Does Semaglutide Make You Tired? Here’s What to Do

If you're taking semaglutide and feeling like you could fall asleep standing up, welcome to the club—you've got plenty of company. After gastrointestinal (GI) symptoms, fatigue is the next most common side effect among people talking semaglutide. You might feel like you want to sleep 12 hours per night or like you're wading through peanut butter all day while your calendar refuses to slow down. It’s especially frustrating because many people want to lose weight to get more energy, so feeling exhausted after starting semaglutide can feel like a bad cosmic joke. That said, this side effect is usually temporary, and there are some pretty straightforward ways to support your body through the adjustment period, so you can minimize the exhaustion and get back to actually enjoying your day. 

Semaglutide (the active ingredient in Ozempic, Wegovy, compounded injections, and oral versions) is a glucagon-like peptide-1 (GLP-1) receptor agonist that is very effective for long-term weight management. Research shows that the mean amount of body weight loss for obese and overweight women with weight-related medical conditions was 15%  after 68 weeks (nearly 16 months). The medication is also effective for menopause-related weight gain. 

Yet the downsides of adjusting to the medication, such as stomach issues and fatigue, can make the first few weeks difficult. There are several reasons that semaglutide causes a feeling of exhaustion, from how the medication actually works on your blood sugar level to factors you can more easily control, like how much water you’re drinking. 

The good news is that the fatigue usually recedes by 12 weeks on the medication. In the meantime, you can reduce your fatigue by trying a few simple lifestyle changes—and if that doesn’t work, work with your healthcare professional to adjust your dosage and scheduling.

Can Semaglutide Make You Tired?

Yes, semaglutide can make you feel tired—and you're definitely not alone if you're experiencing this. While social media might have you thinking it's all smooth sailing and dramatic before-and-after photos, the reality is a bit more nuanced. 

According to one small study, GI symptoms topped the list of side effects for people using semaglutide for weight loss, with fatigue coming in at a close second, affecting about 6.3% of participants. This lines up with what we hear from Midi Health patients, too—some people feel totally fine, while others need extra naps in those first few weeks.

The good news? Fatigue rarely seems to be a deal-breaker that makes people stop the medication. And even better news: For most people who do feel wiped out initially, it's usually a temporary thing. Energy levels tend to bounce back after those first few weeks, as your body adjusts. So if you're currently feeling like you could nap on a hardwood floor, hang in there—it likely won't last forever.

Why Does Semaglutide Make You Feel Tired?

Semaglutide might be leaving you dragging for a bunch of reasons—some are directly tied to how the medication works, while others might be sneaky lifestyle changes you didn't even realize you were making. The thing is, some pretty simple strategies can actually help you get your energy back. The key is figuring out which culprit (or culprits) are behind your fatigue, so you can tackle them head-on and get back to feeling like yourself again.

Some causes might include:

Dipping blood sugar

We’ve all had that tired, grumpy, hangry feeling from low blood sugar, and semaglutide medication can cause that same thing. Simply put, anytime you eat, food is broken down into simple sugars that travel through your bloodstream, and GLP-1, a natural hormone that is released when you eat, triggers the release of insulin from your pancreas. Insulin helps move glucose (sugar) out of the bloodstream and into your cells, so it can be used for energy. Semaglutide medication mimics your natural GLP-1, telling your body to release insulin, so your blood sugar may drop lower than usual, causing you to feel sluggish and tired. In some people, their blood sugar even goes too low, a state called hypoglycemia. This isn’t caused by the medication alone, but it can happen when it’s combined with other medications that lower blood sugar or if you’ve gone too long without eating, exercise more than usual, or drink alcohol.

Shifting hormones

Most of us know firsthand from wherever we are in the menopause journey that hormones greatly affect so many different aspects of how our bodies function. Since semaglutide impacts hormones like insulin and glucagon, which regulate blood sugar levels, shifting hormone levels can lead to a feeling of tiredness.

Not eating enough calories

One of the key ways semaglutide works to aid in weight loss is by reducing hunger and delaying stomach emptying, so you feel fuller for longer. That’s great for weight loss—but if overnight you’re going from eating 3,000 calories per day to 1,500 calories, that’s a sudden drop in your energy supply, and your body will need some time to adjust. Also, if you’re skipping meals or going too long between eating, that could contribute to low energy.

Getting dehydrated

Just because you have a giant water bottle with you at all times doesn’t mean you’re actually drinking from it, and dehydration can cause a feeling of exhaustion or sluggishness. A tricky thing with semaglutide is that GI symptoms (such as nausea, vomiting, and diarrhea) are the most common side effects—and each one can dehydrate you, indirectly contributing to fatigue.

Common Patterns of Semaglutide Fatigue

From talking with countless Midi patients who are using Midi's personalized weight loss prescriptions,* we’ve noticed that for the ones experiencing fatigue, it most often appears early in treatment (during the first few weeks) or after dose increases. We notice fatigue less often with patients who are microdosing smaller amounts of the medication or using a slower titration schedule to step up the dosage more gradually.

We’ve also noted that fatigue may be worse if the patient also has other side effects, such as extreme loss of hunger or nausea/vomiting that can make it difficult to take in enough nutrition and water to maintain their usual energy levels. 

