NEW DELHI: Medications like Wegovy and Ozempic, effective for rapid weight reduction, may come with the risk of uncommon yet serious side effects, including abdominal paralysis, a condition characterised by delayed stomach emptying, a new US study has suggested.
Abdominal paralysis can cause unintended weight loss, malnutrition and other complications that may require medical or surgical intervention.
The study, presented at a medical conference – Digestive Disease Week 2024 – in Washington on Saturday, is based on an analysis of the records of more than three lakh persons with diabetes and obesity of which 1.65 lakh were prescribed GLP-1 agonists that are known to slow stomach emptying and stimulate insulin production among other things.
Dr Prateek Sharma, professor of medicine at the University of Kansas, who led the study, told TOI that abdominal paralysis is a rare side-effect of these drugs but given the high usage of GLP-1 drugs, or weight-loss drugs as it is commonly referred to, it’s important too warn people about it. “These drugs are new and while the positive effects are well-established and talked about, we are yet to discover the full extent of its long-term side-effects and that’s why I feel people who are taking them should be careful,” he said.
Wegovy and Ozempic are not legally available in India. However, reports suggest that these drugs are being sourced by many through the grey market at premium. Recently, a Denmark-based company called Novo Nordisk has launched ‘Rybelsus’ which has semaglutide – the main ingredient of Ozempic – in tablet form in India. It has been approved for diabetes management but, doctors say, the drug is also being used ‘off-label’ for weight loss.
Wegovy and Ozempic were also initially approved for diabetes management. But when reports emerged that it could help lose 10-15% weight within a year, the US FDA allowed its limited use in people with obesity as well. Soon, the drug group took the world by storm as people, including celebrities such as Elon Musk and Oprah Winfrey, said they were using it.
Dr Anoop Misra, chairman, Fortis C-Doc, said Rybelsus is quite expensive with one month’s prescription amount costing over Rs 10,000. “Given the popularity of these drugs, it is likely that we may have easy availability of the drug in near future and that too at lesser costs which is good as these drugs have proven to be effective in managing blood sugar, reducing weight, and even in managing chronic kidney disease. But the medical community as well as the public needs to be aware of its side-effects,” he said.
According to Dr Randhir Sud, chairman of the department of digestive and hepatobiliary sciences at Medanta hospital, drugs like Wegovy and Ozempic work by slowing the stomach movement and thus reducing appetite. “Users can feel nausea and vomiting when they start taking the drug but in most cases these side-effects are likely to subside. I haven’t come across any case of abdominal paralysis yet but these are early days of its usage in India,” he said.
In the US study, Sharma and his colleagues used a large database to analyze healthcare records of over 120 million patients, focusing on those with diabetes and obesity. They compared patients taking GLP-1 drugs to a control group, matching them by demographics and health factors. Over one year, they found that 32% of GLP-1 users experienced gastrointestinal issues like nausea, GERD, and stomach paralysis. While GLP-1 users had more GI-related procedures, they had slightly fewer ER visits and hospital admissions. This suggests that while GLP-1 drugs increase GI side effects, they don’t lead to more severe health crises requiring emergency care or hospitalisation, the Kansas University professor said.
“We aren’t saying that one shouldn’t use them. But our research clearly underscores the need for medical monitoring of gastro-intestinal side-effects such as abdominal paralysis that can impact quality of life,” he added.
