Ozempic® and Keto Diet: A Good Combination?

Ozempic® and Keto Diet: A Good Combination?

Keto is one of the most popular diets. But is it a good idea to follow this diet while taking Ozempic? As a Registered Dietitian, I believe other eating patterns work better than keto, and this blog post will explain why.

Disclaimer: This blog post is for educational purposes only, please consult with your registered dietitian for individualized nutrition advice. 

What is Keto?

The ketogenic (keto) diet is a dietary approach that prioritizes high-fat food, and it is VERY low in carbohydrates. When following this eating pattern, the aim is to induce a state called ketosis, in which the body switches from using glucose as the primary fuel source to burning fat for energy. 

Example of keto meal

By significantly cutting carbs and upping fat intake, the keto diet prompts the body to make ketones, which use energy.  This helps weight loss by boosting fat burning, curbing hunger, potentially improving the blood sugar level, and increasing insulin sensitivity. 

Here is a breakdown of the typical percentages of total calorie intake in this diet:

  • Fats 70-80%
  • Proteins 10-20%
  • Carbohydrates 5-10%

Keto Diet Side Effects

This food plan has a few potential side effects, including:

Gastrointestinal (GI) Issues

This diet is high in fat and often high in fiber, as it cuts out most fruits and whole grains. 

This can lead to constipation and abdominal pain. 

Keto Flu

When people start on a keto diet, it’s common to develop what is known as the keto flu. This includes nausea, constipation, headaches, fatigue, and sugar cravings.

Nutrition Deficiencies

The ketogenic diet is very restrictive, with the main source of calories coming from fat. This means that most foods high in fiber are limited. Also, many vitamins and minerals are restricted by eliminating a large number of different foods.

While many believe that keto is high in protein, in fact, it only allows for 10%-20% of the calories to come from protein.


Low blood sugar is another potential side effect of the keto diet, and I will discuss later in this article why this is an important factor if you’re on Ozempic.

To truly assess the risks and benefits of the keto diet for people taking a GLP-1 receptor agonist, we need to briefly review its effect.

About Ozempic

Ozempic is a medication known as a GLP-1 receptor agonist, developed to help manage diabetes. However, it’s so effective for weight loss, that it’s frequently used off-label for weight management. In fact, a version of this medication—Wegovy®—is now available to treat obesity in those who are not diabetic.

This drug works by lowering blood sugar levels through an increase in the production of insulin in response to food. 

Additionally, it helps with weight loss by reducing appetite, keeping you feeling full for longer periods, and decreasing insulin resistance, which further aids in weight management.

As a result, some people eat very small amounts of food.

Ozempic Side Effects

GI Issues

GI issues are the most common side effects of this medication and include:

  • Nausea
  • Constipation
  • Vomiting 
  • Diarrhea

Nutrition Deficiencies

There are a couple of significant factors related to poor nutrition associated with this drug. 

  • First, research shows that many obese people have nutrition deficiencies that are likely due to their food choices. This is not true for every single person, but it is common.
  • Furthermore, it’s normal that people taking Ozempic significantly reduce how much they eat, thus increasing or developing their nutrition deficiencies.

Other Side Effects

Keto Side EffectsOzempic  Side Effects
ConstipationAbdominal painKeto fluNauseaConstipationHeadachesFatigueSugar cravingsNutrition deficienciesNauseaConstipationVomiting DiarrheaFatigueNutrition deficiencies

Benefits and Risks

Benefits of  Combining the Keto Diet and Ozempic

We know that the keto diet promotes weight loss by reducing appetite and increasing satiety. Ozempic works in a similar way. Thus, following this eating plan can enhance the effectiveness of the medication.

Risks of the Combination

In my expert view, there are three key concerns when considering the combination of keto and Ozempic.

  1. Keto emphasizes intake that is high-fat, moderate in protein, and with minimal carbs. When coupled with the reduced food intake due to Ozempic, you might miss out on vital nutrients. In the short run, this can lead to fatigue. But in the long term, it could result in significant nutritional deficiencies, potentially leading to illness. Furthermore, people taking Ozempic often consume small portions of food, making it essential to ensure that each bite is packed with nutrients. The keto diet is high in fat, leaving little room for important nutrients. 
  2. Both keto and Ozempic cause similar side effects. Therefore, following a keto diet might exacerbate the undesirable side effects of the medication. When advising patients about Ozempic, I often recommend avoiding high-fat meals to reduce these side effects, which contradicts the principles of the keto plan. 
  3. Ozempic is commonly prescribed for diabetics, who may also be taking other medications to lower their blood sugar. Following  a very low-carbohydrate diet while taking a medication that lowers blood sugar can lead to excessively low blood sugar levels, posing a serious risk of harm.

The Bottom Line

In conclusion, based on my expertise, I advise against combining Ozempic and keto. 

The keto diet’s emphasis on high-fat food can worsen the medication’s side effects.

Moreover, because fat is such an important part of the keto diet, it may neglect essential, nutrient-dense foods that are vital for individuals on GLP-1 medication.

Key Nutrient Considerations While Taking Ozempic

When it comes to choosing what to eat, there’s one crucial factor to keep in mind when you’re on Ozempic: you should prioritize nutrient-rich foods. Aim to include foods that are high in protein, fiber, healthy fats, and complex carbohydrates in your diet most of the time. 

Healthy meal

Consider adopting a diet that is rich in protein (around 30-35% of your total calorie intake), but don’t forget about incorporating fiber-rich foods such as vegetables, legumes, whole grains, and fruits. These foods provide essential nutrients and help keep you feeling full and satisfied.

While healthy fats are important, it’s best to consume them in moderation. Opt for sources like nuts, seeds, nut butter, avocados, and healthy oils instead of foods that are high in saturated fat.

By focusing on nutrient-dense foods and maintaining a balanced diet, you can support blood glucose management, lose weight, minimize side effects, and support your overall health and well-being.

Want a meal plan? Click here for a FREE Ozempic diet plan.

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