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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 grow to be well-known for dramatic weight reduction, however each few weeks it additionally appears we hear that social media customers are shining a light-weight 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 effects in females. A few of these secondary results have been scientifically verified, whereas others are nonetheless simply anecdotal.
GLP-1 medicines could cause all or any of those signs.
On a regular basis Well being
A quick word: This text makes use of the model identify Ozempic to consult with semaglutide, the drug’s energetic ingredient. Semaglutide can also be marketed beneath two different names, Wegovy (when bought for weight reduction) and Rybelsus (within the type of a capsule slightly than an injection). Different associated medication, corresponding to liraglutide (Victoza) and tirzepatide (Mounjaro, Zepbound) might trigger among the similar unwanted effects.
Abdomen Issues: Nausea, Diarrhea, Vomiting, Belly Ache, and Constipation
These uncomfortable gastrointestinal troubles make up Ozempic’s most typical and most mentioned unwanted 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 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 |
| Belly ache | 5.7 p.c |
| Constipation | 3.1 p.c |
All informed, 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 larger 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 Frequent? |
|---|---|
| Nausea | 44.2 p.c |
| Vomiting | 24.8 p.c |
| Diarrhea | 31.5 p.c |
| Belly ache | 10.0 p.c |
| Constipation | 23.4 p.c |
At this, the best dosage of semaglutide obtainable, an unbelievable 74 p.c of contributors skilled not less than 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 Lower put it, “You would possibly undergo hell to your post-Ozempic physique.” The creator spoke to a 42-year-old lady 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 issues — almost 1 in each 20.
What’s one of the simplest ways to cope with these nasty issues? On a regular basis Well being’s community web site Diabetes Each day has a complete article on the topic.
Experiences from the Diabetes Each day discussion board counsel that these unlucky results are strongest within the days instantly after injecting the once-weekly medicine. Sufferers are additionally most probably to expertise issues once they begin on the drug or once they step as much as a better dosage; the unwanted effects generally fade away because the physique will get used to the medication.
Ozempic Burps
A foul-smelling burp isn’t precisely essentially the most debilitating of unwanted effects, however it may be slightly 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’s broad settlement that the burps odor like rotten eggs.
Solely a minority of semaglutide trials have recognized burping, or “eructation,” as a aspect impact. Anecdotal experiences counsel that the burps, like different gastrointestinal points, are worse when sufferers start taking their medication or step as much as larger dosages.
Bloating and Farting
These uncomfortable unwanted effects had been reported in scientific trials as “belly distension” and “flatulence.” Bloating and farting complaints are much less widespread than the gastrointestinal results mentioned above, they usually have but to catch on as sizzling matters on social media, however it’s good to know that Ozempic and associated medication might enhance their chance.
Abdomen Paralysis (Gastroparesis)
Weight reduction medication corresponding to Ozempic have been tied to a uncommon however elevated danger 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 medication.[5] Dozens of lawsuits have been filed towards the producers of GLP-1 medicines, in response to Reuters, alleging that the makers didn’t sufficiently warn customers concerning the danger of extreme unwanted effects corresponding to gastroparesis.[6]
Gastroparesis is a situation wherein the abdomen empties too slowly or stops; it causes a wide range of gastrointestinal signs together with bloating, belly 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 danger of dehydration or malnutrition.
Delayed abdomen emptying, the defining function of gastroparesis, is a recognized consequence of Ozempic and associated medication. This delayed emptying partially accounts for a few of Ozempic’s optimistic results, serving to to cut back starvation and provoke weight reduction. Additionally it is chargeable for much less extreme unwanted effects, corresponding to gastrointestinal discomfort.
Fortunately, extreme and chronic gastroparesis seems to be very uncommon. The symptom was not recognized in any of the drug’s section 3 trials, which enrolled 1000’s of contributors to guage semaglutide’s security.
Short-term 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 danger of ileus, a kind of intestinal blockage.[8] In keeping with the Cleveland Clinic, ileus happens when “the muscle contractions that transfer meals by 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 scientific trials, which evaluated semaglutide in 1000’s of contributors. In its up to date steering, the FDA famous, “As a result of these reactions are reported voluntarily from a inhabitants of unsure dimension, it’s not all the time attainable to reliably estimate their frequency or set up a causal relationship to drug publicity.”
