Managing Constipation

Tips for Managing Constipation on GLP-1 Agonists

Supplemental Regimens

Maintenance Therapy

1. Increase Fiber Intake Gradually

Adequate fiber intake is one of the most effective and healthiest ways to prevent and manage constipation. Many individuals do not take enough fiber or use it consistently to see results. For best effects, take fiber supplements with at least 12 ounces of water, which may also help reduce appetite and support weight management.

Psyllium is a cost-effective option but may cause gas or bloating in some individuals. Common brand names include Metamucil. Kirkland (Costco) offers a psyllium capsule option. Start with ~2.5 grams (6 capsules) twice daily, increasing as needed to 7.5 grams (18 capsules) daily in 2–3 divided doses. Kirkland Signature Psyllium Fiber, 720 Capsules | Costco
Methylcellulose is my preferred fiber supplement. It is generally well tolerated and ideal for regular use, though it may be more expensive than psyllium. Common brand names include Citrucel. Walmart offers an Equate version in 500 mg tablets. Start with 1 gram (2 tablets) twice daily before meals, gradually increasing up to 2 grams (4 tablets) three times daily as needed. Equate Fiber Therapy Methylcellulose Caplets, 500 mg, 100 Count - Walmart.com

2. Magnesium Citrate

Magnesium citrate helps maintain regularity by drawing water into the intestines. Start with 250 mg daily, increasing to twice daily if needed. While it can be a helpful addition to fiber therapy, it typically has minimal effects when used alone. Kirkland Signature Magnesium Citrate 250mg, 270 Softgels | Costco

As-Needed Therapy

If you are already experiencing constipation, consider these options in the following order:

Polyethylene Glycol (Miralax) – A gentle, osmotic laxative that draws water into the colon to soften stool. Start with one serving daily, increasing up to three servings daily as needed until regular bowel habits return. This can also be used safely for daily maintenance if necessary. Equate ClearLax Polyethylene Glycol 3350 Powder for Solution, Unflavored, 30 Doses - Walmart.com
Magnesium Citrate Solution – An effective, over-the-counter option for occasional relief. However, it can be very strong, so use with caution and only as needed. Freskaro Magnesium Citrate Oral Solution 10 oz, Lemon Flavor - Walmart.com
Stimulant Laxatives (Senna-S, Bisacodyl) – Effective for occasional use but may cause cramping or discomfort. These should not be used regularly, as the body can develop tolerance over time. Equate Senna-S Laxative and Stool Softener Tablets for Constipation, 30 Count - Walmart.com

Always follow label directions and consult your healthcare provider if you have any questions.

General Lifestyle Recommendations

Stay Hydrated
Drink at least eight cups of water daily unless otherwise directed by your healthcare provider. Proper hydration helps soften stools and supports overall digestive health.
Stay Physically Active
Regular movement, such as walking, light exercise, or yoga, stimulates bowel function and supports digestion. Aim to incorporate daily physical activity into your routine.
Eat Smaller, More Frequent Meals
Large meals can slow digestion, particularly for those on GLP-1 agonists. Eating smaller, more frequent meals throughout the day may help prevent constipation and promote smoother digestion.
Stay Consistent with Medication
Skipping or stopping doses of GLP-1 agonists can disrupt your body’s adjustment period, which may worsen constipation. Use your medication as directed to allow your digestive system time to adapt.
Establish a Bathroom Routine
Try to use the restroom at the same time each day, even if you don’t feel the urge. This consistency can help train your body to maintain regular bowel movements.
Consult Your Healthcare Provider if Symptoms Persist
If constipation becomes severe, persistent, or unmanageable despite these strategies, seek medical guidance. Your provider may recommend additional interventions tailored to your needs.