Weight loss with Ozempic or Wegovy comes with a logical, but potentially shocking, change in eating habits.
Both medications contain semaglutide, which mimics a hormone that tells the brain that you’ve had a meal. Patients taking the drugs feel less hungry and may experience side effects such as nausea, affecting the amount of food they can tolerate.
Jeannine DellaVecchia says she sometimes forced herself to eat while taking Ozempic because she had “absolutely no appetite”, was “completely nauseous” and “vomited all the time”.
“Some days I would have omelettes just to try to introduce something to myself,” DellaVecchia, 40, who works for a hospital in Philadelphia, Pennsylvania, told TODAY.com.
“You don’t feel like eating…it just wasn’t good for me.”
DellaVecchia was prescribed the type 2 diabetes treatment Ozempic to treat symptoms related to insulin resistance caused by congenital adrenal hyperplasia and polycystic ovary syndrome. Weight loss was not a priority although she says she was intrigued that the drug could also help her lose weight.
She did just that, with DellaVecchia losing 30 pounds between August 2022 and February 2023, when she stopped taking the drug because she couldn’t tolerate the side effects, she says. DellaVecchia is currently still at her lowest weight of 152 pounds and is trying to maintain the weight loss with a healthy diet and the help of her dietitian, Emily Rubin.
“I’ve seen patients with chronic nausea and vomiting on (semaglutide), which can cause dehydration and malnutrition if you can’t get enough calories or fluids a day,” Rubin, director of clinical dietetics in the division of gastroenterology and hepatology at Thomas Jefferson University Hospital in Philadelphia, tells TODAY.com.
How to eat while taking Ozempic and Wegovy
Wegovy, which is approved for weight loss by the US Food and Drug Administration, should be used in addition to a calorie-restricted diet and increased physical activity, the agency notes. Ozempic is not approved for weight loss by the FDA, although many people use it off-label for this purpose.
Patients trying to lose weight with either medication should work with a dietitian for a guided meal plan, but in general they should aim to eat 1200-1800 calories per day depending on their initial weight, says Rubin. As a general rule, eating 500 fewer calories a day than usual will result in weight loss of about 1 pound per week, she adds.
Eat lots of different vegetables and healthy proteins as the foundation of your diet, advises Dr. Louis Aronne, a physician specializing in obesity medicine and director of the Comprehensive Weight Control Center at Weill Cornell Medicine and NewYork-Presbyterian.
“We’ve done studies showing that if you eat veggies and protein first and then eat carbs toward the end of the meal, that’s actually good for your blood sugar, probably good for your weight as well,” he said. Aronne, who is a scientist. adviser to Novo Nordisk, the company that makes Ozempic and Wegovy, tells TODAY.com.
“The cornerstone of nutrition should be real food…healthy food.”
For those taking the drug, Rubin recommends increasing your intake of lean proteins such as chicken, turkey, fish, eggs, beans, soy, and low-fat dairy products. If you don’t have an appetite or feel nauseous, try low-calorie protein shakes, she adds.
She advises a minimum of 60 grams (about 2 ounces) of protein per day, preferably spread over meals and snacks. Protein preserves muscle mass and provides the amino acids needed for growth and development, says dietician Kristin Kirkpatrick.
Vegetables and fruits, which are packed with vitamins, minerals and fiber, are essential to a healthy weight loss program, notes Rubin. She also recommends one to two daily servings of healthy fats such as avocados, nuts and seeds.
Choose a small amount of whole grains — one half-cup serving per meal — like whole-wheat pasta, whole-wheat tortillas, quinoa or sweet potato, advises Rubin. These are fiber-rich complex carbohydrates.
How to manage nausea while taking Ozempic and Wegovy
The most common side effects of Ozempic and Wegovy include nausea, diarrhea, vomiting, stomach pain and constipation, according to Novo Nordisk.
Rubin advised patients to talk to their doctors about any bothersome symptoms and discuss the best dose of each medication to minimize side effects.
Patients start with the lowest dose and gradually progress to higher doses, says Aronne. Doctors know how to deal with the nausea problem, he adds. Some patients are given anti-nausea medication.
Generally, if the dose is increased slowly and doctors advise patients not to eat beyond the point of satiety and to notice which foods may exacerbate their symptoms and to eat less of them, the side effects are well tolerated, explains Dr. Ania Jastreboff, director of weight management and obesity prevention at the Yale Stress Center in New Haven, Connecticut. She sits on the Scientific Advisory Board of Novo Nordisk.
For example, DellaVecchia loves hoagies, but if she tried to eat one, it would make her sick, she says. A better option was yogurt with almonds, peanuts and a little cinnamon, which she found delicious and filling.
Another Ozempic patient previously told TODAY.com that fatty foods in general were “really difficult” for her to eat after starting treatment.
Rubin offered these tips for reducing nausea:
Stay hydrated by drinking eight cups of fluids such as water or calorie-free electrolyte drinks daily.
Drink ginger or peppermint tea.
Try chewing gum or ginger capsules.
Eat smaller, more frequent meals.
Do not eat or cook strong-smelling foods.
Avoid hot, fried or fatty foods.
Do not eat too quickly and do not drink a large glass during meals.
Do not lie down shortly after eating.
Don’t wear tight clothes around your waist.
Novo Nordisk had these additional tips:
Eat bland, low-fat foods, such as crackers, toast, and rice.
Eat foods that contain water, such as soups and gelatin.
Go outside to breathe the fresh air.
DellaVecchia says as soon as she stopped taking Ozempic, the hunger returned. She has been able to maintain her weight loss so far.
This article originally appeared on TODAY.com