We often report on alleged side effects of weight-loss drugs like Ozempic and Wegovy. They range from the positively peculiar (floppy feet) to the downright disturbing (loss of vision). But more often than not, these side effects are a rare exception. However, a new report shows that 25,000 Americans may have landed in the emergency room due to weight-loss drug complications related to gastrointestinal (GI) issues.
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Semaglutide-based weight loss drugs were behind nearly 25,000 ER visits, study finds.
A new study, published in the journal Annals of Internal Medicine, calculated the number of emergency room visits attributed by doctors to adverse effects from semaglutide. The data was collected from 82 U.S. hospitals from Jan. 1, 2022, to Dec. 31, 2023.
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is the active ingredient in Novo Nordisk's injectable drugs Ozempic (approved only for type 2 diabetes but taken off-label for weight loss) and Wegovy (approved for weight loss).
As Drugs.com explains, semaglutide targets the brain's GLP-1 receptors, which help regulate appetite. It also slows down how quickly food leaves your stomach. Therefore, it can help people feel fuller for longer and eat less.
The study notes that previous research has linked semaglutide with increased rates of nausea, diarrhea, vomiting, and constipation. Additional research found an increased risk of gastroparesis, pancreatitis, and bowel obstruction.
Therefore, the doctors and scientists involved in the latest study wanted to see how these gastrointestinal side effects correlated with emergency room visits. They recorded 551 semaglutide-related ER visits, which led them to estimate that, across the country, there were 24,499 such visits in just two years.
Though this number sounds quite large, it "translates to about four emergency department visits and less than one hospitalization for every 1,000 patients taking the drug," explains Health. Moreover, less than 18 percent of the total ER visits led to hospitalization.
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Most Ozempic- and Wegovy-related hospital visits were due to GI issues.
Of the total ER visits, nearly 70 percent involved GI issues, 15 percent of which led to hospitalization, reports Gizmodo. The most common side effects were nausea and vomiting, followed by abdominal pain and diarrhea.
Since drugs like Ozempic and Wegovy exploded in popularity, such GI issues have been well-documented.
In May 2024, data from three studies showed that taking GLP-1 agonists could increase one's risk of developing gastroparesis, also known as stomach paralysis. As Best Life reported at the time, the studies concluded that this class of drugs carries "a rare but consistent risk of gastroparesis."
This research followed a 2023 lawsuit against Ozempic's manufacturer, Novo Nordisk, claiming that they had failed to warn patients about the potential GI side effect.
But what exactly is gastroparesis?
"It’s a functional disorder affecting your stomach nerves and muscles," explains Cleveland Clinic. "It makes your stomach muscle contractions weaker and slower than they need to be to digest your food and pass it on to your intestines. This leads to food sitting too long in your stomach."
Common gastroparesis symptoms include nausea, vomiting, indigestion, bloating, loss of appetite, upper abdominal pain, blood sugar complications, and constipation.
In late 2023, another weight-loss-drug-related GI side effect came to light: Ileus, a bowel obstruction in which the contents of the intestine cannot pass through, according to MedLine Plus. Ileus is commonly related to gastroparesis.
Low blood sugar also led to ER visits.
The study found that another 15.6 percent of semaglutide-related ER visits were due to hypoglycemia, or low blood sugar. Of these, 38 percent led to hospitalization.
Study author Pieter Cohen, MD, internist at Cambridge Health Alliance and associate professor of medicine at Harvard Medical School, told Health that there have not been many previous reports of Ozempic and Wegovy leading to hypoglycemia, especially among people not taking other blood sugar-lowering medications such as insulin or sulfonylureas.
Though the information is unrelated to the study, Mayo Clinic notes that semaglutide may lead to low blood sugar if "you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting."
Another 6 percent of ER visits were tied to allergic reactions to semaglutide drugs, while 9 percent were caused by human error, including people taking more of the drug than instructed.
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Novo Nordisk responded to the study.
In speaking with People, Ozempic and Wegovy maker Novo Nordisk responded to the study's claims: "We stand behind the safety and efficacy of Ozempic when used as indicated."
"The safety and efficacy profile of Ozempic has been evaluated in clinical studies involving more than patients," they continued. "The most commonly reported side effects were gastrointestinal, including nausea, vomiting, diarrhea, stomach (abdominal) pain, and constipation. The known risks associated with use of Ozempic are reflected in the FDA-approved product labeling."
To this point, Cohen told Health, "We found that it’s very infrequent that semaglutide leads to very serious adverse events that would land a patient in the hospital, but that they do occur."
Other limitations of the study that are important to keep in mind include:
- The data was clinician-reported, meaning it could be skewed based on doctors' subjective diagnoses
- ER visits were not broken down by whether patients were taking Ozempic, Wegovy, or a non-FDA-approved compound medication prepared by a pharmacist. The FDA recently warned against compound medications, as they may be counterfeit. "They also typically come in vials instead of injection pens, meaning people have to measure out the dose themselves," Health explains.
However, the study authors concluded: "Clinicians could counsel patients when initiating semaglutide about the potential for severe gastrointestinal adverse effects and adjust co-prescribed antidiabetic medications to decrease hypoglycemia risk."
