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[7] In a Bayesian network meta-analysis of 48 randomized trials and nearly 28,000 participants, the dominant gastrointestinal events were nausea (about 21.5%), diarrhea (10.6%), vomiting (9.1%), and constipation (7.9%), with semaglutide carrying one of the highest constipation risks

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It's entirely distinct from the compounded semaglutide products that drew FDA warning letters in 2025 and 2026

It may also worsen existing GERD or trigger reflux symptoms in people who are already prone to it

The key is the 0.9% benzyl alcohol, which acts as a bacteriostatic agent

But here's the good newsstrategic food choices can significantly reduce or even eliminate many of these issues