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By Ross Wollen
Medically Reviewed by Sean Hashmi, MD
Ozempic and different medication within the GLP-1 receptor agonist household have quickly develop into well-known for dramatic weight reduction, however each few weeks it additionally appears we hear that social media customers are shining a lightweight on one other new Ozempic aspect impact. These reactions embody hair loss, fierce gastrointestinal misery, uncommon (however extreme) abdomen paralysis, and a few distinctive Ozempic unwanted side effects in females. A few of these secondary results have been scientifically verified, whereas others are nonetheless simply anecdotal.
GLP-1 drugs may cause all or any of those signs.
On a regular basis Well being
A quick notice: This text makes use of the model title Ozempic to discuss with semaglutide, the drug’s lively ingredient. Semaglutide can also be marketed beneath two different names, Wegovy (when bought for weight reduction) and Rybelsus (within the type of a tablet quite than an injection). Different associated medication, reminiscent of liraglutide (Victoza) and tirzepatide (Mounjaro, Zepbound) could trigger a number of the similar unwanted side effects.
Abdomen Issues: Nausea, Diarrhea, Vomiting, Stomach Ache, and Constipation
These uncomfortable gastrointestinal troubles make up Ozempic’s most typical and most mentioned unwanted side effects by far.
Whereas a majority of customers don’t understand these pains, a really substantial minority do. In keeping with the U.S. Meals and Drug Administration (FDA), placebo-controlled trials of Ozempic discovered the next charges of unwanted side effects from the 1 milligram (mg) dose:[1]
Gastrointestinal Aspect Results of Ozempic (1mg)
| SIDE EFFECT | HOW COMMON? |
|---|---|
| Nausea | 20.3 p.c |
| Vomiting | 9.2 p.c |
| Diarrhea | 8.8 p.c |
| Stomach ache | 5.7 p.c |
| Constipation | 3.1 p.c |
All advised, 30.8 p.c of adults reported a gastrointestinal symptom.[1] However that was solely the 1 mg dose, half of the utmost. The numbers had been a lot greater in a trial of semaglutide (Wegovy) at 2.4 mg in folks with out diabetes:
Gastrointestinal Aspect Results of Wegovy (2.4mg)
| Aspect Impact | How Widespread? |
|---|---|
| Nausea | 44.2 p.c |
| Vomiting | 24.8 p.c |
| Diarrhea | 31.5 p.c |
| Stomach ache | 10.0 p.c |
| Constipation | 23.4 p.c |
At this, the best dosage of semaglutide obtainable, an unbelievable 74 p.c of individuals skilled at the least one gastrointestinal dysfunction, although it’s value noting that just about 50 p.c of those that took a placebo additionally had some tummy troubles.[2]
For some, the gastrointestinal misery is simply an excessive amount of to deal with, and they should cease taking Ozempic solely. As a blogger for New York journal’s The Reduce put it, “You would possibly undergo hell in your post-Ozempic physique.” The writer spoke to a 42-year-old girl with diabetes who endured “fixed nausea” and “power-puking” for weeks, earlier than lastly weaning herself off the drug.[3] In a pivotal trial, 4.5 p.c of Wegovy sufferers stopped taking the medicine as a direct results of gastrointestinal problems — practically 1 in each 20.
What’s the easiest way to take care of these nasty issues? On a regular basis Well being’s community website Diabetes Every day has a whole article on the topic.
Reviews from the Diabetes Every day discussion board recommend that these unlucky results are strongest within the days instantly after injecting the once-weekly medicine. Sufferers are additionally almost definitely to expertise issues once they begin on the drug or once they step as much as a better dosage; the unwanted side effects generally fade away because the physique will get used to the drugs.
Ozempic Burps
A foul-smelling burp isn’t precisely probably the most debilitating of unwanted side effects, however it may be quite disagreeable. As reported in The Atlantic, and mentioned in lots of YouTube and TikTok movies, some folks taking Ozempic discover themselves emitting nasty sulfurous smells once they belch.[4] There may be broad settlement that the burps scent like rotten eggs.
Solely a minority of semaglutide trials have recognized burping, or “eructation,” as a aspect impact. Anecdotal reviews recommend that the burps, like different gastrointestinal points, are worse when sufferers start taking their medication or step as much as greater dosages.
