What is epilepsy?
Epilepsy is a neurological condition where the brain’s electrical activity becomes temporarily disrupted, causing seizures. It’s one of the most common serious neurological conditions, affecting people of all ages.2
Seizures happen when nerve cells in the brain fire abnormally, either in one area (focal seizures) or across the whole brain (generalised seizures). Symptoms range from brief lapses in awareness to full convulsions.
Common features of epilepsy include:
- Recurrent seizures that vary in type and severity
- Possible triggers including stress, poor sleep, missed meals, and alcohol
- The need for long-term anti-epileptic medication in most cases
- Restrictions on driving until seizure-free for a specified period
- An increased risk of anxiety, depression, and social isolation
Most people with epilepsy manage their condition well with medication. Around 70% of people achieve good seizure control with anti-epileptic drugs, though finding the right medication and dose can take time.2
How Mounjaro works
Mounjaro is a once-a-week injection that contains the drug tirzepatide. It works by mimicking two gut hormones, GLP-1 and GIP, that communicate with the brain’s appetite centre (the hypothalamus) to reduce hunger and food-seeking behaviour.
It also slows down digestion, so food stays in the stomach longer. This means you feel full sooner and stay satisfied for longer after eating.
In clinical trials, people taking Mounjaro lost up to 26% of their body weight after two years.3
If you’re taking anti-epileptic medication alongside Mounjaro, it’s worth knowing that Mounjaro slows gastric emptying. This can affect how quickly oral medications are absorbed. Your prescriber may want to monitor your anti-epileptic drug levels, particularly during dose increases.
GLP-1 medications and seizure risk
There’s growing evidence that GLP-1 receptor agonists, the class of drugs that includes Mounjaro, may have neuroprotective properties that are relevant to epilepsy.
A 2024 study in Epilepsia Open analysed health records from over 20,000 people with epilepsy and found that those using GLP-1 receptor agonists had a 24% lower risk of seizures compared to non-users.1 This was an observational study, so it can’t prove cause and effect, but the association is noteworthy.
Earlier research has explored possible mechanisms. A 2023 study found that semaglutide (a GLP-1 receptor agonist similar to tirzepatide) reduced neuroinflammation and showed anticonvulsant effects in animal models.4
GLP-1 receptors are found throughout the brain, not just in appetite-regulating areas. Researchers think the neuroprotective effects may involve reducing brain inflammation, improving blood sugar stability (which affects seizure thresholds), and protecting nerve cells from damage.4
It’s important to keep this in perspective. No clinical trials have directly tested Mounjaro in people with epilepsy. The evidence so far comes from observational data and animal studies. But there’s nothing in the research to suggest GLP-1 medications increase seizure risk, which is reassuring.
Foods to focus on with epilepsy
There’s no single ‘epilepsy diet’ for everyone, but what you eat can influence seizure control, particularly through its effects on blood sugar levels and nutrient status. This is especially relevant when you’re also taking Mounjaro, which reduces appetite and changes eating patterns.
Keeping blood sugar stable
Blood sugar stability matters for epilepsy. Both very low blood sugar (hypoglycaemia) and rapid spikes and crashes can lower the seizure threshold, making seizures more likely.2
Eating regular, balanced meals is the most practical way to avoid this. The Second Nature balanced plate model is a useful framework: half vegetables, a quarter protein, a quarter complex carbohydrates, plus a serving of fat.
This combination of protein, fibre, and fat slows the release of glucose into the bloodstream and keeps energy levels more consistent throughout the day.
Protein at every meal
Protein supports stable blood sugar and helps preserve muscle mass, which can decline during significant weight loss. It also helps you feel satisfied from smaller portions, which matters when Mounjaro is reducing your appetite.
Good sources include chicken, turkey, fish, eggs, Greek yoghurt, beans and lentils, and tofu.
Healthy fats from whole foods
Fat plays important roles in brain health, hormone production, and nutrient absorption. The brain is roughly 60% fat by dry weight, so adequate fat intake supports neurological function.
Focus on whole food sources: olive oil, avocado, nuts, seeds, oily fish (salmon, mackerel, sardines), full-fat dairy, and eggs. Oily fish twice a week provides omega-3 fatty acids, which have anti-inflammatory properties relevant to neurological health.
Complex carbohydrates for steady energy
Fibre-rich carbohydrates provide a slow, steady source of energy rather than the rapid spikes you get from refined options. This helps maintain consistent blood sugar levels, which supports seizure control.
Choose from wholegrain or sourdough bread, rolled oats, brown rice, potato, sweet potato, quinoa, beans and lentils, wholemeal pasta or noodles, and wholemeal couscous.
Folate-rich foods
Several common anti-epileptic drugs, including valproate, carbamazepine, and phenytoin, can deplete folate levels over time.5 Low folate is linked to fatigue, mood changes, and other health issues.
Including folate-rich foods regularly can help maintain healthy levels. Good sources include dark leafy greens (spinach, kale, broccoli), beans and lentils, asparagus, avocado, and eggs.
If you’re taking one of these medications, your GP or neurologist may also recommend a folic acid supplement. Ask at your next appointment.
