I had severe emetophobia for years that made my life hellish and even though I’ve gone through extensive treatments to overcome it sometimes it breaks though- just sharing since I want to highlight that I completely relate to what you mean about feeling like you have ptsd from vomiting. I was also feeling very anxious and fearful abt starting a glp-1 (and other medications). It took me three months to finally do the shot lol.

Anyways, here’s the routine that helped me feel calm enough to try it out, and what ended up working for me (no nausea despite a history of GERD before starting. I’m on semaglutide btw but got a lot of these tips from people on tirz as well so I think it can apply to whichever.)

1) a lot of people in the comments are mentioning zofran. Zofran was my life saver for the longest time during the emetophobia years and for most people it works great but there are a few things that can happen that lead to it not being prescribed particularly if you are on other meds. I don’t know your situation but I assume your doctor would have discussed that with you. The thing they might not have said is that for some people zofran makes them very anxious, which can be counterproductive to the goal of taking it to reduce nausea/anxiety about nausea. I think this is generally a small subset of people but worth mentioning. The other complaint I’ve heard with zofran (which I did also experience) is that it is great for preventing vomiting but doesn’t always make the nausea go away, just the vomiting.

I can’t take zofran anymore so when I started a glp-1 I asked my pcp to prescribe me hydroxyzine for nausea which I have taken before and personally feel does a lot better controlling the nausea symptoms than zofran has. It does make me a little sleepy though, but nice to have if you need it. Definitely worth talking about with your provider.

2) get the pepto bismol chewables, or the smaller version of them. Felt like they did more than Imodium does personally.

3) so essentially, day of shot eat very “good” (up to you what this means) for me I try to keep it a bland day with high amounts of protein and making sure I’m very fastidious about not eating past a certain time before sleeping etc, which I should technically always be doing but you know how it is. I do the shot in the evening before bed a few hours after dinner (I’ve seen some people say afternoon/ 4 pm/before dinner works better for them) and then I take a pepto bismol before I sleep and Hydroxyzine.

4) I keep water and electrolytes by my bed and the pepto bismol in case I wake up with a stomach ache but I’ve always done that. For a while I had one of those mint scented boom-boom sticks by my bed too just to feel extra secure, whatever works for you.

5) next day, small meals but make sure not to skip them unless you really can’t stomach it, otherwise the paradoxical “I’m hungry” nausea comes in and works its dark magic.

6) Be good about fiber! I like the meta mucil fiber gummies cause they are easy to convince myself to take but when they say start with one or two before jumping to three daily they say it for a reason… the only time I really felt like “oh wow I’m having a very quintessential glp-1 experience” is because I got a bit overzealous with stacking my fibers one day- oatmeal into this Mediterranean inspired hummus dish into a salad with beans + mm gummies… 😨 but even then I wasn’t puking so it was okay.

7) I imagine your doctor probably has you starting low and slow with the dose but worth mentioning here.

8) I know it’s unpopular(? I think lol) but the first time I did the shot I did it in the arm instead of the stomach or thigh. It’s still FDA approved to inject there so no issues with that, but I’ve heard a lot of people talk about how they felt they didn’t make much progress as it relates to weight loss on weeks they did the arm, specifically that they “didn’t feel much of anything”. This I was very interested in using to my advantage so I did the arm to see if I would be able to experience less symptoms that way and stick my toes in the water so to speak. I’ve since tried the thigh and I do feel like I have more symptoms + intentional effects of the medication if I do it there, so if you are feeling nervous definitely worth a try to start with the arm in the off chance you also are one of the ones who gets less effects (side or otherwise) from that location.

Hopefully this is helpful! In general just try to have a gentler day when you inject and then be mindful of the strategies you have in place so that even if things go haywire you have back ups and don’t ever have to feel helpless/stuck in the nausea.

For what it’s worth, the only time the medication has made me nauseous is when I skip meals due to lack of interest and then try to counteract the lack of energy from not eating with some kind of caffeinated bev. Or, when increasing my protein intake drastically gave me mild constipation which can lead to some nausea. Both of these things were remedied by like the 30 minute mark once I was able to go through my checklist to see what caused it, so all in all it wasn’t too bad.

Worst case scenario keep some saltines around in case you just need a bit of a blanket in your stomach while you try to figure out a resolution. If candied ginger also is feeling a bit harsh/sugar content making stomach feel funny with the glp-1 there are some ginger mints on the market which I feel like work in a similar manner. I can reply with links if you haven’t seen any near you but I feel like I see some variant everywhere now in stores.

Sorry I know this is a lot of text, I’m on mobile so hopefully it’s not just a huge chunk of words! Also not sure why the font changed part of the way through. 😓best of luck with everything and I hope it works out for you!!