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Why GLP 1 Medications Cause Extreme Fatigue (Doctor Explains)

Dr. Mohammed Paika

9,312 views

#GLP1 #Ozempic #Wegovy #Zepbound #WeightLoss

Why GLP-1 Medications Cause Extreme Fatigue (And How to Fix Low Energy)

Are you exhausted on Ozempic, Wegovy, Mounjaro, or Zepbound? You’re not imagining it. Fatigue is listed in the prescribing information, and it’s one of the most common complaints I see in the comments.

In this video, I’m Dr. Mohammed Paika, an internal medicine and obesity medicine physician. I break down the 4 biological reasons GLP-1 medications can leave you drained: unintentional undereating, quiet dehydration, the drug’s effects on the brain, and nutrient deficiencies like low iron and B12. Then I walk you through 4 practical fixes: a calorie and protein floor, a hydration plan that goes beyond plain water, the blood work to ask your doctor for, and how to talk to your prescriber about dose and titration. I finish with the warning signs that mean you need to be seen right away.

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This video is for education only and is not personal medical advice. Talk to your own clinician before changing your diet, fluids, supplements, or medication.

TIMESTAMPS
0:00 Why you feel exhausted on a GLP-1
2:00 Who I am and why I made this video
3:09 Is the drug toxic? What the trials show
4:35 Cause #1: Running on empty
7:43 Cause #2: The thirst signal goes quiet
10:35 Cause #3: The drug talks to your brain
12:52 Cause #4: The deficiency nobody tests for
15:27 Fix #1: Set a calorie and protein floor
18:01 Fix #2: Hydrate beyond plain water
19:44 Fix #3: The blood work to ask for
21:10 Fix #4: Slow the dose down, don’t quit
22:36 Red flags: when to get seen urgently

REFERENCES

Wegovy (semaglutide) Prescribing Information. FDA, 2024. https://www.accessdata.fda.gov/drugsa...
Zepbound (tirzepatide) Prescribing Information. https://uspl.lilly.com/zepbound/zepbo... Jastreboff AM, et al. N Engl J Med. 2022;387:205–216 (SURMOUNT-1).
Friedrichsen M, et al. Diabetes Obes Metab. 2021;23:754–762. https://doi.org/10.1111/dom.14280
Prado CM, et al. Lancet Diabetes Endocrinol. 2024;12:785–787. https://doi.org/10.1016/S2213-8587(24...
Winzeler B, et al. J Clin Invest. 2021;131:e151800. https://jci.org/articles/view/151800
Gutzwiller JP, et al. Digestion. 2006;73:142–150.
Gabery S, et al. JCI Insight. 2020;5:e133429. https://insight.jci.org/articles/view...
Butsch WS, et al. Obesity Pillars. 2025;15:100186. https://doi.org/10.1016/j.obpill.2025...
Mozaffarian D, et al. Am J Clin Nutr. 2025;122:344–367. https://doi.org/10.1016/j.ajcnut.2025...
Aroda VR, et al. J Clin Endocrinol Metab. 2016;101:1754–1761. https://pmc.ncbi.nlm.nih.gov/articles...
Westerterp-Plantenga MS, et al. J Appl Physiol. 1999;87:391–399. https://pubmed.ncbi.nlm.nih.gov/10409...
Paika MK. GLP-1 Masterclass; The Weight Equation; GLP-1 Diet Cookbook. https://drmohammedpaika.com

⚕️ MEDICAL & EDUCATIONAL DISCLAIMER: This content is for general educational and informational purposes only and is not medical advice or a substitute for care from your healthcare provider. Viewing this content does not create a doctor-patient relationship. Always consult a qualified healthcare professional before starting, stopping, or changing any medication, diet, exercise, or weight-loss plan. Individual results and risks vary. You assume responsibility for decisions made based on this content.

13 Comments

@viennehaake9149 16 hours ago

He gives more info than many prescribers w their rushed 2 minute explanation. Many patents do want info & seek online, BUT, choosing reputable sites is the problem. Lots to wade through. Lots of nonsense. And typical misinformation about literally everything. This guy does not sugar coat info and very helpful w all aspects of taking a GLP1.

@cjbarash3819 13 hours ago

Thank you - excellent info as usual 😊

@drmohammedpaika Creator 20 hours ago

📌 Feeling exhausted on Ozempic, Wegovy, Mounjaro, or Zepbound? You’re not alone!

Here are 4 things that may help:

1️⃣ Nutrition: Make sure you’re eating enough calories and protein, even when your appetite is low.

2️⃣ Hydration: Stay well hydrated. Electrolytes may help if you’re losing fluids.

3️⃣ Bloodwork: If fatigue persists, ask your doctor whether checking for anemia, nutritional deficiencies, thyroid issues, or electrolyte imbalances makes sense.

4️⃣ Dose adjustments: If fatigue worsens after increasing your dose, discuss your symptoms and treatment plan with your prescriber.

