Recently, semaglutide drugs like Ozempic and Wegovy have hit the scene like veritable gifts from heaven for folks struggling to steady their blood sugar and lose weight. According to research, these pharmaceuticals really do what they say, helping to tackle stubborn weight and bringing hemoglobin A1C (the gold standard measure of blood sugar) into a healthier range. A large 2021 study in the New England Journal of Medicine found that people with overweight or obesity who took a once-weekly semaglutide injectable for a year lost an average of 14.9 percent of their body weight. Other studies (like this one and this one) have confirmed that these drugs significantly decrease A1C.
Still, it’s not necessarily all sunshine, rainbows, and showing off smaller pant sizes when you’re on one of these medications. As more and more people use semaglutides, reports are emerging that these drugs can cause nutrient gaps—or even outright deficiencies.
If you’re taking a semaglutide, it’s important to be mindful of these possible outcomes. Nobody wants to end up feeling sick due to nutrient deficiencies. After all, you’re probably on semaglutides to feel better.
Here’s a look at why dietary gaps may happen on semaglutides, and how you can keep your nutrition going strong.
- ABOUT OUR EXPERTS: Alyssa Pacheco, R.D., is a registered dietitian. Dr. Miranda LaBant, N.M.D., is a naturopathic doctor. Brian Tanzer, M.S., is a nutritionist and the Director of Scientific and Regulatory Affairs for The Vitamin Shoppe.
Why You Might End Up With Nutritional Gaps on Semaglutides
As a GLP-1 agonist, Ozempic works on several fronts within your GI tract and even your brain. It activates receptors in the pancreas that release insulin, blocks the secretion of glucagon, slows stomach emptying, and sends signals of fullness to the brain. By firing on all these cylinders, the drug makes you feel significantly less hungry. Some users say that even the little “pocket” of appetite they might keep for a post-dinner dessert or afternoon snack simply goes away.
Of course, this vanishing appetite is exactly why Ozempic promotes weight loss, which is also why it’s not great for maintaining proper levels of nutrients. “With a decreased appetite, people typically eat fewer calories than their body needs, which leads to weight loss,” says Alyssa Pacheco, R.D. “With a significant reduction in calories, though, it can be easier for someone to fall short on getting adequate nutrients into their diet.”
Meanwhile, since semaglutide side effects can include nausea, vomiting, stomach pain, and diarrhea, you may also feel too woozy to eat a regular diet (at least until these pass). For most people, side effects are short-lived, Pacheco says, but if they go on long enough, it’s possible that they could create malnutrition.
Nutrients You’re Mostly Likely To Fall Short On
So…if your intake has dipped from low appetite, which nutrients are you most likely to miss? We don’t know with 100 percent certainty just yet, since not enough research has been conducted on the subject yet, says nutritionist Brian Tanzer, M.S., Director of Scientific and Regulatory Affairs for The Vitamin Shoppe. What we do know, according to data from the CDC, is that the most common nutrient deficiencies in the general population are vitamin B6, iron, vitamin D, and vitamin C. Since everyday folks are more likely to lack these nutrients to begin with, insufficiency may be even more likely (or exacerbated) by Ozempic use. “Nutrient deficiencies [like these] may become more prevalent as more people are prescribed these medications,” says Tanzer.
Meanwhile, naturopath Dr. Miranda LaBant, N.M.D., worries about fat-soluble vitamins (which include vitamins A, D, E, and K). “Since weight loss can impact the absorption of fat-soluble vitamins, monitoring and supplementation may be necessary to prevent deficiencies,” she says.
How to Know If You’re Low
Nutrient deficiencies can show up with all sorts of symptoms, from increased anxiety to fatigue. If you feel like something is off with your health, it’s always a good idea to visit your doctor, rather than self-diagnose. The only way to know for certain whether you’re dealing with a nutrient deficiency is to have a blood test, Tanzer says.
If it turns out that you do have a deficiency related to a medication like Ozempic or Wegovy, you’ll want to stay in close collaboration with your doctor, even after initial testing. This can keep nutrition gaps from becoming dangerous. “Regular assessments of nutrient levels, especially for fat-soluble vitamins, can help identify and address potential deficiencies early on,” LaBant says.
How to Fill Nutritional Gaps While on A Semaglutide
Fortunately, you’re not without options when it comes to checking all your nutritional boxes on Ozempic. Here’s how you can avoid falling short:
1. Eat at regular intervals
Simply scheduling your meals at regular times can keep you from skipping them—and ultimately missing out on important nutrients. “This may seem difficult if you don’t have much of an appetite, but meals don’t have to be big,” says Pacheco. “You can even incorporate smaller meals or snacks throughout the day.” Try planning for meals and snacks every two to six hours.
2. Choose Easily digestibile Foods
If uncomfortable side effects are keeping you from eating much, choose your foods wisely. “Opting for easily digestible and nutrient-rich foods, such as steamed vegetables, lean proteins, and whole grains, can enhance nutrient absorption and promote gastrointestinal comfort,” says LaBant. On the flip side, avoiding harder-to-digest foods like anything greasy or fried, as well as ultra-processed items like cookies, chips, or candy, which lack the nutrients you need, can also help your system settle.
3. Prioritize protein
One nutrient rises to the top of the heap for deficiency prevention: protein. Not only does protein preserve muscle mass while you’re losing weight, but it’s also a great meal starter. Build meals and snacks around a healthy source of protein like beans, eggs, or chicken breast, then round out your plate with complex carbs and good-for-you fats. (Check out these dietitian-approved high-protein snacks, if you need some inspiration.) Protein powders are also easy to add to smoothies and shakes for a nutritional boost.
4. Add a Multi to Your Morning
If you’re concerned about meager micronutrients, adding a well-rounded multivitamin to your routine is a simple way to up your intake and hopefully avoid insufficiency. If your blood tests show you’re low on specific nutrients (like vitamin D or iron), your healthcare provider might advise you to snag a higher-dose supplement to get you back in the black.
5. Consult with a dietitian
You don’t have to go it alone here! Speaking with a nutritionist (especially one who’s knowledgeable about semaglutides) will give you the guidance you need to lose weight and control your blood sugar without missing out on critical nutrients. The Vitamin Shoppe offers free nutrition coaching for all Healthy Awards members.