This content material initially appeared on On a regular basis Well being. Republished with permission.
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Medically Reviewed by Sean Hashmi, MD, MS, FASN
Ozempic is essentially the most hyped diabetes drug ever. It was authorised in 2017 however solely turned a social media weight reduction sensation in 2022, as Diabetes Day by day notes.
With so many individuals sharing their experiences within the public sq., we’re studying about Ozempic’s negative effects in a manner that even a part 3 trial might by no means reveal. Each few weeks, it appears, we hear that TikTok customers are shining a light-weight on one other new Ozempic facet impact.
This text will element every thing we learn about Ozempic negative effects — the great, the dangerous, the scientifically verified, and the anecdotal.
A short be aware: This text makes use of the model identify Ozempic to confer with semaglutide, the drug’s energetic ingredient. Semaglutide can be marketed beneath two different names, Wegovy (when it’s bought for weight reduction) and Rybelsus (when it’s within the type of a tablet fairly than an injection), per Diabetes Day by day. Different associated medicine, equivalent to liraglutide (Victoza) and tirzepatide (Mounjaro), could or could not trigger among the similar negative effects, based on Diabetes Day by day.
Gastrointestinal Facet Results: Nausea, Diarrhea, Vomiting, Belly Ache, and Constipation
These uncomfortable tummy troubles make up Ozempic’s most typical and most mentioned negative effects by far.
Whereas a majority of customers don’t understand these pains, a considerable minority do. And for some, the gastrointestinal misery is simply an excessive amount of to deal with, and they should cease taking Ozempic solely. As a blogger for New York journal’s The Lower put it, “You may undergo hell in your post-Ozempic physique.” The writer spoke to a 42-year-old girl with diabetes who endured “fixed nausea” and “power-puking” for weeks, earlier than lastly weaning herself off the drug.
In line with the U.S. Meals and Drug Administration, placebo-controlled trials of Ozempic discovered the next charges of negative effects from the 1 milligram (mg) dose:
Smaller numbers reported signs equivalent to acid reflux disease and extreme belching or flatulence.
All advised, 30.8 % of adults reported a gastrointestinal symptom. However that was solely the 1 mg dose, half of the utmost. The numbers had been a lot larger in a trial of semaglutide (Wegovy) at 2.4 mg in folks with out diabetes:
- Nausea: 44.2 %
- Vomiting: 24.8 %
- Diarrhea: 31.5 %
- Belly ache: 10.0 %
- Constipation: 23.4 %
At this, the best dosage of semaglutide out there, an unimaginable 74 % of contributors skilled at the least one gastrointestinal dysfunction, although it’s value noting that almost 50 % of those that took a placebo additionally had some tummy troubles. Solely 4.5 % of the semaglutide sufferers stopped taking the medicine as a direct results of gastrointestinal issues.
Stories from the Diabetes Day by day discussion board counsel that these unlucky results are strongest within the days instantly after injecting the once-weekly medicine. Sufferers are additionally more than likely to expertise issues once they begin on the drug or once they step as much as a better dosage; the negative effects generally fade away because the physique will get used to the medication.
What’s one of the simplest ways to cope with these nasty issues? Diabetes Day by day has a whole article on the topic.
Ozempic Burps
A foul-smelling burp isn’t precisely essentially the most debilitating of negative effects, nevertheless it’s value realizing about. As reported in The Atlantic, and mentioned in lots of TikTok movies, some folks taking Ozempic discover themselves emitting nasty sulfurous smells once they belch. There’s broad settlement that the burps scent like rotten eggs.
Solely a minority of individuals expertise sulfurous burps, possible fewer than 10 %. Anecdotal stories counsel that the burps, like different gastrointestinal points, are worst when sufferers start taking their medicine or step as much as larger dosages.
Bloating and Farting
These uncomfortable negative effects had been reported in medical trials as “belly distension” and “flatulence.” Bloating and farting complaints are much less frequent than the gastrointestinal results mentioned above, they usually have but to catch on as sizzling matters on social media, nevertheless it’s good to know that Ozempic and associated medicine could enhance their probability.
Ozempic Face and Ozempic Butt
“Ozempic face” could have been the primary Ozempic facet impact to go viral. In January 2023, everybody was speaking about this rumored facet impact which was coated lavishly within the mainstream media, as Diabetes Day by day reported. In June 2023, the sample repeated itself when claims of “Ozempic butt” hit headlines, equivalent to in Good Housekeeping. In every case, customers complained that the drug had given them a stunning and unlucky flabby look, within the face, within the derriere, or maybe in each.
There’s nothing to fret about. There isn’t any proof that Ozempic or another comparable drug immediately impacts your look. Specialists agree that Ozempic face and Ozempic butt are purely brought on by weight reduction. The identical flabby consequence can happen whenever you shed some pounds the old school manner.
Whenever you lose loads of weight, you may additionally lose among the healthy-looking fats in your face. Fast weight reduction can even result in flabby pores and skin: The pores and skin is an adaptable and elastic organ, nevertheless it can not snap immediately again right into a taut form. Profitable dieters have struggled with these points since lengthy earlier than Ozempic got here on the scene.
