How to Manage Nausea, Vomiting, and Other GI Side Effects on GLP-1 Drugs: Expert Consensus Guidelines

A multidisciplinary panel of 12 experts (endocrinologists, nephrologists, cardiologists, primary care physicians, internists, and diabetes educators) developed consensus recommendations for managing the gastrointestinal side effects of GLP-1 drugs. The guidelines cover how to properly escalate doses to reduce GI symptoms, what to do when nausea, vomiting, diarrhea, or constipation develop during treatment, and practical clinical scenarios that doctors encounter regularly. The goal is to keep patients on therapy rather than having them quit due to side effects.

An expert panel of 12 specialists across six medical disciplines (endocrinology, nephrology, primary care, cardiology, internal medicine, and diabetes nursing) met virtually to review evidence and clinical experience. They developed consensus recommendations through structured discussion, created clinical scenarios representing common situations, and designed infographics for both clinicians and patients.

GI side effects are the number one reason people stop taking GLP-1 drugs — and stopping means losing the blood sugar and weight loss benefits. Yet many patients quit simply because they or their doctors don't know how to manage the symptoms. This consensus provides the first structured, multi-specialty guidance specifically focused on GLP-1 GI side effect management, filling a gap that has real consequences for millions of patients.

As GLP-1 drugs have become some of the most prescribed medications worldwide, the practical challenge of managing their side effects has become a major clinical issue. Many prescribers — especially in primary care — lack specific training in GLP-1 GI management. This consensus fills that gap with actionable, specialty-spanning guidance. The key insight is that most GI side effects are manageable and temporary (especially during dose escalation), but without proper guidance, patients often discontinue prematurely and lose significant health benefits.

This is an expert consensus document, not a systematic review or clinical trial. Recommendations are based on the panel's clinical experience and interpretation of existing evidence, which may not always be backed by randomized trial data. The consensus was developed by Spanish experts and some recommendations may reflect regional practice patterns.