How to Combat Semaglutide Fatigue

Here are the best solid, simple steps to help support your body through the transition of being on a semaglutide, so you can feel more energetic sooner:

• Prioritize sleep: When semaglutide is making you feel like a sloth in slow motion, one of the best moves you can make is to lean into rest—hard. If you're usually a 7- or 8-hour sleeper, consider adding some bonus snooze time to your schedule while your body adjusts to the medication. And if you can swing it, try not to pack your calendar like you're training for an Olympic event during those first few weeks. Future you will thank present you. As for actually getting that restful sleep? Stick to the classics: Keep your bedroom cool (think cozy cave, not tropical resort); banish your phone at least 30 minutes before lights out; and skip the alcohol, caffeine, and late-night snacks. Your body's already working overtime adjusting to the medication—give it the best possible conditions to recharge.
• Eat nutrient-packed food, more frequently: Remember, food is energy. So even if your appetite has gone MIA, you need to be sure you’re taking in enough nutrition to function; if you’re not, that could lead to feeling tired and low energy. You may want to set reminders on your phone or calendar, so you don’t accidentally skip a meal or snack. Whenever you do eat, you’re likely going to eat a much smaller amount than before, so make sure it’s packed with long-lasting nutrition. Prioritize protein and complex carbs to give your body the energy it needs.
• Keep up your hydration: We know dehydration can leave you feeling like a wilted houseplant. Aim for 8 to 11.5 cups of water per day—and yes, we know that sounds like a lot, which is why getting a measured water bottle can be a game changer for tracking your intake. If you’re hitting your minimum of 8 cups of water per day and the fatigue is persistent, or if you’re experiencing vomiting or diarrhea, you may want to try leveling up by adding in some electrolytes.
• Incorporate light exercise: In a review of 12 studies, every one of them showed that physical activity was associated with fewer feelings of low energy and fatigue. That said, super-intense exercise may tire you out more, so if you’re already feeling fatigue, don’t push yourself to run the farthest or lift the heaviest you have in a while; instead, try light exercise to boost your energy level without overexerting yourself.
• Consider adding a B-vitamin complex  and/or magnesium: Since a lack of B vitamins or magnesium can contribute to feelings of fatigue, your healthcare professional may suggest supplementing with a B-complex and/or magnesium if deficiencies are suspected.
• Adjust your titration strategy: If you’ve tried the strategies above and your fatigue is still getting in the way of your daily activities, talk with your healthcare professional about dose adjustments, such as reducing your dose, spreading out how often you take the medication, or even microdosing (taking a very small amount of the medication) .

When to Talk to a Healthcare Professional

There’s no need to suffer through fatigue, especially in the long term. If your fatigue doesn’t improve with lifestyle adjustments to your sleep, nutrition, and hydration—especially if you’re past 4 weeks of taking the medication—then talk with a healthcare professional, like a Midi clinician. They’ll want to check for signs of possible nutrient deficiencies or health conditions that could be causing your fatigue, and they might recommend treating that or changing your dosing amount or schedule. They can also help you decide whether semaglutide is the right fit or if it may be beneficial to switch to another type of weight loss medication that your body may tolerate better.

Key Takeaways

• Semaglutide can make you tired and cause fatigue, especially when your body is first adjusting to this class of weight loss medications.
• According to one small study, GI symptoms topped the list of side effects for people using semaglutide for weight loss, with fatigue coming in at a close second.
• For most people who do feel wiped out initially, energy levels tend to bounce back after 12 weeks on the medication, according to the International Association for Physicians in Aesthetic Medicine.
• Adjusting your dose and timing alongside simple lifestyle changes can reduce fatigue while your body adapts.

Frequently Asked Questions (FAQs)

How long does fatigue last on semaglutide?

For most patients, fatigue is worst during the first 1 to 4 weeks on the medication or in the days after a dosage increase, as the body adjusts. By 12 weeks on the medication, that initial fatigue is generally resolved, according to the International Association for Physicians in Aesthetic Medicine.

How to get more energy while on semaglutide?

To battle fatigue caused by Ozempic, Wegovy, or other versions of semaglutide, think of your body like a phone that just needs a little extra charging time. Prioritize sleep like it’s your job, and be ruthless about what you cut from your to-do list—if it’s not essential, it can wait! You also want to make sure you’re eating small amounts frequently so that you’re getting enough nutrition. Even when food sounds about as appealing as doing your taxes, try to eat small amounts throughout the day so you actually get enough fuel. And if you're dealing with diarrhea or vomiting on top of everything else, hydration becomes extra important—aim for at least eight glasses of water daily, because dehydration is basically an energy vampire. Light exercise, like going for a walk, can actually help boost your energy instead of draining it. Weird but true! Just keep it gentle—this may not be the time to train for a marathon.

Why am I so exhausted on Ozempic?

As your body gets used to semaglutide, fatigue can pop up, thanks to a few usual suspects: dipping blood sugar, shifting hormones, not eating enough calories, or running low on fluids. You can address all of these with lifestyle changes to make sure you’re resting, eating, and drinking enough. If you've tried all the tricks and you're still feeling like you need a nap after your nap, it's time to loop in your a healthcare professional. They can help figure out whether something else is going on or if your dosage needs tweaking.

Is drowsiness a side effect of semaglutide?

Yes, semaglutide can cause fatigue in some people who use the medication. According to a small study, after GI symptoms, fatigue was the second-most common side effect, affecting 6.3% of patients. 

*Licensed healthcare providers may prescribe compounded drugs at their professional discretion. Compounded medications are not approved or evaluated for safety, efficacy, or quality by the FDA. Individual results vary and are impacted by diet and exercise. Do not use if you, or a family member, have a history of thyroid cancer or tumors. See joinmidi.com for additional details.