Can you take Wegovy with IBS?

Jump to: How Wegovy affects the gut | IBS subtypes: what to expect | Managing IBS symptoms on Wegovy | Foods to focus on | When to speak to your GP | Frequently asked questions | Take home message

You can take Wegovy (semaglutide) if you have irritable bowel syndrome (IBS), though the medication may affect your symptoms in unpredictable ways.

IBS affects approximately 10-20% of the UK population, making it one of the most common gastrointestinal conditions.¹

Many people with IBS also struggle with their weight, often due to the complex relationship between gut health, stress, and eating patterns.

No studies have directly investigated how Wegovy affects people with IBS. The potential benefits and risks are based on our understanding of how the medication influences gut motility and digestion.

Some people with IBS report improvements in their symptoms while taking Wegovy, while others find their symptoms temporarily worsen. The outcome often depends on your IBS subtype and how you manage the transition.

How Wegovy affects your gut

Wegovy is a GLP-1 receptor agonist, meaning it mimics the GLP-1 hormone that your body naturally produces. This hormone communicates with your brain’s appetite control centre to lower hunger and food-seeking behaviour.²

The medication also significantly slows gastric emptying, meaning food stays in your stomach longer. This creates a sustained feeling of fullness but can also affect how your digestive system functions overall.

Research shows that GLP-1 reduces gastrointestinal motility and inhibits the migrating motor complex in both healthy individuals and individuals with IBS.³ Put simply, Wegovy slows down the movement of food through your digestive tract.

This slowing effect is why Wegovy commonly causes gastrointestinal side effects. A pooled analysis of the STEP 1-3 clinical trials found that people taking semaglutide 2.4 mg experienced:⁴

• Nausea in 43.9% of users
• Diarrhoea in 29.7% of users
• Constipation in 24.2% of users
• Vomiting in 24.5% of users

For someone without IBS, these side effects are usually temporary and ease within the first few weeks. For someone with IBS, they may interact with existing symptoms in complex ways.

It’s worth noting that Wegovy tends to cause more gastrointestinal side effects than some newer weight-loss medications. The constipation rate in particular (24.2%) is something to be aware of if you have IBS-C.

IBS subtypes: what to expect on Wegovy

Your IBS subtype significantly influences how you might respond to Wegovy. Research on GLP-1 medications and IBS suggests different effects depending on whether you have IBS-D, IBS-C, or IBS-M.⁵

Comparison: Wegovy effects by IBS subtype

Notably, a 2025 systematic review found that GLP-1 receptor agonists significantly reduced pain intensity in patients with IBS.⁶ The medication appears to reduce visceral hypersensitivity, which is a common cause of IBS-related discomfort.

This doesn’t mean Wegovy is a treatment for IBS, but it suggests that some people with IBS may experience unexpected improvements in their symptoms alongside weight loss.

Managing IBS symptoms while on Wegovy

Most gastrointestinal side effects occur during dose escalation and typically improve within 4-8 weeks as your body adjusts.⁴

The good news is that most side effects can be managed with a few practical adjustments.

For nausea and discomfort

Nausea is the most common side effect of Wegovy, affecting nearly 44% of users. This can be particularly challenging if you already have IBS-related digestive sensitivity.

• Eat 3 balanced meals a day with healthy snacks between
• Avoid lying down immediately after eating
• Choose easily digestible foods during the first few weeks, like white fish, scrambled eggs, mashed potatoes, and cooked vegetables
• Ginger tea or ginger supplements may help settle your stomach

For constipation

Constipation affects nearly a quarter of Wegovy users, which is particularly important if you have IBS-C. The median duration of constipation in clinical trials was 47 days, so it’s worth being proactive.

• Increase water intake to at least 2 litres a day
• Add fibre gradually, as sudden increases can worsen symptoms
• Include magnesium-rich foods like leafy greens and nuts
• Gentle movement, like a short walk after meals, stimulates digestion
• Consider a stool softener if needed (discuss with your pharmacist before starting)

For diarrhoea

If you have IBS-D or experience medication-related diarrhoea (which affects nearly 30% of users):

• Eat a diet based on whole foods
• Stay well hydrated with water and electrolyte drinks
• Limit ultra-processed foods and takeaways
• Reduce caffeine and alcohol intake
• Consider temporarily reducing fibre if symptoms are severe
• Monitor for signs of dehydration, especially in the early weeks

Foods to focus on with IBS and Wegovy

Eating a diet based on whole foods becomes even more important when managing both IBS and Wegovy.

Protein-first approach

Protein is essential for maintaining muscle mass during weight loss. Aim for a palm-sized portion at each meal.

Good options that are typically well-tolerated with IBS include:

• Chicken and turkey (plain, not heavily spiced)
• Fish, particularly oily fish like salmon
• Eggs (often well-tolerated even with IBS)
• Tofu and tempeh (some people with IBS tolerate these better than beans)
• Greek yoghurt (if you tolerate dairy)

Low-FODMAP vegetables

If you follow a low-FODMAP approach for IBS, focus on vegetables that are less likely to trigger symptoms:⁷

• Carrots, courgettes, and aubergines
• Spinach and other leafy greens
• Bell peppers and tomatoes
• Green beans and cucumber

Complex carbohydrates

Choose carbohydrates that provide sustained energy without triggering IBS symptoms:

• White or basmati rice (often better tolerated than wholegrain for IBS)
• Oats (if tolerated)
• Potatoes and sweet potatoes
• Sourdough bread (the fermentation process reduces FODMAPs)

Foods to limit or avoid

Some foods may worsen both IBS symptoms and Wegovy side effects:

• Spicy foods (may worsen nausea and digestive discomfort)
• Alcohol (irritates the gut and can worsen dehydration)
• Caffeine in excess (stimulates gut motility unpredictably)
• Artificial sweeteners (particularly sorbitol and mannitol)

When to speak to your GP

While some digestive changes are expected when starting Wegovy, certain symptoms warrant medical attention.

