How to log GLP-1 side effects for your clinician

What to record with each symptom

A log a clinician can actually use stays close to what happened, not what you think it means.

• The symptom, in plain words - nausea, fatigue, injection-site soreness, and so on
• Date and time it started, and roughly how long it lasted
• A severity you assign - mild, moderate, severe, or your clinician’s own scale
• What was true around it: recent dose, meal, activity, or anything else you noticed
• Whether it happened before, and whether it was better, worse, or the same

Severity is for the conversation, not a verdict

Assigning a severity helps you and your clinician talk about a pattern - three mild days versus one severe one is a different conversation. It is not a triage tool, and a tracking app should not present it as one. Vialie records the severity you assign; it does not interpret it, rank it, or tell you what it means.

When something needs a call, not a log entry

Your clinician and the medication label set the actual thresholds for what needs a call versus what can wait for your next visit - not a tracking app. If a symptom is severe, sudden, or matches something you were told to watch for, use the guidance and contact information your clinician or the label gave you. Logging it afterward keeps the record accurate; it is not a substitute for that call.

What the labels and trials report about nausea, constipation and diarrhea

In the main adult placebo-controlled weight-management trials of Wegovy (semaglutide) injection, the Wegovy label reports nausea in 44% of people vs 16% on placebo, diarrhea in 30% vs 16%, and constipation in 24% vs 11%. The label also reports a separate higher-dose trial and tablet data, each with its own rates. In the Zepbound (tirzepatide) weight-management trials, across the studied dose groups, the Zepbound label reports nausea in 25–29% vs 8% on placebo, diarrhea in 19–23% vs 8%, and constipation in 11–17% vs 5%.

Timing: the Wegovy label says GI reactions "were most frequently reported during dosage escalation". A pooled analysis of the STEP 1–3 trials (Wharton S, et al. Diabetes Obes Metab. 2022;24(1):94-105, doi:10.1111/dom.14551) found most GI events were non-serious (99.5%), mild to moderate (98.1%) and transient. In SURMOUNT-1 (Jastreboff AM, et al. N Engl J Med 2022;387:205-216), GI events were mostly mild to moderate, "occurring primarily during dose escalation". Disclosures: some authors of the STEP analysis are Novo Nordisk employees, and SURMOUNT-1 was supported by Eli Lilly.

Both labels say trials ran under widely varying conditions, so rates can't be directly compared between drugs. Placebo rates aren't zero; the gap is what matters. A study of Reddit posts (Sehgal NKR, et al., arXiv 2603.12341; a preprint, not peer-reviewed) found nausea was the side effect people mentioned most, but that is self-reported social-media data, not a true rate. The full table with every source is on GLP-1 statistics.

A 2025 joint advisory from four obesity and nutrition societies (Mozaffarian D, et al.) says GLP-1s "delay gastric emptying, leading to bloating, fullness, and nausea", that nausea "often occurs in the morning or after longer periods without eating", and that it can start a "cycle of not eating due to nausea, which worsens the symptoms". It also says "Constipation is common with weight loss and should be managed proactively" and "Extended constipation can also lead to reactive diarrhea." These are things to raise with your clinician or pharmacist, who can say what fits you.

Pancreatitis and gallbladder: what the labels say

The Wegovy label says acute pancreatitis, "including fatal and non-fatal hemorrhagic or necrotizing pancreatitis", has been observed with GLP-1 receptor agonists. In its adult weight-reduction trials, acute pancreatitis was confirmed by adjudication in 4 people on Wegovy (0.2 cases per 100 patient-years) and 1 on placebo (less than 0.1). If pancreatitis is suspected, the label says to "discontinue WEGOVY and initiate appropriate management".

