# Constipation on GLP-1s: what to track, when it tends to show up, and how to log it

> GLP-1 constipation is listed on the Wegovy (24%), Zepbound (11-17%) and Saxenda (19%) labels. What to log day to day, red flags, and how to track it in Peppy.

Source: https://peppytracker.com/side-effects/constipation/
Last updated: 2026-08-30

Constipation is on every GLP-1 label: Wegovy lists it in 24% of trial participants, Saxenda 19.4%, Zepbound 11-17%, Mounjaro 6-7%, Ozempic 3-5%. Unlike nausea it often builds over weeks rather than hours after a shot. Log severity 1-5 daily with a hydration note, and watch the weekly heat-map against dose step-ups rather than shot days.

## GLP-1 constipation: what it is and who reports it

GLP-1 constipation is the slow, backed-up feeling that many people on semaglutide or tirzepatide notice a few weeks in. These medicines slow gastric emptying and, for many people, slow the whole gut down with it. It gets less attention than nausea because it is quieter, but on the weight-management labels it is one of the top four reactions.

| Label | Constipation (drug) | Constipation (placebo) |
| --- | --- | --- |
| Wegovy 2.4 mg | 24% | 11% |
| Saxenda | 19.4% | 8.5% |
| Zepbound 5 / 10 / 15 mg | 17% / 14% / 11% | 5% |
| Mounjaro 5 / 10 / 15 mg | 6% / 6% / 7% | 1% |
| Ozempic 0.5 / 1 mg | 5% / 3.1% | 1.5% |

Two things stand out. First, constipation is far more common in the weight-management trials than the diabetes trials, which is partly about dose and partly about how much people are eating. Second, on Zepbound the rate is highest at the lowest dose, which is a reminder that these are population averages and not a dose-response curve you can apply to yourself. Compounded [Compounded Semaglutide](https://peppytracker.com/compounds/semaglutide-compounded/) and [Compounded Tirzepatide](https://peppytracker.com/compounds/tirzepatide-compounded/) carry no label; the branded numbers are the reference.

## When it tends to show up

Nausea is a shot-day story. Constipation is usually a weeks story. The labels group all gastrointestinal reactions together and say they were "most frequently reported during dosage escalation" (Wegovy) and "decreased over time" (Mounjaro, Zepbound). But many people report that constipation lags: it creeps in during the second or third week on a new dose, after they have been eating less for a while, and it does not swing much with the day of the week.

That changes what you compare against. For nausea you line severity up with days since the shot. For constipation you line it up with the dose you are on, how many weeks you have been on it, and how much you have been eating and drinking. Wegovy's escalation schedule moves every four weeks and Zepbound's after at least four weeks on a dose, so a four-week window per dose is the natural unit.

## What is worth logging

- **Severity, 1-5, every day.** Score it even on days it is a 1. A run of zeros is data too, and it is what lets a heat-map show the change.
- **Hydration and food in the note.** A short line: "barely drank today", "two meals", "big fibre day". You are not counting calories, just leaving context. Peppy has no food or calorie logging, and a note is enough.
- **The dose you were on, by week.** Constipation in week 2 of 0.5 mg and week 2 of 1 mg are separate baselines.
- **Weight.** A stalled scale during a constipated week is common and easy to misread. Seeing both on one timeline helps.
- **Anything your prescriber suggested.** If they told you to do something, log that you did it so the effect is visible next to the score.

Constipation and [heartburn](https://peppytracker.com/side-effects/heartburn/) often travel together in people's logs, so it is worth tracking both from the start.

## When to contact your prescriber

The labels do not treat constipation alone as an emergency, but they are clear about what sits next to it.

- **Persistent or severe abdominal pain**, "sometimes radiating to the back", "which may or may not be accompanied by nausea or vomiting". This is the pancreatitis warning on every GLP-1 label.
- **Constipation with vomiting or a hard, swollen belly.** That is a different problem from being backed up, and it needs a call the same day.
- **No bowel movement for many days, or pain that is getting worse rather than better.** Bring the log; the weekly view makes the trajectory obvious.

The labels also say to consider delaying a dose escalation if a dose is not tolerated. That is a prescriber decision. Your job is to arrive with a log that makes the decision easy.

## How to do this in Peppy

1. **Turn constipation on.** It is one of the five GLP-1 defaults, so if you set up a GLP-1 protocol it is already on. Otherwise open Settings ▸ Tracking and toggle Constipation. Dehydration is in the same list if you want a second signal.
2. **Score it in the daily check-in.** Tap the check-in row on the Today tab. Constipation is a 1-5 slider next to nausea and the other side effects. Put hydration and meals in the note field, and add your weight while you are there.
3. **Keep your titration ladder in the protocol (Pro).** In Protocols, open your GLP-1 and set the dose ladder with durations. Peppy auto-advances the dose on the Today card and the log sheet, and every step-up becomes a marker on your charts. The [titration tracker guide](https://peppytracker.com/guides/glp-1-titration-schedule-tracker/) shows the setup.
4. **Read the heat-map by week in Progress (Pro).** The Progress tab shows each side effect as a row of weekly cells. For constipation, look at the two or three cells after each step-up marker rather than the individual shot days. Free users see the chart blurred.
5. **Check the Calendar when you want the daily view.** The month grid shows shot days as taken dots; the week strip lets you flip through check-ins and see whether anything tracks with the shot at all.
6. **Set a check-in reminder (Pro).** Settings ▸ Reminders adds a daily nudge. Constipation logs only work if they are continuous, and the reminder is what keeps them that way.

For the full check-in setup including food noise and feelings, read the [side-effects tracking guide](https://peppytracker.com/guides/track-glp-1-side-effects-food-noise/). Related: [nausea](https://peppytracker.com/side-effects/nausea/), [dehydration](https://peppytracker.com/side-effects/dehydration/), [Zepbound tracker](https://peppytracker.com/trackers/zepbound-tracker/).

## Frequently asked

### Does Ozempic cause constipation?

Ozempic's label lists constipation in 5% of patients at 0.5 mg and 3.1% at 1 mg, versus 1.5% on placebo. The higher-dose weight-management labels list more: Wegovy 24% versus 11% on placebo, and Zepbound 11-17% versus 5%.

### How long does GLP-1 constipation last?

The labels do not give a duration for constipation specifically. They say gastrointestinal reactions cluster around dose escalation and decrease over time. Many people report constipation as slower to settle than nausea. A daily 1-5 log across several weeks is the only reliable way to see your own trajectory.

### Is constipation worse on Mounjaro or Zepbound?

Same molecule, different trial populations. Mounjaro's label (type 2 diabetes trials) lists constipation at 6-7% versus 1% on placebo. Zepbound's label (weight-management trials) lists 17%, 14% and 11% at 5, 10 and 15 mg versus 5% on placebo.

### When should I worry about constipation on a GLP-1?

The labels flag persistent or severe abdominal pain, sometimes radiating to the back, as a possible sign of pancreatitis and say to contact a prescriber. Constipation that comes with severe pain, vomiting, or no bowel movement for many days is a prescriber call, not something to wait out.

### Can I track constipation and nausea together?

Yes. In Peppy both are GLP-1 defaults in the daily check-in, each scored 1-5, and the Progress tab (Pro) shows them side by side as a weekly heat-map lined up with dose step-ups.

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Peppy is a tracking tool, not medical advice. Dose calculations are mathematical conversions only. Always follow your prescriber's instructions and verify every draw-up yourself.

Peppy is a free iPhone app (Pro subscription optional). App Store: https://apps.apple.com/us/app/peptide-tracker-peppy/id6775005514