Does semaglutide make you tired? The truth about fatigue

Semaglutide (Wegovy, Ozempic, Rybelsus) is a game-changer for type 2 diabetes and weight loss in people who are obese or overweight when combined with a healthy diet and exercise.

Semaglutide works by targeting GLP-1 receptors in the brain that regulate appetite and slow down how quickly the stomach empties, making you feel fuller for longer

Semaglutide’s growing popularity for weight loss and blood sugar control raises concerns about side effects like gastrointestinal issues, fatigue, and potential long-term risks.

Fatigue is a common concern among semaglutide users, particularly during the medication adjustment phase or with significant weight loss.

Semaglutide and fatigue: Does this medication cause tiredness? Learn why semaglutide might make you tired, how to manage fatigue, and when to seek medical advice.

What is semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used to treat type 2 diabetes and help with weight loss. It’s available under the brand names Wegovy, Ozempic, and Rybelsus. Wegovy is FDA-approved for chronic weight management in obese and overweight patients. Ozempic and Rybelsus are prescription drugs approved for adults with type 2 diabetes.

Semaglutide belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. It mimics a natural hormone called GLP-1, which helps control blood glucose by releasing insulin when you eat, lowering blood sugar. GLP-1 also slows how fast food moves through your stomach (gastric emptying), making you feel full longer, and helps control appetite by lowering blood glucose levels and promoting weight loss.

Semaglutide helps control hunger by activating parts of the brain that regulate appetite. This makes you feel fuller and less hungry, helping you make healthier food choices and eat fewer calories. It also slows down how quickly food leaves your stomach, making you feel full longer and reducing cravings.

• Ozempic: Subcutaneous injection approved by the FDA on December 5, 2017, to lower blood sugar in people with type 2 diabetes and off-label for weight loss in people with obesity and overweight.
• Wegovy: Subcutaneous injection approved by the FDA on June 4, 2021, for chronic weight management in patients with obesity (body mass index of 30 or more) and overweight (body mass index of 27 or more) with a weight-related condition like cardiovascular disease, high blood pressure, or type 2 diabetes. It was also approved in 2024 for reducing the risk of serious heart problems in adults with obesity or overweight.

Why does semaglutide cause fatigue and make you tired?

Fatigue is a possible side effect of semaglutide treatment, and some people may feel more tired than usual especially as their body adjusts to the medication. This tiredness can sometimes make it harder to be active or focused. If you find that fatigue affects your daily life or doesn’t go away, you should contact your healthcare provider for advice.

In clinical trials, about 11% of people taking Wegovy (semaglutide) reported fatigue compared to 5% of people taking the placebo. Fatigue is reported as the 7th most common side effect. While fatigue can happen with Wegovy, it’s a rare side effect. Patient experiences vary; some people may experience mild fatigue that gets better over time, and others may experience more persistent tiredness, especially during the first few weeks of treatment or when the dose is increased.

Healthcare providers usually start patients on a low dose of semaglutide and increase the dose over time as your body gets used to the medication. This helps to minimize the side effects, but some people may still experience temporary fatigue.

The possible reasons for fatigue are:

• Gastrointestinal side effects
• Your body is getting used to the medication
• Eating fewer calories
• Hormonal changes
• Changes in blood sugar levels

Metabolic shifts

Semaglutide slows gastric emptying, meaning food stays in the stomach longer and you feel full and less hungry. This means you eat less and therefore consume fewer calories. With fewer calories in, the body uses stored energy (fat reserves) for fuel and that can lead to weight loss.

Semaglutide also boosts insulin secretion at mealtime so the body can use glucose more efficiently. By improving insulin sensitivity, the body can store glucose in cells for energy, reduce blood sugar spikes and improve energy regulation. It also suppresses glucagon, a hormone that raises blood sugar, so the body doesn’t produce energy when it’s not needed.

Together, these effects help with blood sugar control and how the body uses and stores energy. While semaglutide can help with fat-burning and metabolic processes, reduced appetite and slower digestion may make some people feel fatigued or low on energy if their nutrient intake is not balanced.

Blood sugar fluctuations

Semaglutide helps with blood sugar levels in multiple ways. It increases your body’s sensitivity to insulin, the hormone that regulates blood sugar, and reduces the amount of sugar produced by the liver so you don’t get blood sugar spikes after meals. Changes in blood sugar levels can cause fatigue when using semaglutide due to appetite regulation and insulin sensitivity.

Also, semaglutide slows down digestion, so blood sugar levels don’t rise too quickly after meals. This is good for people with type 2 diabetes but also for those using semaglutide for obesity or overweight.

While the blood sugar-regulating effects of semaglutide are important for those using it for weight loss or type 2 diabetes, it may have negative effects for those with low blood sugar. If you experience dizziness or lightheadedness, see a healthcare provider.

