Wegovy/ Ozempic Bowel Movements

[Superlambaanana]

Caution: may contain TMI, bordering on Bristol Stool Chart level analysis of poo 🧐 😊

I’m looking for advice from those of you who’ve been on semaglutide for a while now. How did you find digestion and bowel movements?

I’m only on week 2. Last week during week 1, I only pooed twice. I felt a bit constipated and by the end of the week felt a bit sluggish.

Obviously I was eating less than usual. And I was aware that it can slow the digestion process and cause constipation, so I may have been overthinking a bit. Hard to know, but only 2 poos in a week isn't normal as I'd eaten a good 8,000+ calories.

So I bought some generic dulcoease and took 2 pills yesterday. This morning I experienced a big sludge which has certainly emptied my bowel alright, but I don’t fancy having to poo that way from now on! The toilet roll bill would go through the bloody roof!

SO, should I just take one dulcolax occasionally, or introduce a natural laxative (fruit juice etc)? Or is this normal at the start and will regulate itself after a while?

I'm 8 months in and constipation was my main side effect.
I've been in pretty hard core calorie deficit which obviously makes a difference too. Like you say, not so much in the system.

It does get better after a couple of weeks normally, but don't let yourself go for too long without a bowel movement, use the dulco ease even if it's not great. It's been discussed elsewhere and I totally agree that the actual branded DulcoEase capsules (stool softener) work best, even if it takes a while on them. Other brands can be brutal and make you really crampy.

I would steer away from fruit juice because of the calories/sugar content.
I took psyllium husk capsules for a few months but didn't have much effect.
What I do now is I take magnesium citrate capsules nightly and drink lots of water (a minimum of 2 liters/day - also really, really helps shift the weight).

The other thing that works for me if it's been a while is a few of those sugar free Werthers original sweets or Fruit-tella drops in little boxes. M&S have some strawberry & cream ones too that are OK. Full of additives yes, but it feels like a bit of a treat as well, and in calorie deficit it's nice to have a few small treats. And it's my choice. For me they have a better/nicer effect than dulco ease.

Very greasy, carby meals ie pizza have been known to give me diarrhea, even if I didn't have much. Same with alcohol, which I'm trying to avoid (and crave less on the jab). Overnight oats with skimmed milk can also work to but I'm steering away from carbs as much as possible so that's out for me.

Full disclosure: The only time I have really "good, clean, normal" BMs now is when I've done lots of walking + eaten more 'normally' ie treated myself on holiday. During these 8 months I've only really done dog walks most weeks since lots of exercise on a calorie deficit doesn't work very well. You can get quite fatigued as the body essentially has no extra fuel.

But for me the changes in BMs are manageable and a small price to pay, I've lost over 4,5 stone and are now a healthy BMI and waist.
Best of luck!

sorry about all the typos, far too late for me : )

@VanellopeVonSchweetz99 wow, thank you so much for taking the time to share your experience. That's truly invaluable to me. I will try the sweets and the magnesium citrate.

Dog walking is great exercise- think of all the people who don't have dogs and how little walking they do in comparison! (Before I had a dog my step count was lucky to reach 2,000 in a day).

Oh and huge congratulations on losing 4.5 stone. That is amazing and I'm sure you feel like a new woman.

I have 20 years of IBS - slow gut motility - and ozempic caused me to be chronically constipated, this is inevitable due to slow gastric emptying which was now even slower. 10 days between BM’s was normal for me. I even got my pregnancy piles back again due to it.

I did stop ozempic a few months ago and due to my continuing good diet my BM’s are almost completely normal for the first time in my adult life. My gut absolutely hates too much sugar and I have always been plagued by IBS-D and C, likely due to excess sugar intake, fermenting away in my very slow moving bowels.

Do NOT drink or take too much magnesium citrate it is literally bowel prep for colonoscopies.

@Menora So sorry to hear about your experience!
Can I ask a really dumb question re. "Do NOT drink or take too much magnesium citrate it is literally bowel prep for colonoscopies."

What would be the risks, if it agrees with me, iyswim? Depletion of nutrients/ malnutrition long term? And what would you consider too much water and magnesium in your experience? Is it "bad" that the bowels empty?
Just wondering because you are clearly very knowledgeable and magnesium citrate and staying well hydrated has many benefits too but I wouldn't want to give bad advice based on my experiences.
Thank you.

@VanellopeVonSchweetz99 in terms of laxative effects, too much is going to clean your bowel out completely in a very painful, messy and exhausting way and dehydrate you. Whilst we need to keep our bowels moving, stimulant laxatives (something to speed your bowel up) can have negative consequences and long term side effects on your bowels. Some laxatives draw water into your stools to make them easier to pass. I wasn’t aware magnesium citrate was recommended for long term use, it draws in water very quickly. Long term use would be of a very gentle daily stool softener which is not going to cause you to get rapidly dehydrated. You should always consult with a doctor about long term medication.

@VanellopeVonSchweetz99 sorry I had to dash off before. I know mostly only from my own experience of chronic IBS and using stool softeners but even Holland and Barrett have cautioned against daily use of magnesium citrate.

https://www.hollandandbarrett.com/the-health-hub/vitamins-and-supplements/supplements/magnesium-citrate/

Thank you, that's really interesting!

@Menora thanks for your advice. Do you mind me asking how you found ozempic, how long were you on it and at what dose? How long have you been off - it sounds like you are managing to keep the weight off which appears to be the holy grail. Did you make a lot of lifestyle and diet changes when you were on it? Basically could you download your entire experience into a thread post please 🤣 Ok that's probably not possible but as I am at the start of this journey I'm fascinated by anyone who has real life experience.

@Superlambaanana that’s ok! I will try help. I do have a thread here. I have kept it off. But I have not reached my goal. I have seen a big slow down in weight loss since I stopped. I took 0.25mg and 0.5mg for months. I did not move up to 1mg as it was too hard to find. I didn’t need it either 0.5mg was fine. I have lost 3stone total since I started trying. I am 10kg from my goal weight now and it’s getting harder to shift weight. I am having to count calories and work out a lot. But I feel less gross now than I did on ozempic. It is true the hunger comes back. Some of my plateau is due to over eating after I stopped ozempic. I was not being careful as I had come to rely on ozempic to stop me over eating, as I felt so nauseous all the time, when you no longer do it’s very hard. I have had to do a lot of mindfulness about WHY I binge eat and try to eliminate the reasons I over eat. I also do not want my IBS back so that is one motivation!

Thanks @Menora. Sounds like you are doing very well and working hard to keep on track. Well done! Hope I can see a similar level of success x

@Superlambaanana I am not anti ozempic because without it I never would have got this far. But I can see how coming off it is going to be a big problem. Not everyone will be able to afford to take it forever or worry about long term effects so eventually people will want to stop. There is no support for stopping.

Ozempic is meant to teach you to eat well but I do think this is partly a myth. It does a lot of the heavy lifting in managing your hunger by making it lesser, so when it comes back it is a shock. You may think you are working hard but ozempic is working hard at helping you to work hard. I do eat, I don’t starve myself at all but I have had to start tuning out the constant hunger like it is a case of chronic tinnitus. I can only liken it to a chronic ailment that will not go away. I have had to learn ways to manage it, ignore it, talk to it, hate it, stop thinking about it, embrace it, compromise with it. I don’t know how else to make it go away, it seems to be part of me now that I have to learn to live with. I am hungry all day and all night even shortly after I have eaten so I am not sure anymore it’s actually genuine or a malfunctioned sensory receptor I can’t switch off. Yes I drink lots of water. The mother fucker is still there.