An NHS doctor has issued a stark warning to individuals considering weight loss injections, highlighting a particularly distressing and common side effect that can be "absolutely miserable" for patients. These medications, known as GLP-1 inhibitors, have surged in popularity due to their effectiveness in managing diabetes and promoting weight loss, but they come with significant gastrointestinal risks.
The Common and Severe Side Effect
In a recent video on TikTok, NHS doctor Suraj Kukadia, widely recognised online as Dr Sooj, addressed his substantial following of over 300,000 people. He emphasised that constipation is the most frequent adverse effect encountered by users of these injections. Dr Kukadia explained that GLP-1 medications, including Ozempic, Mounjaro, and Wegovy, work by slowing gastric emptying, which helps individuals feel fuller for longer and reduces appetite.
How Constipation Develops
This mechanism, however, extends beyond the stomach to affect the entire gastrointestinal tract. The slowing of intestinal contractions means stool moves through the system much more slowly, allowing increased water absorption and leading to constipation. Dr Kukadia noted that while this side effect varies among individuals, higher doses tend to exacerbate the issue, and those already prone to constipation or on other gut-slowing medications like opioids may experience severe symptoms.
Official Warnings and Statistics
The British Heart Foundation corroborates this warning, listing constipation as a "very common" side effect of weight loss injections. According to patient leaflets for Mounjaro and Wegovy, digestive problems such as nausea, diarrhoea, constipation, and stomach pain affect approximately one in ten users. Additionally, these medications can cause other issues including tiredness, dizziness, hair loss, low blood sugar, and an elevated heart rate in some individuals.
It is crucial to note that while Ozempic is not approved for weight loss in the United Kingdom, Mounjaro and Wegovy are authorised for this purpose. The BHF also highlights a potential risk of acute pancreatitis, estimated to affect up to one in a hundred users, advising immediate medical consultation if symptoms like sudden severe abdominal pain occur.
Prevention and Management Strategies
To mitigate the risk of constipation, Dr Sooj recommends several lifestyle adjustments. Maintaining adequate hydration is essential, as sufficient water intake helps keep stools soft despite slowed gut motility. Additionally, ensuring a daily fibre intake of around 30 grams from sources like fruits, vegetables, nuts, and whole grains is vital, though he cautions against abruptly increasing fibre to avoid bloating and discomfort.
Regular physical activity, particularly walking, can stimulate gut motility and alleviate symptoms. If these measures prove insufficient, Dr Sooj suggests considering laxatives or stool softeners, or opting for natural remedies such as prune juice, which contains sorbitol, a natural laxative. Patients experiencing any side effects should consult their doctor, as dosage adjustments or discontinuation may be necessary.
The widespread use of GLP-1 inhibitors underscores the importance of awareness regarding their potential adverse effects. As these medications continue to gain traction for weight management and diabetes control, understanding and addressing side effects like constipation becomes increasingly critical for patient wellbeing and informed decision-making.
