What Not to Do While Taking Oral GLP-1s for Obesity — and What to Do Instead

An oral glucagon-like peptide-1 (GLP-1) medication might, for some people, be easier than an injection, especially if you’re not a fan of needles. But taking a pill for obesity isn’t exactly as simple as swallowing a tablet.

If you’re using an oral GLP-1, such as Wegovy (semaglutide) or Foundayo (orforglipron), you may need to take the medication at a specific time or gradually adjust the dosage in ways that you may not need to do with an injection GLP-1, says Marsha Novick, MD, a board-certified obesity medicine physician in private practice in Malvern, Pennsylvania, and the chief medical officer at MeAgain, an app for people taking GLP-1 medications.

Not making these adjustments, though, can make the treatment less effective or harder to tolerate. Learn what to avoid while taking an oral GLP-1 for obesity, and what to do instead.

1. Don't Take Your Medication at Just Any Time

You may have a specific time of the day when you take your pills — alongside your morning coffee, for instance, or before you go to bed. But some oral GLP-1s need to be taken on an empty stomach, says Absalon Gutierrez, MD, an endocrinologist at UT Health Houston and an associate professor at UTHealth Houston McGovern Medical School in Texas.

Eating or drinking (usually liquids other than water) as well as taking other medications and supplements may also affect how well the body absorbs a GLP-1, which may make the medication less effective, says Dr. Novick.

What to Do Instead

Check your medication’s instructions about when to take the tablet, including how long you may need to wait before eating or drinking.

• Wegovy Take this medication first thing in the morning on an empty stomach with no more than 4 ounces of water — plain water only, no other beverage.

  [1]

  Wait at least 30 minutes before eating, drinking, or taking other oral medications or supplements.

  [1]

• Foundayo Take this tablet once daily at any time, with or without food.

  [2]

   It doesn’t have the same food and water restrictions as Wegovy, Novick says.

If you’re unsure of your medication’s administration instructions, ask your prescriber or pharmacist for guidance.

2. Don't Split, Crush, or Chew the Tablets

What to Do Instead

3. Don’t Skimp on Hydration

You’ll almost certainly eat less when you’re taking an oral GLP-1, but you may end up drinking less, too. Some people feel less thirsty, forget to drink, or develop an aversion to water, says Eleanor Yusupov, MPH, DO, a board-certified obesity medicine physician and an assistant professor at New York Institute of Technology’s College of Osteopathic Medicine in Old Westbury.

What to Do Instead

Dr. Yusupov recommends drinking at least 64 ounces of water every day, unless your care team has given you a different goal. You may need to hydrate even more during vigorous exercise or when spending time in the sun, she says.

4. Don’t Increase Your Dose Too Quickly

Increasing an oral GLP-1 too quickly can cause significant stomach-related side effects, Yusupov says. And taking more than prescribed can cause nausea and vomiting, Novick notes, which may lead to dehydration.

What to Do Instead

Take the medication exactly as prescribed and follow your healthcare provider’s dose-escalation schedule. For both Wegovy tablets and Foundayo, you’ll generally remain at each dose level for at least 30 days before a possible increase, Yusupov says.

Contact your prescriber for questions about dose escalation, for help managing difficult oral GLP-1 side effects, or if you think your medication isn’t working as well as you hoped.

5. Don’t Eat Large, Rich, or Fatty Meals

Yusupov and Gutierrez recommend limiting greasy or fatty foods because they can worsen digestive symptoms. “Similarly, large or rich meals while taking oral GLP-1 medications may increase gastrointestinal side effects like nausea, heartburn, stomach cramps, or diarrhea,” says Yusupov.

What to Do Instead

Aim for smaller, more frequent meals throughout the day, and limit fried or fatty foods that can worsen your symptoms, says Yusupov.

6. Don’t Neglect Protein and Exercise

Staying sedentary can contribute to muscle loss, too, says Yusupov, as can eating too little protein, since that can make it harder to preserve muscle, adds Gutierrez.

What to Do Instead

• Eggs
• Plain or Greek yogurt
• Chicken or fish
• Beans or lentils
• Tofu

Make regular physical activity a priority as well. Yusupov recommends strength training, such as using resistance bands, free weights, or body-weight exercises to prevent the excessive muscle loss and frailty that can occur with significant weight loss.

“Exercise and adequate protein intake help you keep the weight off and protect muscles,” says Gutierrez.

7. Don’t Skip Meals or Restrict Calories Too Much

Yusupov cautions against skipping meals because long stretches without eating may contribute to low blood sugar.

What to Do Instead

If a full meal doesn’t appeal to you, Yusupov suggests eating a protein-rich snack, such as plain yogurt, cottage cheese, an egg, or tofu, instead. Throughout the day, aim to eat lean protein and other nutrient-dense foods, along with enough fluids, Novick says.

A registered dietitian or your care team can help you meet your nutritional needs if you’re concerned that you aren’t eating enough.

8. Don’t Ignore Severe or Persistent Symptoms

In other cases, “neck swelling and trouble swallowing or breathing are signs of an allergic reaction and reasons to head to the emergency department right away,” says Novick.

What to Do Instead

Contact your care team right away if you’re experiencing vomiting, diarrhea, or abdominal pain that is severe or doesn’t improve, says Novick. Let them know if you’re also feeling lightheaded or dizzy.

Seek immediate medical care for severe or persistent abdominal pain. Call 911 for difficulty breathing or swallowing or swelling of the face, lips, tongue, or throat.

9. Don’t Forget to Mention Your Medication Before Surgery or Sedation

If you’re undergoing surgery or a procedure that requires sedation, always tell your provider that you’re taking an oral GLP-1.

What to Do Instead

“Your medical team will advise you when to stop weight loss pills to prevent residual food in the stomach,” Yusupov says. Always seek guidance from your care team before stopping these medications on your own.