Ozempic, Other GLP-1 Meds Highly Effective But Come With Risks

Ozempic is a highly effective drug for treating type 2 diabetes and promoting weight loss, but like many medications, it brings a long list of potential side effects and risks. It’s important to discuss these risks with your physician whenever you’re considering a new medication in your healthcare journey.

Injectable weight loss medications like Ozempic have exploded in popularity in recent years for helping people drop excess weight fast, manage blood sugar, and curb appetite. While numerous medications have come to market at different times to aid weight loss and treat type 2 diabetes, they all belong to a class of drugs called GLP-1 receptor agonists. Glucagon-like peptide 1 (GLP-1) is a gut hormone that regulates appetite and signals the brain to release insulin; GLP-1 medications mimic this natural process.

Medication has its place in the treatment of type 2 diabetes and obesity. However, it’s expensive and can be hard to find (its surge in popularity led to disruptions in the supply chain). Most health insurance companies won’t cover weight loss injectable medications over the long term, and once you stop taking them, you’ll gain most of your excess weight back. That’s why, for many people, non-surgical weight loss procedures like endoscopic sleeve gastroplasty and gastric balloons are more sustainable, effective, and cost-efficient over the long term.

Still, for people who can afford and tolerate GLP-1 medications, they are very effective tools.

Common Side Effects of GLP-1 Medications

GLP-1 weight loss injectable medications, including Ozempic, Wegovy, Mounjaro, Zepbound, and Saxenda, come with a wide range of side effects. Most are considered mild and may even improve over time. Stomach pain, nausea, vomiting, constipation, and diarrhea are the most common. Less common mild side effects include headache, dizziness, tachycardia (increased heart rate), and flatulence.

You can usually manage mild symptoms at home with these simple tips:

• Quell nausea by avoiding strong smells, chewing on mints, or eating crackers or ginger-based food and drinks about 30 minutes after taking your GLP-1 medication.
• Drink plenty of water to avoid dehydration from vomiting and diarrhea.
• Staying hydrated also helps ease constipation. Fiber, too, will keep your bowels moving, but back off high-fiber foods if you start to experience loose stools and diarrhea, or if you feel overly full.  
• You can ease your symptoms by eating smaller amounts of food more frequently, avoiding physical exertion after eating, and paying careful attention to your satiety – avoid getting too full and uncomfortable.

Another side effect of rapid weight loss is changes to your appearance. “Ozempic face” is a term coined for more noticeable wrinkles, sunken eyes, and gauntness that comes with losing a lot of weight very quickly. Some people may also notice sagging skin around their jaw and neck and changes in the size of their cheeks, lips, and chin.

Unfortunately, GLP-1 injectable medications have also been linked to more serious health complications, including:

• Diabetic retinopathy: High blood sugar can damage the blood vessels in the eye, causing vision problems and even blindness. In rare cases, the GLP-1 medications can accelerate this process.
   
• Gallbladder disease: Gallstones are hard masses of undissolved bile or cholesterol that form in the gallbladder. They can lead to an obstruction of the bile ducts, which floods the liver with excess bile, leading to pain, inflammation, and jaundice-like symptoms. If left untreated, a bile duct blockage can cause life-threatening problems, including infection and death.  
  
  
• Kidney problems: Research around how GLP-1 medications affect kidney function is mixed. In patients who experience severe vomiting and diarrhea leading to dehydration, these medications can damage the kidneys and exacerbate existing problems with kidney function. On the other hand, type 2 diabetes can also cause kidney damage, so GLP-1s show promising results in lowering the risk of kidney disease in patients with type 2 diabetes. It’s always smart to talk to your doctor, assess your risk of kidney disease, and monitor your symptoms closely to get the right treatment plan for you.
  
  
• Pancreatitis: Inflammation and swelling in the pancreas is a rare, and potentially life-threatening complication associated with GLP-1 use. If unrecognized or untreated, pancreatitis can be fatal. For this reason, any severe or persistent abdominal pain should be immediately reported to your medical provider.
  
  
• Thyroid cancer: GLP-1 medications may increase your risk of thyroid cancer, especially if you have a family history of medullary thyroid cancer or you have a rare genetic disorder called multiple endocrine neoplasia type 2. Signs of thyroid cancer include shortness of breath, wheezing, trouble swallowing, a pain or lump in your neck, and a hoarse voice.
  
  
• Hypoglycemia: Low blood sugar can cause dizziness, confusion, shakiness, chills, sweating, increased hunger, blurred vision, and more serious symptoms like seizures. Hypoglycemia is more common if you’re taking a GLP-1 medication alongside insulin or other diabetes medication. Following a consistent meal plan and schedule can help keep blood sugar levels stable. You may need to adjust your insulin dosage to prevent episodes of hypoglycemia.
  
  
• Gastroparesis: Slow stomach emptying is part of what makes GLP-1 medications effective for weight loss, but for some people, this can lead to persistent nausea, vomiting, foul-smelling belching, severe constipation, and even stomach paralysis.
  
  
• Bowel obstruction: Stomach paralysis can cause partially digested food to get stuck in the digestive tract, causing potentially life-threatening complications. The FDA has received reports of more than 30 bowel obstructions (including two deaths) in patients taking Ozempic, Wegovy, or Mounjaro.
  
  
• Allergic reaction: Some people may have a life-threatening allergic reaction to GLP-1 medications. Shortness of breath, hives, chest tightness, trouble swallowing, wheezing, and abdominal pain are all symptoms of anaphylaxis and require immediate medical attention.

It’s important to monitor your symptoms whenever you start a new medication. If you experience severe vomiting and/or diarrhea, jaundice (yellowing of the skin and eyes), an inability to make a bowel movement or pass gas, or severe pain or tenderness in your abdomen, you should seek medical help immediately.

Effective Alternatives to GLP-1 Medications

If you’re looking for alternatives to GLP-1 weight loss medications, True You Weight Loss can help.

True You Weight Loss is the highest-volume endoscopic weight loss center in the country, and we offer a personalized, comprehensive approach to helping our patients achieve their weight loss goals over the long term. Here is a brief overview of the non-surgical procedures we offer:

• Endoscopic Sleeve Gastroplasty (ESG): Endoscopic sleeve gastroplasty (ESG) is a non-surgical, incisionless, minimally invasive procedure that reduces the overall stomach size by 70 to 80%, promoting rapid, long-term weight loss. Patients recover in a matter of days, and on average lose 20-23% of their total body weight.
• Gastric Balloons: This non-invasive, fully-reversible weight loss procedure involves the non-surgical, temporary placement of a small silicone balloon in the stomach. The 15-minute, outpatient procedure helps jumpstart weight loss and has been proven to help patients lose 3-4x more weight than most experience with diet and exercise alone. Patients experience a feeling of fullness that limits food intake.
• Bariatric Revisional Procedures: For patients who have previously undergone a gastric bypass or gastric sleeve surgery but have experienced weight regain, these non-surgical procedures offer patients a second chance at bariatric surgery success. Using advanced suturing tools, our highly-trained endoscopists can help restore the original pouch or sleeve to its original size, facilitating rapid, safe and effective weight loss – all without surgery.

Dr. Lauren Donnangelo, Dr. Daniel Maselli, and Dr. Christopher McGowan are among the few physicians in the nation who are triple board-certified in internal medicine, gastroenterology, and obesity medicine. They are nationally recognized for their expertise in endoscopic suturing, having performed thousands of non-surgical weight loss procedures. Their unrivaled level of experience means better outcomes, greater weight loss, and long-term success for patients.

If you’d like to learn more about endoscopic weight loss procedures, please contact us to request a consultation.