Keto and Semaglutide: A Risky Combination?

Keto and semaglutide

Keto and Semaglutide: A Risky Combination?

Two strategies for health and weight loss have become popular in recent years: keto and semaglutide. Keto is a specific restrictive eating program and semaglutide is a medication designed to help with weight loss and regulate blood sugar levels.

As with any health intervention, though, it’s important to understand both the benefits and possible risks involved.

This blog post will explore the potential risks and considerations of combining keto and semaglutide. We will examine if this combination is a risky one.

What is the Keto Diet?

Keto is a high-fat, low-carbohydrate diet used for weight loss.

Keto diet

It works by pushing your body into a state of ketosis, in which it burns fat for fuel rather than glucose. To achieve this, you must drastically reduce your carb intake and replace it with healthy fats.

The following is a typical breakdown of the keto diet, showing percentages of the total calorie intake. 

Fats 70-80%

Proteins 10-20%

Carbohydrates 5-10%

What does this mean?

It means you will be mostly eating fat, a very small serving of protein, and almost zero carbs. In addition, you can eat non-starchy vegetables.

How Does Ketogenic Dieting Work?

When you eat a low amount of carbohydrates, your body enters a metabolic state called ketosis. Instead of burning carbohydrates for energy, the body burns fat in this state. The production of ketones occurs during ketosis, and they can serve as an energy source for the body.

This often results in decreased hunger and appetite. That makes the keto diet easy to follow in the short term and effective for weight loss.

Potential Side Effects

GI Issues

The keto diet can cause abdominal pain, constipation, diarrhea,, and vomiting for some individuals.

Not everyone can handle the keto diet, and while the digestive problems may eventually resolve, it’s important to keep them in mind as a possible complication.

Nutrition Deficiencies

The keto diet is very restrictive, as it only allows a small amount of carbohydrates, including fruit. The main source of calories in this diet is fat. This means that foods high in fiber, vitamins, and minerals are limited.

For this reason, keto followers have a higher risk of experiencing nutritional deficiencies.

What is Semaglutide?

Semaglutide is a medication that helps people manage their blood sugar levels and lose weight. Semaglutide is the generic name for Ozempic and Wegovy.

Ozempic is a once-weekly injection that helps improve blood sugar control and weight loss in adults with type 2 diabetes.

Wegovy is a once-monthly injection to help you lose weight if you are obese or overweight, together with lifestyle changes.

Semaglutide injection

How Does Semaglutide Work?

Semaglutide works by copying the action of the naturally occurring hormone GLP-1. GLP-1 is released in the body after eating and triggers the release of insulin, which regulates blood sugar.

This prescription medication also reduces hunger and suppresses appetite by activating satiety hormones.

Semaglutide is usually prescribed in conjunction with lifestyle changes, like exercise and dietary adjustments, to help you achieve the best results.

According to clinical trials, people who take semaglutide lose an average of 15% of their body weight over a year.

Common Side Effects

GI Issues


Semaglutide—especially when used together with other medicine that will lower blood sugar—can increase the risk of hypoglycemia (low blood sugar). Symptoms may include sweating, dizziness, weakness, and confusion.

Semaglutide and Malnutrition

Some people using semaglutide may be at risk of malnutrition due to decreased appetite and food intake.

It’s important that individuals taking semaglutide are properly monitored by their doctor and receive counseling on nutrition, physical activity, and other lifestyle changes to ensure they get adequate nutrition while managing their weight.

Can You Combine the Keto Diet and Semaglutide?

Before you follow a keto diet while taking semaglutide, consider the following.

It Can Lead to Nutrition Deficiencies

Semaglutide works by decreasing appetite, and it’s very effective. Thus, it’s important for the goal of a combined nutrition plan to be optimizing the nutrients in the food you eat. Doing so can prevent nutritional deficiencies that can significantly affect your health.

The keto diet encourages you to consume most of your calories from fat, which is the least nutrient-dense food group.

As you can see, you are more likely to develop nutrition deficiencies when these two weight loss methods are combined. However, I am mostly speaking from experience with my clients and my knowledge as a dietitian. There is a need for more research on this topic. 

It Can Lead to a Very Low-Calorie Diet

As we have established, semaglutide reduces how much a person eats. The amount of fat in keto-friendly meals can also lead to feelings of fullness after a few bites.

At first glance, a very low-calorie diet seems positive if you want to lose weight. But, when taken too far, it can lead to nutrition deficiencies and fatigue. Furthermore, if your intake of calories is too low for too long, it can have a negative impact on your metabolism.

GI Issues

Both the keto diet and semaglutide are known for their gastrointestinal side effects, including constipation, diarrhea, nausea, and vomiting.

My Expert Opinion

Because of the risk of nutrition deficiencies and potential worsening of GI symptoms, I don’t recommend combining the keto diet and semaglutide. Instead, I guide my clients to a healthy diet that optimizes nutrition intake.

Semaglutide diet plan

If you are interested in more information about the best diet for semaglutide, check these articles:

Semaglutide Diet Plan [For Weight Loss]

What to Eat While Taking Wegovy

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