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For individuals taking GLP-1 receptor agonists (Ozempic, Wegovy, Mounjaro, Rybelsus, Saxenda, etc.), fasting during Ramadan presents unique challenges due to prolonged fasting hours and medication effects on appetite, blood sugar, and digestion.

Here’s how to manage Ramadan fasting safely while on GLP-1 medications:

• Weekly GLP-1s (Ozempic, Wegovy, Mounjaro) → No need to adjust, as they work continuously. Choose a day when you are most comfortable taking it (e.g., just after Iftar).
• Daily GLP-1s (Rybelsus, Saxenda) →
  • Rybelsus: Typically taken empty stomach in the morning. During Ramadan, take it before Suhoor with a small sip of water, then wait 30 minutes before eating.
  • Saxenda: Can be injected at Iftar or Suhoor, but most prefer Iftar to avoid nausea during fasting.

• Risk: Dehydration is common, as GLP-1 slows gastric emptying, reducing thirst signals.
• Solution:
  ✔ Drink at least 2–3 liters of water between Iftar and Suhoor.
  ✔ Include electrolytes (salt, potassium, magnesium) from foods like dates, coconut water, and broth-based soups.
  ✔ Limit caffeine (coffee, tea) as it can worsen dehydration.

• Risk: Large, high-fat, or high-sugar meals immediately after fasting can worsen nausea, bloating, and refluxdue to delayed stomach emptying from GLP-1.
• Solution:
  ✔ Start with small, protein-rich foods (Greek yogurt, eggs, dates with nut butter).
  ✔ Avoid deep-fried foods & heavy meals right away. Opt for soups, lean proteins, and slow-digesting carbs(lentils, quinoa, oats).
  ✔ Wait 15–30 minutes before having a full meal after breaking your fast.

• Risk: GLP-1 reduces appetite, and fasting limits the eating window → risk of under-eating, muscle loss, and nutrient deficiencies.
• Solution:
  ✔ High-protein Iftar & Suhoor → Aim for 1.2–1.6g protein per kg (chicken, fish, eggs, Greek yogurt, tofu).
  ✔ Healthy fats & fiber for sustained energy (avocados, nuts, seeds, olive oil, whole grains).
  ✔ Slow-digesting carbs at Suhoor to prevent energy crashes (sweet potatoes, oats, whole wheat bread).
  ✔ Consider protein shakes if appetite is too low to eat enough whole foods.

• Risk: If fasting while on diabetes medications (insulin, sulfonylureas, SGLT-2 inhibitors, etc.), hypoglycemia can be dangerous.
• Solution:
  ✔ Monitor blood sugar levels if you are diabetic.
  ✔ If feeling dizzy, weak, or excessively fatigued, break the fast early to avoid complications.
  ✔ Consult a doctor about adjusting diabetes medications.

• Risk: Exercising while fasting can lead to dizziness & fatigue.
• Solution:
  ✔ Best time to exercise? After Iftar or before Suhoor for energy balance.
  ✔ Strength training 2–3x per week to prevent muscle loss from calorie restriction.
  ✔ Walking or light activity before Iftar is ideal if heavy workouts feel too difficult.

• Some people pause GLP-1 medications during Ramadan if fasting becomes too difficult.
• If severe nausea, weakness, or difficulty eating enough, consider lowering the dose or spacing injections farther apart (for weekly GLP-1s).
• Always discuss with your doctor before stopping or adjusting doses.