The cases are raising red flags.
Concerns surrounding weight-loss medications such as Ozempic and Wegovy have been growing, with recent findings suggesting that approximately 25,000 Americans may have visited emergency rooms due to gastrointestinal complications linked to these drugs. Although side effects like nausea or vision disturbances are often considered rare, new research points to more frequent and severe health outcomes than previously thought.
A study published in the Annals of Internal Medicine examined data from 82 hospitals across the U.S. between January 2022 and December 2023. The analysis focused on emergency department visits connected to adverse reactions from semaglutide—the active ingredient in both Ozempic (primarily prescribed for type 2 diabetes but frequently used off-label for weight loss) and Wegovy (approved for weight management).
Semaglutide is a GLP-1 receptor agonist that affects appetite regulation by slowing gastric emptying and signaling fullness to the brain. While this mechanism aids weight loss, it can also result in digestive disturbances. Past research has linked semaglutide to symptoms such as nausea, vomiting, constipation, and diarrhea, with additional studies pointing to more severe conditions like gastroparesis (delayed stomach emptying), pancreatitis, and intestinal blockages.
The researchers identified 551 semaglutide-related ER cases and extrapolated that roughly 24,499 similar incidents may have occurred nationwide over the two-year period. While that number may sound alarming, it amounts to roughly four ER visits and fewer than one hospitalization for every 1,000 patients taking the medication. Of these visits, just under 18% resulted in hospital admission.
About 70% of the recorded cases involved gastrointestinal issues, with the most frequent complaints being nausea, vomiting, abdominal pain, and diarrhea. Around 15% of these GI-related cases required hospitalization. These issues align with prior reports and clinical data highlighting similar concerns.
In May 2024, findings from three separate studies reinforced the link between GLP-1 agonists and gastroparesis, a condition that hinders the stomach’s ability to process and move food effectively. Symptoms of gastroparesis include bloating, indigestion, reduced appetite, and abdominal discomfort. The disorder is thought to result from impaired muscle contractions and nerve activity in the stomach.
Another condition observed in connection with semaglutide is ileus, a type of intestinal blockage where digestive contents cannot progress through the bowels. This can sometimes occur alongside or as a result of gastroparesis.
The study also noted that 15.6% of semaglutide-related ER visits were due to hypoglycemia, with more than a third of those leading to hospitalization. While low blood sugar is a known risk when combining semaglutide with other antidiabetic drugs, it has not been widely reported among those using it as a standalone treatment. Still, factors like missed meals, increased physical activity, alcohol intake, or vomiting could trigger such episodes.
Additional ER visits—roughly 6%—were linked to allergic responses, while 9% were attributed to user errors, such as taking incorrect doses.
Novo Nordisk, the pharmaceutical company behind both Ozempic and Wegovy, responded to the findings by reaffirming the drugs’ safety when used appropriately. In a statement, the company noted that gastrointestinal effects are the most common side effects, all of which are listed in FDA-approved labeling.
Study co-author Dr. Pieter Cohen of Harvard Medical School emphasized that while serious reactions are uncommon, they are not negligible. He advised that patients should be informed about the risks before starting semaglutide and that their other medications should be adjusted to avoid complications such as hypoglycemia.
It’s also worth noting that the study relied on reports from healthcare professionals, which may introduce some bias or inconsistencies. Additionally, the data did not distinguish between FDA-approved medications and compounded versions of semaglutide, the latter of which are unregulated and pose additional risks. The FDA has recently cautioned against using these compounded alternatives due to safety and dosing concerns.
Ultimately, the study suggests that healthcare providers should clearly communicate the potential for serious gastrointestinal issues when prescribing semaglutide-based medications and take steps to reduce risks through proper monitoring and patient education.
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