Oct. 5, 2023 – People taking popular medications like Ozempic, Wegovy, and Rybelsus for weight loss are at higher risk for potentially serious stomach and intestinal issues, compared to people taking a weight loss drug approved in 2014, a large study reveals.
Those taking one of these drugs, known as glucagon-like peptide-1 (GLP-1) receptor agonists, were nine times more likely to have pancreatitis, an often painful inflammation of the pancreas, compared to others taking a combination of naltrexone and bupropion for weight loss (brand name Contrave).
Other findings show that people taking these drugs:
- Were over four times more likely to get a bowel obstruction, which prevents food from going through the large or small intestines, with symptoms like nausea, vomiting, cramping and/or bloating
- Were more than three-and-a-half times more likely to get stomach paresis, a blockage of food in the stomach that can cause nausea, vomiting, and stomach pain
The study was published today in the Journal of the American Medical Association.
Researchers say their findings are not about scaring people off the weight loss drugs, but instead about increasing awareness that these potential adverse outcomes can happen. That way, people can consider the risks and benefits before starting these medications.
Rare But There
People taking these drugs for weight loss have about a 1% to 2% chance of having these events, including a 1% risk for stomach paresis, said Mahyar Etminan, PharmD, the study’s senior author and an expert in drug safety and pharmacoepidemiology at the University of British Columbia in Vancouver, Canada.
Given the popularity and wide use of these drugs, these adverse events, although rare, “must be considered by patients thinking about using them for weight loss,” co-author Mohit Sodhi, a graduate of the University of British Columbia’s Experimental Medicine Program and fourth year medical student, said in a news release about the study.
People taking a GLP-1 to treat diabetes might be more willing to accept the risks, Etminan said, given their potential advantages, especially for lowering the risk of heart problems. “But those who are otherwise healthy and just taking them for weight loss might want to be more careful in weighing the risk/benefit equation,” he said.
Stomach Blockage Warning
This is not the first report of GI issues linked to these medications, but it’s one of the largest. Most reports have been about a few people with stomach and other issues.
The FDA announced on Sept. 28 that it would require drugmakers to include a warning about intestinal blockages on the Ozempic label.
Regarding ileus, the medical term for intestinal blockage, “this is yet another condition Ozempic users might experience,” said Steven Batash, MD, a leading doctor at the Batash Endoscopic Weight Loss Center in New York City. He was not involved in the study.
"There are a few GI conditions that are more likely among people using agents like Ozempic for weight loss, including a more rare side effect – gastroparesis, also known as stomach paralysis,” said Batash, a gastroenterologist with NYU Medical Center, Lenox Hill Hospital, and New York-Presbyterian Hospital. Semaglutide, the active ingredient in these medications, slows down digestion in the stomach and, in rare cases, can cause gastroparesis, he explained.
The new study’s findings are based on health insurance claim records for about 16 million U.S. patients. Sodhi and colleagues looked at people prescribed either semaglutide or liraglutide (Saxenda), two main GLP-1 agonists, between 2006 and 2020. FDA approval of GLP-1s for weight loss did not come until 2021, so the researchers also included people whose records showed a recent history of obesity.
One limitation of looking at medical records is the researchers were not able to confirm people were only taking semaglutide or liraglutide for weight loss. Some people may have been taking them for diabetes or both.
