GLP-1 Weight Loss Injections with an Ileostomy: Experiences?

Hi all

I was interested in trying the weight loss medication called Zepbound, which is similar to all the other GLP-1 medications. I was told that since I have an ileostomy, I should never consider taking medications because they would cause blockages. The medication slows down the digestive process and could be harmful. I want to know if anyone else has tried GLP-1 medications and, if so, what were your results? Or have your doctors said the same thing? I have gained weight since my surgery and wanted to try the medication.

Hi and welcome. I'm an ileo too... 8 yrs now. Never heard of these medications to reduce weight. I would think as an ileo you lose weight due to liquid flow constantly.

Hang on... others will help advise. Just wanted to say be careful with weight loss meds and dehydration.

Big issues over the long term.

I hear the welcome wagons coming🤭... sit tight.

In my honest opinion, if it can cause digestive problems, that's not something I would take. We have a lot to deal with already, juggling between thick and thin and staying hydrated. Staying hydrated and avoiding blockages are our battles every day. There is a list you can find about medications and ostomies. It details which types of pills are safe and wouldn't cause a blockage, and which gels, capsules, and coated pills can. Also, the list will tell you how each type of medicine can affect your stoma. Granted, we are all different. But just Google it, and you can read up if you want to. And as warrior said, just be careful with hydration.

G-Day Shelly,

If you want to lose weight, don't eat as much. Medication to lose weight can't be doing a person's body any good. Regards, IGGIE

Agree. Watch the food intake and walk. It takes time but it's safer and proven to work.

Airport Security Tips Living with an Ostomy with April | Hollister

Hi, I have two female friends (fully bowled) who have taken Ozempic. Yes, it works, but so do the side effects: vomiting, diarrhea, nausea. There are long-term side effects too (Ozempic face - loose, saggy, aging skin). One of them had to stop taking it because of the effects, and the other has stopped. It's not worth taking, in my opinion. You still have to eat well and exercise. The best bet is to do what I do: download the Fat Secret app and log your food. You can set how many calories a day to eat; it tells you all your calories, macros, etc., and tells you where you need to be eating-wise. I also weigh my food to log it and have a good, simple exercise program to start with. It worked well for me. I've gone too far and am now trying to put weight back on, but I was training hard too.

Just my opinion... I'm not a doctor.

Zepbound side effects are just as applicable to ostomates as anyone else. The side effects must be seriously considered if you have an ileostomy.

The side effects are:
•    Nausea
•    Diarrhea
•    Vomiting
•    Constipation
•    Abdominal pain
•    Indigestion (dyspepsia)
•    Pancreatitis

Nausea, diarrhea, and vomiting can lead to complications like dehydration or electrolyte imbalances. Severe dehydration can lead to kidney problems or kidney failure.

As with side effects, not everyone experiences any or all of them. Adjusting Zepbound's dosage can help prevent or reduce side effects. Starting with a low dose (e.g., 2.5 mg weekly) and gradually increasing it allows the body to adapt, minimizing digestive side effects like nausea and vomiting. Staying hydrated is very important.

GLP-1's slow gastric emptying and intestinal motility can lead to constipation and partial blockages.

You have to weigh the risk versus the benefit. The use of a GLP-1 is not a weight loss and done activity. Current information suggests that continued use of the GLP-1 is likely necessary to maintain weight loss. However, combining medication with healthy lifestyle changes can play a crucial role in supporting long-term weight management and overall health.

Many GLP-1 drugs are injected (as you know but saying for the benefit of the silent readers). This is attractive for an ileo since you don't need to worry about it coming out in your bag!

Do you have type 2 diabetes or have you ever been tested for insulin resistance (precursor to type 2 diabetes)? These medical conditions are often genetic and can make it very easy to gain weight and very difficult to lose weight. These are the conditions that GLP-1s were developed to treat.

If you have one of these underlying conditions, the first line of treatment is normally metformin. But metformin is a pill (no idea if it will come out in your pouch) and it carries many of the same side effects as GLP-1s.

This is a very tricky situation and you must have a doctor who thoroughly understands the interaction between your illness, your ileostomy, and the drug effects and side effects. I'd even consider getting 2 opinions before starting.

IMHO, with your complex situation, I would not take advice on "do or don't take this medicine" from laypeople. I don't think this is what you were looking for but just saying...

If a medication could cause a blockage, I wouldn't take it. I've had a blockage that landed me in the emergency room, all dehydrated and miserable, and ended up staying in the hospital for 4 days. Luckily, they didn't have to operate. But you don't want to risk this. Trust me, you won't like the results if you did get a blockage.

I have used these meds to help lose weight to get prepared for more surgery while having an ileostomy. Drink water... the meds delay your digestive system so instead of everything being watery, it was thick and wanted to hang at the top of my bag. Once I started drinking much more water, it became more "normal" again. Water, tea, and protein shakes are what I made it through with.

Although I would really like to lose weight, I value my life more. I have ileostomy due to Chrons and I have no large bowel. I have read that these types of drugs can freeze the small intestine and cause blockage. My doctors - GI, Endo, and GP have all advised against doing these drugs and tell me that I am not a candidate.

Need to find another way other than starving myself. I would like to know more about the carnivore diet or other diets that might help.

I'd be careful with the keto diet. My husband (not an ostomate) is on this and he got something called the keto flu at the start. That was caused by flushing out his electrolytes.  If you have an ileostomy and trouble staying hydrated already, it might be very dangerous.  

