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Casa de Santé
GLP-1 Digestive Health
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Eating Less, Bloating More?
Here's what's really happening in your gut on GLP-1 medication, and the two-step fix that's working for my patients.
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A patient told me something last month that I now hear at least twice a week. |
"I'm eating half of what I used to. Smaller portions. Better food choices. And I'm more bloated than before I started my medication." |
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She assumed it was something she ate. She tried eliminating dairy, then gluten, then raw vegetables. Nothing changed. The problem wasn't on her plate.
Your GLP-1 medication reduces your body's own digestive enzyme output. A clinical review published in BMJ Gut found that GLP-1 receptor activation decreases gastric acid secretion by 67% and lipase, your primary fat-digesting enzyme, by 36%. That means your stomach makes less acid to break down protein, and your pancreas releases fewer enzymes to process fat. Even a small meal can sit half-digested.
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67%
drop in gastric acid secretion
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36%
drop in lipase secretion
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Source: clinical review, BMJ Gut
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When Food Breaks Down Too Little, Too Late
Three things happen, and they compound with every meal:
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Gas builds in your upper GI tract
Undigested carbohydrates ferment. Undigested proteins putrefy. Both produce gas.
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Your small intestine works harder
Without adequate enzyme breakdown in the stomach, larger food particles arrive downstream. Absorption drops.
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Bloating becomes chronic, not occasional
It's not one bad meal. It's every meal, because the enzyme deficit is constant while you're on the medication.
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A separate meta-analysis of over 12,000 semaglutide users confirmed that 31% experienced GI adverse events, with bloating, nausea, and discomfort the most common complaints. |
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Two Things That Helped My Patients |
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Take a broad-spectrum digestive enzyme 10 minutes before eating
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Not after symptoms start. Before the meal hits your stomach. The enzyme blend compensates for what your body produces less of: lipase, protease, and amylase above all. Look for a formula with at least 15 enzyme types to cover the full range of food groups.
I formulated our GLP-1 Digestive Enzyme Companion for this exact situation.
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![GLP-1 Digestive Enzyme Companion bottle]() |
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Eat protein and fat before carbohydrates at each meal
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When you lead with protein, you give your limited enzyme supply the highest-priority work first. Carbohydrates are simpler to break down and can wait. This sequencing reduces the fermentation that causes most post-meal gas.
Our FODMAP Digestive Enzymes with Pre/Pro/Postbiotics adds gut flora support alongside the enzyme blend.
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![FODMAP Digestive Enzymes with Pre/Pro/Postbiotics bottle]() |
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That patient I mentioned? She started taking enzymes before her two main meals. Within a week, the bloating dropped. Not gone. But she told me: |
"I ate lunch at my desk and forgot about my stomach for the first time in months." |
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That's what this is about. Not perfection. Just digesting your food the way your body used to. |
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Dr. Onikepe Adegbola, MD PhD
Founder, Casa de Santé
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