Managing Nausea on Wegovy

Nausea is the most commonly reported side effect of Wegovy. In clinical trials, around 40% of people experienced it at some point, most often during the first few weeks on a new dose. For most women it is mild and manageable; for a smaller number it is genuinely disruptive. Either way, there is a lot you can do to make it better.

Why it happens Wegovy slows the rate at which food leaves your stomach. This is part of how it makes you feel full for longer, and it is also why a full stomach can feel uncomfortably heavy or queasy. On top of that, GLP-1 receptors sit in the brain areas that regulate appetite and nausea, so the medication has a direct signalling effect too.

Nausea usually peaks in the first week or two after a dose increase, then fades as your body adapts. If you push through a difficult week, most people find the following week is noticeably easier.

When to expect it - The first week on your very first dose - The first week or two after each dose increase - After larger, richer or fattier meals - Late in the evening, particularly on injection day - On an empty stomach when you have gone too long without eating

If you can predict when you are most vulnerable, you can plan around it - lighter meals, earlier dinners, and being kind to yourself for a few days.

What tends to help - Eat smaller meals more often rather than three big ones - Stop eating at the first sign of fullness, not when your plate is empty - Slow down - put your cutlery down between bites - Avoid fried, greasy, very fatty or heavily fragrant foods for a few days after a dose increase - Cool, bland foods often go down easier than hot rich ones - Sip water, still or fizzy, and consider ginger tea, peppermint tea or ginger sweets - Get fresh air after eating rather than lying down - Keep the bedroom cool at night and sleep slightly propped up if reflux is an issue

Foods that tend to be gentle - Plain crackers, oatcakes, dry toast - Greek yogurt, cottage cheese, milk - Bananas, apples, melon - Boiled or scrambled eggs - Chicken or fish, poached or grilled without heavy sauces - Rice, potatoes, plain pasta - Clear soups and broths

Foods that tend to trigger nausea - Deep fried food, takeaways, very oily meals - Rich creamy sauces - Highly spiced or heavily perfumed dishes - Large portions of red meat - Alcohol, especially wine and spirits - Coffee on an empty stomach

You do not have to give any of these up forever. You are simply giving your stomach easier work while it adjusts.

Hydration and electrolytes Nausea, reduced eating and occasional vomiting can leave you dehydrated, which then worsens the nausea. Aim for at least 1.5 to 2 litres of fluid a day. Water is fine; adding an electrolyte tablet or a small amount of squash makes it easier to get down. Watch for headaches, dark urine, dizziness on standing or muscle cramps - all signs to drink more and add some salt.

Medicines that can help Over-the-counter options are limited, but your prescribing clinician can consider short-term anti-sickness medication if nausea is affecting your daily life. Common options include cyclizine, prochlorperazine, or ondansetron. Do not source these online without a prescription; they interact with other medicines and are not appropriate for everyone.

When to contact your clinician Contact your prescriber sooner rather than later if you experience:

• Vomiting more than once or twice, or unable to keep fluids down
• Severe upper abdominal pain, especially radiating to the back
• Yellowing of the skin or eyes
• Signs of dehydration you cannot correct at home
• Nausea that is not improving after two weeks on the same dose
• Any symptom that feels wrong or frightening to you

Severe, persistent upper abdominal pain can occasionally signal pancreatitis or gallbladder problems and needs urgent medical review.

Slowing the pace If you have tried the strategies above and a dose still feels intolerable, ask your prescriber about staying at your current dose for longer, or stepping back down a level before trying again. There is no prize for reaching the top dose on schedule. The best dose is the one that gives you steady progress with side effects you can live with.

Nausea is temporary. The habits you build around it - smaller meals, slower eating, gentler cooking - are worth keeping long after the queasiness has passed.