When to Expect It
GLP-1 medicines slow down how quickly your stomach empties after you eat. When food stays in your stomach longer, you may be more likely to experience acid reflux — a burning feeling in your chest or throat caused by stomach contents moving back up into your food pipe (esophagus).
This side effect can happen when you first start the medicine and is also common when your dose is increased. It can be triggered by eating large meals, lying down soon after eating, or eating certain foods. The good news is that simple changes to your eating habits and daily routine can often help.
If you already have heartburn or acid reflux problems, let your care team know before starting or increasing your dose, as symptoms may become more noticeable.
How to Manage It
Nutrition Strategies
- Eat smaller, more frequent meals — large meals increase pressure and chance for acid backup
- Eat slowly and stop at comfortable fullness-pay attention to your body's signals rather than finishing everything on your plate
- Avoid eating within 3 hours of lying down or going to bed
- Limit trigger foods during flare-ups (see table below)
- Favor lower-acid options: cooked vegetables, lean proteins, oatmeal, bananas, melons
- Chew food thoroughly- this increases saliva, which helps neutralize acid in the esophagus
Behavioral & Positional Strategies
- Stay upright for 3 hours after eating
- Elevate the head of your bed 6–8 inches if nighttime reflux is a problem (use a wedge or bed risers — not extra pillows)
- Sleep on your left side — reduces acid exposure in the esophagus
- Wear loose-fitting clothing around the abdomen
- Manage stress —Many people believe stress causes the stomach to make more acid, but research shows that's not usually what happens. Instead, stress makes your body more sensitive to the acid that's already there — so the same amount of acid feels worse. Relaxation techniques, deep breathing, or other stress-reduction methods may help.
Common Reflux Triggers & What to Try Instead
| Food Trigger |
Better Alternative |
| Fried or high-fat foods |
Baked, steamed, or grilled options |
| Chocolate |
Small amounts of dark chocolate if tolerated; carob (a naturally sweet, caffeine-free substitute for chocolate, available as powder or chips) |
| Coffee and caffeinated drinks |
Herbal tea, low-acid coffee, decaf |
| Carbonated beverages |
Still water, herbal tea, flat water with lemon |
| Alcohol |
Still water, non-alcoholic alternatives |
| Tomatoes and tomato sauces |
Low-acid tomato options; pesto or olive oil sauces |
| Citrus fruits and juices |
Bananas, melons, pears |
| Mint and peppermint |
Ginger tea (may support digestion) |
| Spicy foods |
Mild herbs: basil, oregano, parsley |
Over-the-Counter Options
- Antacids (Tums, Rolaids) — fast, short-term relief; neutralize stomach acid
- H2 blockers (famotidine/Pepcid) — reduce acid production; helpful for frequent symptoms. These may become less effective over time with daily use — talk to your care team if you notice they stop working as well
- Proton pump inhibitors (omeprazole/Prilosec) — strongest acid reduction; discuss ongoing use with your care team
- Alginates (Gaviscon) — create a protective barrier that helps stop acid from rising; often well tolerated
Additional Tips
- Keep a food and symptom log for 1–2 weeks — your personal triggers may differ from common lists
- Nicotine weakens the muscle that keeps acid in your stomach, making reflux significantly worse. If you smoke or use nicotine products, talk to your care team about quitting
- Even modest weight loss can reduce reflux pressure — your Onsera program supports this
- If you have a scheduled procedure, tell your care team you are on GLP-1 medication — a 24-hour liquid-only diet before the procedure may be recommended
Contact Your Care Team If…
Reach Out — Don't Wait It Out
- Reflux occurs more than 2–3 times per week and is not responding to dietary changes
- Symptoms are disrupting your sleep regularly
- Reflux is making it difficult to eat adequately or causing significant discomfort
- You are interested in a short-term acid-reducing medication
- Symptoms started or worsened significantly after a dose increase
- You have a history of GERD, Barrett's esophagus, or esophageal issues
Seek Urgent or Emergency Care If…
- It hurts to swallow or you feel like food is stuck in your throat or chest
- You have chest pain that you are not sure is heartburn — call 911 or go to the emergency room right away to be safe
- You throw up blood or something that looks like coffee grounds
- You have black, tar-like stools, which can be a sign of internal bleeding
- You have severe stomach pain that radiates to your back
- You lose a lot of weight without trying and have heartburn
- You start choking, have a cough that will not go away, or your voice sounds hoarse
- You cannot stop vomiting or have been vomiting for several days
- Symptoms are disrupting your sleep regularly
- Reflux is making it difficult to eat adequately or causing significant discomfort
- You are interested in a short-term acid-reducing medication
- Symptoms started or worsened significantly after a dose increase
- You have a history of GERD, Barrett's esophagus, or esophageal issues
This guide is for educational purposes only. It does not take the place of personalized medical advice from your health care provider. Always consult your Onsera care team before making any changes to your medication or treatment plan
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