Ozempic Face and Ozempic Butt
“Ozempic face” might 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 isn’t any proof that Ozempic or every other comparable drug instantly impacts your look. Consultants appear to agree that Ozempic face and Ozempic butt are purely brought on by weight reduction. The identical flabby outcomes can and can happen once you shed weight the old style approach, or by different medical strategies corresponding to bariatric surgical procedure.
It seems that not all weight reduction enhances your look. Whenever you lose a number of weight, you may additionally lose some healthy-looking fats that you simply’d want to maintain in locations like your face or butt. Fast weight reduction may result in saggy pores and skin: The pores and skin is an adaptable and elastic organ, however 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 usually a matter of oral hygiene.[10] Meals particles and micro organism within the mouth can create foul odors. Although in some circumstances unhealthy breath (halitosis) can sign a extra substantial medical situation, specialists appear unworried that Ozempic breath is a severe signal.
How does Ozempic trigger unhealthy breath? One attainable clarification is Ozempic’s tendency to trigger dry mouth (xerostomia). Saliva helps to cleanse the mouth, and a scarcity of saliva can enable micro organism to fester, develop, and get pungent. Although dry mouth was not initially reported amongst semaglutide’s recognized unwanted effects, it has been extensively mentioned in social media and clinicians have revealed experiences of utmost circumstances.[11]
“Keto breath” may clarify some circumstances of Ozempic breath. This aspect impact is widespread when folks swap to a keto weight loss plan, which strictly limits the variety of carbohydrates you might be allowed to eat. Keto breath, which tends to have a fruity aroma, is brought on by 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 could 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, basically the identical medicine. Three p.c of contributors within the drug’s pivotal trial reported hair loss (3 instances as many as those that used a placebo).[2]
Like Ozempic face and Ozempic butt, nevertheless, that is merely a standard consequence of fast weight reduction. Dramatic weight reduction, irrespective of the way it’s triggered, 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 step by step grew out in all sufferers.”[14]
Hopefully, the minority of Ozempic customers who lose some hair on the drug may have the identical good luck.
Ozempic Aspect Results in Females
So far as analysis goes, most of semaglutide’s unwanted effects are widespread to each women and men, and there’s no particular interplay between GLP-1 medication and feminine hormones. However there are specific Ozempic unwanted effects that particularly have an effect on girls.
Ozempic Infants
We could also be experiencing an Ozempic child increase. Throughout social media, girls are crediting shock pregnancies to their GLP-1 medicine.
Although there’s no stable knowledge on the phenomenon, specialists agree that Ozempic has a variety of 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 might simply enhance a lady’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’s additionally an opportunity, nevertheless, that Ozempic might intrude with the contraception capsule. Right now, there isn’t a scientific proof that this occurs, however a associated drug within the class, tirzepatide (Mounjaro, Zepbound), carries warnings on its FDA labels that it “might cut back the efficacy of oral hormonal contraceptives as a result of delayed gastric emptying.” Sufferers are suggested to modify to a non-oral type of contraception or so as to add a barrier technique, corresponding to 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.
Girls who’ve misplaced weight with Ozempic and different GLP-1 medicines are complaining that their breasts have a saggy or deflated look. However there isn’t a proof that Ozempic has a specific impact on breast tissue. Slightly, any change in breast form is sort of actually because of the fast and substantial weight reduction that these medication so regularly trigger. Girls who’ve misplaced weight with different strategies have seen the identical situation.
Tiredness and Fatigue
There are experiences that Ozempic could cause fatigue — principally, tiredness or exhaustion that isn’t improved by sleep. The FDA label for semaglutide (Wegovy) experiences that 11 p.c of trial contributors skilled fatigue, slightly 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 gas into your physique, basically 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 attainable that Ozempic dizziness stems from the glucose-lowering results of the drug — dizziness is a standard symptom of hypoglycemia. Even sufferers who will not be susceptible to extreme hypoglycemia (sometimes those that don’t use insulin or sulfonylureas) might 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-about wholesome and pure.
Some specialists, nevertheless, imagine that Ozempic and associated medication are inflicting a shocking and worrying quantity of muscle loss.
We solely have a modicum of fine knowledge 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 count on to see. A evaluation revealed in 2017 said that individuals utilizing different strategies to shed weight are likely 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 critically, 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 might be sensible for customers to interact in strength-building workouts to assist protect muscle mass throughout weight reduction. Consuming sufficient protein may assist.
This potential aspect impact may be a very good reminder that Ozempic is inappropriate for individuals who shouldn’t have a very good medical purpose to shed weight.
