Nutrition on Ozempic: How to Preserve Muscle and Reduce Side Effects

To lose fat rather than muscle on Ozempic (semaglutide), you need three things: enough protein at every meal (the joint advisory suggests 1.0–1.5 g per kilogram per day, unless you have kidney disease), strength training 2–3 times a week and a moderate rate of weight loss. In studies, between a quarter and almost 40% of the weight lost on GLP-1 therapy was lean mass, so muscle needs protecting from the first month. With a reduced appetite it is easy to eat too little protein and drink too little water — build your meals around protein, and ease nausea with small portions and less fatty food.

In short

• What to do: protein at every meal (eggs, cottage cheese, Greek yoghurt, fish, poultry, legumes, tofu); strength training 2–3 times a week and a daily walk; 1.5–2 L of water a day; small portions and eating slowly; fibre from whole grains, legumes, berries and seeds — increased gradually; vegetables — for volume and satiety.
• What to avoid: skipping meals “because you’re not hungry”; fatty, fried and very sweet food — it makes nausea worse; alcohol; fasting and very-low-calorie diets; supplements taken “at random” without lab tests.
• When to see a specialist: persistent nausea, vomiting or constipation lasting more than a few days; marked weakness, hair loss; weight coming off too fast; severe abdominal pain — see a doctor immediately.

What is Ozempic and how does it affect the body

Ozempic (active ingredient — semaglutide) is a medication used for the treatment of type 2 diabetes and weight management. It belongs to the group of glucagon-like peptide-1 (GLP-1) receptor agonists. The drug slows gastric emptying, reduces appetite, and helps control blood sugar levels.

The impact of Ozempic on appetite and metabolism

Ozempic works comprehensively:

• Reduces the feeling of hunger by affecting the satiety centres in the brain.
• Slows down digestion, helping you feel full for longer.
• Regulates insulin levels, reducing blood sugar spikes.

At the same time, some people may experience side effects such as nausea or bloating. Therefore, balanced nutrition during the Ozempic course is extremely important.

Key nutritional principles while taking Ozempic

• Eat regularly and in small portions. Try to consume food every 3–4 hours to avoid sharp blood sugar fluctuations.
• Focus on quality, not quantity. Choose foods with high nutritional value.
• Control the intake of simple carbohydrates. Reduce sugar and pastries in favour of whole grain products.
• Do not skip meals. This will help avoid intense hunger and overeating.
• Chew food thoroughly – this will ease digestion, especially with delayed gastric emptying.

Which foods to include in the diet for better effect

1. Protein foods: chicken fillet, fish, eggs, cheese, legumes. They help preserve muscle mass and provide a lasting feeling of fullness.
2. Vegetables — for volume and satiety: broccoli, zucchini, asparagus, cucumbers, spinach. Fibre comes mainly from whole grains, legumes, berries and seeds — add them gradually so as not to worsen bloating.
3. Healthy fats: avocado, olive oil, nuts, and seeds. They promote better absorption of fat-soluble vitamins.
4. Whole grain products: buckwheat, oatmeal, quinoa, bulgur. They provide a stable energy level.
5. Fruits with a low glycaemic index: apples, pears, berries. They can be consumed in moderation.

Foods to avoid during treatment

• Sugar and sweets: can cause sharp blood sugar fluctuations.
• Carbonated drinks and alcohol: irritate the stomach and increase nausea.
• Highly processed foods: fast food, sausages, chips — they overload the digestive system.
• Fatty and fried foods: may worsen symptoms of bloating and nausea.
• Large portions of fibre at one meal: may cause discomfort. Introduce fibre gradually.

The role of proteins, fats, and carbohydrates in balanced nutrition

• Proteins (guide: 1.0–1.5 g per kg of body weight per day): help repair tissues and maintain muscles during weight loss.
• Fats (20-25%): necessary for hormonal balance. Prefer unsaturated fats.
• Carbohydrates (40-45%): the main source of energy. Prefer complex carbohydrates.

Why hydration is important when taking Ozempic

Taking Ozempic can slow down digestion, so it's important to drink enough water to avoid constipation. Recommended:

• Drink 1.5–2 litres of water per day.
• Start the day with a glass of warm water.
• Add liquid meals to the diet (soups, smoothies).
• Limit coffee and strong tea to prevent dehydration.

Eating habits that help avoid side effects (nausea, bloating):

• Eat slowly and in small portions.
• Avoid heavy meals before bedtime.
• Avoid carbonated drinks.
• Choose boiled, stewed, or baked dishes.
• If nausea occurs, consume ginger or drink mint tea.

Do you need supplements or vitamins during the Ozempic course

Ozempic can affect appetite and eating behaviour, so sometimes the body may not receive essential nutrients. You might need:

• Vitamin B complex — to support energy levels.
• Omega-3 fatty acids — for heart and joint health.
• Magnesium — to relieve muscle spasms and improve sleep.
• Probiotics — to support gut microbiota.

Consult a specialist before taking supplements.

Dietitian's advice for combining Ozempic and physical activity

Physical activity combined with a balanced diet enhances the effect of Ozempic:

• Cardio exercises (walking, swimming, dancing) — 3–4 times a week.
• Strength training — twice a week to maintain muscle mass.
• Yoga or Pilates — help relieve stress and improve flexibility.
• Start with light workouts and gradually increase intensity.

When to consult a specialist for diet correction

It is recommended to consult a dietitian in the following cases:

• You experience constant nausea or stomach discomfort.
• Weight loss is happening too quickly or too slowly.
• You have difficulty creating a balanced menu.
• You plan to take supplements or change your diet programme.

Specialists at Dr. Bezugla's Clinical Dietology Centre will help create a personalised nutrition programme that considers all the features of your body and the course of treatment with Ozempic.

Take care of your health, listen to your body's needs, and don't hesitate to seek help from specialists.

Sources

1. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory (American College of Lifestyle Medicine, American Society for Nutrition, Obesity Medicine Association, The Obesity Society) — Obesity, 2025.
2. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies — Diabetes Obes Metab, 2024.
3. NICE NG246. Overweight and obesity management — National Institute for Health and Care Excellence, 2025.

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