Shift work on treatment: steady routines when your hours change

Early, late and night shifts move meals and sleep away from the body's usual daily rhythm. The German statutory accident insurance explains that unusual meal times can affect how the digestive system works, and that a shifted sleep rhythm can influence hunger and fullness signals (DGUV, Leben mit Schichtarbeit).

The EU product information for these medicines lists reduced appetite and digestive symptoms such as nausea among common effects (EMA product information). Together with shift work, this means it can help to plan meals ahead rather than rely on hunger alone.

German public nutrition advice recommends keeping a regular daily meal rhythm during shift work. Before a night shift, a balanced evening meal is suggested. During the night, a small, light and easy-to-digest snack, such as a vegetable soup, a sandwich or a wrap, fits better than a large meal. In the second half of the night, eating little or nothing is advised, and a light breakfast after the shift can stop hunger from disturbing your sleep (BMLEH; DGE JOB&FIT).

Smaller, calmer meals may also feel more comfortable if you notice nausea or early fullness. If the canteen or vending machine doesn't suit you, prepare meals and snacks at home and take them with you (BMLEH).

Drink regularly across your shift, including at night. Water and unsweetened tea are good choices, and you may need more with heavy physical work or in hot or dry air (BMLEH; DGUV).

Enjoy caffeinated drinks in moderation and avoid them in the hours before you plan to sleep, because caffeine can disturb sleep. Public advice also recommends avoiding alcohol after a shift, especially if you have trouble falling asleep (BMLEH; DGE JOB&FIT).

Daytime sleep is easier in a dark, quiet and cool room. Blackout curtains or an eye mask and a short, fixed routine before bed can help your body wind down (DGSM patient guide; NHS).

Try not to go to bed hungry or with a very full stomach, as both can disturb sleep (DGSM). If sleep problems continue, talk to your GP. The German Sleep Society describes structured treatments for insomnia that can also help people who work shifts (DGSM).

Each weekly injection and daily tablet comes with its own instructions on timing, for example a fixed day each week, or how to take a tablet in relation to food and drink. You find these in the package leaflet (EMA product information).

If your rota makes your usual day or time hard to keep, ask your prescribing doctor or pharmacist how to plan it. Do not move, skip or double a dose without advice. A doctor reviews your details and decides on the prescription.

Contact your doctor promptly about severe or worsening symptoms, such as persistent vomiting, being unable to keep fluids down, signs of dehydration, fainting, severe stomach pain that may spread to the back, chest pain or shortness of breath. The EMA product information lists such symptoms as reasons to seek medical advice. If you feel dizzy or faint, do not drive or operate machinery at work, and seek advice. Get urgent help for sudden or unclear symptoms. If you have severe side effects, contact a doctor straight away, the out-of-hours service on 116117 or, in an emergency, 112.

You can also report suspected side effects to the authorities; in Germany through the BfArM and PEI reporting portal. Your own GP remains an important part of your care.

This Journal article offers general information about shift work during prescribed weight-management treatment. It is not a diagnosis, a prescription or a promise of any result. Your prescribing doctor decides on suitability, dose changes and personal limits after clinical review. This article is for information and does not replace medical advice.