If you've recently started a GLP-1 medication or had your dose increased, you might be feeling a little off. Maybe it's nausea after meals, or a stretch of days where your stomach just doesn't feel right. Side effects can be quite common – many people experience at least some symptoms.  

Here's the most important thing to know: feeling a little off in the first few weeks does not always mean something is wrong. It usually means your body is adjusting to the medication. These side effects are well-documented and expected, and for most people, they improve with time.

The second most important thing: your Bold Care team is here for exactly this. If something doesn't feel right, reach out. We’re here to help you manage your symptoms, your medication dosage, and your overall weight loss plan. Please do not skip a dose or change your medication schedule. If something needs to change, we'll figure that out together.

This post is a practical reference you can come back to whenever you need it. We've organized it by symptom so you can find what's relevant to you, get tips that actually help, and know when it's time to give us a call.

Nausea

How common is it? Very. Nausea affects 30% to 50% of people taking a GLP-1, making it the most common side effect people on GLP-1s tend to experience. It's most likely to show up right when you first start the medication, or after a dose increase.

What it feels like: A general queasiness, sometimes worse after eating. Some people describe it as a low-grade "off" feeling that comes and goes throughout the day. For most people, it fades as your body adjusts to the medication.

What helps: 

Eat smaller meals more frequently rather than two or three large ones. Eating slowly helps too — give your body time to process what you're taking in. 

Bland, easy-to-digest foods tend to sit better: think toast, rice, bananas, crackers, or broth-based soups. Greasy, fried, or very rich foods can make nausea worse, so it's worth scaling those back while your body is adjusting. 

Try not to lie down right after eating. A gentle walk after a meal, even just around the house, can help with digestion.

When to call Bold: If you cannot keep food or drinks down for more than 24 hours, pause your next medication dose and call your Bold care team. There are adjustments we can make to help you feel better.

When to go to the ER: If you experience nausea accompanied by passing out, or severe dehydration, go to the Emergency Room immediately. 

Vomiting

How common is it? Less common than nausea, but it can happen, especially in the first few weeks, or after a dose increase.

What it feels like: Sometimes vomiting follows a wave of nausea. Other times it comes on its own, particularly after eating too much or too quickly.

What helps:

If you experience vomiting, you’ll need to focus on staying hydrated. Take small, frequent sips of water or an electrolyte drink rather than trying to gulp down a full glass at once. 

Don't force yourself to eat — let your stomach settle first, then ease back in with something bland when you feel ready. If you're vomiting repeatedly, keep track of how often it's happening (you can log this in your Bold profile), because that's information your care team will want to know.

When to call Bold: If your vomiting lasts longer than 24 to 48 hours, or if you cannot hold down liquids, pause your next medication dose and call your Bold care team. We may need to adjust your dose or your titration schedule.

When to go to the ER: If you're experiencing constant vomiting, vomiting blood, extreme dizziness, confusion, or are unable to urinate, go to the Emergency Room immediately. 

Diarrhea

How common is it? About 10% to 20% of patients on GLP-1s experience diarrhea. Like other GI side effects, it tends to be most common when you're starting the medication, or moving to a higher dose.

What it feels like: Loose or watery stools, sometimes with urgency. It may come and go rather than being constant.

What helps: 

Stay on top of your fluids — diarrhea can dehydrate you faster than you'd expect, especially if you're not feeling thirsty. Water is great, and adding an electrolyte drink is a great way to replace depleted nutrients. 

Food-wise, bland options tend to help with getting rid of diarrhea: white rice, bananas, toast, applesauce are all good options. You may want to temporarily cut back on greasy or high-fiber foods (beans, many raw fruits and vegetables) until things settle down.

When to call Bold: If you’re experiencing frequent loose stools lasting more than 48 hours, or mild belly cramps, call your Bold care team.

When to go to the ER: If you're experiencing severe diarrhea (more than 8 to 10 times a day), blood in stool, dark black stool, or a fever,  go to the Emergency Room immediately. 

