Desi Talk

www.desitalk.com – that’s all you need to know 7 HEALTH January 30, 2026 I’m A Gastroenterologist. Here Are Some Surprising GLP-1 Gut Benefits Q : I’m worried that GLP-1s are bad for my gut. Should I avoid them altogether for this reason? A: In the original clinical trials of GLP-1 medi- cations for weight loss, the most common side effects were gastrointestinal, including nausea, vomiting and constipation. Ask almost anyone who’s been on one, and they’ll probably tell you that they’ve had some GI issues – even if very mild. So you might be surprised that as a gastroenterologist, when my patients tell me they’re considering starting a GLP-1 (the class of drug that includes Ozempic, Wegovy and Zepbound, among others), my answer is often highly enthusiastic: Do. It. We hear all the time about the weight loss or heart health benefits of GLP-1s, but as a scientist who stud- ies GLP-1 and the stomach in my own laboratory, I’ve seen first-hand how powerful and beneficial they can be for gut health. The GI effects of GLP-1s that I wish more people talked about? Randomized controlled trials have found that they can, in some cases, improve outcomes for people with fatty liver disease and fibrosis – or liver scar- ring – which previously no drugs could reliably achieve. GLP-1s are also associated with a lower risk of stom- ach ulcers, according to research I conducted with my colleagues and – here’s a big one – they’re linked to lower odds of colorectal cancer. Many of these potential associ- ated benefits are unrelated to weight loss, although the weight loss alone can start a cascade of wins. For example, one of my patients who started a GLP-1 lost about 20 pounds after six months. Losing that 20 pounds helped her knees, which had been aching all the time, and allowed her to begin exercising regularly. She began walking daily and then, before long, joined a Zumba class. This would have been unheard of for her before taking a GLP-1. Now, even though her weight has remained steady, she’s a healthier person because she stays active, something that lowers the risk of cancer and heart disease regardless of her weight. That doesn’t mean I downplay the GI issues, rather in my practice, I anticipate them and make a proactive plan. With each patient, I have an honest discussion about the possibility of unwanted side effects, including the possi- bility of more serious, although rare, complications such as pancreatitis. Let’s be real: The majority of people taking GLP-1s do experience symptoms like nausea or constipation. How- ever, in most cases, these symptoms are mild to moder- ate and transient: Less than 5 percent of people stop treatment because of GI symptoms. So if someone wants to stick with their GLP-1, I like to help give them every chance I can. And with a pill version ofWegovy now avail- able, they’re going to become increasingly accessible. Everyone interested in GLP-1s should have that clear- minded discussion with their own physician who knows their own medical history and goals. To help start that conversation, here are some of the most common ques- tions I get: WHAT EXACTLY ARE GLP-1 MEDICATIONS DOING TO MY GUT? You’ve probably heard that GLP-1, or glucagon-like peptide 1, is a hormone produced by the body that is in- volved in hunger signaling. But GLP-1 medications do so much more than this. For instance, they suppress stom- ach acid production and fortify the protective mucus layer along the stomach’s lining, which is at least partly how scientists like myself hypothesize they may help reduce the risk of ulcers. Perhaps most evident to anyone taking them is that GLP-1s slow the stomach down. As a result, food sits inside longer before it gets emptied into the small intestine, and that can create an uncomfortable sense of fullness and queasiness. (Hello, Ozempic burps!) A similar slowing occurs in the colon. Because one of the colon’s primary jobs is to absorb water, the longer the waste sits there, the drier and harder it becomes. Hence, constipation. We still have much to learn about GLP-1’s other effects on the gut and body. How GLP-1 medication influence our microbiome is an emerging area of research, but some limited studies in humans suggest that they may influence the production of beneficial bacterial metabo- lites. They also appear to help reduce chronic inflamma- tion, which plays a big role in multiple diseases. HOW CAN I TREAT THE UNWANTED SIDE EFFECTS? You should explore possible treatments with your physician, who can make tailored recommendations. The goal isn’t for