Starting semaglutide can feel overwhelming, especially when it comes to figuring out what you should eat. Throughout my years as a Registered Dietitian, I have seen how people often struggle to manage their symptoms and still get the nutrition they need to lose weight. 

We know that one of the biggest side effects (and benefits) of semaglutide is that it helps reduce your hunger and cravings. And, while this is handy for weight loss, it’s also a concern you need to learn how to handle. You want to be in a caloric deficit (eating fewer calories than the body needs) without reducing them too much. 

That is why figuring out what to eat to help you manage your symptoms, while still giving your body just the right amount of nutrients it needs, will play a crucial role in the results you get from your treatment. 

After all, semaglutide injections are meant to be a temporary practice. Learning how to eat during the treatment is going to help you not only achieve the best results, but also make sure you keep them for a long time. 

Here, we will walk you through everything you need to know about eating while on semaglutide, from the best macronutrient breakdown to specific foods that can help (or hurt) your weight-loss journey. 

Quick Answer

If you are on a semaglutide journey, aim for a high protein intake (more than 1.2 grams of protein per kilogram of body weight), fiber-rich carbohydrates, and healthy fats while avoiding greasy, sugary, and carbonated items that can worsen your nausea. Try to focus on small, slow meals with proper hydration to help improve tolerance and enhance weight loss.

Why Diet Matters on Semaglutide

Semaglutide belongs to a class of medications called GLP-1 receptor agonists. These drugs work by slowing down gastric emptying (which is the rate at which your food moves from your stomach to your small intestine) and reducing appetite signals in your brain. This mechanism means that food stays in your stomach longer than usual, making you feel fuller for longer. 

So, when you eat the wrong types of foods, this delayed emptying can lead to uncomfortable side effects like nausea, vomiting, and acid reflux. On the other hand, choosing the right foods can help you reduce these issues while still supporting your weight-loss goals. 

Many people who start semaglutide experience rapid weight loss, which can lead to muscle loss if protein intake is insufficient. Research shows that keeping an adequate protein intake (at least 1.2 g/kg of body weight) helps preserve lean muscle mass during weight loss. 

Another thing to consider is fat timing. While healthy fats are important for nutrition, eating large amounts of fat can further slow gastric emptying, potentially worsening nausea and producing more digestive discomfort. 

There is another lingering topic people often don’t talk about when starting semaglutide. One of the many mechanisms in which semaglutide works is by reducing your appetite. This makes it easier to reach a caloric deficit since you are not hungry. But what about when you stop taking the medication? 

Without understanding how to create a sustainable diet plan or without making lifestyle changes, people can unintentionally transition back to eating more calories, returning to their less healthy eating patterns. Consequently, it can lead to rapid weight regain. 

That is why focusing on your nutrition while you are on your semaglutide journey is going to be important. Now, it’s not only for the results you are getting at the moment, but for the results that you want to keep for years to come. 

Macronutrient Targets

Getting your macronutrient ratios right can make the difference between feeling energized and struggling with side effects. Here is what current research suggests: 

Protein: Your Foundation

Aim for at least 1.2 grams per kilogram of body weight daily (0.54 grams per pound). For many, this translates to 30-35% of total calories from protein. That means that if you weigh 200 lbs, you should strive to get at least 108 grams of protein daily. 

Great high-protein foods that you can include are: 

• Lean meats such as chicken, turkey, and lean cuts of beef and pork. 
• Fish and seafood like salmon, tuna, and shrimp. 
• Eggs and egg whites. 
• Dairy products, including Greek yogurt, cottage cheese, and low-fat cheese. 
• Plant-based options such as tofu, tempeh, and edamame. 
• Legumes like lentils, chickpeas, and black beans. 
• Protein powders that are derived from whey, casein, and plants like pea or rice. 
• Nuts and seeds, including almonds, chia seeds, and pumpkin seeds. 

Carbohydrate: Choose Wisely

Focus on low-glycemic, fiber-rich carbohydrates with a goal of at least 25 grams of fiber daily. Good options include: 

• Quinoa and brown rice
• Sweet potatoes
• Legumes and lentils (they offer both protein and carbohydrates)
• Non-starchy vegetables
• Berries and apples 

Fats: Quality Over Quantity

Keep fats to 35% or less of total calories, emphasizing monounsaturated and polyunsaturated fats (MUFA/PUFA) such as: 

• Avocados and olive oil
• Nuts and seeds
• Fatty fish like salmon or sardines 
• Limited amounts of coconut oil

Remember that if you have any questions regarding the best macronutrient ratio or diet plan for your goals and needs, it’s best to speak with a healthcare professional or a registered dietitian. Book a call with one of our nutrition experts to help you create a personalized plan. 