Gastroparesis (Abdomen Paralysis)
In July 2023, CNN reported that some semaglutide customers had skilled extreme gastroparesis, or abdomen paralysis, which in some instances didn’t get higher even months after discontinuing the medication.
Gastroparesis is a situation by which the abdomen empties too slowly or stops, per the Nationwide Institute of Diabetes and Digestive and Kidney Ailments; it causes quite a lot of gastrointestinal signs together with bloating, belly ache, nausea, and vomiting. Within the worst instances gastroparesis could make it very tough to eat or drink something in any respect, resulting in a danger of dehydration or malnutrition.
Delayed abdomen emptying, the defining characteristic of gastroparesis, is a recognized consequence of Ozempic and associated medicine. This delayed emptying has constructive results, serving to to scale back starvation and provoke weight reduction, in addition to damaging ones, contributing to gastrointestinal discomfort.
Fortunately, extreme and protracted gastroparesis seems to be very uncommon. The symptom was not recognized in any of the drug’s part 3 trials, which enrolled 1000’s of contributors to guage semaglutide’s security.
Pritesh Mutha, MD, a gastroenterologist and affiliate professor at McGovern Medical College at UTHealth Houston, states that the danger of extreme gastroparesis is at the moment unimaginable to evaluate: “We don’t have the info to point out how lots of the individuals who take this drug really expertise gastroparesis.”
Hair Loss
Ozempic may cause hair loss, per Diabetes Day by day. Whereas it isn’t listed as a facet impact on Ozempic’s FDA label, hair loss is listed on the FDA’s label for Wegovy, basically the identical medicine. Three % of contributors within the drug’s pivotal trial reported hair loss (3 occasions as many as those that used a placebo).
Like Ozempic face and Ozempic butt, nonetheless, this isn’t a worrying chemical impact of the medicine however fairly an inevitable consequence of speedy weight reduction. Dramatic weight reduction, regardless of the way it’s triggered, typically causes hair loss. For instance, a examine printed in 1974 of crash dieters discovered a number of instances of “profuse hair loss.” And greater than half of people that obtain bariatric surgical procedure expertise hair loss, too, per analysis.
The excellent news: A examine printed in 2017 discovered that “hair loss stopped and new hair steadily grew out in all sufferers.” Hopefully, the minority of Ozempic customers that lose some hair on the drug may have the identical good luck.
Fatigue
There are stories that Ozempic may cause fatigue — principally, tiredness or exhaustion that isn’t improved by sleep. The FDA label for semaglutide (Wegovy) stories that 11 % of trial contributors skilled fatigue, a bit bit greater than twice as typically as those that used a placebo.
It’s unclear why Ozempic would trigger fatigue, though one very believable clarification is the truth that it causes folks to eat a lot much less meals. Ozempic causes excessive weight reduction by encouraging customers to eat at an excessive calorie deficit. You’re placing much less gasoline into your physique. Is it any marvel {that a} crash food regimen can sap your power?
Dizziness
Dizziness has additionally been reported in a slim minority of Ozempic customers. It’s attainable that Ozempic dizziness stems from the glucose-lowering results of the drug — dizziness is a standard symptom of hypoglycemia, based on Diabetes Day by day. Even sufferers who will not be vulnerable to extreme hypoglycemia (usually these that don’t use insulin or sulfonylureas) could really feel dizzy whereas experiencing transient low blood sugar episodes.
Muscle Loss
It’s inevitable that weight reduction will contain some muscle loss. That is thought-about wholesome and pure.
Some specialists, nonetheless, imagine that Ozempic and associated medicine are inflicting a stunning and worrying quantity of muscle loss, greater than we see with different weight reduction strategies.
We solely have a modicum of excellent knowledge on this query. Physique composition analyses of volunteers in two trials (printed in Diabetologia and The New England Journal of Medication) discovered that semaglutide customers misplaced about 40 % lean mass and 60 % fats. A evaluation printed in 2017 said that dieters utilizing different strategies to shed some pounds are likely to lose solely 20 to 30 % lean mass.
The science right here stays unsettled; we don’t know if Ozempic causes further muscle loss. Both manner, specialists agree that it might be smart for Ozempic customers to interact in strength-building workout routines to assist protect muscle mass throughout weight reduction. Consuming sufficient protein may assist.
This potential facet impact may be a great reminder that Ozempic is inappropriate for individuals who shouldn’t have a great medical cause to shed some pounds.
Ozempic Desires
Behold, essentially the most beguiling of all Ozempic negative effects: the Ozempic dream. In April, The Wall Road Journal reported that many customers had been experiencing unusual vivid goals, typically involving celebrities.
It’s unimaginable to know if it is a actual facet impact or only a social media confabulation, although based on Insider, some specialists have speculated on ways in which the drug — or the load loss it creates — might improve vivid dreaming.