you to “suffer through” therapy with GLP-1 in the name of good health, but to make taking a GLP-1 drug as sustainable as possible. I tell my patients when starting these drugs to expect side effects and plan for them. And no, GI symptoms like nausea are not what drives weight loss, so don’t hold back seeking help. Let your hunger cues guide you Contrary to how many of us eat otherwise, when tak- ing a GLP-1 it’s important to try to eat only when actually hungry, eat slowly and respond to your body’s cues saying you’re full. It’s common for people to eat smaller portions than they’re used to, but still feel satisfied. Be proactive about bowel issues Anyone who struggles with their bowel movements at baseline, speak up now: We need to be especially proactive. Sometimes it’s as simple as starting a daily fiber supplement, which can be helpful for diarrhea or constipation (both are possible with GLP-1s). In the case of constipation, over-the-counter laxatives like a capful of powdered polyethylene glycol (like in Miralax) can help, while for diarrhea, loperamide (like in Imodium) can be great. But don’t give up if these feel inadequate – there are also several prescription medications that can help get your colon back on track. Try OTC remedies for nausea and heartburn For nausea, sometimes the fix can be to simply lower the dose of the GLP-1 you’re taking, although there are medications that can help. Over-the-counter rem- edies like bismuth subsalicylate (like in Pepto-Bismol), dimenhydrinate (like in Dramamine) or ginger tea can provide quick relief. If these are insufficient, your doctor may consider prescription anti-nausea medications. Because of the delay in stomach emptying, heartburn can also show up, but over-the-counter treatments like histamine-2 blockers (like Pepcid AC and Zantac 360) can help. WHO IS MORE LIKELY TO EXPERIENCE SIDE EFFECTS? In real-world studies of people taking these medica- tions, men appear to have half the risk of experiencing GI side effects as women. The most important advice to avoid side effects is to start on a low dose and increase slowly. ARE CERTAIN GLP-1S MORE LIKELY TO CAUSE SIDE EFFECTS? Head-to-head trials comparing semaglutide (Ozem- pic, Wegovy) with liraglutide (Victoza, Saxenda) show broadly similar GI side effects overall, though results vary somewhat by study and dose. The good news is that major trials have found that these side effects were more common in the first few days or weeks of starting treat- ment, when they peaked, but then tended to subside. So I tell my patients that even if they experience GI symptoms initially, there’s a good chance they’ll get better. WHAT I WANT MY PATIENTS TO KNOW GLP-1 drugs are often spoken of as weight loss tools but, to me, that really misses the point. Obesity is a chronic, inflammatory disease that drives up the risk of heart disease, Type 2 diabetes and certain cancers. Using a medication to treat a medi- cal condition is not a moral failing – as some of my patients have been made to feel. There are fewer more powerful steps someone can take for their health than to reduce that constant state of inflammation, and as a doctor, I will always find that worth celebrating and supporting. Trisha Pasricha is an instructor of medicine at Harvard Medical School. -Special to TheWashington Post By Trisha Pasricha, MD, MPH PHOTO: Instagram @trishapasrichamd Ask Sahaj: I’m Terminally Ill. My Wife Is ‘Freaked Out’ I’m Preparing For My Death D ear Sahaj: I am retired. My former husband and my subsequent long-term partner both died. I’ve been with S for five years now. He refuses to marry me, claiming the reason is that he is so much wealthier than me. He has no children, by choice, and says it’s because he doesn’t want any of his money to get to my now adult kids. He has a temper, is uncompro- mising and judgmental, and has managed to seriously of- fend most of my dearest long-term friends, who wonder why I remain with him. Remaining in this relationship is difficult for me, as I feel micromanaged, put down and criticized much of the time. I have a therapist, who believes he compromises my mental health. She thinks my depression would improve if I left him, but I’m fearful of ending up alone, as many older people do. I don’t know why I can’t get up the nerve to leave him! I have my own nice place, a secure but small income, a loving son living nearby and long-term friends. What’s holding me back from leaving him? – Stuck Stuck: As I see it, you have already survived profound By Sahaj Kaur Kohli - Continued On Page 8