📘 Get my FREE GLP-1 Diet Cookbook when you join my newsletter: www.drmohammedpaika.com/newsletter

🎓 Learn more about my GLP-1 Masterclass: www.drmohammedpaika.com

👇 I’d love to hear from you! Which GLP-1 are you taking, and when is your fatigue worst—right after your injection or throughout the week? I read your comments!

⚠️ Severe weakness, fainting, chest pain, confusion, or inability to keep fluids down requires prompt medical attention.

@RepuBlicOfChaD 20 hours ago

Dr. Hair,
In your videos you explain what people are experiencing on glps and how to fix symptoms.

Solid advice as always 👊

@palakagarwal6978 1 hour ago

fatigue seems to be the one side effect that gets brushed off compared to nausea or gut issues, but it's probably the most disruptive for daily life since it tanks your motivation to even eat right or move. Bioligent GLP-1 Support is a supplement made with yerba mate and bitter melon, ingredients generally associated with appetite control and steady energy rather than a stimulant-type crash. Might be worth looking into for anyone wanting to manage food noise without adding to the fatigue issue.

@CoquelleFrance 19 hours ago (edited)

Merci beaucoup pour toutes vos vidéos qui sont claires.

@LP-goforit 18 hours ago

Excellent explanation and recommendations. Great suggestions such as the screen shot of possible lab work that can be talking points with your physician. The new Medicare bridge program has numerous doctors, especially Gerontologists, prescribing GLP-1 medications for weight loss which hasn’t been covered by Medicare. It is helpful to have a MD provide an explanation that I plan to share with my MD and their care team. Thank you!

@mikereed4876 38 minutes ago

Dr. Chest Brah (hope you get the reference),

Your advice has helped a lot in my first few weeks of this journey. Thanks, doc!

@bettyblue391 17 hours ago (edited)

I absolutely love this video. It's really great information that is desperately needed by so many people. I have a few friends who are on this and when they don't have food noise, they think they don't need to eat, so then their body gets incredibly weak, and their mind gets incredibly foggy. This is really valuable and I hope that many, many people see it. I'm very excited to share this video with them. Because not everyone has a dietician or a doctor who is knowledgeable and takes the time. In this rush rush, insane insurance world. So once again, you are educating the people for free and absolutely saving lives and sanity. You're my favorite brain date

@deborahperkins6764 20 hours ago (edited)

Great video! You need to think about you body. What am I putting in it? If needs to provide nutrition. Thanks for the reminder! ❤❤❤

@thestrappingentrepreneur2822 7 hours ago

😂 they make you feel this way because a calorie deficit always makes you feel this way 😂

@XboxSeriess-k6d 16 hours ago

Over all I’m 😴

@loriirvine4946 18 hours ago

Hi Dr Piaka, thank you so much for your videos, they have been very informative but I’m at a lost. I’m a 66 year old woman that just took my second dose of Zepbound 7.5. The first 3 weeks nothing happened. It didn’t quite the food noise but the last 2 days of week 4 I urinated like crazy. I went to the doctor a day later and i had lost 5 lbs but I know that was water weight from all the urination and during those 4 weeks I was doing major dieting which was a battle since I still had the food noise. My doctor increased me to the 5mgs. The first 2 weeks nothing but by the third week the food noise subsided during the day but came back at night same with the 4th dose. I never had any side effects on the 2.5 or 5 mgs other than occasional fatigue. By week 9 I was increased to the 7.5. I take my shot on Thursday night at between 8-9pm just incase of dizziness or nausea so I can just go to bed and hopefully sleep it off. Only thing I experienced were the sulfur burps. By Friday I still had the sulfur burps and by evening I was nauseous but never threw up and I developed diarrhea. Saturday I was still nauseous and had diarrhea and my stomach was hurting in the lower part of my abdomen. Sunday the nausea was subsiding and the diarrhea was gone. I was just weak Sunday from the 2 previous days of misery. The sulfur burps had stopped. My 2nd shot of the 7.5 which I took this pass Thursday everything was fine but Friday I got so sick. I was nauseous and was throwing up and had diarrhea at the same times d I was freezing cold. I couldn’t eat or drink. After I thought I had got everything out of me I was able to somewhat rest and take a few sips of ginger tea but shortly after I was back in the bathroom throwing up and had diarrhea again. When it finally stopped I was so thirsty but scared to drink or eat anything. I did take occasional sips of ginger water throughout the night and sat up in a recliner because I was afraid to lay down. Now it’s Saturday day 2 after the shot the nauseous is gone but I still have occasional diarrhea and I’m no longer cold. I e only had a cup of ginger tea and eat half of a banana. My stomach is still sore from throwing up. I know I need to eat and drink but I’m scared. What should I eat and drink that won’t send me back to the bathroom until I can get to see or talk to my doctor