Reduction From Meals Noise, Need to Drink, and Addictive Behaviors
Many Ozempic customers are amazed to search out that they’re partaking in much less addictive and compulsive habits. In some way the drug seems to cut back our damaging tendency to overindulge in actions like ingesting, purchasing, 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 appearing instantly within the mind.[20] We all know that Ozempic doesn’t simply assist you really feel full quicker, 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 habit.”[21] It additionally calmed down the mind’s dopamine circuitry. A number of scientific trials are actually 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 might be prescribed as a remedy for addictive or compulsive habits. However within the meantime, it might assist customers with extra than simply compulsive consuming.
Suicidal Ideas
Authorities well being authorities in the USA, 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, nevertheless, 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 analogous announcement.[23]
Right now, the official FDA labels for Wegovy and Zepbound proceed to warn that there’s a danger of suicidal ideation, however the company clarified in its announcement that the warning relies on proof from “older medicines used or examined for weight reduction.”
Elevated Coronary heart Price
There’s been comparatively little on-line chatter about this aspect impact, which is famous on Ozempic’s FDA label. In scientific trials, decrease doses of Ozempic “resulted in a imply enhance in coronary heart fee 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 fee ought to discontinue the medicine.
Whereas this aspect impact appears disconcerting, it’s value remembering that semaglutide and tirzepatide have overwhelmingly optimistic results on coronary heart well being. Semaglutide was just lately accredited as a remedy for the prevention of coronary heart assaults, and preliminary research counsel that tirzepatide additionally imparts broad cardiovascular advantages.[24]
Diabetic Retinopathy
Individuals with diabetes ought to know that there’s some proof that Ozempic might 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 danger of diabetic retinopathy,[25] and the FDA has reported {that a} considerably larger share of Ozempic customers have DR as compared with customers of comparable medication like dulaglutide (Trulicity) and liraglutide (Victoza).[26] The connection is disputed, nevertheless, as one other massive research of semaglutide discovered no such danger.[27]
If the connection is actual, it appears attainable that Ozempic’s unbelievable effectiveness explains its unfavorable 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 most important long-term advantages of higher blood sugar management grow to be evident.
A current dialogue of the problem by specialists from the American Academy of Ophthalmology steered that “early worsening” from Ozempic is each non permanent and manageable, though it does name for elevated scrutiny from eye medical doctors.[28]
There isn’t any proof that individuals with out diabetes have any purpose to fret about their eyesight on Ozempic.
Low Blood Sugar (Hypoglycemia)
Whereas Ozempic in all probability doesn’t itself trigger hypoglycemia, its glucose-lowering impact can sharply enhance the chances that different medication, principally insulin or sulfonylureas, trigger hypoglycemia. If Ozempic lowers your baseline blood sugar degree, your outdated dosage of glucose-lowering medicine might now be greater than you want.
If in case you have diabetes and also you’re beginning a brand new GLP-1, you might want to alter the dosages of the opposite diabetes medication that you simply use. Your physician may ask you to be additional vigilant about checking your blood sugar. If you happen to’re not snug altering your insulin-dosing practices by your self, you ought to be able to contact your physician between visits to get steering on making changes.
Erectile Dysfunction
A research revealed in February 2024 revealed that males with out diabetes who use semaglutide might be 10 instances extra more likely to expertise erectile dysfunction, (1.4 p.c complete, 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 outcome shocked the research’s authors as a result of weight reduction often improves erectile dysfunction.[30] The science remains to be unclear, nevertheless, as different research have discovered that GLP-1 medicines can really enhance testosterone ranges and enhance erectile dysfunction.[31][32]
There are lots of therapies for erectile dysfunction, each pharmaceutical and pure.
Uncommon, Severe Aspect Results
Semaglutide additionally results in a small variety of uncommon however doubtlessly severe unwanted effects:
- Pancreatitis This situation, wherein the digestive enzymes assault the pancreas, might 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 effects, significantly diarrhea and vomiting, might improve this danger. Nonetheless, for most individuals the drug seems to have a optimistic impact on kidney well being.
- Gallbladder Illness This will likely 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 creating thyroid most cancers, which has been noticed in research of rodents. A European well being authority, nevertheless, has introduced that it couldn’t discover any hyperlink in people.[34]
There have additionally been some experiences of allergic reactions to GLP-1 receptor agonists.
Ozempic is highly effective stuff: If you happen to’re experiencing a response you could’t clarify, please attain out to your healthcare supplier.
