The most common side effects are nausea, early fullness, constipation, mild stomach discomfort, and fatigue. These are usually mild and improve as your body adapts over several weeks. Small changes to meals, hydration, and timing can help manage most symptoms.
Nausea: Eat small, slow meals. Choose bland foods when queasy and avoid greasy or spicy options. Ginger tea or peppermints can help. Stop eating at early fullness.
Constipation: Build fiber intake gradually to 25-35 g/day (oats, beans, chia, psyllium). Drink 2--3 liters of water daily. A 10-20 minute walk after meals helps. If needed, try magnesium at night or an osmotic laxative (PEG 3350) per label directions.
Fatigue and GI discomfort: Stay hydrated, prioritize protein at each meal, and consider adding electrolytes on active or hot days.
Injection site redness: This is common and usually resolves on its own. Rotate your injection sites.
When to contact your provider: Reach out if nausea or vomiting lasts more than 24 hours, you can't keep fluids down, constipation lasts more than 3--4 days despite taking steps above, or side effects worsen after a dose increase.
Warning signs --- seek urgent care: Severe or persistent abdominal pain, repeated vomiting, signs of dehydration, black or bloody stools, yellowing skin or eyes, swelling of face or throat, trouble breathing, chest pain, confusion, or severe weakness. If you think it's an emergency, call 911.