Constipation

How common is it? About 10% to 20% of patients on GLP-1s experience diarrhea. GLP-1 medications slow the speed at which food moves through your digestive system, which is part of how they work, but it can also mean things slow down more than you'd like.

What it feels like: Infrequent bowel movements, straining, or a feeling of being "backed up." Constipation tends to build gradually, rather than hitting all at once. 

What helps:

The biggest thing you can do is drink more water. Constipation and dehydration go hand in hand, and if you're not drinking enough fluids, things will only get harder to move. 

Gradually increasing your fiber intake helps too: fruits, vegetables, and whole grains can all make a difference. 

Staying physically active (a daily walk counts!) supports healthy digestion. Don't wait until constipation is already uncomfortable to address it. Start with extra fluids and movement as a preventive habit if you feel a shift in your digestion. .

When to call Bold: If you have no bowel movements for more than 3 days, along with mild belly discomfort, call your Bold care team.

When to go to the ER: If you're experiencing severe belly swelling, intense pain, vomiting stool, or an inability to pass gas, go to the Emergency Room immediately.

Dizziness and lightheadedness

How common is it? This one varies. It's more likely to happen when your weight or fluid levels are shifting, which is common in the early weeks and months of treatment.

What it feels like: A head rush when you stand up, a general wooziness, or brief moments where you feel unsteady. This can happen because changes in weight and hydration can cause a temporary drop in blood pressure when you change positions (also known as orthostatic hypotension).

What helps:

Take your time when changing positions.  When you've been sitting or lying down, take a moment before standing — you can try counting to ten after sitting up, before standing. Standing up after bending over or crouching down are also transitions to be aware of – consider having a sturdy piece of furniture or wall nearby for support. 

Stay on top of your hydration throughout the day (you'll notice this comes up a lot! Drinking enough water really does matter when you’re on GLP-1s). 

Pay attention to patterns: does it happen more at a certain time of day? After meals? When it's hot? That kind of information helps your care team figure out what's going on.

When to call Bold: If dizzy spells are happening more than 1-2 times per week, if you've had a near-fall, or if you're feeling unsteady enough that it's affecting your confidence moving around, call your Bold Care provider. This is especially important if you're taking other medications for blood pressure, because we may need to coordinate an adjustment with your primary care physician.

When to go to the ER: If you're experiencing persistence dizziness, lightheadedness, or if you actually faint, go to the Emergency Room immediately. 

Low blood sugar (hypoglycemia)

How common is it? Uncommon on its own. The risk goes up if you're also taking medications for diabetes or blood pressure.

What it feels like: Shakiness, sweating, sudden confusion, feeling faint, or a racing heartbeat. Low blood sugar can come on quickly and feel alarming. If you take diabetes medications, it's worth knowing what these symptoms feel like so you can recognize them early.

What helps:

If you think your blood sugar is dropping, eat or drink something with fast-acting sugar — a few glucose tablets, a small glass of juice, or a few hard candies. Then follow up with a more substantial snack that includes some protein to help stabilize things.

When to call Bold: If you’re taking insulin or sulfonylurea pills (such as glipizide or glimepiride) and experiencing symptoms of low blood sugar, call your Bold care team.

When to go to the ER: If you're experiencing blood sugar levels under 50 mg/dL, confusion, passing out, or seizures, go to the Emergency Room immediately.

Upper-right belly pain

How common is it? Less common than the side effects above, but GLP-1 medications do carry an increased risk of gallstones and gallbladder inflammation, often signified by upper-right belly pain.

What it feels like: A sharp, sometimes intense pain in the upper right side of your abdomen, often after eating. The pain may be accompanied by nausea. The pain can last anywhere from a few minutes to several hours.

When to call Bold: If you’re experiencing pain in your upper-right belly, especially after eating meals, or paired with nausea, call your Bold care team. 