As your body gets used to the medication, you may feel more energetic. Monitor your symptoms and see a healthcare provider if fatigue persists.

Calorie restriction

Semaglutide suppresses your appetite by acting on the brain and slowing down digestion, so you’ll feel less hungry throughout the day. Semaglutide mimics a hormone called GLP-1 that’s produced in the gut after you eat. This lowers blood sugar, reduces sugar in the liver, and controls calorie intake so you’ll feel full for longer.

This makes it easier to eat smaller portions and less food. Eating less means your body will start to burn stored fat for energy, which helps with weight loss. This appetite suppression will help you stick to a healthier diet and manage your weight over time. However, eating less will also mean less energy intake and less fuel for the body to convert into energy, which can lead to fatigue.

A study of 72 obese adults found that 2.4mg semaglutide once a week reduced appetite, food intake, and body weight without slowing down gastric emptying. Participants on semaglutide also reported more control over eating and fewer food cravings than the placebo.

Dehydration

Semaglutide-induced nausea, diarrhea and vomiting can lead to dehydration, which can cause fatigue. When you vomit, your body throws up not only stomach contents but also essential fluids and electrolytes.

This fluid loss can dehydrate you. As your body loses water and electrolytes like sodium and potassium, it’s harder to maintain energy levels, muscle function, and overall bodily functions.

Dehydration also reduces blood volume making it harder for oxygen and nutrients to get to cells which can add to feelings of tiredness and weakness. The combination of dehydration and electrolyte imbalance can worsen fatigue.

Gastrointestinal distress

Semaglutide can cause gastrointestinal side effects such as nausea, vomiting, diarrhea, constipation, stomach pain, bloating, belching, loss of appetite, and upset stomach. These gastrointestinal side effects can disrupt nutrient absorption and make you feel tired.

This can lead to decreased energy intake and hinder the body’s ability to absorb essential nutrients, contributing to fatigue. Managing these side effects through gradual dose adjustments, smaller meals, staying hydrated, and avoiding trigger foods can help reduce discomfort and improve energy levels.

These side effects are usually temporary, especially in the first few weeks of treatment, but will go away over time. If they get severe or don’t go away, talk to a healthcare provider.

Sleep disruption

Semaglutide can mess with your sleep which can cause fatigue. One of the common side effects of semaglutide is gastrointestinal upset including nausea, vomiting, and indigestion. If these symptoms occur at night, they can make it hard to fall asleep or stay asleep. Discomfort from nausea or bloating can cause frequent awakenings, poor sleep quality, and disrupted sleep cycles.

Additionally, semaglutide slows gastric emptying which can make you feel full or uncomfortable in your stomach for a longer period. This can make it harder to wind down before bed and make it harder to fall asleep. Sleep disturbances can also occur due to reduced appetite as lower food intake can affect your body’s natural circadian rhythms which are linked to metabolism and energy balance.

Poor sleep quality worsens fatigue. When the body doesn’t get enough rest it can’t recover and replenish energy. The combination of disrupted sleep, gastrointestinal discomfort, and reduced nutrient intake due to semaglutide use can create a cycle of fatigue that’s hard to break. As a result, you may feel more tired and able to function less during the day making it even harder to manage the side effects of the medication.

Hormonal changes

Hormones are chemical messengers that control hunger, metabolism, and energy use. Hormonal changes are changes in the levels of hormones that control different things in your body.

When you take semaglutide, it changes certain hormones, especially GLP-1, which is produced in the gut after you eat. This hormone tells your brain to reduce appetite and slows down digestion, so you’ll feel full for longer. These hormonal changes can cause delayed energy release and fatigue.

Semaglutide fatigue: How long does it last?

Fatigue is a common side effect of semaglutide, especially during the initial phase of treatment. This fatigue is often linked to gastrointestinal symptoms such as nausea, vomiting, and reduced appetite, which can disrupt energy levels.

In most cases, fatigue caused by semaglutide improves within a few weeks as the body adjusts to the medication. However, the duration and severity of fatigue can vary from person to person.

This is particularly true as the body adjusts to the medication, and the gastrointestinal side effects begin to subside. Clinical trials have shown that side effects, including fatigue, are most prominent during the first few weeks of therapy and often diminish as the body adapts to the drug. In general, fatigue may start to improve after 2 to 4 weeks of consistent use.

Factors that can prolong fatigue

While many people’s fatigue decreases over time, several factors can influence how long that takes:

• Dosage: Higher doses of semaglutide or rapid dose increase can cause more gastrointestinal side effects (including fatigue). Gradually increasing the dose as recommended by your healthcare provider can help minimize these effects and may shorten the duration of fatigue.
• Individual metabolism: Everyone metabolizes differently. Some people metabolize semaglutide more slowly and may experience side effects for more time, including fatigue. People with slower metabolism may have fatigue for longer than others.
• Underlying health conditions: People with pre-existing health conditions like diabetes, thyroid conditions or gastrointestinal issues may have longer-lasting fatigue. These conditions can amplify the fatigue from semaglutide or make it harder for the body to recover fully.

