People who have taken drugs like Ozempic or Wegovy, known for their potential to induce significant weight loss, are speaking out about the serious side effects they have experienced. Joanie Knight from Louisiana, Brenda Allen from Dallas, and Emily Wright from Toronto have all had distressing encounters with the medications.
Joanie Knight regrets ever trying these drugs, stating that they have made her life a living hell, causing financial strain, stress, and disruptions in her family life. Brenda Allen, who was prescribed Wegovy for weight loss, has been grappling with persistent problems even after discontinuing the medication, leading to dehydration due to severe vomiting. Emily Wright, a teacher, experienced impressive weight loss with Ozempic but has been battling frequent vomiting, leading her to take a leave of absence from work.
Ozempic and Wegovy, which share the same medication called semaglutide, belong to a family of drugs that mimic a hormone naturally produced in the body, GLP-1. This hormone plays a role in slowing down the passage of food through the stomach, contributing to a sense of fullness. However, if the stomach slows down excessively, it can cause complications.
Knight and Wright have both been diagnosed with severe gastroparesis, commonly referred to as stomach paralysis, which they believe might have been triggered or worsened by Ozempic. Wright also received a diagnosis of cyclic vomiting syndrome, resulting in frequent vomiting throughout the day. Brenda Allen, while lacking a specific diagnosis, started experiencing stomach issues after taking Wegovy as directed by her doctor.
Reports indicate that more cases like these are emerging as the popularity of these drugs continues to rise. The US Food and Drug Administration (FDA) has received reports of people developing stomach paralysis as a side effect of the drugs. Additionally, the American Society of Anesthesiologists has warned about the increased risk of regurgitation during surgery for patients taking these medications.
While such extreme cases are considered rare, doctors believe they could be related to an existing, undiagnosed condition known as delayed gastric emptying. Some individuals may have silent delayed gastric emptying without realizing it, making them more susceptible to adverse effects when taking these drugs. Notably, the drugs’ labels do not specifically caution about the possibility of gastroparesis.
In response to concerns, Novo Nordisk, the manufacturer of Ozempic and Wegovy, emphasized that gastrointestinal events are recognized side effects of the GLP-1 class of drugs, including symptoms like nausea and vomiting.
Gastroparesis can have various causes, including diabetes, which is one of the reasons many individuals are prescribed these medications. Women are also at a higher risk of developing the condition. However, in over half of gastroparesis cases, the cause remains unknown.
Dr. Michael Camilleri from the Mayo Clinic explains how these drugs work, slowing gastric emptying to help people feel fuller longer. However, the mechanism may not be well understood by many doctors and patients, leading to unexpected complications. Camilleri’s research on a similar drug called liraglutide demonstrated significant delays in stomach emptying, indicating a potential association between this drug class and gastroparesis.
He suggests that some patients with borderline slow gastric emptying could experience a full-blown case of gastroparesis after starting GLP-1 agonists like Ozempic or Wegovy. More robust studies are needed to better understand the impact of these drugs on gastric emptying and associated side effects.
Understanding the Unprecedented Vomiting
Joanie Knight from Angie, Louisiana, vividly recalls her birthday meal in 2021 when she ate chicken fajitas at her favorite restaurant. Shortly after, she felt panic when the food seemed stuck in her throat, leading to a severe bout of vomiting. Having been on Ozempic for two years and already eating very little due to the drug’s effects, Knight was shocked at the amount she was throwing up.
Visiting a gastroenterologist, Knight underwent a gastric emptying study that revealed severe gastroparesis, a condition where food remains in the stomach for an extended period. Normally, less than 10% of food remains in the stomach four hours after a meal. In Knight’s case, it exceeded 35%.
Emily Wright, a teacher from Toronto, also experienced weight loss with Ozempic but suffered persistent nausea and vomiting. Clinical trials indicated that nausea and vomiting were common side effects of both Ozempic and its higher-dose counterpart, Wegovy, which is used for weight loss. Wright was later diagnosed with gastroparesis, prompting her doctors to add medications to manage her symptoms but not suspecting the link to Ozempic.
Both Knight and Wright felt some relief after discontinuing the medication, but their problems continued. Wright’s condition worsened, with persistent vomiting of recently eaten food.
Gastroparesis is challenging for those who have it, taking a considerable toll mentally and physically. Knight eventually opted for stomach bypass surgery, which helped her eat some of her favorite foods in small amounts and alleviate malnourishment.
