For millions of Americans, GLP-1 medications such as Ozempic, Wegovy, Mounjaro, Zepbound and Rybelsus have changed their lives.
Since semaglutides received FDA approval, they have helped patients lower their body mass index (BMI) and A1C. But as the popularity of these medications continues to soar, concerns about serious side effects and lawsuits are growing.
Dr. Allison Steele, a bariatric medicine specialist at HonorHealth, said the most common side effects are gastrointestinal-related. She sees worsening acid reflux because the drugs affect the gut-brain connection that regulates hunger and fullness, Dr. Steele said.
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Symptoms are often most noticeable during the first 24 to 48 hours after an injection and may improve throughout the week, she added. Some patients have mentioned eye issues as well.
Phillips Law Group attorneys are representing about 20 clients with claims involving “digestive injuries” and vision-related complications, according to Olivia Lemorrocco with Phillips Law Group.
Lawyers say the manufacturers may not have adequately warned patients about the risk of severe digestive — other — complications.
The Uptown Phoenix firm currently represents approximately 20 clients with injury, according to Lemorrocco. Phillips Law Group has two litigations — one for GI issues, the other for non-arteritic anterior ischemic optic neuropathy (NAION). Although uncommon, attorneys say they continue receiving inquiries from individuals who believe their vision problems developed after using GLP-1 medications, Lemorrocco said.
“When we talk about side effects, we need to discuss what they can mean for daily life,” Lemorrocco said. “It comes down to your ability to see, to eat, to work and to care for your family. There’s an optic nerve condition that can cause vision loss. This one is a really rare side effect of the semaglutides.”
Dr. Raj K. Maturi in March’s American Academy of Ophthalmology Journal reported on NAION studies about semaglutides and vision changes.
Dr. Maturi said studies show there may be a connection between semaglutides and increased risk for NAION. But, Dr. Maturi added, there isn’t enough data to suggest patients should be concerned or stop taking their medications. People who have diabetes are already at risk for NAION, whether they use semaglutide or not.
Gut reaction
Many of the GI effects can be managed through lifestyle adjustments, HonorHealth’s Steele said. Patients are encouraged to stay hydrated, consume adequate fiber and focus on minimally processed foods while limiting greasy or high-fat meals that can worsen symptoms. Regular medical monitoring is also considered important for minimizing complications.
“I tell my patients to minimize nausea to make sure that they’re eating consistently,” Dr. Steele said. “You want to eat every three to four hours to make sure they’re getting enough nutrients.
“Your body’s not having those same hunger signals as what they were when they weren’t on a medication. So, nausea can actually be a signal of hunger. That goal is around 20 to 30 grams of fiber. The goal is around 20 to 30 grams of fiber, and then plenty of water.”
Because GLP-1 medications are designed to slow digestion, experts say patients with preexisting digestive problems should be evaluated carefully before starting treatment. The use of semaglutides also ups the risk of pancreatitis in patients who were previously diagnosed with it.
“Then, there’s an increased risk of gallstone formation, although that can happen with any weight loss,” she said.”
The 7.2 milligram dose of Wegovy sometimes makes patients feel like they have a sunburn.
“It’s manageable, but as you reduce the dose of medication or stop it, it tends to improve that as well.”
Despite these concerns, experts caution against overlooking the substantial benefits of the medications. Dr. Steele noted that many patients have regained the ability to perform everyday activities, exercise comfortably, travel with greater confidence and participate more fully in family life. For many, the medications have been genuinely life changing.
As lawsuits move forward, the debate surrounding GLP-1 medications underscores a broader issue in modern healthcare: balancing the benefits of innovative treatments with transparent communication about potential risks. While courts will ultimately determine whether warnings were sufficient, medical professionals and attorneys agree that patients need clear information so they can make informed decisions about their health.