Foods That Help vs Hurt (Nausea & Reflux)

It’s important to know which foods work with your medication and which ones counteract it—learning this can make the semaglutide experience a lot more enjoyable. 

The foods that are going to help are the ones we mentioned in the previous section. Options like lean fish, Greek yogurt, oatmeal, berries, and roasted vegetables are all great options that can create a well-balanced meal.

If you are feeling too nauseous, try adding ginger tea. Research has shown that ginger can help reduce nausea symptoms. And, if you feel that you are feeling a bit dehydrated, consider adding an electrolyte drink to your daily routine. 

While some foods can help manage your symptoms, others can increase digestive discomfort and trigger unwanted side effects. Foods to be aware of include: 

• Fried foods: heavy and greasy, fried foods can be difficult to digest and may lead to bloating or indigestion. 
• High-sugar desserts: Excessive sugar can cause energy spikes and crashes that can increase inflammation. 
• Alcohol: Alcohol intake may irritate the digestive system and affect your sleep, making it harder for the body to recover. 
• Fizzy soda: Carbonated drinks may lead to bloating and discomfort, especially for those who are sensitive to gas retention. 
• Large raw salad bowls: Although they are nutrient-rich, large amounts of raw vegetables can be harder to digest for some, causing bloating and gas. 
• Spicy meals: Spicy foods can irritate the stomach lining and may lead to heartburn or discomfort, especially for those who are prone to acid reflux. 
• Caffeine: Coffee (or any caffeinated beverage) can increase stomach acid production, which can worsen nausea and reflux when your stomach is emptying more slowly than usual. If you are going to have coffee, try to drink it with food or choose a decaffeinated option. 

Remember that these are just suggestions. What affects some may not affect you. In this case, it’s important to pay attention to your symptoms. Try to keep a food journal to check any patterns and determine what the best foods are for you. 

Timing & Portion Hacks

How and when you eat is just as important as what you are eating. Here are some tips that can help you have the best digestion. 

• Eat 4-6 smaller meals instead of 3 large ones
• Take at least 20 minutes to finish each meal
• Chew your food thoroughly
• Stop eating when you are satisfied, not full
• Avoid lying down for 30 minutes after eating 

Water also plays an important role in your digestion and managing your semaglutide symptoms. Here are some recommendations: 

• Try to drink half your body weight in ounces of water
• Sip water between meals, not during meals
• Consider an electrolyte replacement, especially if you are experiencing rapid weight loss
• Monitor your urine color since this can be a great indicator of your current hydration 

What about intermittent fasting? Can you practice it while doing semaglutide? 

Some people find success with moderate intermittent fasting, thinking a 12:12 or 14:10 method. However, make sure you avoid extreme fasting windows (more than 18 hours daily) since this can worsen nausea. 

Sample 3-Day Meal Plan (Printable)

If you are still unsure what to have while on semaglutide, here is a meal plan targeting around 1,500 calories with optimal macronutrient ratios. 

Remember that this meal plan is for educational purposes only. Speak with a healthcare professional to get a plan tailored to your goals and needs. 

Day 1

Breakfast: Protein Smoothie 

• 1 cup of unsweetened almond milk
• 1 scoop of vanilla protein powder
• ½ frozen banana
• 1 cup of spinach 
• 1 tbsp of almond butter

Lunch: Quinoa Chicken Bowl

• 4 ounces grilled chicken breast
• ½ cup of cooked quinoa
• Roasted vegetables
• 1 tbsp olive oil vinaigrette 

Dinner: Salmon and Vegetables

• 5 ounces of baked salmon
• Roasted asparagus 
• One medium sweet potato
• Side salad with lemon dressing 

Snacks

• Greek yogurt with berries 
• Handful of almonds 

Day 2

Breakfast: Overnight Oats

• ½ cup rolled oats
• 1 cup Greek yogurt
• 1 tbsp chia seeds
• 1 cup mixed berries

Lunch: Turkey Lettuce Wraps

• 4 ounces lean turkey
• Large lettuce leaves
• ½ cup of hummus
• 1 medium apple in slices
• Roasted vegetables