Eating 3 balanced meals a day, even if you’re not hungry
Mounjaro significantly reduces appetite, and some people find they naturally start skipping meals. With epilepsy, this is worth being careful about, because missed meals can cause blood sugar dips that affect seizure control.
Even on low-appetite days, aim for three balanced meals. They don’t need to be large. Greek yoghurt with berries and nuts, scrambled eggs on sourdough, or a small bowl of porridge with seeds all provide the protein, fat, and fibre your body needs.
Batch cooking on better days can help, so you’ve always got something ready to eat when energy or appetite is low.
Foods to be mindful of
Alcohol is a well-established seizure trigger. It can lower the seizure threshold, disrupt sleep (another trigger), and interact with anti-epileptic medications.2 If you drink at all, keeping intake low and consistent is safer than occasional heavy drinking.
Ultra-processed foods and those high in added sugar can cause rapid blood sugar fluctuations, which isn’t ideal for seizure management. Focusing on whole, minimally processed foods is a more reliable way to keep blood sugar steady.
Staying active with epilepsy
Regular physical activity is beneficial for people with epilepsy. Research suggests that exercise can improve seizure control in some people, alongside benefits for mood, sleep, cardiovascular health, and quality of life.6
A common concern is that exercise might trigger seizures, but the evidence generally doesn’t support this. Most studies show that physical activity either has no effect on seizure frequency or reduces it.6
Starting small and building habits
The most important principle is that any movement is better than none. You don’t need to hit a specific target straight away.
Research on habit formation shows that it takes an average of 66 days for a new behaviour to become automatic.7 The key is starting with something small enough that it barely feels like effort, and attaching it to something you already do.
For example, a 10-minute walk after lunch, or some gentle stretching before bed. Once that feels natural, you can gradually do a little more as it feels manageable.
Safety considerations
If your seizures aren’t fully controlled, there are some practical safety considerations around certain activities:
- Swimming alone isn’t safe if you have uncontrolled seizures. Always swim with someone who knows about your epilepsy and can help if needed
- Activities at height (climbing, some gymnastics) carry additional risk if a seizure could cause a fall
- Cycling on busy roads may be better replaced with a stationary bike or cycling in a safe, enclosed area
These aren’t reasons to avoid exercise. They’re practical adjustments that let you stay active safely. Many people with epilepsy are fully active in sports and exercise, particularly once seizures are well controlled.
Types of movement that work well
Both aerobic activity and resistance training are beneficial. Options that many people with epilepsy find manageable include:
- Walking, starting with whatever distance is comfortable
- Swimming with a companion in a supervised pool
- Yoga or tai chi, which combine movement with breathing and relaxation (and may help with stress, a common seizure trigger)
- Light resistance exercises using bodyweight or resistance bands
- Group exercise classes where others are present
As a general guide, the NHS recommends 150 minutes of moderate activity per week, but this is a long-term aspiration, not a starting point. Begin wherever you are and build up gradually.
Looking after your mental health
Epilepsy has a significant psychological dimension. Research shows that around 30% of people with epilepsy experience depression and roughly 20% experience anxiety, both considerably higher than the general population.2
Several factors contribute to this. The unpredictability of seizures can create constant worry about when the next one will happen. Driving restrictions limit independence. Some anti-epileptic medications can affect mood directly. And the social stigma around epilepsy, though improving, still leads many people to conceal their condition.
The stigma factor
Stigma is one of the most consistent predictors of poor mental health in people with epilepsy. Fear of having a seizure in public, concerns about how others will react, and reluctance to disclose the condition at work or in social settings can all contribute to isolation and low mood.
Connecting with others who understand, whether through Epilepsy Action, local support groups, or online communities, can help reduce this sense of isolation.
Managing weight and self-image
Some anti-epileptic medications, particularly valproate and carbamazepine, can cause weight gain as a side effect.5 This adds another layer of difficulty if you’re already trying to manage your weight.
Starting Mounjaro alongside these medications may help with weight loss, but it’s worth being aware that changes in weight can occasionally affect how anti-epileptic drugs are metabolised. Your neurologist should be involved in monitoring this.
When to speak to your GP
If you notice persistent low mood, loss of interest in things you used to enjoy, increased anxiety, difficulty sleeping beyond what’s normal for you, or thoughts of self-harm, speak to your GP. These are treatable conditions, and getting support early makes a difference.
Cognitive behavioural therapy (CBT) has good evidence for anxiety and depression in people with epilepsy. Your GP can refer you, and some anti-depressants are safe alongside anti-epileptic medication, though your prescriber will need to check for interactions.
Mounjaro clinical data
| Measure |
Detail |
| Drug |
Tirzepatide |
| Mechanism |
Dual GLP-1 and GIP receptor agonist |
| Administration |
Once-a-week subcutaneous injection |
| Available doses |
2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg |
| Weight loss (clinical trials) |
Up to 26% of body weight after two years3 |
| Key trial programme |
SURMOUNT (obesity), SURPASS (type 2 diabetes) |
| Common side effects |
Nausea, diarrhoea, constipation, reduced appetite (typically most noticeable during dose increases) |
| Known interaction with epilepsy |
None reported. No direct trials in epilepsy populations |
| Potential relevance to epilepsy |
Observational data suggests GLP-1 medications may reduce seizure risk by 24%1 |
Frequently asked questions
Can I take Mounjaro if I have epilepsy?
