Leah Kenyon's Wegovy side effects: what the data shows

What did @leahkenyon5 actually say?

She reported losing roughly seven pounds in her first week on semaglutide (Wegovy) at the 0.25 mg starting dose. She described two GI side effects: explosive diarrhea that resolved on its own, and new-onset sulfur burps she called "burps that literally smell like rotten eggs." She said she'd never heard anyone else report sulfur burps on Wegovy, and she took Gas-X after Googling the symptom. She also noted she isn't feeling hungry and has to force herself to eat or she feels sick. That's actually a pretty honest, granular account. No miracle claims, no specific health promises, just a symptom diary.

Worth noting: she's one week in, on the lowest titration dose. Most clinical effects, good and bad, scale up as the dose does.

Does the science back this up?

Yes, mostly. The GI side effect profile she's describing is textbook semaglutide. The sulfur burps are less commonly discussed online, but they're not mysterious, and the rapid early weight loss is real but probably not what she thinks it is.

The STEP 1 trial (Wilding et al., 2021, NEJM) found nausea, diarrhea, vomiting, and constipation were the most common adverse events in semaglutide-treated participants, with GI events leading to discontinuation in about 4.5% of cases. That's the clinical baseline.

On the sulfur burps specifically: semaglutide slows gastric emptying significantly. Food sitting longer in the stomach and gut ferments more, producing hydrogen sulfide gas. A 2022 review in Obesity Reviews (Jensterle et al.) noted that delayed gastric motility is a primary mechanism behind GI complaints on GLP-1 agonists. Her symptom is explainable and reported by other users, even if it doesn't dominate the clinical literature yet.

The seven-pound loss in one week is real, but it's almost certainly mostly water weight and glycogen depletion from reduced caloric intake, not fat loss. That distinction matters for setting realistic expectations.

What did they get wrong (or right)?

She got more right than wrong. The side effects are documented, her self-management approach was reasonable, and she wasn't overselling the drug. But one thing she got wrong: she said "I haven't heard anybody else have that" about the sulfur burps, framing it as unusual or unknown. It isn't.

Sulfur burps on GLP-1 agonists are widely reported in patient communities and have a clear mechanistic explanation tied to delayed gastric emptying. A 2023 pharmacovigilance analysis using the FDA Adverse Event Reporting System found eructation (burping) among catalogued GI events for semaglutide users, though it's less frequent than nausea or diarrhea. She's not a medical outlier. She just hasn't found the right forums yet.

Credit where it's due: she correctly identified that forcing herself to eat when appetite is suppressed is necessary to avoid feeling worse. The clinical guidance on this is real. Eating small, low-fat meals can reduce GI side effects on semaglutide, and total food avoidance can worsen nausea and cause nutrient deficiency.

• Got right: GI symptoms are consistent with documented semaglutide adverse effects
• Got right: Gas-X (simethicone) is a reasonable, safe first step for gas-related symptoms
• Got wrong: Framing sulfur burps as rare or unknown, they have a clear mechanism and documented occurrence
• Unclear: Whether the 7 lbs is fat loss or mostly water weight, she doesn't distinguish

What should you actually know?

If you're starting Wegovy and hitting these symptoms, you're not having a weird reaction. You're having a typical one. The GI side effects on semaglutide are tied directly to how the drug works: it slows digestion, reduces appetite via central and peripheral mechanisms, and alters gut motility. Those same actions that cause weight loss cause stomach upset.

A few things the clinical literature actually supports for managing early GI symptoms:

• Eating smaller, lower-fat meals reduces gastric load and can decrease nausea and bloating
• Staying hydrated matters, especially if diarrhea is present early on
• Simethicone (Gas-X) has no known drug interactions with semaglutide and is reasonable for gas symptoms
• Most GI side effects in the STEP trials peaked during dose escalation and then decreased, they don't typically persist at a stable dose

The rapid early weight loss she's reporting (seven pounds in roughly a week at the lowest dose) should be contextualized. At 0.25 mg, the pharmacodynamic effect is modest. A drop of that size in week one almost always reflects reduced water retention and glycogen stores from eating less, not meaningful fat oxidation. That's not a criticism of her results, it's just important for managing expectations when the scale slows down in weeks two and three.

One more thing: she mentioned Googling her symptoms and self-managing. That's fine for Gas-X. It's less fine as a general strategy. Severe or persistent GI symptoms on any GLP-1 agonist, especially upper abdominal pain, should prompt a call to the prescribing provider. Pancreatitis is a rare but serious risk that warrants clinical evaluation, not a Google search.