Clinical trials for semaglutide have shown fatigue as a side effect, but it’s usually temporary.

While fatigue is usually transient, some people may experience persistent or severe fatigue that doesn’t go away with time. If fatigue persists for more than a few weeks or is debilitating, see a doctor. Persistent fatigue could be a sign of other underlying issues like dehydration, nutrient deficiencies, thyroid dysfunction, or other health conditions worsened by semaglutide.

Also, if fatigue is accompanied by other symptoms like dizziness, significant weight loss, severe stomach pain, or trouble breathing, call a doctor right away. These could be signs of more serious side effects or complications that need immediate attention.

Managing semaglutide-induced fatigue: A holistic approach

To minimize side effects like fatigue, it’s important to increase the dose gradually under the guidance of a healthcare provider so your body can build up tolerance and reduce discomfort.

To combat fatigue, healthcare professionals, recommend a balanced diet, sleeping well, exercising, minimizing stress, and staying hydrated.

Healthy diet

When you start semaglutide, you will likely eat smaller, less frequent meals, but don’t cut calories drastically. Gradual weight loss is key to sustainability and energy. Focus on nutrient-dense foods like iron-rich options (lean meat, eggs, leafy greens) to avoid deficiencies that can cause fatigue. A balanced diet will help you feel your best while losing weight.

What you eat is as important as how much you eat. Focus on foods rich in vitamins and minerals to prevent nutrient deficiencies and consider taking supplements (iron B vitamins) if necessary to support your nutrition while on semaglutide.

You can combine weight loss medications like semaglutide with support from health coaches and dietitians to know exactly what to eat.

Hydration

Feeling tired or having brain fog could be dehydration, especially with semaglutide side effects like diarrhea. Drinking plenty of water will help with fatigue and flush out water weight, so you see results faster on the scale.

Exercise and physical activity

Movement is key to a healthy strong body and can be effective for reducing semaglutide fatigue. Walking, jogging, or stretching can boost energy levels and mood and support weight loss. Even small amounts of movement in your daily routine can have a big impact on your overall health and well-being.

Sleep optimization

Coffee can give you a quick fix, but too much of it can disrupt your sleep cycle. To avoid this, have your last cup at least 6 hours before bed and practice good sleep habits like limiting screen time and keeping your room cool, dark, and quiet, which will help you fall asleep and improve sleep quality.

Stress management

Stress management can help with fatigue while on semaglutide. Try stress-relieving activities like deep breathing, relaxation techniques, getting enough sleep, or talking to someone you trust to calm your mind and keep your energy up.

Stress management will give you more energy and help your body respond better to treatment and live a healthier, balanced life.

Supplements and medications

To manage fatigue from semaglutide, supplements and other medications can help with deficiencies and side effects. B12 and iron supplements can help with energy deficiencies if appetite is reduced.

Magnesium can help with fatigue and muscle cramps, and vitamin D supplements can help support immune health and keep muscles and brain cells working. Anti-nausea medicines (meclizine or ondansetron) can help with nausea and prevent decreased food intake, antacids or PPIs can help with indigestion and appetite.

Staying hydrated and replenishing electrolytes is also crucial to prevent dehydration-related fatigue. Always consult a healthcare provider before starting any supplements or medications to ensure they are appropriate for your needs.

Alternative therapies

Complementary therapies like acupuncture and massage can help with fatigue and overall well-being. Acupuncture can help fatigue by balancing energy and discomfort, and massage relaxes, and improves circulation and sleep.

Both can reduce stress and muscle tension, and support energy overall. Always consult a healthcare provider before trying these treatments to make sure they are safe for you.

When to seek medical advice

You should seek medical advice if you experience:

• Severe or persistent fatigue that lasts more than a few weeks despite self-care.
• Dehydration signs like dry mouth and reduced urine
• Nutrient deficiency signs like dizziness or weakness
• Other warning signs like rapid heart rate, dizziness, mood changes, or weakness, which may be a sign of something more serious
• No improvement despite self-care like hydration, rest, or dietary changes
• Suspect underlying health conditions

Semaglutide and energy levels: The long-term implications

Semaglutide can increase energy over time by helping with weight loss and better blood sugar control, which reduces fatigue. However, some people may still experience fatigue due to side effects, nutrient deficiencies, or underlying health conditions.

Ongoing blood sugar, nutrition, and overall health monitoring are key to managing energy and addressing any issues that arise. Regular checkups with your doctor are important to get the most out of semaglutide.