Wright remains hopeful that her condition will improve with medications and time, but the uncertainty is a source of anxiety.
For those with gastroparesis, these experiences are common and can profoundly impact their daily lives. The condition is challenging to manage, and individuals often face long periods of uncertainty regarding their recovery.
Weighing the Benefits and Risks
Drug regulators have acknowledged receiving reports of stomach paralysis among patients using GLP-1 agonist drugs. The US Food and Drug Administration (FDA) has been alerted to cases of gastroparesis linked to semaglutide and liraglutide, with some instances showing no recovery even after discontinuing the respective drug.
The reports were submitted through the FDA’s publicly accessible adverse events tracking system, but the agency highlighted that not all reports contain enough information for proper evaluation. Consequently, it has been challenging for the FDA to ascertain whether the medications were the direct cause of gastroparesis or if other factors contributed.
Gastroparesis can be a complication of diabetes, particularly in cases of long-standing or poorly controlled disease, making it harder to determine the drugs’ role in reported events.
Despite the potential risk for individuals with slow digestion, the FDA suggests that the benefits of these medications may still outweigh the risks, even for this group. Drug labeling regulations dictate that a drug should be contraindicated only when the risk clearly outweighs the possible therapeutic benefit. As known hazards are the basis for contraindications, theoretical possibilities are not considered.
The FDA emphasizes that individuals with gastroparesis were not excluded from clinical trials of these medications, and in some patients with gastroparesis or delayed gastric emptying, the benefits for diabetes and weight management may be substantial.
Experts specializing in treating gastroparesis, like Dr. Linda Nguyen at Stanford University, have observed an increasing number of cases linked to GLP-1 agonists. In typical instances, the cessation of GLP-1 agonists leads to improved gastric emptying. However, cases like Emily Wright’s and Joanie Knight’s seem unusual as their conditions did not improve after discontinuing the medication.
Dr. Nguyen, also a spokesperson for the American Gastroenterological Association, reaffirms the occurrence of gastroparesis or delayed gastric emptying associated with GLP-1 agonists but suggests that the situation typically improves upon drug cessation.
Growing Concerns Over Surgery for Patients on GLP-1 Agonist Drugs
Medical experts, including anesthesiologists, are sounding the alarm over the real hazards associated with stomach paralysis in patients taking GLP-1 agonist drugs, raising the need for more information about the risks for both doctors and patients.
Dr. Renuka George, fellowship director of regional anesthesiology at the Medical University of South Carolina, recently shared a cautionary tale via a tweet. She posted a photo of the stomach contents suctioned from a patient who had diligently fasted as directed before surgery but was using a GLP-1 agonist for diabetes. Surprisingly, the patient’s stomach was still full despite following all preoperative instructions.
The risk arises from the potential of stomach contents, including acidic digestive juices, being aspirated into the lungs during anesthesia. This can lead to serious complications, ranging from coughing to the need for prolonged mechanical ventilation.
Dr. George stressed the importance of anesthesiologists being aware of this complication, especially as more individuals are taking these medications without adequate information about the associated stomach slowdown. Patients may not realize the need to inform their doctors about being on such drugs, leading to inappropriate fasting before surgery.
The American Society of Anesthesiologists advises patients to discontinue GLP-1 agonists for one week prior to surgery to mitigate the risk of aspiration. However, the appropriate fasting duration and cessation of the drug remain uncertain due to limited scientific evidence on the delay in stomach emptying caused by these medications.
President of the American Society of Anesthesiologists, Dr. Michael Champeau, emphasized that the guidance was issued based on the best available evidence but acknowledged the ongoing need for research on this matter. Studies to better understand this complication are underway, and more publications on the topic are expected in the coming years.
In the meantime, patients are encouraged to be open with their doctors about all medications they are taking. Joanie Knight, a gastroparesis patient from Louisiana, shared her experience and warned others about carefully considering the risks associated with these drugs.
Dr. Linda Nguyen from Stanford University advises patients to pay attention to side effects, particularly persistent vomiting. Patients experiencing ongoing vomiting should seek medical evaluation, and consideration should be given to adjusting the medication dosage or stopping the drug if necessary.
Until more is known about the potential complications, vigilance and open communication between patients and healthcare providers are essential for ensuring safe and informed treatment decisions.