Contact your GP or prescriber if you experience:

• Severe or persistent diarrhoea lasting more than a week
• Signs of dehydration: dizziness, dark urine, extreme thirst
• Blood in your stool or black, tarry stools
• Severe abdominal pain that doesn’t improve
• Significant worsening of your IBS symptoms that affects daily life
• Inability to keep fluids down for more than 24 hours

Your prescriber may recommend adjusting your dose, extending the time between dose increases, or trying different ways to manage symptoms.

Continue any prescribed IBS medications unless advised otherwise, and maintain contact with your gastroenterologist if you have one.

Frequently asked questions

Can Wegovy make IBS worse?

Wegovy may temporarily worsen IBS symptoms, particularly during the first few weeks of treatment or when increasing your dose.

The most common issues are nausea, constipation, or diarrhoea. However, these effects typically improve as your body adjusts to the medication.

Should I take Wegovy if I have IBS-C or IBS-D?

Both IBS-C and IBS-D patients can take Wegovy, but with different considerations. If you have IBS-C, be aware that constipation affects 24.2% of Wegovy users, so proactive management with fibre and hydration is essential.

If you have IBS-D, the medication-induced diarrhoea (29.7% of users) may temporarily worsen symptoms, but the slowing effect on gut transit could eventually help.

Will Wegovy help my IBS symptoms?

There’s no guarantee, but some people report improvements in IBS symptoms while taking Wegovy. Research suggests GLP-1 medications may reduce abdominal pain and visceral hypersensitivity. Weight loss itself can also improve IBS symptoms by reducing inflammation.

What foods should I avoid on Wegovy if I have IBS?

Limit ultra-processed foods, spicy dishes, alcohol, excessive caffeine, and artificial sweeteners. These can worsen both Wegovy side effects and IBS symptoms. Focus on bland, easily digestible foods during the first few weeks.

How long do Wegovy side effects last with IBS?

Most gastrointestinal side effects improve within 4-8 weeks as your body adjusts. Clinical trial data shows that nausea, diarrhoea, and vomiting typically peak around week 20 and decrease thereafter. Constipation may last longer, with a median duration of 47 days in trials.

Can I continue my IBS medication while taking Wegovy?

In most cases, yes. Continue any prescribed IBS medications unless your doctor advises otherwise. Wegovy is unlikely to interact with common IBS treatments, but always inform your prescriber of all medications you take.

Should I follow a low-FODMAP diet while on Wegovy?

If you already follow a low-FODMAP diet for IBS, there’s no reason to stop while taking Wegovy. The reduced appetite may actually make it easier to avoid trigger foods. However, ensure you’re still getting adequate nutrition from the foods you do eat.

Will losing weight improve my IBS?

Research suggests that weight loss can improve IBS symptoms, possibly by reducing inflammation.⁸ However, the relationship between weight and IBS is complex, and weight loss alone may not resolve all symptoms.

Can Wegovy cause bloating?

Yes, bloating is a possible side effect of Wegovy due to the slowing of gastric emptying. This can be particularly noticeable if you already experience bloating as part of your IBS. Eating smaller meals and avoiding carbonated drinks may help.

Is it safe to exercise on Wegovy with IBS?

Yes, gentle exercise is encouraged and can actually help manage both IBS symptoms and Wegovy side effects. Walking, swimming, and yoga are good options. Avoid intense exercise immediately after eating, and stay well hydrated.

Take home message

You can take Wegovy if you have IBS, but expect some adjustment period as your body adapts to the medication’s effects on your digestive system.

The good news is that most side effects can be managed with a few practical changes: eat smaller meals, prioritise hydration, keep a symptom diary, and communicate regularly with your healthcare team.

Many people with IBS find that once they get through the initial weeks, the medication becomes manageable alongside their existing IBS symptoms. Some even report improvements in abdominal pain and discomfort.

Focus on eating a diet based on whole foods rich in protein and vegetables, and don’t hesitate to seek medical advice if your symptoms significantly worsen.

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References

1. NICE. (2021). Irritable bowel syndrome in adults: diagnosis and management (CG61)
2. Wilding, J.P.H., et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989-1002.
3. Hellström, P.M., et al. (2008). GLP-1 suppresses gastrointestinal motility and inhibits the migrating motor complex in healthy subjects and patients with irritable bowel syndrome. Neurogastroenterology & Motility, 20(6), 649-59.
4. Wharton, S., et al. (2022). Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity. Diabetes, Obesity and Metabolism, 24(1), 94-105.
5. Tack, J., et al. (2013). Role of glucagon-like peptide-1 in the pathogenesis of irritable bowel syndrome. International Journal of Molecular Medicine, 31(4), 1021-1027.
6. Mostafa, E.S. & Alrasheed, M.M. (2025). Improvement of irritable bowel syndrome with glucagon like peptide-1 receptor agonists: a systematic review and meta-analysis. Frontiers in Endocrinology, 16, 1548346.
7. Halmos, E.P., et al. (2014). A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology, 146(1), 67-75.e5.
8. Richards, R., et al. (2025). A Remotely Delivered, Semaglutide-Supported Weight Management Program: 12-Month Outcomes From a Retrospective Service Evaluation. JMIR Formative Research, 9(1), e72577.