I don't know anything about the other diets. But I'd advice talking to a nutritionist familiar with ileostomies before making a major change to your diet. About the only thing I'd risk without advice is reducing calories by eating less of the same foods. 

Hello, 

Everyone is different, but I've been taking Liraglutide, a GLP-1, for a year and 1/2 specifically to decrease my ostomy output and slow down gi transit with great results.  I suffered from frequent blockages before starting Liraglutide so I was rolling the dice as to whether taking a GLP-1 would increase the frequency of blockages.  Thankfully it has not.  That being said, I did have 3 months of rather severe nausea as my body adjusted to the medication.  If you decide to try a GLP-1, my advice would be to start with the lowest dose possible and increase slowly.  I was out of other options to try so I was willing to take a chance.  Since starting liraglutide, I've read several articles in respected medical journals about using Liraglutide to treat bile acid diarrhea so its use is expanding.

Colonostomy here 10/2023, and I blame the upper GI bleed I got on taking Monjaro…same meds for 10-20 years…then took 2.5 mg for 3 months, then moved to 5 mg dose for 1 month & that's when I had the upper GI bleed that almost killed me (literally - heart attack + 3 H crit whatever) dialysis + transfusions later, took part of my intestine & appendices, then a month later told septic (still in hospital), and gave me an ostomy…they blamed diverticulitis for it all, but I blame Monjaro as that was the only change in 10 years…so I wouldn't recommend it or if you do I would advise to be precautious & monitor yourself/body…I too fight weight as I take prednisone so gain weight just by existing - I'm a pescatarian & don't eat sweets or junk food…FYI, there are other alternatives to biologicals a good physician could advise you….Anyways, good luck!…

I am also an ileostomate and just started on Wegovy. My gastroenterologist is the person who recommended this. He is the top in his field. I have multiple medical issues and he would not recommend this if it were to be harmful. I have not had any issues and don’t think blockages were to be an issue. Blockages are caused by food and possibly strictures so as long as you are monitored and eat healthy you will benefit from it. Good luck. 😉 

Fat Secret is excellent. I have an ileostomy and use Fat Secret.  I've successfully lost weight, and find it to be very user-friendly and easy to track your calorie intake.

Hi,

I have an illeo and am on Wegovy. Have tried Ozempic(lower dose of the same med and Saxenda(pre ostomy). I get a bit of nausea but no other negative side effects. I have found that my transit time has significantly slowed, before it would take apprx 6 hours for food to go through me and now its more like 9, sometimes longer. But I have not had any issues with blockages at all. It does not cause blockages, only slows transit time. Just make sure you are doing all of the things you normally should do like chewing and drinking enough liquids. You will be able to judge if you are getting enough liquid by your output. It also does not cause dehydration as some have mentioned. Good luck!

Hi, can you tell me what dose you are on and has it slowed your output? 😀

I have been on Mounjaro for 8 weeks and lost 14 lbs - so not too fast. I have had no problems with my ileostomy but have had the odd day of diarrhea. I think I will try to stay on a low dose.

I took masses of medical advice and the only comment was it may decrease or increase your output.

I've had an ileostomy for 18 years due to UC.

Be careful. I wouldn't take the chance.

My oncologist, GP, and surgeons all approved Zepbound for my moderate obesity in spite of my permanent colostomy and ongoing treatment for anal cancer (so far, radiation, traditional chemo, two big surgeries, one of which removed my reproductive and lower gastro organs, and currently Keytruda). Their reasoning was that I'd feel better and there was no medical conflict, and lower body weight might improve my cancer prognosis.

Intro dose for two months and two months so far on standard dose (5 mg). Lucky for me, there are no side effects and a moderate loss of about 30 lbs, of which an unknown portion is organ removal (maybe 7 lbs?). I feel great and hope to lose another 25 lbs or so.

The main thing it does for me is kill the food noise. No more eating for comfort or boredom: I just eat to live (though I do still enjoy eating). And I fill up fast, so I eat a lot less. Less in, less out. Obviously, everybody is different, but mine is definitely a success story, at least so far.

I'm not on here a lot. I have never heard of Fat Secret, but I will research it. Thanks.

With an ileostomy, GLP-1 weight loss injections may affect hydration and nutrient absorption differently, so close monitoring is essential. Using MeAgain as a GLP-1 app and tracker can help you log symptoms, fluid intake, and weight changes to share more accurate data with your care team.

This is a very important safety question. The advice you were given is medically sound.

GLP-1 medications like Zepbound work by slowing down digestion (gastric emptying). For someone with an ileostomy, where digested material passes directly out of the body through a stoma, a significant slowdown can indeed increase the risk of a bowel obstruction or blockage, which is a serious medical emergency. While it's frustrating when a potential solution comes with risks, your health and safety are the priority. It is crucial to follow this medical guidance. A better approach for you would be to consult with a registered dietitian who has experience working with ostomy patients. They can create a tailored nutrition and exercise plan that supports safe and effective weight loss without this risk. For a free consultation, visit our site: https://www.valleymedicalweightloss.com/

I’ve seen mixed opinions on this from surgeons. Some are cautious because GLP1 meds slow stomach emptying and that can change how output behaves. I do use semaglutide myself through Minimal and the main effect is smaller meals and slower digestion. If someone has an ileostomy, that could either help or make things awkward, depending on how fast their system normally runs. The only way I’ve seen people get clear answers is asking the GI surgeon directly, not the general doctor.