When to go to the ER: If you're experiencing sudden, severe upper-right belly pain accompanied by fever or chills, go to the Emergency Room immediately. 

Severe belly pain

How common is it? Less common than the side effects above, but GLP-1 medications do carry risk of severe belly pain.

What it feels like: A sharp, sometimes intense pain in your belly. The pain may be accompanied by nausea. The pain can last anywhere from a few minutes to several hours.

When to call Bold: If you’re experiencing severe stomach pain that spreads to your back, along with nausea, vomiting, or fever, call your Bold care team. 

When to go to the ER: If you're experiencing unbearable belly pain with fever, fast heart rate, or severe weakness, go to the Emergency Room immediately.

Protecting your body while you lose weight

Weight loss is just part of the equation towards a healthier body and being able to do more. To ensure that you’re losing weight in a way that supports these goals, you’ll focus not only on losing fat but on actively building strength. When you lose weight quickly, your body can lose muscle along with fat. For adults over 65, that matters a lot: less muscle and bone means less stability, less balance, and more risk of falls and fractures.

That's why your Bold Care Plan includes specific guidance around nutrition, exercise, and hydration. These aren't bonus recommendations. They're part of how we make sure the medication is working for you, not against you.

Eat protein at every meal. Protein is what protects your lean muscle while you're losing weight. Good choices include eggs, yogurt, fish, chicken, beans, or a protein shake. Your provider has set a daily protein target for you — try to spread it across all of your meals rather than loading it into one. For more on why protein matters, how much you need, and easy ways to get enough, read The Protein Guide for Adults 60+.

Do your Bold strength routine. Even light resistance and strength training makes a meaningful difference in keeping muscles strong, protecting your joints, and improving your balance. Resistance training is an important part of maintaining muscle and bone mass – you’ll aim for twice a week workouts. Your Bold routine is personalized to you (it could include seated options, or higher intensity for people who are ready for it) so you can do your workout in a way that works for your body.

Drink on a schedule, not just when you're thirsty. As we get older, the feeling of thirst becomes a less reliable signal, which means you can become dehydrated before you notice. This is especially true when you're on a GLP-1, because side effects like nausea, vomiting, and diarrhea can all cause you to lose fluids faster than usual. Your provider can help you set a daily target for water-intake. Keep a water bottle nearby and sip throughout the day, whether you feel thirsty or not. If you find yourself not drinking enough, consider setting alarms to remind yourself. 

When to call your Bold Care team

Small discomforts can still impact your daily life in a big way. You don't need to wait for something to get bad before reaching out. Your Bold care team is here for you, no matter what. 

Call or message your Bold Care provider if:

• Side effects aren't improving over time, or they're getting worse.
• You're having trouble eating, drinking, or getting through your day because of how you feel.
• You're concerned about how your GLP-1 might be interacting with other medications you take.
• You're thinking about skipping a dose, changing when you take your medication, or stopping altogether.

We'll decide together if something needs to change. Your provider reviews your symptoms, your progress, and your overall plan at every visit, and can adjust your dose, your titration schedule, or your Care Plan based on how you're doing. Logging your symptoms in your Bold dashboard allows your provider to understand how you’re doing, and whether anything needs to change. 

When to stop your medication and seek emergency care

Some side effects require immediate action. These are infrequent, but serious. If you experience any of the symptoms noted above in the “When to go to the ER” sections, hold your medication, call your Bold Care provider, and go to the emergency room. Don't wait to see if the severe symptoms pass. These are situations where getting medical attention quickly matters.

We’re here for you

Side effects don't mean the medication isn't working – they mean your body is adjusting. 

Your Bold Care provider reviews everything at each followup visit — your symptoms, your progress, your medications, your daily habits — and adjusts the plan as needed. Our goal is simple: help you feel your best, and stay strong.The most important thing you can do is stay in contact with your Bold team. If something feels off, say something. We’re here for you!