Individuals who take common drugs for weight loss, such as Ozempic or Wegovy, may be at a high risk of severe stomach problems.
The researchers say, to create a connection between the use of such drugs, called GLP-1 agonists, for weight loss and the risk of such gastrointestinal conditions. GLP-1 agonists include semaglutide — the drug found in Ozempic and Wegovy — and liraglutide, the drug used in Saxenda. Both drugs are made by Novo Nordisk.
The drugs were initially developed to help individuals with Type 2 diabetes to control their blood sugar levels but were later found to be effective for weight loss.
GLP-1 medications work, in part, by slowing down how fast-food passes through the stomach, leading individuals to feel fuller longer. But they can also lead to gastrointestinal side effects, including vomiting, nausea and abdominal pain, as shown in clinical trials and noted on drug labels.
Recently the drugs have become extremely popular, which have reports of patients who developed stomach paralysis, or gastroparesis.
Until 2021, Wegovy was not approved. However, Ozempic, which has the same active ingredient semaglutide, was approved in 2017 and some doctors recommends it as off-label for weight loss.
Individuals included in the investigation had records of obesity and did not have diabetes, which itself can cause gastroparesis.
Compared to individuals taking bupropion-naltrexone, individuals taking a GLP-1 drug had a higher risk of pancreatitis, bowel obstruction and gastroparesis, the study found. There was no increase in risk for biliary disease, which has conditions which will affect the gallbladder, liver and the bile ducts, as its incidence was almost the same for both types of drugs.
Pancreatitis, or inflammation of the pancreatitis, happened at a rate of about 5 cases per 1,000 users of semaglutide and 8 cases per 1,000 users of liraglutide. The condition caused severe abdominal pain and, in some cases, hospitalization and surgery was needed.
Gastroparesis was seen at a rate of about 10 cases per 1,000 semaglutide users and 7 cases per 1,000 liraglutide users. The condition, which became difficult to treat, caused severe abdominal pain, nausea and vomiting.
Bowel obstructions — which happens when a blockage prevents food or liquid from moving through the intestines — were seen at a rate of 8 cases per 1,000 users of liraglutide. There were no observed cases in semaglutide users. Depending on how severe it is, surgery may be needed to treat a bowel obstruction.
However, although the conditions are rare, the medications’ widespread popularity means that if 1 million individuals are prescribed those drugs, tens or even hundreds of thousands of individuals could experience them.
Dr. Andres Acosta, a gastroenterologist at the Mayo Clinic, said the findings tell us that GLP-1 medications are usually safe but may have a risk of serious gastrointestinal side effects.
All along I have informed my patients that all medications including GLP-1s, contains certain amount of risk and we all know that the GLP-1 medications have a risk of vomiting, nausea and a delay of gastric emptying, says Acosta.
Dr. Susan Spratt, an endocrinologist and a senior medical director recommended that patients prescribed GLP-1 drugs should be counseled about starting the least dose and gradually increasing it, waiting at least four to six weeks before they escalate to the next dose.
Doctors should also research and find out the risk of pancreatitis, which includes a history of gallstones or past cases of pancreatitis, and avoid its risk factors, which include drinking alcohol while using the medication.
