Weight Management Medications
Side Effects: What's Normal And What Isn't
Most side effects are uncomfortable but expected, and they settle as your body adjusts. A few are not. Here's how to tell the difference.
Call 911 Or Go To The Nearest Emergency Room
- Chest pain or heart palpitations
- Numbness on one side of your body, or numbness affecting how you move
- Signs of stroke — facial drooping, slurred speech, sudden weakness
- Sudden confusion
- Trouble breathing, or swelling of the throat
- Intense, severe abdominal pain
- Fainting or seizure-like activity
If you are having thoughts of harming yourself, call or text 988 — the Suicide & Crisis Lifeline, available 24 hours a day.
Get Evaluated In Person Today — Don't Wait To Hear Back From Us
Go to an urgent care center, your primary care provider, or an emergency room if any of these apply:
- Severe abdominal pain that spreads to your back, especially with vomiting
- Pain in your upper right abdomen, fever, yellowing of the skin or eyes, or pale stools
- Vomiting or diarrhea you can't keep ahead of, or not urinating normally
- Shakiness, sweating, or confusion that improves after you eat
- Any change in your mood that concerns you
Since we are a remote practice, we can't provide emergency or same-day in-person care, as your provider won't be available every day. For anything above, get seen locally first. Afterward, send us a message so your provider knows what happened and can adjust your treatment plan if needed.
If You Took More Than Your Prescribed Dose
Call Poison Control at 1-800-222-1222 — free, confidential, and available 24 hours a day. They'll tell you what to watch for and whether you need to be seen.
If you also have severe nausea, vomiting, or abdominal pain, treat it as an emergency and call 911.
Once you're safe, send us a message so your provider knows and can help you get back on schedule. Don't take your next dose until you've heard from them.
Managing The Common Ones
These are what most people notice in the first weeks, and again after a dose increase. They typically ease as your body adjusts. Tap any one for what tends to help.
These are suggestions, not prescriptions. The over-the-counter options below are what we most often recommend, but they aren't right for everyone. Talk to your provider before starting anything you haven't used before, before combining more than one, if you take other medications or have kidney, liver, or heart conditions, and any time symptoms keep going despite trying these. Follow the directions on the package.
Nausea
- Eat smaller portions more often instead of three full meals
- Stop eating when you feel full — this medication makes full arrive sooner
- Go easy on fried, greasy, and very rich foods
- Eat slowly, and stay upright for a while afterward
- Sip fluids steadily through the day rather than a lot at once
- Ginger — capsules, tea, or chews. The most useful first thing to try.
- Vitamin B6 can settle nausea for some people
- Meclizine or dimenhydrinate if it's persistentBoth can make you drowsy — don't drive until you know how they affect you.
- Bismuth subsalicylate for nausea with an upset stomachTurns your stool and sometimes your tongue dark — harmless, but startling if you're not expecting it. Avoid if you're allergic to aspirin or take a blood thinner.
- There are also prescription options for nausea that don't clear with the above. Message your provider if you think you may need to go that route — it's a common request and nothing to push through on your own.
Constipation
- Increase water first — this is the most common cause, and nothing else works well without it
- Daily movement, even a short walk, makes a real difference
- Docusate, a stool softener, is a reasonable first step
- Polyethylene glycol 3350 draws water into the stool and is gentle enough for regular use
- Magnesium hydroxide or magnesium citrate work similarlyCheck with your provider first if you have any kidney problems.
- Psyllium or methylcellulose fiber — start low, build up gradually, and always take with plenty of water
- Senna or bisacodyl if the gentler options aren't workingThese are stimulants — for occasional use, not every day.
- Give each option a couple of days before adding another
- If you haven't had a bowel movement in several days despite all of this — or you have severe abdominal pain, bloating, or vomiting — stop treating it at home and see the sections above
Gas & Bloating
- Smaller portions, eaten slowly — swallowed air is a big contributor
- Cut back on carbonated drinks
- Watch for personal triggers: beans, cruciferous vegetables, sugar alcohols
- A walk after eating helps more than lying down
- Simethicone is the most straightforward option and can be taken as needed
- Alpha-galactosidase taken before a meal helps if beans and vegetables are your trigger
- Lactase if dairy is the pattern
- Enteric-coated peppermint oil can ease cramping and bloating
Sulfur Burps
- Smaller, lower-fat meals — food sitting longer is usually the cause
- Limit high-sulfur foods for a while: eggs, red meat, garlic, onions, broccoli
- Stay well hydrated
- Bismuth subsalicylate works particularly well for this oneTurns your stool and sometimes your tongue dark — harmless, but startling if you're not expecting it. Avoid if you're allergic to aspirin or take a blood thinner.