Addictive and Compulsive Conduct Aid
Many Ozempic customers are amazed to seek out that they’re participating in much less addictive and compulsive conduct. In some way the drug seems to scale back our damaging tendency to overindulge in actions like consuming, purchasing, playing, or to compulsively choose at our pores and skin or chunk our nails.
The science right here continues to be in its infancy, however it seems that one of many causes Ozempic is ready to stem starvation cues is by appearing immediately within the mind, per analysis. We all know that Ozempic doesn’t simply show you how to really feel full quicker, it really lowers your yearning for meals. And it appears as if it reduces your yearning for different issues, too.
Specialists have recognized for years that GLP-1 receptor agonists might need these behavioral results. In a examine printed in 2022 of exenatide (Byetta), mind scans confirmed that the drug lowered exercise in “essential mind areas for drug reward and dependancy.” It additionally calmed down the mind’s dopamine circuitry.
We’re years away from the day that Ozempic or any associated drug will likely be prescribed as a remedy for addictive or compulsive conduct. However within the meantime, it might assist customers with extra than simply compulsive consuming.
Suicidal Ideas
Regulators within the European Union and United Kingdom have signaled that they’re investigating stories that Ozempic and comparable medicine are inflicting ideas of suicide and self-harm.
In america, the FDA already acknowledges a danger of suicidal ideation with GLP-1 receptor agonists, however just for sufferers with out kind 2 diabetes. Wegovy (semaglutide) and Saxenda (liraglutide) each carry warnings about suicidal conduct and ideation on their official FDA labels. However when both drug is bought to be used as a diabetes medicine, as Ozempic (semaglutide) or Victoza (liraglutide), there isn’t a such warning.
The FDA recommends that semaglutide shouldn’t be prescribed to “sufferers with a historical past of suicidal makes an attempt or energetic suicidal ideation,” and that customers ought to be monitored for rising or worsening despair.
Coronary heart Price Will increase
There’s been surprisingly little on-line chatter about this facet impact, which is famous on Ozempic’s FDA label. In medical trials, decrease doses of Ozempic “resulted in a imply enhance in coronary heart charge of two to three beats per minute.” Some sufferers, like a girl profiled by The Lower, discovered the expertise extraordinarily uncomfortable.
The FDA advises sufferers to “inform their healthcare suppliers of palpitations or emotions of a racing heartbeat whereas at relaxation.” Sufferers that skilled “sustained” will increase in resting coronary heart charge ought to discontinue the medicine.
Worsening Eyesight
Individuals with diabetes ought to know that there’s some proof that semaglutide (Ozempic) could enhance the incidence of diabetic retinopathy. In line with Pharmacy Occasions, one among a number of pivotal research of semaglutide discovered an elevated danger of DR, and the FDA has reported {that a} considerably larger share of Ozempic customers have DR as compared with customers of comparable medicine like dulaglutide (Trulicity) and liraglutide (Victoza), per analysis. The connection is disputed, nonetheless, as one other massive examine of semaglutide discovered no such danger.
If the connection is actual, it appears attainable that Ozempic’s unimaginable effectiveness explains its damaging impact on the eyes. Opposite to all expectations, speedy enchancment in glucose management can really worsen diabetic retinopathy. As Diabetes Day by day reported, that is known as “early worsening,” as a result of the eyes will worsen earlier than the foremost long-term advantages of higher blood sugar management develop into evident.
A latest dialogue of the problem by specialists from the American Academy of Ophthalmology recommended that “early worsening” from Ozempic is each “short-term and manageable,” though it does name for elevated scrutiny from eye docs.
Hypoglycemia
Whereas Ozempic in all probability doesn’t itself trigger hypoglycemia, its glucose-lowering impact can sharply enhance the percentages that insulin or sulfonylureas trigger hypoglycemia.
If in case you have diabetes and also you’re beginning a brand new GLP-1 receptor agonist, it’s attainable that you simply’ll want to alter the dosages of the opposite diabetes medicine that you simply use. Your physician may ask you to be further vigilant about checking your blood sugar. Should you’re not comfy altering your insulin-dosing practices by your self, try to be able to contact your physician between visits to get clearance for making changes.
Uncommon, Severe Facet Results
Semaglutide additionally results in a small variety of uncommon however doubtlessly severe negative effects:
- Pancreatitis This situation, by which the digestive enzymes assault the pancreas, could really feel like intense abdomen ache that radiates to your again.
- Kidney Failure Analysis signifies that some instances of semaglutide contribute to kidney illness. Dehydrating negative effects, significantly diarrhea and vomiting, could improve this danger.
- Gallbladder Illness This may occasionally trigger extreme abdomen ache, yellowing of the eyes or pores and skin, fever, and “clay-colored stools.”
- Thyroid C-Cell Tumors It’s unknown if semaglutide really causes these doubtlessly cancerous tumors in people, nevertheless it has been noticed in research of rodents.
There have additionally been some stories of allergic reactions to GLP-1 receptor agonists.
Ozempic is highly effective stuff: Should you’re experiencing a response you could’t clarify, please attain out to your healthcare supplier.