Dinner: Shrimp Stir-Fry

• 6 ounces of shrimp
• Mixed vegetables
• ½ cup brown rice
• 1 tsp sesame oil

Snacks

• Cottage cheese with cucumber slices
• Protein bar 

Day 3

Breakfast: Egg White Omelet

• 4 eggs white + 1 whole egg
• Vegetables
• 1 slice of whole-grain toast
• 1 tsp olive oil 

Lunch: Lentil Soup

• 1 cup of lentil vegetable soup
• Side salad with light vinaigrette
• Small whole-grain roll 

Dinner: Grilled Tofu with Vegetables

• 5 ounces of firm tofu
• Roasted mixed vegetables
• 1 cup of quinoa pilaf 

Snacks

• Protein smoothie
• Handful of mixed nuts 

Supplements & Hydration

While foods should be your primary source of nutrition, there are certain supplements that could be beneficial. Here are some supplements that could be beneficial (remember always to speak with your doctor before starting): 

• Vitamin B12: If bloodwork shows it’s low, consider adding a vitamin B12 supplement, especially if you follow a plant-based diet. 
• Electrolytes: When rapid weight loss happens, you may need additional sodium and potassium. Choose a sugar-free electrolyte supplement to avoid adding unwanted sugar. 
• Multivitamin: A basic multivitamin can help fill in nutritional gaps while you get adjusted to your new eating habits and medication. 

When people reduce their calorie intake, some may experience constipation. However, avoid taking herbal laxatives since they can worsen dehydration and create electrolyte imbalances. Try increasing your fiber and water intake, drink warm lemon water, and take a 10-minute walk after every meal. 

Special Scenarios

There are certain situations that require modified approaches to eating on semaglutide. Here are some special cases. 

Diabetes Management 

• Pair carbohydrates with protein (aim for less than 30 grams of carbs per meal).
• Monitor your blood glucose closely, especially if you are taking insulin or sulfonylureas.
• Work with your healthcare provider to adjust your diabetes medication as needed. 

Post-Bariatric Patients

• Eat even smaller portions than the ones that are recommended when taking semaglutide. 
• Choose chewable multivitamins. 
• Focus on protein-dense foods first. 
• Monitor for nutrient deficiencies more closely. 

Athletes

• Boost your protein intake to at least 1.6 grams of protein per kilogram of bodyweight. 
• Pay extra attention to hydration before, during, and after exercise. 
• Consider timing your carbohydrates around your workouts. 
• Monitor energy levels and adjust intake as needed. 

FAQs

Can I drink alcohol on semaglutide?

It’s best to avoid alcohol while taking semaglutide since alcohol can worsen nausea and digestive issues. It also provides empty calories that can affect your weight loss results. If you do choose to drink, do so in moderation and always with some food. 

Is keto necessary?

No, it’s not necessary to follow a keto meal plan. While some people may do well with a lower-carb approach, they are not necessary to achieve success on semaglutide. 

Why does greasy food make me vomit?

High-fat foods slow gastric emptying even more than semaglutide. This can make you feel fuller for longer, increase nausea, and potentially lead to vomiting. 

Key Takeaways & Next Steps

• Prioritize protein at every meal to help preserve muscle mass and reduce nausea. 
• Choose fiber-rich carbohydrates that provide sustained energy without blood sugar spikes. 
• Eat small, frequent meals slowly and mindfully to work with your medication. 
• Avoid trigger foods like fried, sugary, and carbonated items that worsen your side effects. 
• Stay hydrated with water and electrolytes to support your body during your weight loss journey. 

Start by implementing one or two changes at a time rather than trying everything at once. Slower changes can lead to more impactful and long-term results. 

If you need help planning your meals, download our printable meal plan and grocery list to help you stay on track with your nutrition. And, if you need personalized guidance, book a call with one of our nutritionists to get a personalized meal plan. 

BOXED WARNING: RISK OF THYROID C-CELL TUMORS

Rodent studies have shown that semaglutide might increase the risk of thyroid C-cell tumors. It is currently unknown whether semaglutide causes thyroid C-cell tumours, including medullary thyroid carcinoma (MTC), in humans. Still, semaglutide is contraindicated in patients with a personal or family history of MTC or those with Multiple Endocrine Neoplasia syndrome type 2 (MEN-2).Disclaimer: This blog post is for informational purposes only and does not replace medical advice. Speak to a qualified healthcare professional before making any decisions about your health or treatment.