Weight loss drugs may be linked to stomach paralysis and other rare but serious problems, study says

Blockbuster weight loss and diabetes drugs like Wegovy and Ozempic may be associated with an increased risk of three rare but serious stomach illnesses in nondiabetic patients, according to a new epidemiological study released Thursday.

The study, published in the research journal JAMA, comes as Novo Nordisk’s Wegovy, Ozempic and similar treatments soar in popularity in the U.S. for their ability to cause dramatic weight loss over time. But these drugs, known as GLP-1, are also facing increasing scrutiny after some patients reported experiencing stomach paralysis and suicidal ideation while taking them.

GLP-1s slow digestion to suppress a person’s appetite, but can cause problems if this process is too slow.

Researchers at the University of British Columbia said the conditions in the study include a disorder not mentioned on the warning labels for these medications: stomach paralysis, which slows or completely stops the movement of food from the stomach to the intestine and can cause symptoms such as persistent vomiting.

The study also notes an increased risk of intestinal obstruction, a disorder in which food is blocked from passing through the small or large intestine, and pancreatitis, which refers to inflammation of the pancreas. Drug labels already include warnings about pancreatitis and certain types of intestinal obstruction.

Researchers specifically looked at semaglutide, the active ingredient used in Wegovy and Ozempic, and another GLP-1 called liraglutide, compared to another weight loss treatment called bupropion-naltrexone, which works differently to help patients lose weight. Weight. Wegovy is approved specifically for weight loss in the US, while Ozempic is only approved for diabetes.

Their research is the first large population-level study to examine the risk of serious stomach problems in non-diabetic patients who specifically use GLP-1 for weight loss.

Previous studies have highlighted the risk of these conditions in diabetic patients taking GLP-1, according to the researchers. People with diabetes are also at greater risk of suffering from stomach paralysis and pancreatitis in general, even without treatment.

“That’s why we wanted to take diabetes out of the equation,” said Mohit Sodhi, one of the study’s authors. “In addition to the fact that millions of people around the world use these medications to help them lose weight.”

A Novo Nordisk spokesperson noted that some of the study’s gastrointestinal side effects are already included in the labels for its GLP-1s, adding that the company “stands by the safety and effectiveness of all of our GLP-1 medicines when used in manner consistent with product labeling and approved indications.”
“We recommend that patients take these medications according to approved indications and under the supervision of a healthcare professional,” the spokesperson said. “Treatment decisions should be made in conjunction with a healthcare professional who can assess the appropriateness of using GLP-1 based on assessment of the patient’s individual medical profile.”

The study’s findings are based on an analysis of health insurance claims records for nearly 16 million U.S. patients.

The researchers specifically looked at people with a recent history of obesity who were prescribed semaglutide or liraglutide between 2006 and 2020. They excluded those with diabetes or patients who were prescribed another diabetes medication.

Most patients in the study received liraglutide, but researchers said the increased risks they observed could apply to the entire GLP-1 drug class.

“The end date for our data was the end of 2020, whereas the recent semaglutide boom happened last year,” Sodhi said. “However, we believe it is a class effect.”

Researchers measured the rate at which patients developed four different serious stomach illnesses while taking semaglutide, liraglutide, and bupropion-naltrexone, which are stomach paralysis, pancreatitis, intestinal obstruction, and biliary disease, a group of conditions that affect the gallbladder.

Compared with bupropion-naltrexone, GLP-1s were associated with a 9-fold increased risk of pancreatitis, a 4-fold increased risk of intestinal obstruction and a more than 3-fold increased risk of stomach paralysis, according to the study. These conditions are greater in patients who specifically take GLP-1 rather than other weight loss medications that work differently.

About 7 out of 1,000 patients experienced stomach paralysis while taking liraglutide, and nearly 10 out of 1,000 patients experienced this condition while taking semaglutide.

And Sodhi noted, “the number continues to rise when you bring it up to the population level.”

“When there are more than a million people taking the drug worldwide, that’s 10,000 people who could suffer from gastroparesis based on the semaglutide incidence rate,” he told CNBC. “It’s rare, but it’s still a lot of people.”

Nearly 5 out of every 1,000 patients experienced pancreatitis while taking semaglutide, while about 8 out of every 1,000 patients experienced this condition while taking liraglutide.

Meanwhile, about 8 out of every 1,000 patients experienced intestinal obstruction while taking any of these GLP-1s.

The researchers also found a high rate of biliary disease in patients taking liraglutide or semaglutide, but said the difference was “not considered statistically significant.”

Researchers hope the study will inform healthcare providers who prescribe GLP-1 about the potential downsides of taking the medications.

“We are all big advocates of informed patient consent,” Sodhi said. “If someone has decided they would like to take a GLP-1 for weight loss, we encourage them to talk to their provider about how it can help them achieve their goals. taking this medicine.”