What you need to know about the connection between stomach paralysis and Ozempic

This month’s new research is the latest to link the use of Ozempic, Wegovy and other GLP-1 drugs to a higher risk of gastroparesis, a potentially serious medical condition. So, what exactly is gastroparesis and how concerned should you be about it if you are taking or considering taking these medications?

Gastroparesis is defined simply as delayed gastric emptying. When the food reaches the stomach, the organ’s powerful muscles usually crush the food into smaller pieces and push the pieces to the small intestine without hassle. But in people with gastroparesis, these muscles slow down or stop working altogether (which is why it’s also commonly called stomach paralysis), causing delays in digestion.

Symptoms of gastroparesis vary, but may include: feeling full very quickly after a meal, nausea, vomiting, bloating, heartburn, and abdominal pain. The longer gastroparesis lasts, the more likely it is that serious symptoms such as severe dehydration, malnutrition, and unintentional weight loss will appear. Sometimes the delay caused can also allow food to clump together into a solid mass called a bezoar, which can obstruct the stomach and prevent anything from reaching the small intestine, a potentially fatal complication. Other times, people may experience few or no symptoms.

Most cases of gastroparesis are considered idiopathic, meaning they do not have a clear cause. But there are known risk factors, such as diabetes and certain medications. And over the years the evidence has been accumulate that GLP-1 medications are one of these risk factors. The most recent research comes from three preliminary studies presented last weekend during Digestive Disease Week 2024.

Two of these studies found a significantly higher risk of being diagnosed with gastroparesis in people who received GLP-1 compared to those who did not take the medication, while the third analyzed the health of people who received GLP-1. GLP-1 and who later developed it. Former patients have also started to pursue the creators of Ozempic, Wegovy, Mounjaro and Zepbound. These next generation GLP-1 drugs are significantly more effective in treating obesity than previous non-surgical options. The lawsuits allege that taking these medications led to serious complications, including gastroparesis.

An important consideration here is that gastroparesis appears to be rare, even for GLP-1 users. In one of the recent studies by researchers at University Hospitals in Cleveland, for example, 0.1 percent of obese people who received a GLP-1 drug for weight loss developed gastroparesis six months or more later, compared with 0.04% of patients of the same type who had not received gastroparesis. I did not prescribe GLP-1. This rarity may also help explain why clinical trials of these GLP-1 drugs have failed to find a link to gastroparesis, as one would need to study many people to see a clear trend, even if it were genuine.

Anecdotally, doctors have reported that stopping GLP-1 use generally helped relieve their patients’ gastroparesis, although some people have continued experience symptoms long after you stop taking the medicine. Diet changes or certain medications can also treat it, but severe or chronic cases may require more drastic interventions like IV nutrition or jejunostomy tube feedingwhere liquid food is sent through a tube inserted into the small intestine to bypass the stomach.

Currently, GLP-1 medications like Wegovy do not have labeling directly warning people of the potential risk of gastroparesis, although they note that these medications may delay gastric emptying, which could affect the absorption of other medications . But it’s certainly possible that the FDA will require an update to disclose this risk as new evidence emerges. Last fall, the agency mandated a change in Ozempic’s label mentioning the potential risk of ileus, or intestinal blockage, following reports of adverse events, but without confirming ileus as a side effect.

For now, gastroparesis also remains a suspected but unconfirmed side effect of GLP-1 use. And while it may be rare, it’s definitely a complication that doctors and patients will need to watch for when taking these medications.