Other factors that may cause fatigue

Fatigue can be caused by a variety of factors unrelated to semaglutide. Here are some common potential causes of tiredness:

Underlying health conditions

• Anemia: A condition where there is a lack of healthy red blood cells to carry oxygen to the body’s tissues. This can lead to feelings of tiredness, weakness, and shortness of breath.
• Thyroid issues: Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause fatigue. Hypothyroidism, in particular, is commonly associated with feeling sluggish and tired due to a slow metabolism.
• Sleep apnea: A sleep disorder where breathing repeatedly stops and starts during sleep. This can result in poor-quality sleep, leading to chronic fatigue.
• Depression or anxiety: Mental health conditions often cause physical fatigue, even in the absence of physical exertion. These conditions can disrupt sleep and lower energy levels.

Lifestyle factors

• Chronic stress: High-stress levels can lead to both physical and mental fatigue. Stress triggers the release of hormones like cortisol, which in the long term can drain energy levels.
• Poor sleep: Lack of quality sleep, due to insomnia or other sleep disturbances, is one of the most common causes of fatigue. Sleep is essential for restoring energy, and disruptions can leave you feeling tired throughout the day.
• Diet and hydration: A poor diet, especially lacking essential nutrients like iron, vitamin D, and B vitamins, can cause tiredness.
• Physical inactivity: While it may seem counterintuitive, being sedentary can lead to lower energy levels. Regular exercise improves circulation and boosts energy over time.

Interactions with other medications

• Medication side effects: Some other medications can cause fatigue as a side effect. For example, antihistamines, antidepressants, blood pressure medicines, and painkillers can make you experience fatigue.
• Drug interactions: If someone is taking multiple medications, some medications can interact with each other and increase tiredness.

Common side effects of semaglutide

Semaglutide is a safe and effective medication used for weight loss and managing type 2 diabetes, but it can cause gastrointestinal side effects. These symptoms usually improve over time as your body gets used to the medication.

Common side effects of semaglutide include:

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Decreased appetite
• Indigestion
• Belching
• Constipation
• Headache

Semaglutide can cause serious side effects such as pancreatitis (inflammation of the pancreas), gallbladder problems, changes in vision, allergic reactions, and kidney issues.

Semaglutide can also cause low blood sugar (hypoglycemia), especially if you are taking other diabetes medications. Over time, this can lead to episodes of hypoglycemia, which need careful management, so monitor your blood sugar levels regularly.

Semaglutide has a black box warning from the FDA (U.S. Food and Drug Administration) for the risk of thyroid tumors or thyroid cancer, including medullary thyroid carcinoma (MTC).

It is essential to be aware of these potential side effects and seek medical advice from your healthcare professional if you notice any concerning symptoms.

Semaglutide and fatigue: FAQs

How long does fatigue last on semaglutide?

Fatigue is more prominent during the first few weeks of starting semaglutide, as the body adapts to the medication. It usually goes away after a few days or weeks as your body adjusts.

Can semaglutide cause chronic tiredness?

Semaglutide can cause tiredness as a temporary side effect, but it’s not usually linked to chronic tiredness. If fatigue persists for a long time, it’s important to consult your doctor to rule out other causes.

Are there ways to prevent fatigue while taking semaglutide?

To help prevent fatigue while taking semaglutide, try staying well-hydrated, eating balanced meals, and getting enough sleep. Starting with a lower dose and gradually increasing it can also help your body adjust more easily.

Should I stop taking semaglutide if I feel tired?

It’s normal to feel fatigued as your body adjusts to semaglutide, but everyone’s experience can be different. Pay attention to how you feel, take regular breaks, and adjust your schedule to include rest periods, especially during the initial weeks of treatment.

Bottom line

Semaglutide can be very effective for weight loss and diabetes management, but fatigue is common, especially during the adjustment phase or with significant weight loss. It can also be related to other side effects, medications, or health conditions.

Fortunately, fatigue is manageable with the right strategies such as eating a balanced diet, staying hydrated, exercising regularly, and getting enough sleep.

Semaglutide works by mimicking the GLP-1 receptor agonist that helps control blood sugar, suppress appetite, and slow stomach emptying resulting in weight loss and reducing cardiovascular events.

If you’re tired for weeks on semaglutide, it’s a sign of a problem that needs medical attention.
Other symptoms associated with tiredness are dizziness, weakness, drowsiness, or lightheadedness. If you have any of these symptoms, contact your healthcare provider.

If you’re struggling with fatigue while taking semaglutide, don’t hesitate to reach out to your doctor for personalized guidance and support.

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U.S. Food and Drug Administration

• Federal regulatory agency for food and health-related products

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U.S. Food and Drug Administration

• Federal regulatory agency for food and health-related products

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Trusted source

U.S. Food and Drug Administration

• Federal regulatory agency for food and health-related products

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Trusted source

U.S. Food and Drug Administration

• Federal regulatory agency for food and health-related products

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