- Simethicone for the associated bloating and pressure
- Calcium carbonate antacids can help settle things
- If it comes with vomiting or severe abdominal pain, see the sections above
Diarrhea
- Replace fluids with something containing electrolytes, not just water — an oral rehydration solution is better than sports drinks
- Stick to bland, simple foods for a day or two
- Pause dairy, greasy foods, and caffeine temporarily
- Loperamide for uncomplicated diarrheaDon't use it if you have a fever or blood in your stool — get seen instead.
- Bismuth subsalicylate is a gentler alternativeTurns your stool and sometimes your tongue dark. Avoid if you're allergic to aspirin or take a blood thinner.
- If you can't keep fluids down, or you aren't urinating normally, get seen today
Indigestion & Reflux
- Smaller meals, and finish eating two to three hours before bed
- Stay upright after eating rather than reclining
- Raise the head of your bed slightly if it's worse at night
- Common triggers: spicy food, tomato, citrus, chocolate, caffeine, alcohol
- Calcium carbonate antacids for occasional, immediate relief
- Famotidine lasts longer and can be taken before a meal you expect to bother you
- Omeprazole or esomeprazole if it's happening most daysThese are intended as a short course of about two weeks — let your provider know if you need them longer than that.
Headache
- Dehydration and skipped meals are the usual culprits — address both first
- Eat something with protein even when you aren't hungry
- Keep your sleep schedule steady
- Acetaminophen is the better choice while you're on this medication
- Ibuprofen or naproxen work too, with one caveatOnly if you're drinking and eating normally. These are harder on the kidneys when you're dehydrated, which is easy to become on this medication — skip them on days you've been vomiting or not keeping fluids down.
- A sudden, severe headache is different — see the emergency section above
Fatigue
- There's no over-the-counter fix for this one — it responds to nutrition and fluids, not a pill
- Eating less means fewer nutrients — protein at every meal matters more now
- Dehydration shows up as tiredness before you notice thirst. Electrolytes help if you've been eating very little.
- Gentle, regular activity helps more than rest
- Most people find this improves after the first few weeks at a dose
- If it's persistent, tell your provider — it may be worth checking labs rather than pushing through
Hair Thinning
- This is usually a response to rapid weight loss rather than the medication itself
- It's typically temporary, and it usually starts a few months in
- Adequate protein and consistent nutrition are the most useful things you can do
- Topical minoxidil is available over the counter and can help while things recover
- Rather than starting supplements on your own, mention it at your follow-up — iron, vitamin D, and thyroid are all worth checking, and treating the actual cause works better than guessing
- There are also prescription treatments for hair thinning. Message your provider if you think you may need to go that route.
Injection Site Reactions
- Rotate sites — at least an inch from your last injection
- Let the medication come to room temperature before injecting
- A cool compress afterward helps redness and itching
- Don't rub the site after injecting
- Hydrocortisone 1% cream for itching and irritation at the site
- Cetirizine or loratadine if the itching is bothering you — neither tends to cause drowsiness. Diphenhydramine works too but will make you sleepy.
- Spreading redness, warmth, drainage, or fever needs to be seen today
When To Message Your Provider
For anything that isn't urgent — a side effect that won't settle, a question about whether to adjust your dose, or something that just doesn't feel right — send your provider a message through the patient portal. That's the fastest way to reach the person who knows your treatment plan.
Never change your dose on your own. If a side effect is making it hard to stay on your current dose, say so — adjusting the plan is a normal part of this, not a setback.
If You Went To Urgent Care Or The Emergency Room, Tell Us
Even after you've been seen and you're feeling better, we want to know. Send your provider a message with what happened, what you were told, and any new medication you were given. Records from an outside visit don't reach us automatically, and what happened may change how we handle your next dose. There are often next steps we can walk you through.
This page is general information for our patients and is not a substitute for medical evaluation. If you're unsure how serious something is, treat it as serious and get seen. In an emergency, call 911.