Constipation on a GLP-1: 24 percent on Wegovy and falling as the Zepbound dose rises
Constipation reached 24 percent on Wegovy 2.4 mg and fell from 17 to 11 percent as Zepbound went from 5 mg to 15 mg, in the clinical trials printed on their FDA labels. GLP Chart read both labels on DailyMed, revised June and August 2026.
| Label and dose | Who was in the trial | On the drug | On placebo |
|---|---|---|---|
| Wegovy 2.4 mg (June 2026 label) | adults with obesity or overweight, n=2,116 | 24% | 11% (n=1,261) |
| Wegovy 2.4 mg (June 2026 label) | adults in the trial comparing the two maintenance doses, n=304 | 19% | 8% (n=303) |
| Wegovy 7.2 mg (June 2026 label) | adults in the trial comparing the two maintenance doses, n=1,311 | 20% | 8% (n=303) |
| Zepbound 5 mg (August 2026 label) | adults with obesity or overweight, n=630 | 17% | 5% (n=958) |
| Zepbound 10 mg (August 2026 label) | adults with obesity or overweight, n=948 | 14% | 5% (n=958) |
| Zepbound 15 mg (August 2026 label) | adults with obesity or overweight, n=941 | 11% | 5% (n=958) |
| Ozempic 0.5 mg (June 2026 label) | adults with type 2 diabetes, n=260 | 5% | 1.5% (n=262) |
| Ozempic 1 mg (June 2026 label) | adults with type 2 diabetes, n=261 | 3.1% | 1.5% (n=262) |
| Mounjaro 5 mg (August 2026 label) | adults with type 2 diabetes, n=237 | 6% | 1% (n=235) |
| Mounjaro 10 mg (August 2026 label) | adults with type 2 diabetes, n=240 | 6% | 1% (n=235) |
| Mounjaro 15 mg (August 2026 label) | adults with type 2 diabetes, n=241 | 7% | 1% (n=235) |
The one GI reaction that does not climb with the dose
Zepbound's table reads 17 percent at 5 mg, 14 percent at 10 mg and 11 percent at 15 mg. It falls by six points across the ladder while nausea and diarrhea rise across the same three columns. Ozempic does the same thing, 5 percent at 0.5 mg down to 3.1 percent at 1 mg.
Mounjaro is close to flat at 6 and 7 percent. Wegovy's high-dose table reads 19 percent at 2.4 mg and 20 percent at 7.2 mg, a one-point move where nausea moved four.
Read the placebo column before you read anything else. 11 percent of the placebo arm in the Wegovy trials reported constipation and 5 percent did in the Zepbound trials. Both arms were on a reduced-calorie diet, and the placebo column is what that produced on its own.
What a slower ladder costs
Neither label says what the slower route costs. On some programs the lower dose is the cheaper one and on others the price does not move at all.
| Drug | Cheapest program we track | At the maintenance dose | At the top dose it publishes |
|---|---|---|---|
| Wegovy | Knownwell | $299 a month | Publishes one figure only |
| Zepbound | CVS MinuteClinic | $428 a month | $528 a month |
LifeMD charges $200 a month more at the top of its ladder than at the dose below it. Holding a step for 4 weeks on that plan saves $200. Ask the program what it charges at each dose before you agree to climb.
Compare every program at its real maintenance price →
What the row actually counts
Zepbound's label says its constipation row counts constipation and hard stool together. Wegovy's counts constipation alone. So Wegovy's 24 percent and Zepbound's 17 percent are not counting the same thing.
Neither diabetes label carries a tolerability sentence. Ozempic and Mounjaro make every step past the first conditional on needing more glycemic control and say nothing about pausing for side effects. On a diabetes label the dose conversation is a different one.
Frequently asked questions
How common is constipation on a GLP-1?
Wegovy's label puts it at 24 percent at 2.4 mg against 11 percent on placebo. Zepbound's puts it at 17 percent at 5 mg, 14 percent at 10 mg and 11 percent at 15 mg, against 5 percent on placebo. On both labels it is the second or third most reported reaction after nausea.
Does it get worse at a higher dose?
Not on tirzepatide. Zepbound's own table falls from 17 percent at 5 mg to 11 percent at 15 mg. Ozempic falls too, from 5 percent at 0.5 mg to 3.1 percent at 1 mg. Mounjaro is close to flat at 6 percent and 7 percent, and Wegovy reads 19 percent at 2.4 mg against 20 percent at 7.2 mg.
What is in the label's constipation row?
Zepbound's label says the row counts constipation and hard stool together. Wegovy's label lists constipation on its own. The two figures are not a clean comparison.
Does the label say what to do about it?
Not for this reaction specifically. What both weight-management labels give the prescriber is the dose lever. Wegovy's says to consider delaying escalation for 4 weeks if a dose is not tolerated. Zepbound's says to consider a lower maintenance dosage. Anything beyond that is a conversation with the prescriber.
Does staying on a lower dose cost less?
On some programs, yes. Others charge one price at every dose, so holding a step changes the clinical picture and not the bill.
Every dosage sentence on this page is written to a prescriber, not to you. Holding a dose, dropping back or stopping changes what the drug is doing. Take the label language to the appointment.
Sources
Evidence checked August 31, 2026
Every figure above is taken from the document beside it, the FDA label or the trial that produced it, so you can read the source instead of trusting us. No clinician reviews these pages. What that means.
- The 24 percent Wegovy figure, the 19 against 20 percent reading at 2.4 mg and 7.2 mg, and the tolerability sentence about delaying escalationFDA prescribing information for Wegovy, injection and tablets (DailyMed, revised June 2026)
- The Zepbound rates at 5 mg, 10 mg and 15 mg, the note that the row counts hard stool as well as constipation, and the sentence about considering a lower maintenance dosageFDA prescribing information for Zepbound (DailyMed, revised August 2026)
- The Ozempic rates at 0.5 mg and 1 mg in adults with type 2 diabetesFDA prescribing information for Ozempic injection (DailyMed, revised June 2026)
- The Mounjaro rates at 5 mg, 10 mg and 15 mg in adults with type 2 diabetesFDA prescribing information for Mounjaro (DailyMed, revised August 2026)