Yes. There’s no known interaction between tirzepatide and anti-epileptic medications. A 2024 observational study found that people with epilepsy who used GLP-1 receptor agonists had a 24% lower risk of seizures, so the evidence is reassuring.1 Always let your neurologist know you’re starting a new medication.
Will Mounjaro affect my anti-epileptic medication?
Mounjaro slows gastric emptying, which can affect how quickly oral medications are absorbed. This could theoretically alter blood levels of anti-epileptic drugs. Your prescriber may want to check your medication levels, particularly when you’re increasing your Mounjaro dose.
Can losing weight change my seizure control?
It’s possible. Significant weight changes can affect how some anti-epileptic drugs are metabolised and distributed in the body. This is one reason to keep your neurologist informed about your weight-loss progress so they can adjust doses if needed.
Is it safe to exercise with epilepsy?
Yes, and research suggests exercise may actually help reduce seizure frequency in some people.6 The main safety consideration is avoiding activities with a high fall or injury risk if your seizures aren’t fully controlled. Swimming alone, for example, isn’t safe, but swimming with a companion in a supervised pool is fine.
Can skipping meals trigger a seizure?
It can. Low blood sugar is a known factor that can lower the seizure threshold. Because Mounjaro reduces appetite, it’s important to eat three balanced meals a day even when you’re not feeling particularly hungry. Keeping blood sugar stable supports seizure control.
Should I avoid alcohol if I have epilepsy and I’m taking Mounjaro?
Alcohol is a well-established seizure trigger. It can lower the seizure threshold, disrupt sleep, and interact with anti-epileptic medications. If you choose to drink, keeping intake low and consistent is safer than occasional heavy drinking. Mounjaro can also amplify the effects of alcohol for some people.
Do anti-epileptic drugs cause weight gain?
Some do. Valproate and carbamazepine are both associated with weight gain as a side effect.5 Others, like topiramate and zonisamide, are associated with weight loss. If weight gain from your anti-epileptic medication is a concern, discuss alternatives with your neurologist before making any changes.
Will Mounjaro affect my mood or mental health?
The most common side effects of Mounjaro are gastrointestinal (nausea, reduced appetite). There’s no strong evidence linking it to mood changes. However, epilepsy itself carries a higher risk of depression and anxiety, so if you notice changes in your mood after starting Mounjaro, it’s worth raising with your healthcare team.
Some people on Reddit say they feel more tired on GLP-1 medications. Will this make my epilepsy fatigue worse?
Some people do report feeling tired when they first start GLP-1 medications, often related to eating less than usual. This tends to improve as your body adjusts. Focusing on nutrient-dense meals and staying hydrated can help. If fatigue is significantly worse than your baseline, speak to your prescriber.
Take home message
You can take Mounjaro if you have epilepsy. There are no known interactions between tirzepatide and anti-epileptic medications, and emerging research suggests GLP-1 medications may have neuroprotective properties that could benefit seizure control.
The key practical considerations are keeping your neurologist informed, maintaining regular meals to support stable blood sugar, and being thoughtful about exercise safety if your seizures aren’t fully controlled.
Alongside medication, focusing on blood sugar stability through balanced meals, building gentle movement habits, and looking after your mental health can all support your overall wellbeing while managing both conditions.
Second Nature’s Mounjaro programme combines medication with support from registered dietitians and a structured habit-change programme. It’s built around the balanced plate model (half vegetables, a quarter protein, a quarter complex carbohydrates, plus a serving of fat) and focuses on sustainable changes rather than restrictive dieting.
In a published study, active subscribers on Second Nature’s semaglutide-supported programme lost an average of 19.1% of their body weight at 12 months, with 77.7% achieving at least 10% weight loss.8
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
- Sindhu, S. et al. (2024). Newer glucose-lowering drugs reduce the risk of late-onset seizure and epilepsy: a meta-analysis. Epilepsia Open, 9, 2528-2536.
- NHS. (2024). Epilepsy.
- Aronne, L.J. et al. (2024). Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomised clinical trial. JAMA, 331(1), 38-48.
- Wang, L. et al. (2021). Semaglutide attenuates seizure severity and ameliorates cognitive dysfunction by blocking the NLRP3 inflammasome in pentylenetetrazole-kindled mice. International Journal of Molecular Medicine, 48(6), 219.
- NHS. (2024). Sodium valproate.
- Pimentel, J. et al. (2015). Epilepsy and physical exercise. Seizure, 25, 87-94.
- Lally, P. et al. (2010). How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998-1009.
- Richards, R. et al. (2025). A remotely delivered GLP-1RA-supported specialist weight management program in adults living with obesity: retrospective service evaluation. JMIR Formative Research, 9(1), e72577.
