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semaglutide (Wegovy) and diarrhea: incidence, timing, management, and when to escalate.
Most common in the first 4 weeks of each titration step. Often alternates with constipation as motility patterns shift.
GLP-1 agonists alter gut transit time unevenly. Some patients shift toward faster colonic transit, especially after high-fat or high-sugar meals.
Avoid greasy or sugary foods. Loperamide for acute episodes is safe short-term. If diarrhea is fatty (steatorrhea), discuss pancreatic enzyme function with your prescriber.
More than 4-6 watery stools daily, blood in stool, signs of dehydration, or fever. Same-day contact.
Diarrhea is less common than nausea on Wegovy but more disruptive socially. Track triggers (high-fat meals are the most common). It usually resolves at maintenance dose.
Editorial summary, not medical advice. Incidence figures from FDA prescribing information and pivotal trial publications. Individual experience varies. Coordinate side effect management with your prescriber.