• Zepbound: in the pool of its two weight trials, acute pancreatitis was confirmed in 0.2% of people on Zepbound and 0.2% on placebo (0.14 vs 0.15 per 100 years of exposure). In trials for a different indication, the rate was 0.23 vs 0.11 patients per 100 years of exposure on comparators, and in the pooled sleep apnea (OSA) trials it was 0.84 per 100 years vs 0 on placebo. Patients are told "to discontinue ZEPBOUND promptly and contact their healthcare provider if pancreatitis is suspected" (Zepbound label).
• The UK regulator, the MHRA, reported on 29 January 2026 that it had received 1,296 UK Yellow Card reports of pancreatitis (all forms) associated with GLP-1 or dual GLP-1/GIP receptor agonists between 2007 and October 2025; 19 were fatal and 24 were reported as necrotising. For context, roughly 25.4 million packs were dispensed in the past 5 years. It warns early symptoms "may be attributed to other causes such as common gastrointestinal side effects", says to use these medicines with caution in people with a history of pancreatitis, and says not to restart if pancreatitis is confirmed. Spontaneous reports can't show how often something happens or prove cause.
• Gallbladder, Wegovy: in the adult weight-reduction trials of the injection, gallstones (cholelithiasis) were reported in 1.6% vs 0.7% on placebo and cholecystitis in 0.6% vs 0.2%. Rates were higher in pediatric patients aged 12 years and older, and the label says these events were more common on Wegovy "even after accounting for the degree of weight loss".
• Gallbladder, Zepbound: in the pooled weight trials, cholelithiasis 1.1% vs 1%, cholecystitis 0.7% vs 0.2%, and cholecystectomy 0.2% vs 0. The label says: "Acute gallbladder events were associated with weight reduction."
• NIDDK says gallstones are the most common cause of acute pancreatitis, and the main symptom is pain in the upper abdomen that may spread to the back.
• Both Medication Guides ask you to tell your healthcare provider before starting if you "have or have had problems with your pancreas". Their symptom lists are quoted word for word under "When to call: the official wording" below.

Mood changes: what the FDA review found

In a Drug Safety Communication on 13 January 2026, FDA said its meta-analysis of 91 placebo-controlled trials with 107,910 patients (60,338 on a GLP-1 receptor agonist, 47,572 on placebo) "did not show an increased risk for SI/B or for other relevant psychiatric adverse events such as anxiety, depression, irritability, or psychosis". A Sentinel claims study of 2,243,138 people with type 2 diabetes, comparing new users of GLP-1 receptor agonists with new users of SGLT2 inhibitors, found no increased risk of intentional self-harm, including in the subgroup with obesity. FDA said the "totality" of published studies "does not support a causal relationship".

• FDA said the original warning was based on "a variety of older medicines used or studied for weight loss", and asked the makers of Saxenda, Wegovy and Zepbound to remove it. Type 2 diabetes labeling "does not currently include" it. The current DailyMed labels list "Suicidal Behavior and Ideation" as "(Removed) 02/2026".
• A Swedish cohort study (Taipale H, et al. Lancet Psychiatry 2026;13(4):327-335) followed 95,490 people in Sweden with depression or an anxiety disorder who used any diabetes medicine, 2009–2022, with a within-individual design. Semaglutide was associated with a lower risk of worsening mental illness (aHR 0.58) and liraglutide with 0.82; exenatide and dulaglutide showed no association; GLP-1 receptor agonists as a group were associated with a lower risk of self-harm (0.56). It is observational, so it can't show cause and effect, and the authors call for randomized trials. It was funded by Finnish foundations and the Finnish Ministry of Social Affairs and Health, not a GLP-1 maker.
• The 2025 joint advisory (Mozaffarian D, et al.) includes screening for mood disorders, suicidal thoughts and eating disorders in its recommended assessment before GLP-1 treatment.
• FDA's own wording for patients, including the 988 line, is quoted exactly in the next section.

When to call: the official wording

Vialie doesn't judge urgency. These are the labels' and health agencies' own words, quoted exactly.

Where this sits in Vialie

Symptom entries sit on the same timeline as your dose history, with severity and notes attached. When you export a PDF or CSV for an appointment, symptoms travel with the doses around them, so the pattern is there without you having to reconstruct it from memory.