The Ultimate Guide to Mounjaro Constipation

Amy Beney MS RD CDCES

 March 2, 2024

Bloating, discomfort and constipation – welcome to the not-so-glamorous side effects of Mounjaro/Zepbound (tirzepatide). Let’s talk about how to keep things moving!

Here’s the skinny on how to poop on Mounjaro or Zepbound (tirzepatide).

 

 

What is Mounjaro/Zepbound (tirzepatide)?

 

Mounjaro (tirzepatide) is a new diabetes medication whose most significant side effect is weight loss. It works in the body in 5 ways.

  1. It stimulates the body to release insulin when blood sugar is high.
  2. Helps the body remove excess sugar from the blood.
  3. Stops the liver from making and releasing too much sugar.
  4. Reduces how much food is eaten.
  5. Slow down how quickly food leaves the stomach.

 

What is constipation?

 

Chronic constipation can affect from 2% to 27% of the population. Constipation is physically and mentally troublesome for many patients and can significantly interfere with their daily living and well-being.

If you or a loved one suffers from constipation, you understand how altering it can be.

Constipation is a problem with passing stool. Constipation generally means passing fewer than three stools a week or having difficulty passing stool.

Constipation is complex and multifactorial, where aspects like disturbance in colonic transit, genetic predisposition, lifestyle habits, psychological distress, and many others need to be taken into consideration.

 

 

Am I the only one with constipation on Mounjaro/Zepbound (tirzepatide)?

 

 

The most common adverse reactions reported in ≥5% of Mounjaro-treated patients in placebo-controlled trials were nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, and abdominal pain. Mounjaro may cause constipation due to delayed gastric emptying time and decrease in fiber from the diet.

There is good news and you can prevent constipation on Mounjaro (tirzepatide) by following these recommendations.

 

Mounjaro (tirzepatide) Constipation Remedy.  

 

There are several ways to prevent constipation on Mounjaro (tirzepatide). Understanding constipation as a side effect of Mounjaro is your first priority so you can take steps to prevent constipation.

There is a 4-prong attack of:

Diet

Exercise

Water

Supplements

 

 Diet-  

 

A diet high in soluble, insoluble and prebiotic fiber can help with constipation. The recommended amount of fiber daily for women is approximately 25 grams and men is 30 grams a day. Meeting these estimated needs may be difficult if appetite is decreased or if there are food aversions from this medication.

There are two types of fiber: soluble fiber and insoluble fiber. They are equally important but do different things in our bodies.

What is Soluble fiber?

 

Are you familiar with gut health? Research is promising that if we take care of our good gut bacteria, it will take care of us. A diverse colon with many healthy bacteria can help manage many diseases. Our gut is often referred to as our second brain. It is connected to the brain in our head through the vagus nerve.

  • Soluble fibers serve as a food source for bacteria living in the colon.
  • Gut bacteria provide much health benefits.

Soluble Fiber dissolves in water.

Sources include.

  • Fruits
  • Oats
  • Barley
  • Legumes
  • Root vegetables

What is Insoluble Fiber?

 

This type of fiber comes from plant cell walls and doesn’t dissolve in water.

The bacteria in the colon don’t consume insoluble fiber. Insoluble fiber’s superpower is retaining water and helps promote larger, bulkier stool and more regular bowel habits.

Foods included:

Foods for regularity-add these to your diet to prevent constipation on Mounjaro (tirzepatide)

 

Water pulling-adding water to stool.  These foods add water to the stool to make it softer and easier to pass

  1. Foods high in Magnesium- seeds, pumpkin or chia seeds, nuts (almonds or cashews) soy products, brown rice, salmon, black beans.
  2. Chorella- type of algae.
  3. Leafy greens- spinach, kale.
  4. Spirulina

Try magnesium supplements if having trouble getting enough in your diet.

Other foods that help provide constipation relief. 

Kiwi-2 kiwi a day can help stimulate the GI tract.

Papaya

Sorbitol- is a natural laxative.  These foods contain sorbitol.

  1. Prunes
  2. Dates
  3. Apples
  4. Peaches
  5. Apricots.

Stimulants (Fats)- Can “grease the pipes”

  1. Oily fish
  2. Avocado
  3. Coconut oil
  4. Olive oil
  5. Nuts and seeds

Herbs

  1. Aloe vera
  2. Senna
  3. Smooth move tea

Bulking-  Bulk up the stool.

  1. Fiber
  2. Chia seeds
  3. Flax seeds
  4. Berries
  5. Apples
  6. Figs

Probiotics/Fermented foods- May also help with constipation from Mounjaro.

  1. Sauerkraut
  2. Kimchi
  3. Kombucha
  4. Yogurt
  5. Kefir

Exercise-  

 

Getting regular physical activity can help with constipation. The recommended amount of weekly exercise is 150 minutes a week.

Water-

 

Fluid intake is an important part of having a regular bowel movement.

How much fluid does the average, healthy adult living in a temperate climate need? The U.S. National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is:

  • About 15.5 cups (3.7 liters) of fluids a day for men
  • About 11.5 cups (2.7 liters) of fluids a day for women

Additional Supplements  for Mounjaro (tirzepatide) and constipation

 

There are several supplements that may help constipation with Mounjaro

Fiber supplements including gummies, pills

Metamucil, Benefiber

Miralax

Mag07

Magnesium citrate

Additional Tips for Mounjaro/Zepbound (tirzepatide) Constipation Help.

 

Position on toilet- Try a different position when having a bowel movement.  Use a stool under your feet to help with positioning.  

Pelvic floor– Exercises to manage your pelvic floor may be helpful if constipation has been a long standing issue.  There are specialists that specifically work on pelvic floor dysfunction and constipation can be a symptom.

Bathing in warm water- Warm water can help relax a tense abdomen and may help with constipation.

Still struggling with constipation from Mounjaro/Zepbound (tirzepatide)?

 

If you are struggling with constipation and are taking Mounjaro/Zepbound (tirzepatide) or if you are taking Mounjaro and not losing weight, meeting with a dietitian may benefits you and help you meet your health goals.

You may be pleasantly surprised that a dietitian is covered by insurance.

Start your weight loss and diabetes medication journey with a step by step guide to the best Mounjaro diet.

Final Thoughts on Constipation on Mounjaro/Zepbound (tirzipatide)

There are several ways to prevent constipation on Mounjaro (tirzepatide).  Understanding constipation as a side effect of  Mounjaro is your first priority so you can take steps to prevent constipation.

There is a 4 prong attack of diet, exercise, water and supplements to help you poop on Mounjaro