Bloating and Farting
These uncomfortable unwanted side effects had been reported in medical trials as “stomach distension” and “flatulence.” Bloating and farting complaints are much less frequent than the gastrointestinal results mentioned above, they usually have but to catch on as scorching matters on social media, nevertheless it’s good to know that Ozempic and associated medication could enhance their probability.
Abdomen Paralysis (Gastroparesis)
Weight reduction medication reminiscent of Ozempic have been tied to a uncommon however elevated threat of extreme abdomen issues. In July 2023, CNN reported that some semaglutide customers had skilled gastroparesis, or abdomen paralysis, which in some circumstances didn’t get higher even months after discontinuing the drugs.[5] Dozens of lawsuits have been filed towards the producers of GLP-1 drugs, in keeping with Reuters, alleging that the makers didn’t sufficiently warn customers concerning the threat of extreme unwanted side effects reminiscent of gastroparesis.[6]
Gastroparesis is a situation by which the abdomen empties too slowly or stops; it causes quite a lot of gastrointestinal signs together with bloating, stomach ache, nausea, and vomiting.[7]
Within the worst circumstances, gastroparesis could make it very tough to eat or drink something in any respect, resulting in a threat of dehydration or malnutrition.
Delayed abdomen emptying, the defining characteristic of gastroparesis, is a recognized consequence of Ozempic and associated medication. This delayed emptying partially accounts for a few of Ozempic’s constructive results, serving to to scale back starvation and provoke weight reduction. It is usually liable for much less extreme unwanted side effects, reminiscent of gastrointestinal discomfort.
Fortunately, extreme and chronic gastroparesis seems to be very uncommon. The symptom was not recognized in any of the drug’s part 3 trials, which enrolled 1000’s of individuals to judge semaglutide’s security.
Non permanent Intestinal Paralysis (Ileus)
Abdomen paralysis isn’t the one extreme gastrointestinal aspect impact that customers have reported.
In late September 2023, the FDA up to date the official Ozempic label to warn customers of a possible threat of ileus, a kind of intestinal blockage.[8] In keeping with the Cleveland Clinic, ileus happens when “the muscle contractions that transfer meals by means of your intestines are briefly paralyzed,” trapping meals throughout the intestine. The signs resemble these of a bodily bowel obstruction, together with bloating and constipation, and the situation can result in dehydration.[9]
Ileus is probably going a uncommon aspect impact — it wasn’t recognized in earlier medical trials, which evaluated semaglutide in 1000’s of individuals. In its up to date steerage, the FDA famous, “As a result of these reactions are reported voluntarily from a inhabitants of unsure measurement, it’s not all the time doable to reliably estimate their frequency or set up a causal relationship to drug publicity.”
Ozempic Face and Ozempic Butt
“Ozempic face” could have been the primary Ozempic aspect impact to go viral. Quickly after, the sample repeated itself when claims of “Ozempic butt” hit headlines. In every case, customers complained that the drug had given some a part of their our bodies a shocking and unlucky flabby look.
There’s nothing to fret about. There is no such thing as a proof that Ozempic or some other related drug instantly impacts your look. Consultants appear to agree that Ozempic face and Ozempic butt are purely attributable to weight reduction. The identical flabby outcomes can and can happen if you shed weight the old style manner, or by means of different medical strategies reminiscent of bariatric surgical procedure.
It seems that not all weight reduction enhances your look. If you lose numerous weight, you may also lose some healthy-looking fats that you just’d favor to maintain in locations like your face or butt. Speedy weight reduction may also result in saggy pores and skin: The pores and skin is an adaptable and elastic organ, nevertheless it can’t snap immediately again right into a taut form. Profitable dieters have struggled with these points since lengthy earlier than Ozempic got here on the scene.
Ozempic Breath and Dry Mouth
Unhealthy breath is often a matter of oral hygiene.[10] Meals particles and micro organism within the mouth can create foul odors. Although in some circumstances dangerous breath (halitosis) can sign a extra substantial medical situation, specialists appear unworried that Ozempic breath is a critical signal.
