What to Know about Taking GLP-1s Postpartum

Women and birthing people deal with overwhelming pressure to “bounce back” or “lose the baby weight” after giving birth. Rather than ranting about how ridiculous these expectations are, we’ll keep it short and say: this noise is unwelcome and uncalled for.

That said, postpartum weight retention is often a frustrating reality and is worth addressing if it’s affecting your mental or physical health. We all know that nutrition and exercise are top recommendations for weight loss at any life stage, but a new player has entered the field: GLP-1 medications. 

There are a lot of GLP-1s on the market: compounded semaglutide, Ozempic, Wegovy, Zepbound, Saxenda, Mounjaro… the list goes on. These medications can be an attractive weight loss tool, especially if you’ve just had a baby. After all, it’s not easy to lose weight when you’re sleep deprived, physically recovering from birth, and dealing with a newborn! However, GLP-1s can affect postpartum people differently than the general population, and medication timing and postpartum physiology are important to consider. 

Still wondering if taking a GLP-1 to lose postpartum weight is right for you, or already have a prescription? Read on as we discuss key GLP-1 details, common questions, and what you need to know about taking these drugs postpartum.  

How your body changes postpartum 

Gaining weight during pregnancy is a natural and oh-so-necessary part of the process, and your body doesn’t just snap back to your pre-pregnancy “normal” after giving birth. Postpartum weight retention is a common struggle, as:

• One year after giving birth, half of women and birthing people retain at least 10 pounds of pregnancy weight 
• One quarter retain at least 20 additional pounds at one year postpartum. 

Glucagon-like peptide-1 receptor agonists, or GLP-1s for short, are not gimmicky postpartum weight loss supplements; they’re prescription medications that alter how your brain and body interact with food and hunger. While effective for weight reduction, taking Wegovy or Ozempic for postpartum weight loss is more complex than it is for other life stages, due to physiological changes during pregnancy and delivery. Here’s just a snapshot of how pregnancy and giving birth affect your system:  

• Gastrointestinal (GI) changes, such as altered gut motility (the movement of digested food through the digestive organs)
• Tissue healing and remodeling, including more elastic ligaments, loss of muscle mass, and possible pelvic organ prolapse
• Neuromuscular control changes, including reduced pelvic floor strength and coordination 
• Nutritional requirements, since you need enough fuel to fully recover from birth and breastfeed or chestfeed (but GLP-1s aren’t recommended if you’re breastfeeding!)  

Is it safe to take GLP-1s postpartum?

Taking GLP-1s while your body adjusts to postpartum changes can compound and cause some uncomfortable side effects (hellooo, constipation). Moreover, rapid weight loss can affect your body in ways that are already in flux postpartum.

Provided you’re not breastfeeding, medications such as Zepbound or Mounjaro can still be a part of your postpartum weight loss plan. However, it’s crucial that they don’t operate in a vacuum. Combine GLP-1s with: 

• Musculoskeletal training to make sure you maintain muscle mass, joint health and function, and bone strength while losing weight
• Pelvic floor therapy to combat pelvic floor weakness, help with bladder control, and improve coordination for more comfortable poops   

With this in mind, let’s take a look at some specific ways GLP-1 medications can interact with postpartum physiology and answer a few commonly asked questions. 

How long does GLP-1 constipation last, and why does it happen?

Constipation from semaglutide, the active ingredient in both Wegovy and Ozempic, can last a median of 47 days, or about six weeks. It typically begins during the first month of treatment and improves over time. So, if GLP-1s are part of your diet plan after pregnancy, know that constipation can get better with time. 

While researchers don’t fully understand why semaglutide causes constipation, both slower gut motility and changes in diet are likely contributors. Pregnancy and postpartum also affect your gut motility and eating habits, which can make taking Wegovy or Ozempic for postpartum weight loss a constipation double whammy! Let’s take a quick look at the details: 

• Gut motility: High progesterone levels during pregnancy relax the muscles that control your stomach and intestines, causing your digestion to slow down. This slowdown often leads to constipation, and taking a GLP-1 postpartum can keep you stopped up for longer. 
• Dietary changes: GLP-1s help you feel fuller for longer, which can make you eat less food and therefore less fiber! Combine this with postpartum stress and a busy, baby-focused schedule, and you might not be getting the food and liquids that help keep you regular.  

How GLP-1s, constipation, and your pelvic floor are related 

For those dealing with Ozempic or Wegovy constipation postpartum, taking care of your pelvic health is essential! This is because your pelvic floor muscles play a major role in bowel function. These muscles can: (1)  become injured during pregnancy and birth, and (2) chronic constipation stresses the pelvic floor muscles even further.

If GLP-1s are a part of your postpartum weight loss plan, working with a pelvic PT can help you maintain pelvic muscle strength and proper function. Your pelvic physical therapist can help you manage postpartum constipation with customized programs and techniques.   

How rapid weight loss can affect your musculoskeletal system

GLP-1 medications can cause pretty rapid weight loss, and this usually means you’re not just getting rid of excess body fat: you’re losing muscle, too. Losing muscle mass can put more strain on your ligaments and joints, which can eventually lead to pain or injury. 

If you’re taking GLP-1s postpartum, preventing these possible effects is key! Work to protect your musculoskeletal system with safe strength training and postpartum recovery routines, as pregnancy impacts your musculoskeletal system.   

How do I protect my muscle mass with weight loss drugs?

Eating enough protein and engaging in resistance training are essential for maintaining muscle mass and bone density while taking GLP-1s for weight loss. When not paired with protein and exercise, rapid weight loss can increase your risk of sarcopenia (the loss of skeletal muscle mass and strength). 

Sarcopenia, in turn, is linked to impaired mobility and muscle function. This means your muscles get smaller and thinner throughout your body… including your pelvic floor. With sarcopenia, your pelvic floor muscles might not work as effectively as before, which can lead to pelvic floor dysfunction. So, protecting your muscle mass while taking GLP-1s is much more than just preventing so-called “Ozempic butt,” especially postpartum! 

Does rapid weight loss cause bladder leaks?

Rather than causing them, weight loss typically helps reduce bladder leaks! A study of 338 overweight or obese women found that weight loss led to a 47% decrease in weekly leaks, especially leaks due to things such as sneezing, coughing, or laughing. If you’re dealing with bladder leaks postpartum, physician-managed GLP-1 use may help.

Can GLP-1s like Ozempic cause prolapse?

GLP-1s don’t directly cause prolapse, but rapid weight loss can affect the muscles and connective tissue holding your pelvic organs in place. While pelvic organ prolapse and rapid weight loss may be slightly related, prolapse and giving birth are very closely related (Handa, 2011). We’ll say it again: your pelvic muscles are vulnerable and healing after delivery, and need some TLC and physical therapy, especially if your healthcare provider has suggested a GLP-1 prescription for you.

Supporting your body postpartum

Pregnancy, birth, and taking care of a new baby are challenging; 

You have to give it your everything, both physically and emotionally. GLP-1 medications can help take some of the weight off your shoulders (literally) and help you feel like you again. 

However, when it comes to postpartum weight loss, whole-body health is always priority #1. If you’re thinking about a GLP-1 prescription or looking for postpartum physical support, book an appointment today. We’re here to help the whole you.