Does Ozempic (semaglutide) cause fluid retention?

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Last updated: June 24, 2025View editorial policy

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From the Research

Ozempic (semaglutide) does not typically cause fluid retention, and in fact, is associated with fluid loss as part of its weight loss effects. The medication works by slowing gastric emptying, increasing feelings of fullness, and reducing appetite through its action on GLP-1 receptors in the brain and digestive system 1. Patients taking Ozempic commonly experience initial weight loss that includes both fat and fluid reduction. Some patients might confuse normal fluctuations in body water with medication effects, but clinical trials have not identified fluid retention as a common side effect of semaglutide. The more common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.

Key points to consider:

  • Semaglutide has been shown to reduce the risk of heart failure events and improve symptoms in patients with heart failure with preserved ejection fraction (HFpEF) 2, 3.
  • In patients with type 2 diabetes and chronic kidney disease, semaglutide reduced the risk of major kidney disease events and death from cardiovascular causes 4, 5.
  • The medication's effects on weight loss and fluid reduction are thought to contribute to its beneficial effects on cardiovascular and kidney outcomes.
  • If a patient on Ozempic experiences unexpected swelling, particularly in the ankles or legs, they should consult their healthcare provider as this could indicate an unrelated condition requiring medical attention.

Overall, the evidence suggests that Ozempic (semaglutide) is not typically associated with fluid retention, and its benefits on weight loss and cardiovascular and kidney outcomes make it a valuable treatment option for patients with obesity, type 2 diabetes, and chronic kidney disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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