Popular weight-loss drugs may raise stomach paralysis risk in non-diabetics

TORONTO: While popular weight loss drugs like Wegovy, Ozempic may help you lose weight and fight diabetes, these may come with a heightened risk of severe gastrointestinal problems in people without the blood sugar condition, finds a study, led by an Indian-origin researcher.

The findings, published in JAMA, showed that the medications known as GLP-1 agonists, originally developed for managing Type-2 diabetes, which includes brands like Wegovy, Ozempic, Rybelsus and Saxenda, are associated with an increased risk of serious medical conditions including stomach paralysis, pancreatitis and bowel obstruction.

“Given the wide use of these drugs, these adverse events, although rare, must be considered by patients thinking about using them for weight loss,” said first author Mohit Sodhi, a graduate at the University of British Columbia’s (UBC) experimental medicine programme.

“The risk calculus will differ depending on whether a patient is using these drugs for diabetes, obesity or just general weight loss. People who are otherwise healthy may be less willing to accept these potentially serious adverse events,” he added.

The team examined health insurance claim records for approximately 16 million US patients and looked at people prescribed either semaglutide or liraglutide, two main GLP-1 agonists, between 2006 and 2020.

Compared to bupropion-naltrexone, another weight loss drug, GLP-1 agonists were associated with a 9.09 times higher risk of pancreatitis, or inflammation of the pancreas, which can cause severe abdominal pain and, in some cases, require hospitalisation and surgery.

People using the drugs were 4.22 times at higher risk of bowel obstruction, whereby food is prevented from passing through the small or large intestine, resulting in symptoms like cramping, bloating, nausea and vomiting.

Depending on the severity, surgery may be required.

The risk of gastroparesis, or stomach paralysis was 3.67 times higher.

The condition limits the passage of food from the stomach to the small intestine and results in symptoms like vomiting, nausea and abdominal pain.

The study also found a higher incidence of biliary disease, a group of conditions affecting the gallbladder, but the difference was not found to be statistically significant.

The researchers say that although the events are rare, with millions around the world using the drugs, it could still lead to hundreds of thousands of people experiencing these conditions.

“These drugs are becoming increasingly accessible, and it is concerning that, in some cases, people can simply go online and order these kinds of medications when they may not have a full understanding of what could potentially happen. This goes directly against the mantra of informed consent,” said Sodhi.

In the meantime, the researchers hope that regulatory agencies and drug makers will consider updating the warning labels for their products, which currently don’t include the risk of gastroparesis.

“This is critical information for patients to know so they can seek timely medical attention and avoid serious consequences,” said Sodhi.