Wegovy Diarrhea: Why It Happens & How to Prevent It

1. Slowed Gastric Emptying

Wegovy slows how quickly food moves from your stomach to your intestines. This can disrupt normal digestion and alter gut motility, sometimes causing food to move too quickly through the intestines once it leaves the stomach—resulting in diarrhea.

2. Changes in Gut Bacteria

GLP-1 medications like Wegovy can alter your gut microbiome composition. These changes can affect how your intestines process food and absorb water, sometimes leading to looser or more frequent stools.

3. Reduced Fat Digestion

Wegovy affects pancreatic and bile function, which can impair your body's ability to digest and absorb fats. Undigested fats moving through your intestines can cause diarrhea—especially after eating fatty meals.

4. Dietary Changes

When starting Wegovy, many people drastically change what they eat—often increasing fiber, reducing portion sizes, or eliminating certain foods. These sudden dietary shifts can trigger temporary digestive upset, including diarrhea.

Reduce Fat Intake (Especially Early On)

Limit high-fat foods during your first 4-8 weeks on Wegovy. Choose lean proteins (chicken breast, white fish, egg whites) and avoid fried foods, fatty cuts of meat, heavy sauces, and large amounts of nuts, seeds, or oils.

Why it works: Your body may struggle to digest fats on Wegovy. Reducing fat intake prevents undigested fats from causing diarrhea.

Eat Smaller, More Frequent Meals

Instead of 2-3 large meals, eat 5-6 small meals or snacks throughout the day. Smaller portions are easier for your digestive system to process and less likely to trigger diarrhea.

Example: Greek yogurt at 8am, protein shake at 11am, small chicken salad at 1pm, apple with peanut butter at 4pm, small dinner at 7pm.

Limit High-Fiber Foods Temporarily

While fiber is important for health, too much can worsen diarrhea. Temporarily reduce raw vegetables, beans, lentils, bran cereals, and whole grains. Focus on easily digestible foods like white rice, bananas, cooked vegetables, and lean proteins.

Note: You can gradually reintroduce fiber once diarrhea resolves.

Stay Hydrated with Electrolytes

Diarrhea can quickly lead to dehydration and electrolyte imbalances. Drink 64-80 oz of water daily, and include electrolyte drinks or supplements (Pedialyte, LMNT, Liquid IV, coconut water).

Why it matters: Replacing lost fluids and electrolytes prevents dehydration, fatigue, and cramping.

Avoid Common Trigger Foods

Certain foods are known to worsen diarrhea or irritate your digestive system. Avoid or limit:

• Coffee and caffeinated beverages
• Spicy foods
• Artificial sweeteners (sorbitol, mannitol)
• Dairy products (if lactose intolerant)
• Alcohol
• Greasy or fried foods

Consider Probiotics

Taking a daily probiotic supplement can help restore healthy gut bacteria balance disrupted by Wegovy. Look for probiotics with Lactobacillus and Bifidobacterium strains. Some users report improvement in digestive symptoms with consistent probiotic use.

Slow Down Dose Escalation

If diarrhea is severe with each dose increase, talk to your doctor about staying at your current dose longer before titrating up. Slower dose escalation gives your body more time to adjust and may reduce digestive side effects.

Over-the-Counter Anti-Diarrheal Medications

Imodium (loperamide) is generally safe and effective for managing Wegovy-related diarrhea. Take as directed on the package. It works by slowing intestinal motility.

Pepto-Bismol can also help by coating your stomach and intestines. However, check with your doctor before using regularly, especially if you're taking other medications.

BRAT Diet

Follow the BRAT diet (Bananas, Rice, Applesauce, Toast) for 24-48 hours to give your digestive system a break. These bland, low-fiber foods are easy to digest and can help firm up stools. Add plain chicken or scrambled eggs for protein.

Hydration is Critical

Drink water, electrolyte drinks, clear broths, or herbal tea frequently throughout the day. Aim for at least 8-10 cups of fluid daily when experiencing diarrhea. Watch for signs of dehydration: dark urine, dizziness, dry mouth, fatigue.

Avoid Fiber Supplements

While fiber supplements like Metamucil can help with constipation, they can worsen diarrhea. Avoid them until your bowel movements normalize.

Rest Your Digestive System

If diarrhea is severe, consider eating very lightly for 24 hours—small portions of bland foods only. This gives your gut time to recover. Don't force yourself to eat if you're not hungry.

Is diarrhea more common with Wegovy than other GLP-1 medications?

Diarrhea rates are similar across all GLP-1 medications (Wegovy, Ozempic, Mounjaro, Zepbound). About 20-30% of users experience it regardless of which medication they take. It's a class effect, not specific to Wegovy.

Will diarrhea come back every time I increase my dose?

Not necessarily. Some people experience brief diarrhea with each dose increase, while others only have it initially and never again. Each person's response varies. If it does return with dose increases, it typically resolves faster than the first time.

Can I take Imodium regularly while on Wegovy?

Short-term use of Imodium (loperamide) is generally safe, but don't rely on it long-term without consulting your doctor. Regular use can mask underlying issues and may cause constipation. Focus on dietary strategies and address the root cause rather than constantly suppressing symptoms.

Does diarrhea mean the medication is working better?

No. Diarrhea is a side effect, not an indicator of effectiveness. You can achieve excellent weight loss results on Wegovy without experiencing any diarrhea. The two aren't related.

Should I stop taking Wegovy if I have severe diarrhea?

Contact your doctor before stopping. They may recommend staying at your current dose, reducing your dose temporarily, or implementing more aggressive symptom management. Most cases can be managed without discontinuing treatment, but severe cases may require adjustment.