Glucagon-Like-Peptide-1 Agonists, like Ozempic, have become extremely popular for weight loss. In fact, about 1 in 8 Americans have taken a GLP-1 drug at some point in their life, according to KFF health.
Drugs like Ozempic and Mounjaro are highly effective at curbing pounds. Participants that took Tirzepatide, which is the active ingredient in the weight loss drug Zepbound that is also a GLP-1 agonist, lost 15-21% of their body weight over a 72 week period, according to a study published in The New England Journal of Medicine.
These drugs can result in dramatic weight loss because they delay emptying of food from the stomach, which keeps people full for longer periods of time. In addition, they act on hunger centers in the brain to prevent and curb cravings.
In general, GLP-1 agonists are safe and well tolerated, but there can be some side effects that are important for everyone to know. Not everyone will experience side effects and some patients may experience some while others experience completely different ones.
Gastrointestinal Effects
By far, the most common side effects patients will have will be gastrointestinal side effects like nausea, vomiting, diarrhea and constipation. Nearly 1 in 5 people taking Ozempic can have nausea, according to WebMD. Many of these side effects can be managed by decreasing the dose, taking the drug with food, drinking water to stay hydrated and eating slower.
More rare but serious gastrointestinal side effects include stomach paralysis and intestinal obstruction. Because GLP-1 agonist drugs delay emptying of food from the stomach, food can get backed up in the stomach, preventing transit into the intestines which can paralyze and weaken the stomach. This can lead to a life-threatening condition known as bowel obstruction because food is not passing through the intestines in a timely manner. Signs and symptoms to look for would be severe abdominal pain, inability to pass gas or have a bowel movement, vomiting and bloating. If this starts to occur, you need to go to the emergency room immediately to be evaluated by a doctor. This condition can lead to malnutrition, dehydration and even death if not treated appropriately.
Other Serious But Less Common Side Effects
Rarely, GLP-1 agonists can cause a condition called acute pancreatitis, which is when your pancreas gets inflamed. When you have pancreatitis, you typically have severe abdominal pain that radiates to your back. This can also be life-threatening and you need to go the emergency room as soon as possible if you are experiencing such symptoms.
These drugs can also cause gallbladder problems, such as gallstones or even inflammation of the gallbladder which is known as cholecystitis. Patients with gallbladder issues typically have upper abdominal pain, and if the gallbladder is inflamed, can also have a fever. If you have a history of gallbladder disease, you should not take GLP-1 agonists.
Ozempic and Wegovy, both of which are GLP-1 agonists, can also result in vision changes. These drugs stimulate the pancreas to release insulin, which then decreases blood sugar levels. Changes in blood sugar can affect the shape of the lens of the eye which can result in blurry vision. Older patients are more at risk for this side effect, and vision changes can last for a couple months.
‘Ozempic Face’ And ‘Ozempic Butt’
The terms “Ozempic face” and “Ozempic butt” are not truly side effects of GLP-1 drugs, but rather consequences that occur from rapid weight loss from the face and rear end. Fat around the face and butt are crucial to maintain skin volume and elasticity. When that fat is lost quickly, the skin on the face and butt can hang and sag, resulting in the condition “Ozempic face” and “Ozempic butt”. These conditions can be treated or mitigated by decreasing dose, adequate hydration, increasing protein in the diet and with procedures like dermal fillers and other skin tightening procedures.
Risk Of Thyroid Cancer
Studies performed in rodents have shown a link between GLP-1 agonists and the development of a rare type of thyroid cancer known as medullary thyroid cancer. The good news is human studies have not currently shown a significant risk between these drugs and the development of thyroid cancer. In fact, among over 14,500 participants that were studied across multiple studies assessing the risk of thyroid cancer incidence and the use of Semaglutide (the active ingredient in GLP-1 agonists), the risk of thyroid cancer was less than 1%. However, more research still needs to be done and you should not take GLP-1 agonists like Ozempic if you have a family history of medullary thyroid cancer or a condition known as multiple endocrine neoplasia 2 that would increase your risk for such tumors.
Mental Health Concerns Like Suicidal Thoughts
Mental health concerns became an issue of importance with GLP-1 agonists when the FDA Adverse Event Reporting System received numerous reports of individuals who reported suicidal thoughts and ideations while taking GLP-1 agonist drugs. However, after a careful review by the FDA, the administration found no evidence that these drugs cause suicidal thoughts or actions. In addition, a study published in BMJ also found no increased risk of suicidal thoughts in patients with type 2 diabetes taking GLP-1 agonists when compared to two other diabetic drugs.
The FDA also noted that they could not rule out whether a small risk of suicidal thoughts and actions existed, and much more research would be needed to clarify if a real association existed. For these reasons, if taking drugs like Ozempic, you should report and seek medical attention immediately if you are having suicidal thoughts or have any changes in your mental health.
The Bottom Line
GLP-1 agonists like Ozempic offer a power tool for patients for both diabetes and weight loss. As with all drugs, they are not without risk and anyone considering these medications should have a thorough discussion with their doctor to weigh potential benefits and side effects. Also, with the popularity of these drugs soaring, the need for long-term safety data is paramount to ensure weight loss does not come at the cost of overall well-being.
