Fasting while on semaglutides: Experts advise on using Ozempic, Mounjaro or Wegovy during Ramadan

Ozempic , Mounjaro and Wegovy, otherwise known as semaglutides, have been some of the most disruptive breakthroughs in the diet and weight loss industry for decades. Originally created as a medication for people with type 2 diabetes as a way to manage blood sugar levels, it quickly made headlines for its effects on weight loss. With research ongoing into the long-term effects of taking semaglutides both for diabetes and weight loss, the period of fasting during Ramadan may also affect how your body reacts to and metabolises the medication. “Semaglutides are medications used to manage diabetes and support weight loss, working by suppressing appetite, slowing digestion and stabilising blood sugar levels,” says Dr Ruhil Badiani, family physician at Cornerstone Clinic. “These mechanisms make their use during Ramadan fasting a complex decision that requires careful consideration of individual health conditions.” Overall health, weight and dosage are all factors to take into account when understanding whether to take semaglutides when fasting during the Holy Month. “Fasting while on semaglutides can generally be safe if managed correctly, but it is essential to consult with a healthcare provider before Ramadan,” says Dr Karima Arroud, consultant functional medicine and aesthetics at Wellth. “Semaglutides slow digestion and reduce appetite, which can align with the fasting schedule, but the individual’s overall health, treatment goals and potential risks like hypoglycemia or gastrointestinal discomfort should be assessed. Adjustments to dosage or timing may be required for a safe fasting experience.” Users also need to factor in any other medications they are currently taking, as the effects of semaglutides coupled with fasting might have additional effects. “One of the primary concerns is blood sugar management,” says Dr Badiani. “While semaglutides alone are not typically associated with a high risk of hypoglycemia, combining them with other medications, such as insulin or sulfonylureas can increase the likelihood of dangerously low blood sugar levels, especially during prolonged fasting hours. "The large and often carbohydrate-rich meals consumed at iftar may lead to post-meal blood sugar spikes, which semaglutides aim to regulate,” she adds. Maintaining good levels of hydration while taking semaglutides is vital. Ozempic is prescribed with information warning about dehydration given that the medication can lead to a reduction in thirst for some users. Reported side effects of taking the medication, both scientific and anecdotal can include constipation, diarrhoea, nausea, dizziness, fatigue and headaches, all of which can be exacerbated by a lack of water. “Proper hydration is not just about metabolising the medication, but also to ensure overall health,” says Dr Ashik Kadambot, consultant gastroenterologist at Rak Hospital. “During Ramadan, drinking enough water during non-fasting hours is crucial, as gastric emptying is delayed by the medication. Hydration helps mitigate nausea and constipation. Individuals should distribute their water intake throughout the evening to maintain adequate hydration.” Foods and drinks that act as a diuretic should also be avoided, such as coffee, green tea, watermelon and pineapple. “I’ve been taking Mounjaro for about four months,” says Sara*, recruitment consultant from Dubai. “I was finding that as I got older, the usual ways I used to lose weight, such as upping my exercise or reducing carbohydrates were no longer working. I started on the 2.5mg dose and during Ramadan I will be on the 7.5mg dose. I spoke to my endocrinologist about fasting during Ramadan while taking it and she stressed the importance of drinking water as soon as I break my fast and getting up earlier to hydrate before sunrise.” Adds Dr Arroud: “Incorporate fibre by focusing on high-fibre foods, such as whole grains, vegetables and fruits to improve digestion and reduce constipation risks.” After a day spent abstaining from eating and drinking, those taking semglutides should be additionally mindful when breaking their fast. “Fasting can exacerbate gastrointestinal side effects commonly associated with semaglutides, such as nausea, bloating and indigestion,” says Dr Badiana. “Breaking a fast with a large meal after a long period of fasting may amplify these discomforts, particularly given the delayed gastric emptying caused by the medication.” Experts suggest starting with a light meal that centres simple, easily digestible foods such as soup or dates, along with water, and avoiding fatty or carbohydrate-heavy options. Grazing on small amounts in the hours between iftar and suhoor is also advised rather than eating one large meal. “Start with proteins, then vegetables and finally carbohydrates,” says Dr Hala Youssef Hamdy, specialist endocrinologist at Rak Hospital. “Opt for smaller portions and eat frequent, balanced meals to avoid overeating and ensure smooth digestion.” Adds Dr Kadambot: “Overeating in a short time frame can lead to issues like vomiting or heartburn, as these medications slow stomach emptying.” “What’s been so interesting about taking a semaglutide is just how effectively it takes away your appetite and quietens the food noise in your head,” says Sara. “Truthfully, I think it will help me stay more focused while fasting because I won’t be thinking about food at all. The Mounjaro suppresses my appetite during the day and I tend to eat a small meal in the early evening after work which is similar to fasting hours.” She adds: “This year, I do feel that I will be more mindful about how I break my fast. In previous years I’ve been guilty of diving straight into the food, but now that I’m more relaxed around food, I can take my time and enjoy smaller amounts.” If using the medication for weight loss purposes, expert advice is not to come off of it for Ramadan. Stopping your injections can lead to weight gain, fluctuations in blood sugar levels and the fact that if you are on a higher dose, you would need to return to the lowest starting dose if you choose to restart your injections afterwards. “Individuals who choose to stop taking semaglutide for Ramadan should be aware of potential changes in appetite, digestion and blood sugar control,” says Badiana. “Appetite may increase significantly once the medication is discontinued.” Stopping semaglutides abruptly can lead to gastrointestinal changes, such as faster gastric emptying, which might affect how meals are tolerated. “If someone decides to stop taking semaglutides for Ramadan, weight gain is a potential outcome,” says Dr Hamdy. “Plus, if they were on a higher dose, they will need to titrate the medication carefully after Ramadan by starting with a smaller dose and gradually increasing it, under medical supervision.” For diabetics taking the medication, Dr Arroud suggests careful planning around injection timings and blood sugar level monitoring. “Administer injections after suhoor to align with fasting hours,” she says. “This ensures the medication works in tandem with the day’s fasting schedule. Regular blood sugar level checks are vital, particularly in the early days of Ramadan, to identify and address any glucose imbalances.” *name changed by request

Fasting while on semaglutides: Experts advise on using Ozempic, Mounjaro or Wegovy during Ramadan

Whether taking the medication for diabetes or weight loss, several factors such as staying hydrated and breaking fast need careful consideration during the holy month