Shutterstock/EdugrafoGLP-1 agonist shots, like those pictured, and oral medications have become increasingly popular over the past few years. If you’re prescribed a GLP-1 agonist, consult your doctor before diving.
In recent years, GLP-1 agonists such as semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro/Zepbound) and liraglutide (Victoza/Saxenda) have revolutionized the treatment of health conditions including diabetes and obesity.
While there has not been research published on how GLP-1 drugs affect divers specifically, it can be helpful to know how to adjust your diving around some of the known side effects—as they become more commonly prescribed, there’s a higher likelihood that you or your dive buddy will be taking one of these medications.
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Common Side Effects
GLP-1 medications mimic the body’s natural hormones to increase insulin secretion and slow gastric muscle movement.
This means food moves through the gastrointestinal system much more slowly, allowing patients to feel full for longer. By suppressing appetite, these medications can lead to significant weight loss and are thus used to treat obesity and diabetes.
Although it makes the drugs effective, slowing down GI movement comes with many predictable side effects. The most common are gastro-related and include nausea, vomiting, diarrhea, bloating and abdominal pain.
These side effects typically occur within the first month of starting treatment and often recur within 48 hours after increasing dosage.
Some rare, potentially life-threatening side effects have also been reported with GLP-1 agonists. Talk to your doctor before starting any medication to ensure safety and effectiveness.
GI Effects for Scuba Divers
Nausea is one of the most often reported side effects of GLP-1 agonists. When combined with rocking boats, those who are already sensitive to seasickness may experience significant worsening of symptoms. And because the underlying cause of the nausea is different, typical anti-seasickness medications may not work to soothe queasiness.
The vomiting and diarrhea that sometimes accompany GLP-1 agonists can also lead to dehydration and electrolyte imbalance. This can increase the risk of cramps, fatigue and decompression sickness—especially when diving in hot, humid environments.
Thankfully, there are things we can do to manage these side effects. First, avoid diving soon after starting a GLP-1 agonist or increasing your dose. Wait until you have a good understanding of how you react to the medication before returning to the water.
Second, eat slowly and in smaller amounts than you normally would. Because food is not digested as quickly, eating too fast or too much can trigger nausea and GI upset.
Finally, drink plenty of fluids before and after dives, and avoid diving if you are experiencing vomiting or diarrhea.
As always, include the medication on your predive medical questionnaire and let your buddy and the boat crew know about relevant health conditions so they can better assist in case of emergency.
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Taking a Holistic Approach to Health
While the side effects of GLP-1 agonists are often manageable, it is best to consider the overall picture of your health when deciding whether to dive while taking these medications.
The first step is understanding the underlying health condition you’re taking the medication to treat. Doctors may prescribe GLP-1 agonists for obesity, diabetes, cardiovascular disease, metabolic liver disease and various off-label medical conditions. Each underlying issue may affect diving safety.
As an example, poorly controlled diabetes can lead to dangerously low blood sugar underwater (see the Underwater Wellness column in our December issue for tips on diving with diabetes). Thus, it is important to talk to your doctor about other risk factors that may inhibit your diving, such as your cardiac health or exercise tolerance.
GLP-1 agonists represent a powerful new class of medications with many benefits. However, their gastrointestinal side effects pose meaningful considerations for scuba divers.
As such, divers and clinicians should engage in thoughtful risk assessment, symptom monitoring and individualized planning to ensure safety and optimal performance underwater.
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