How does Ozempic trigger dangerous breath? One doable clarification is Ozempic’s tendency to trigger dry mouth (xerostomia). Saliva helps to cleanse the mouth, and an absence of saliva can enable micro organism to fester, develop, and get smelly. Although dry mouth was not initially reported amongst semaglutide’s recognized unwanted side effects, it has been extensively mentioned in social media and clinicians have revealed reviews of maximum circumstances.[11]
“Keto breath” might also clarify some circumstances of Ozempic breath. This aspect impact is frequent when folks swap to a keto weight loss plan, which strictly limits the variety of carbohydrates you’re allowed to eat. Keto breath, which tends to have a fruity aroma, is attributable to acetone, a by-product of ketosis. It’s possible that some Ozempic customers have unintentionally adopted a ketogenic consuming sample because of their diminished appetites — consuming 50 grams or much less of carbohydrates per day can set off ketosis.
Hair Loss
Ozempic may cause hair loss. Whereas it isn’t listed as a aspect impact on Ozempic’s FDA label, hair loss is listed on the FDA’s label for Wegovy, primarily the identical medicine. Three p.c of individuals within the drug’s pivotal trial reported hair loss (3 occasions as many as those that used a placebo).[2]
Like Ozempic face and Ozempic butt, nonetheless, that is merely a standard consequence of fast weight reduction. Dramatic weight reduction, regardless of the way it’s prompted, usually causes hair loss. This science is well-established. For instance, a research of crash dieters revealed in 1974 discovered a number of circumstances of “profuse hair loss.”[12] And greater than half of people that obtain bariatric surgical procedure expertise hair loss, too.[13]
The excellent news: One research discovered that “hair loss stopped and new hair progressively grew out in all sufferers.”[14]
Hopefully, the minority of Ozempic customers who lose some hair on the drug can have the identical good luck.
Ozempic Aspect Results in Females
So far as analysis goes, most of semaglutide’s unwanted side effects are frequent to each women and men, and there’s no particular interplay between GLP-1 medication and feminine hormones. However there are specific Ozempic unwanted side effects that particularly have an effect on ladies.
Ozempic Infants
We could also be experiencing an Ozempic child growth. Throughout social media, ladies are crediting shock pregnancies to their GLP-1 medicine.
Although there’s no strong information on the phenomenon, specialists agree that Ozempic has numerous totally different options that would account for elevated fertility. Weight problems itself has lengthy been recognized to trigger subfertility and infertility, so the dramatic weight reduction related to Ozempic may simply enhance a girl’s probabilities of conceiving.[15] The impact could also be even stronger when weight reduction and metabolic enhancements assist enhance or alleviate a situation like polycystic ovary syndrome (PCOS).
There may be additionally an opportunity, nonetheless, that Ozempic may intrude with the contraception tablet. In the present day, there is no such thing as a scientific proof that this occurs, however a associated drug within the class, tirzepatide (Mounjaro, Zepbound), carries warnings on its FDA labels that it “could scale back the efficacy of oral hormonal contraceptives attributable to delayed gastric emptying.” Sufferers are suggested to change to a non-oral type of contraception or so as to add a barrier technique, reminiscent of condoms.[16]
Ozempic Breasts
First, there was Ozempic face, then, there was Ozempic butt. Lastly, complaints of “Ozempic breasts” hit headlines within the spring of 2024.
Ladies who’ve misplaced weight with Ozempic and different GLP-1 drugs are complaining that their breasts have a saggy or deflated look. However there is no such thing as a proof that Ozempic has a selected impact on breast tissue. Relatively, any change in breast form is sort of actually because of the fast and substantial weight reduction that these medication so often trigger. Ladies who’ve misplaced weight with different strategies have observed the identical concern.
Tiredness and Fatigue
There are reviews that Ozempic may cause fatigue — mainly, tiredness or exhaustion that isn’t improved by sleep. The FDA label for semaglutide (Wegovy) reviews that 11 p.c of trial individuals skilled fatigue, just a little bit greater than twice as usually as those that used a placebo.
It’s unclear why Ozempic would trigger fatigue, though one very believable clarification is the truth that it causes folks to eat a lot much less meals. Ozempic causes excessive weight reduction by encouraging customers to eat at an excessive calorie deficit. You’re placing much less gasoline into your physique, primarily crash weight-reduction plan. Is it any surprise that Ozempic would possibly sap your vitality?
