can do about it.
Why GLP-1 Medications Cause Constipation
Slowed Gastric Emptying
GLP-1 medications work partly by slowing down how quickly food moves through your digestive system. This is intentional—it helps you feel full longer and eat less. But the same mechanism can slow down your entire GI tract, including your colon.
- Food stays in stomach longer
- Transit time through intestines increases
- More water is absorbed from stool
- Result: harder, less frequent bowel movements
Reduced Food Intake
When you eat less:
- Less fiber enters your system
- Less bulk to move through intestines
- Less stimulation for natural bowel movements
Dehydration
GI side effects like nausea can lead to:
- Drinking less water
- Fluid loss from vomiting
- Harder stools due to less water content
How Common Is It?
Clinical trials show constipation affects 10-24% of people on GLP-1 medications. It's usually mild to moderate and often improves over time as your body adjusts.
Symptoms to Watch For
Constipation on GLP-1s may present as:
- Fewer than 3 bowel movements per week
- Hard, dry, or lumpy stools
- Straining during bowel movements
- Feeling of incomplete evacuation
- Bloating and abdominal discomfort
- Feeling "backed up"
Prevention Strategies
The best approach is preventing constipation before it becomes severe:
1. Prioritize Fiber
Even when eating less, make fiber a priority:
- Target: 25-30 grams per day
- Best sources: Vegetables, berries, legumes, whole grains
- High-fiber fruits: Pears, raspberries, prunes
- Tip: Increase gradually to avoid gas and bloating
2. Stay Hydrated
- Aim for 64+ ounces of water daily
- More if you're active or live in hot climate
- Fiber needs water to work—without it, fiber can worsen constipation
- Set reminders if you forget to drink
3. Move Your Body
Physical activity stimulates the digestive system:
- Daily walks can help significantly
- Core exercises massage the intestines
- Even gentle movement helps
- Aim for 30 minutes of activity most days
4. Establish a Routine
- Try to go at the same time daily
- Morning after breakfast is often best
- Don't ignore the urge—go when you feel it
- Give yourself time without rushing
| Strategy | How It Helps | Goal |
|---|---|---|
| Fiber intake | Adds bulk, softens stool | 25-30g daily |
| Water | Keeps stool soft | 64+ oz daily |
| Exercise | Stimulates bowel movement | 30 min/day |
| Prunes/prune juice | Natural laxative effect | 3-5 prunes daily |
| Magnesium | Draws water to colon | 200-400mg |
Treatment Options
If prevention isn't enough, here are safe treatment options:
Fiber Supplements
- Psyllium husk (Metamucil): Gentle, effective bulk-forming laxative
- Methylcellulose (Citrucel): Less likely to cause gas
- How to use: Start with small amounts, increase gradually
- Important: Take with plenty of water
Osmotic Laxatives
These draw water into the colon:
- Miralax (polyethylene glycol): Very effective, minimal side effects
- Milk of Magnesia: Works faster, can be used as needed
- Lactulose: Prescription option
Stool Softeners
- Docusate (Colace): Makes stool easier to pass
- Best for: Hard, dry stools
- Can be taken daily: Gentle and safe for regular use
Stimulant Laxatives
- Senna, Bisacodyl (Dulcolax): Work within 6-12 hours
- Use sparingly: Not for daily use
- Best for: Occasional relief when other methods fail
Important Note
Don't rely on stimulant laxatives daily—your colon can become dependent on them. Use fiber, water, and osmotic laxatives as your first-line approach, reserving stimulants for occasional use.
Natural Remedies That Work
Prunes and Prune Juice
- Contain sorbitol (natural laxative)
- High in fiber
- 3-5 prunes or 4-8 oz juice daily
- Often effective within 24-48 hours
Magnesium Supplements
- Magnesium citrate or oxide work best for constipation
- Draws water into the intestines
- Also supports muscle and nerve function
- 200-400mg daily can help
Coffee
- Stimulates colon contractions
- Works for many people
- Warm beverages in general can help
- Best in the morning to establish routine
Kiwi
- Contains enzymes that aid digestion
- High in fiber
- Studies show 2 kiwis daily can help
Foods That Help vs. Foods to Limit
Foods That Help
- Prunes, pears, apples, berries
- Vegetables (especially leafy greens)
- Legumes (beans, lentils)
- Whole grains (oats, barley)
- Flaxseed and chia seeds
- Yogurt with probiotics
Foods to Limit
- Processed foods (low fiber)
- White bread and refined grains
- Cheese and dairy (can be binding)
- Red meat (takes longer to digest)
- Fried foods
- Bananas (especially unripe)
When to See a Doctor
Contact your healthcare provider if you experience:
- No bowel movement for more than 7 days
- Severe abdominal pain or cramping
- Blood in your stool
- Vomiting or inability to pass gas
- Unexplained weight loss
- Constipation that doesn't improve with treatment
Warning: Bowel Obstruction
In rare cases, severe constipation on GLP-1s can contribute to bowel obstruction. Seek emergency care if you have severe abdominal pain, vomiting, and cannot pass stool or gas. This is more likely with pre-existing GI conditions.
Does Constipation Improve Over Time?
For many people, yes. Constipation often:
- Is worst during the first few weeks
- Improves as body adjusts to medication
- May fluctuate when doses increase
- Becomes manageable with proper habits
However, some people experience ongoing constipation throughout treatment. The strategies above can help manage it long-term.
Frequently Asked Questions
Is it dangerous to be constipated on Ozempic?
Mild to moderate constipation is uncomfortable but not dangerous for most people. However, severe constipation should be addressed. Staying proactive with prevention is key.
Should I stop taking my GLP-1 if I'm constipated?
Don't stop your medication without consulting your doctor. Constipation is usually manageable with the strategies above. If it's severely affecting your quality of life, discuss options with your provider.
Can I take Miralax daily while on Ozempic?
Yes, Miralax (polyethylene glycol) is safe for daily use and is often recommended for GLP-1-related constipation. It's non-habit forming and works by drawing water into the colon.
Will fiber supplements interfere with my medication?
Fiber supplements are generally safe with GLP-1 medications. However, take them at different times than other medications to avoid affecting absorption. Discuss with your pharmacist if you take multiple medications.
Is constipation worse on higher doses?
Some people experience worsening constipation when they increase their dose, as the medication's effects on gastric emptying become stronger. If you're increasing doses, be proactive about prevention.
Conclusion
Constipation on GLP-1 medications is common but manageable. Focus on prevention: adequate fiber, plenty of water, and regular physical activity. If needed, fiber supplements and osmotic laxatives like Miralax are safe for regular use. Don't let constipation derail your weight loss journey—address it proactively.
Key Takeaway
Constipation doesn't have to be an inevitable part of GLP-1 treatment. With the right strategies, most people can maintain comfortable, regular bowel movements while benefiting from these effective weight loss medications.
Related Articles
Learn more about managing GLP-1 side effects in our guide: Ideal Diet While Taking GLP-1 Medications.