Feeling Cold All the Time on a GLP-1? Here’s Why It Happens
If you’re on a GLP-1 medication like semaglutide or tirzepatide and suddenly find yourself reaching for a sweater while everyone else feels fine, you’re not alone. Feeling cold is a surprisingly common experience on GLP-1 therapy, and for most people, it’s completely expected.
As a healthcare provider, this is something I hear from patients often. The good news is that it usually isn’t a sign that something is wrong. It’s your body adjusting to changes that come with weight loss and improved metabolic health.
Let’s break down what’s really going on in a way that actually makes sense.
1. Loss of Body Fat Means Less Insulation
One of the main reasons people feel colder on a GLP-1 is simple physics. Body fat acts as insulation. As you lose fat, especially in the early stages of weight loss, your body has less natural protection against the cold.
This is why people often notice feeling cold even when weight loss is happening at a healthy pace. It’s not the medication making you cold directly. It’s the result of your body composition changing.
2. Your Metabolism May Be Running More Efficiently
GLP-1 medications help regulate appetite and improve how your body uses energy. As your calorie intake decreases, your resting energy expenditure can also drop slightly. That means your body is burning fewer calories at rest.
Calories equal energy, and energy creates heat. When your body is producing less heat, you may notice you feel colder than usual, especially when sitting still or at night.
This doesn’t mean your metabolism is damaged. It means your body is becoming more efficient.
3. Eating Less Means Less Heat Production
Every time you eat, your body produces heat during digestion. This is called diet-induced thermogenesis. When meals become smaller or less frequent, that heat production drops.
Many people on GLP-1s are eating fewer calories and spacing meals out more, which can contribute to feeling cold throughout the day.
4. Circulation Changes Can Play a Role
Weight loss and reduced inflammation can change circulation patterns. Some people notice colder hands and feet as blood flow redistributes throughout the body.
This is usually harmless but can feel uncomfortable, especially in cooler weather.
Is Feeling Cold on a GLP-1 Normal?
For most people, yes. Feeling cold is a common and expected side effect of weight loss and metabolic changes. It often improves over time as your body adapts.
However, if the cold sensitivity feels extreme, persistent, or is accompanied by symptoms like fatigue, dizziness, hair loss, or shortness of breath, it’s worth checking in with your healthcare provider.
What Can Help If You’re Always Cold?
A few simple adjustments can make a big difference:
Make sure you’re eating enough protein and not drastically under-fueling
Stay well hydrated
Avoid skipping meals entirely unless guided by a provider
Consider checking iron levels, B12, and thyroid labs if symptoms are ongoing
Dress in layers and prioritize warmth during early weight loss phases
When to Talk to a Provider
If feeling cold is severe, worsening, or interfering with daily life, labs may be helpful to rule out issues like anemia or thyroid dysfunction. While GLP-1s don’t directly cause these conditions, weight loss can sometimes uncover them.
The Bottom Line
Feeling cold on a GLP-1 doesn’t usually mean something is wrong. It’s often a sign that your body is adapting to weight loss, lower calorie intake, and improved metabolic efficiency.
Your body is recalibrating, and that takes time.
If you ever feel unsure or uncomfortable with symptoms, don’t ignore them. Ask questions, advocate for yourself, and work with a provider who understands GLP-1 therapy.
Ready to start GLP1 therapy? Check out your options HERE-