GLP-1 Help

Free handbook · chapter 3 · 10 pages · PDF

GLP-1 Side Effects, Explained

Why nausea happens, how to read the side-effect numbers for your medicine, and when to get help. A free chapter from the Fewer Bites GLP-1 handbook, by Dr. Chiranjeevi Peetla.

Get the PDF What is inside
Phone card titled When adults should get help for vomiting, with emergency and call-your-clinician criteria
Page 6: the help card, sized for a phone screen. Also on its own page: glponehelp.com/help-card.

What is inside

Ten pages, each one traceable

  1. Why side effects happen (pages 2 to 5)

    Two likely routes to nausea: a brainstem "border checkpoint" shown in animals, and a slower, fuller stomach. Which one matters most in people is not known, and the chapter says so.[13]

  2. The trial numbers, one card per medicine (pages 7 and 8)

    Wegovy: 2,116 people on the medicine, 1,261 on placebo.[1] Zepbound 15 mg: 941 on the medicine, 958 on placebo.[2] Each card has its own placebo group, so you compare within a medicine, never across.

  3. The help card (page 6)

    When vomiting needs a clinician, and when it needs 911. Restated in our own words from MedlinePlus, with the labels' additions.[19][1][2]

  4. Ask AI to explain a page (page 9)

    One prompt that keeps an AI assistant tied to the passage you paste, with a worked example and a list of what to keep out of the chat.

  5. What to do next (page 10)

    The companion episode, how to hear about the full handbook, and the author and sourcing notes.

Pages 7 and 8

Side effects reported in the trials, people out of 100

Counts are people who reported the effect at least once during the trial. The placebo group is a dummy injection, so some of every number is not the medicine. Indigestion means dyspepsia.

Side effects reported in the Wegovy trials, 2.4 mg, people out of 100: nausea 44 vs 16 on placebo, diarrhea 30 vs 16, vomiting 24 vs 6, constipation 24 vs 11, abdominal pain 20 vs 10, headache 14 vs 10, fatigue 11 vs 5, indigestion 9 vs 3, dizziness 8 vs 4, burping 7 vs under 1, reflux 5 vs 3, hair loss 3 vs 1

Wegovy 2.4 mg

Adults with obesity or overweight. Source: Wegovy FDA label, Table 3.[1]

Save card (PNG)
Side effects reported in the Zepbound trials, 15 mg, people out of 100: nausea 28 vs 8 on placebo, diarrhea 23 vs 8, vomiting 13 vs 2, constipation 11 vs 5, abdominal pain 10 vs 5, indigestion 10 vs 4, fatigue 7 vs 3, burping 5 vs 1, reflux 5 vs 2, hair loss 5 vs 1, dizziness 4 vs 2

Zepbound 15 mg

Highest studied dose. Source: Zepbound label, Table 1, Studies 1 and 2.[2]

Save card (PNG)
Help card: when adults should get help for vomiting

Help card

When vomiting needs a clinician or 911. Read it on its own page too.[19]

Open the help card

The myth the chapter takes apart

"Nausea means it's working"

In the pooled Wegovy trials, weight loss was large in people who never had nausea, and stomach side effects explained less than one percentage point of the weight lost.[13] Nausea is a side effect, not a sign of success. The chapter walks through how the researchers checked this.

What is still unknown

  • Which nausea route matters most in people.
  • Why nausea fades for most people.
  • Why one person gets constipation and another diarrhea.

A note on the suicidal-thoughts warning: the FDA removed it in January 2026 after reviewing 91 trials with 107,910 patients and a 2.2-million-person database and finding no increased risk.[27]

Page 9

Ask AI to explain a page

Copy this prompt into ChatGPT, Gemini, Claude or Perplexity, then paste one paragraph from the handbook. It keeps the assistant tied to the passage and your personal details out of the chat.

I'm reading the Fewer Bites handbook. Use only the passage I paste below. Explain it in three short sentences for someone with no science background. If there's a number, tell me who was studied, what was counted, and what the comparison was. Tell me one thing the passage cannot establish about an individual person. Finish with one question I could ask my prescriber. If the passage doesn't answer something, say so. Don't diagnose symptoms or suggest starting, stopping, or changing treatment.

Passage: [Paste a paragraph or chart caption from the handbook.]

Keep these out of the chat

Your name, your medical records and your own symptoms. An AI assistant is not a clinician. If the answer adds a dose, a diet tip, a reason to stop or a diagnosis, ignore it. That gap belongs to your prescriber.

Questions to take to your prescriber

This site explains; it does not decide. These are the questions the chapter leaves you with.

  • Which side effects should I report right away, and which can wait for our next visit?
  • What result should I expect by week 12, and what would make you change the plan?
  • I take this medicine; who on my surgical or dental team needs to know before a procedure with sedation?
  • Do any of my other medicines or conditions change how you will monitor me?

About the full handbook (the honest note)

The full edition will be an illustrated, question-led book: a chart with its source for every number, and the questions to take to your prescriber after each chapter. It does not exist yet, and its price and length are not set. Nothing in this free chapter is cut down to sell it; the free edition and the full one are held to the same sourcing standard.

Who wrote this

Written and maintained by Dr. Chiranjeevi Peetla, a research scientist, not a physician. He holds a pharmacy degree and a PhD from Germany, spent seven years as a research scientist in cancer nanomedicine at a top-ranked US academic medical center, where he authored peer-reviewed papers, and now works in IT consulting while building a healthcare IT startup.

Nothing here is medical advice or a clinical review. Every page is built from primary sources, with each claim traced and graded. A credited clinician reviewer will be added as the site grows.

How the chapter was made: a research dossier came first (the FDA labels, the trial reports and MedlinePlus, each read in full and graded). The chapter was drafted from the dossier and revised through three rounds of editorial review. Organ pictures are AI renders made to the author's brief; outlines, routes and labels are drawn in code and checked by the author. Chart values are drawn by code from the source tables. Free edition 1.0, November 2026.

Sources

Numbering matches the free handbook, so a source number on a page and in the PDF point to the same document. "Primary" means we read the original label or study; "secondary" means a report about it.

  1. FDA label (primary). Wegovy (semaglutide) US prescribing information, revised 02/2026. Section 6.1, Table 3. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/218316s004lbl.pdf
  2. FDA label (primary). Zepbound (tirzepatide) US prescribing information, revised 08/2026. Table 1. https://pi.lilly.com/us/zepbound-uspi.pdf
  3. primary study. Wharton S et al. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity (pooled STEP trials). Diabetes, Obesity and Metabolism, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9293236/
  4. health agency. MedlinePlus Medical Encyclopedia. Nausea and vomiting: when to contact a medical professional. https://medlineplus.gov/ency/article/003117.htm
  5. health agency. US FDA. Review of suicidal thoughts or actions with GLP-1 receptor agonists: conclusions, January 2026. https://www.fda.gov/media/190557/download