Dizziness
Dizziness has additionally been reported in a slim minority of Ozempic customers. It’s doable that Ozempic dizziness stems from the glucose-lowering results of the drug — dizziness is a standard symptom of hypoglycemia. Even sufferers who aren’t vulnerable to extreme hypoglycemia (sometimes those that don’t use insulin or sulfonylureas) could really feel dizzy whereas experiencing transient low blood sugar episodes.
Extreme Muscle Loss
It’s inevitable that weight reduction will contain some muscle loss. That is thought of wholesome and pure.
Some specialists, nonetheless, consider that Ozempic and associated medication are inflicting a shocking and worrying quantity of muscle loss.
We solely have a modicum of fine information on this query. Physique composition analyses of volunteers in two trials discovered that semaglutide customers misplaced about 40 p.c lean mass and 60 p.c fats.[17] That is extra muscle loss than researchers anticipate to see. A evaluation revealed in 2017 said that individuals utilizing different strategies to shed weight are inclined to lose solely 20 to 30 p.c lean mass.[18]
In February 2024, The New York Occasions reported that the producers of GLP-1 medication are taking the issue significantly, and have begun to develop mixture drug therapies that would assist customers of Ozempic and associated medication protect lean mass.[19]
Within the meantime, specialists agree that it could be sensible for customers to interact in strength-building workout routines to assist protect muscle mass throughout weight reduction. Consuming sufficient protein might also assist.
This potential aspect impact might also be a superb reminder that Ozempic is inappropriate for individuals who don’t have a superb medical purpose to shed weight.
Aid From Meals Noise, Want to Drink, and Addictive Behaviors
Many Ozempic customers are amazed to seek out that they’re partaking in much less addictive and compulsive habits. In some way the drug seems to scale back our damaging tendency to overindulge in actions like ingesting, buying, playing, and even biting our nails.
The science right here remains to be in its infancy, however it seems that one of many causes Ozempic is ready to stem starvation cues is by performing instantly within the mind.[20] We all know that Ozempic doesn’t simply enable you to really feel full sooner, it really lowers your yearning for meals, switching off the meals noise that compels some folks to perpetually fixate on their subsequent snack or meal. And it appears as if the drug reduces your yearning for different issues, too.
Consultants have recognized for years that GLP-1 receptor agonists might need these behavioral results. In a research of exenatide (Byetta), mind scans confirmed that the drug lowered exercise in “essential mind areas for drug reward and dependancy.”[21] It additionally calmed down the mind’s dopamine circuitry. A number of medical trials at the moment are underway to discover the potential of GLP-1 medication as anti-addiction medicine.
We’re years away from the day that Ozempic or any associated drug may very well be prescribed as a remedy for addictive or compulsive habits. However within the meantime, it may assist customers with extra than simply compulsive consuming.
Suicidal Ideas
Authorities well being authorities in the US, and European Union initially signaled concern that semaglutide and different GLP-1 medication had been inflicting ideas of suicide and self-harm.
An intensive evaluation of the proof, nonetheless, seems to have set these considerations to relaxation. In January 2024, the FDA introduced that it couldn’t establish a “causal hyperlink” between GLP1 medication and suicidal ideas or actions.[22] In April, EU regulators made an identical announcement.[23]
In the present day, the official FDA labels for Wegovy and Zepbound proceed to warn that there’s a threat of suicidal ideation, however the company clarified in its announcement that the warning is predicated on proof from “older medicines used or examined for weight reduction.”
Elevated Coronary heart Fee
There’s been comparatively little on-line chatter about this aspect impact, which is famous on Ozempic’s FDA label. In medical trials, decrease doses of Ozempic “resulted in a imply enhance in coronary heart price of two to three beats per minute.” Some sufferers have discovered the expertise uncomfortable.
The FDA advises sufferers to “inform their healthcare suppliers of palpitations or emotions of a racing heartbeat whereas at relaxation.” Those that expertise “sustained” will increase in resting coronary heart price ought to discontinue the medicine.
