Constipation on Mounjaro, Ozempic & co.: what helps?

Tirzepatide (Mounjaro) and semaglutide (Ozempic, Wegovy) slow down stomach emptying and the movement of the gut. That contributes to feeling full – but it also makes stools harder and less frequent. On top of that, if you eat much less, there is simply less “bulk” in your gut, and many people unconsciously drink less.

In the pivotal trial SURMOUNT-1, about 11–17 % of participants on tirzepatide had constipation, compared with around 6 % on placebo. The symptoms mainly occur in the first weeks and after dose increases.

• Drinking: Enough water or tea spread across the day. Thirst is often dampened on GLP-1 medications – a fixed drinking schedule helps.
• Increase fibre slowly: Vegetables, pulses, oats, linseed or psyllium husk. Always take bulking agents with plenty of water – otherwise they make constipation worse.
• Exercise: Even daily walks get the gut moving.
• Don’t wait: Go when you feel the urge; fixed times (e.g. after breakfast) help many people.
• Magnesium: Has a mild laxative effect. Check with your doctor or pharmacy first, especially if you have kidney disease or take other medications.

If diet and exercise are not enough, mild laxatives such as macrogol can make sense. Get advice from a pharmacy or a doctor rather than experimenting on your own long-term. Important: if you take medications at fixed times, take bulking agents with some time in between so absorption isn’t disrupted.