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Women taking the diabetes drug Ozempic may have an extra reason to pat their bellies. Not only does the injectable drug cause weight loss, a finding that has sparked off-label demand worldwide, but in recent months it has also been linked to a surprise baby boom.
Scientists are now trying to understand the mechanism behind the “Ozempic babies” phenomenon, which has also been reported by users of similar drugs. This is important: These drugs have never been tested for use in women who are pregnant or trying to conceive, and animal studies of Ozempic’s key active ingredient, semaglutide, suggest a link to birth defects.
Today, the number of people taking weight-loss drugs makes them a pressing health issue. These drugs are prescribed for diabetes, obesity, and weight-related complications, but they also appear to improve heart and kidney health. Hence the calls for more widespread prescription, lower prices by drugmakers, and coverage by insurers. But it seems presumptuous to consider these drugs essential when their long-term impact, including on the health of babies born to these people, remains unknown.
Ozempic belongs to a class of injectable drugs known as glucagon-like peptide-1 receptor agonists (GLP-1 agonists). These drugs were originally developed to treat diabetes: they slow down processes in the stomach, which helps control blood sugar and insulin production. But its active ingredient, semaglutide, also suppresses appetite and causes weight loss. This has sparked off-label demand beyond diabetes and spawned similar drugs targeting obesity. There are other injectable drugs approved for diabetes and weight management: Ozempic and Wegovy contain semaglutide; Mounjaro and Zepbound contain tirzepatide.
This year, some users, mainly of Ozempic, began sharing stories of unexpected pregnancies, with the hashtag #OzempicBabies trending on social media. Some had already had trouble conceiving; others were on birth control at the time (as the prescribing guidelines clearly recommend). While there are no precise figures on how many people are affected, Novo Nordisk, the maker of Ozempic and Wegovy, has started a pregnancy registry to track babies through their first year of life. A spokesperson for Eli Lilly, which makes Mounjaro and Zepbound, said the company had not studied tirzepatide’s effect on fertility and said it should not be used by pregnant women or those hoping to conceive. And a Novo Nordisk spokesperson stressed that semaglutide should not be used during pregnancy and that the company does not endorse, suggest or encourage any use outside of the approved indications.
Most researchers believe the baby boom is simply due to weight loss boosting fertility. Diabetes and obesity are known to disrupt the menstrual cycle and ovulation; both conditions reduce female fertility and increase the risk of miscarriage and other complications. They also harm male fertility by compromising sperm quality.
But Charlotte Moffett, a pharmacology researcher at Ulster University, thinks the problem may be more complex, because the receptors targeted by weight-loss drugs are also found in the reproductive system. “These GLP-1 receptors… are in the pituitary gland and the hypothalamus,” she told me. “We see them on the ovaries, on the testes, and all along the endometrial lining.” That means they could be involved in hormone production, ovulation and implantation, as well as male fertility. Her hunch is that gut hormones play a role in fertility, which could one day lead to treatments for infertility. But not yet. Although small observational studies suggest that babies born to women taking weight-loss drugs appear healthy, Moffett said, the safety data is far too sparse to be reassuring.
Where does this leave us? Weight-loss drugs are increasingly being touted as miracle drugs, capable of reducing obesity, diabetes, and many other diseases. This provides immediate benefits to individuals, employers, healthcare providers, and society – a good thing. But the long-term effects, including on fetal development, are not quantified. More targeted studies must be a priority, and clearer warnings about the risks are needed.
This is all the more urgent as many young women scour social media for health information and online pharmacies. Weight-loss drugs could now be seen as solutions to two deeply rooted aspects of female identity: body image and motherhood. For those desperate for a child, the hashtag #OzempicBabies will not be a red light but a call to action.
anjana.ahuja@ft.com
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