Whereas this aspect impact appears disconcerting, it’s value remembering that semaglutide and tirzepatide have overwhelmingly constructive results on coronary heart well being. Semaglutide was not too long ago accredited as a therapy for the prevention of coronary heart assaults, and preliminary research recommend that tirzepatide additionally imparts broad cardiovascular advantages.[24]
Diabetic Retinopathy
Individuals with diabetes ought to know that there’s some proof that Ozempic could enhance the incidence of diabetic retinopathy, a type of eye illness that may result in imaginative and prescient loss. In keeping with Pharmacy Occasions, one in every of a number of pivotal research of semaglutide discovered an elevated threat of diabetic retinopathy,[25] and the FDA has reported {that a} considerably greater proportion of Ozempic customers have DR compared with customers of comparable medication like dulaglutide (Trulicity) and liraglutide (Victoza).[26] The connection is disputed, nonetheless, as one other massive research of semaglutide discovered no such threat.[27]
If the connection is actual, it appears doable that Ozempic’s unbelievable effectiveness explains its detrimental impact on the eyes. Opposite to all expectations, fast enchancment in glucose management can really worsen diabetic retinopathy. That is referred to as “early worsening,” as a result of the eyes will worsen earlier than the key long-term advantages of higher blood sugar management develop into evident.
A latest dialogue of the problem by specialists from the American Academy of Ophthalmology prompt that “early worsening” from Ozempic is each momentary and manageable, though it does name for elevated scrutiny from eye docs.[28]
There is no such thing as a proof that individuals with out diabetes have any purpose to fret about their eyesight on Ozempic.
Low Blood Sugar (Hypoglycemia)
Whereas Ozempic most likely doesn’t itself trigger hypoglycemia, its glucose-lowering impact can sharply enhance the percentages that different medication, principally insulin or sulfonylureas, trigger hypoglycemia. If Ozempic lowers your baseline blood sugar stage, your previous dosage of glucose-lowering medicine could now be greater than you want.
When you’ve got diabetes and also you’re beginning a brand new GLP-1, you could want to alter the dosages of the opposite diabetes medication that you just use. Your physician might also ask you to be additional vigilant about checking your blood sugar. In the event you’re not comfy altering your insulin-dosing practices by your self, you have to be able to contact your physician between visits to get steerage on making changes.
Erectile Dysfunction
A research revealed in February 2024 revealed that males with out diabetes who use semaglutide may very well be 10 occasions extra more likely to expertise erectile dysfunction, (1.4 p.c whole, vs solely 0.14 p.c in a management group). The danger of hypogonadism (low testosterone) additionally sharply elevated.[29] The report confirmed anecdotal proof on social media, the place some males have complained that the drug has lowered their intercourse drive or made it harder to take care of an erection.
This consequence stunned the research’s authors as a result of weight reduction often improves erectile dysfunction.[30] The science remains to be unclear, nonetheless, as different research have discovered that GLP-1 drugs can really enhance testosterone ranges and enhance erectile dysfunction.[31][32]
There are numerous therapies for erectile dysfunction, each pharmaceutical and pure.
Uncommon, Critical Aspect Results
Semaglutide additionally results in a small variety of uncommon however probably critical unwanted side effects:
- Pancreatitis This situation, by which the digestive enzymes assault the pancreas, could really feel like intense abdomen ache that radiates to your again.
- Kidney Failure Analysis signifies that some circumstances of semaglutide contribute to kidney illness.[33] Dehydrating unwanted side effects, significantly diarrhea and vomiting, could improve this threat. Nonetheless, for most individuals the drug seems to have a constructive impact on kidney well being.
- Gallbladder Illness This will trigger extreme abdomen ache, yellowing of the eyes or pores and skin, fever, and “clay-colored stools.”
- Thyroid C-Cell Tumors Semaglutide’s FDA labels warn of the danger of growing thyroid most cancers, which has been noticed in research of rodents. A European well being authority, nonetheless, has introduced that it couldn’t discover any hyperlink in people.[34]
There have additionally been some reviews of allergic reactions to GLP-1 receptor agonists.
Ozempic is highly effective stuff: In the event you’re experiencing a response which you could’t clarify, please attain out to your healthcare supplier.
