Nausea Rescue Guide: How to Manage GLP-1 Side Effects

In my internal medicine training, we were taught to treat the disease. But in my functional medicine training at the Institute of Functional Medicine, we were taught to treat the person.

There is no place where this distinction matters more than with GLP-1 medications (like Semaglutide and Tirzepatide).

If you look at the clinical trials, the dropout rates can be high. Why? Because people feel sick. They get nausea, they get heartburn, or they get constipation, and because they don't have a strategy to manage it, they quit.

This breaks my heart because I know how life-changing these metabolic tools can be.

At Magnolia Functional Wellness in Southlake, we don't just write the script and wish you luck. We give you a "Rescue Guide." I want to share the exact protocols I use with my patients to ensure they get the weight loss without the misery.

Why Do You Feel Nauseous? (The Mechanism)

First, you have to understand what the drug is doing. GLP-1 agonists slow down gastric emptying. Usually, when you eat a burger, it leaves your stomach in a couple of hours. On this medication, it might hang out there for 4 or 5 hours.

If you eat the same way you used to—fast, heavy, and large portions—that food sits there like a brick. Your stomach gets distended, and it sends a signal to your brain saying, "Eject! Eject!"

The Magnolia Rescue Protocol

Here is the strategy I teach my patients to prevent the side effects before they start.

1. The "Half-Portion" Rule: For the first month, I tell patients: "Whatever you think is a normal portion, cut it in half."You can always eat more later. But you can't un-eat it. If you overfill the tank while the drain is clogged, you’re going to have a bad time. Eat slowly. Chew thoroughly. Give your brain time to catch up with your stomach.

2. Hydration with Electrolytes (Not Just Water): This is the biggest rookie mistake I see.GLP-1s can dull your thirst mechanism. Plus, if you’re eating less, you’re getting less water from food.Dehydration feels exactly like nausea.I recommend sipping water with electrolytes (sodium, potassium, magnesium) throughout the day. It stabilizes your blood pressure and keeps the nausea at bay.

3. Alcohol is Not Your Friend: I’ll be blunt: Alcohol and GLP-1s do not mix well.Alcohol irritates the stomach lining. Combine that with delayed emptying, and you have a recipe for severe heartburn and nausea. During the titration phase (when we are increasing your dose), I recommend cutting alcohol out completely.

4. The "Rescue Meds": We don't let you suffer. When you start treatment at Magnolia, we can prescribe Zofran (for nausea) to have on hand just in case. Knowing you have the safety net often reduces the anxiety about getting sick.

Avoiding "Ozempic Face" (Muscle Loss)

The other "side effect" you hear about is looking gaunt or aging rapidly.This isn't a drug side effect. It’s a starvation side effect.

If you lose 30 pounds in two months by not eating, you will lose facial volume and muscle mass. You will look sickly. My background in Functional Medicine emphasizes body composition, not just weight.

• Protein is Non-Negotiable: You must hit your protein targets to keep your muscle.
• Strength Training: You have to lift heavy things.
• Collagen & Hydration: Keep the skin elastic.

We monitor your body composition weekly to make sure you are losing fat, not structure.

The Bottom Line

Side effects are not the price you have to pay for being thin. They are usually a sign that we need to adjust your dose or your habits.

If you are suffering through your weight loss journey, you’re doing it wrong. Let’s adjust the plan and support your biology. You should feel better on this medication, not worse.

‍