Top reasons Ozempic users visit the ER — and when you should go

New York Post

01-05-2025

Though popular weight loss jabs like Ozempic and Wegovy have been deemed safe and effective by the FDA, concerning side effects are sending some users to the ER.
A staggering one in eight adults in the US have used a GLP-1, and a study published last month in the Annals of Internal Medicine revealed how often these users develop complications that require a trip to the hospital.
The study outlined the top reasons people are seeking medical attention — and one doctor is warning about a 'Wild West' factor that could be at the root of an unexpected issue.
3 A staggering one in eight adults in the US has tried GLP-1
mbruxelle – stock.adobe.com
Using a national surveillance network, a team of researchers at Cambridge Health Alliance tracked emergency room visits linked to semaglutide in 82 different hospitals over a two-year period.
In total, semaglutide side effects resulted in 551 emergency room visits, though less than 18% led to hospitalization. Statistically speaking, this amounts to four ER visits and less than one hospitalization for every 1,000 semaglutide patients.
Of these ER visits, 70% cited gastrointestinal distress, with common complaints of nausea, vomiting, abdominal pain and diarrhea.
GLP-1 medications are notorious for triggering digestive discomfort.
Shrinking tummy, uncomfortable tummy
A recent report found that more than 30% of GLP-1 patients drop the meds after just four weeks because they suffer early side effects like nausea or other digestive problems.
These medications slow down the passage of food through the stomach, allowing people to feel fuller, longer. However, issues arise if the drugs slow down the stomach too much and, in some cases, can lead to severe gastroparesis, or stomach paralysis.
The Post previously reported that about 30% of Wegovy users have experienced diarrhea, including some who claim they've woken up in the middle of the night to discover that they've defecated in their sleep.
Of the 70% of ER visits related to GI issues, 15% required hospitalization.
'We found that it's very infrequent that semaglutide leads to very serious adverse events that would land a patient in the hospital, but that they do occur,' study author Pieter Cohen, MD, internist at Cambridge Health Alliance and associate professor of medicine at Harvard Medical School, told Health.
A surprising twist
Low blood sugar resulted in a further 16.5% of ER visits, with nearly 38% of those cases requiring hospitalization.
That one comes as a bit of surprise, since GLP-1s play a role in regulating blood sugar.
At least one doctor thinks off-brand, compounded drugs — which are typically prepared by a pharmacist and dispensed in vials, allowing patients to administer their own dosages — could be to blame.
Compounded drugs aren't regulated by the FDA and don't undergo the same level of scrutiny as FDA-approved drugs.
'It's kind of like the Wild West when it comes to medications [that] are compounded because there is no standardization,' Dr. Peminda Cabandugama, endocrinologist at Cleveland Clinic and spokesperson for The Obesity Society, told Health.
3 Of the documented ER visits, 70% cited gastrointestinal distress, with common complaints of nausea, vomiting, abdominal pain, and diarrhea.
zigres – stock.adobe.com
Other GLP-1 issues
Less common complications that resulted in hospital visits included allergic reactions, pancreatitis, and bile duct disease.
GLP-1 users have also reported experiencing vision changes, erectile dysfunction, personality changes, increased reckless behavior, and the infamous 'Ozempic butt' and 'Ozempic boobs' (sagging in all the wrong places).
Doctors have also seen other unusual complications, such as allodynia, a type of nerve pain where things that shouldn't hurt — like brushing your hair or wearing a shirt — suddenly do.
Researchers contributing to this recent study predicted that the vast majority of ER visits would be driven by GI distress; however, they were surprised at the number of cases connected to low blood sugar, as Ozempic and Wegovy have not been previously linked to hypoglycemia.
3 A number of Ozempic users have also reported to the emergency room with gallbladder inflammation — a side effect that stems from the body failing to adapt quickly enough to rapid weight loss.
nilsversemann – stock.adobe.com
Experts note that this latest study has limitations, specifically that the data is based on documentation from ER physicians who did not differentiate between patients taking Ozempic, Wegovy, or compounded semaglutide.
Despite the FDA's warning against using off-brand semaglutide compounds due to their potential 'adverse effects,' a shortage of brand-name drugs and their hefty $1,300-a-month price tag is motivating people to seek cheaper, more accessible options.
When should you go to the doctor?
While severe side effects related to GLP-1 are rare, experts suggest seeking emergency medical attention if you experience one or more of the following symptoms: fever, vomiting, and diarrhea that lasts longer than a few hours, or constipation that lasts several days and is accompanied by vomiting.
In addition, severe pain that radiates from the abdomen through the back could be a symptom of pancreatitis, which can require hospitalization.
According to Cabandugama, clinicians should ensure that patients do not have a history of pancreatitis before prescribing Ozempic or Wegovy.
'It's very important to mention that patients go to the right trained providers for weight loss, especially with all the rise of the Instagram clinics and online clinics,' explained Cabandugama.
A number of Ozempic users have also reported to the emergency room with gallbladder inflammation — a side effect that stems from the body failing to adapt quickly enough to rapid weight loss.
'Rapid weight loss causes the liver to pump out more bile and more cholesterol, both of which can lead to the formation of gallstones within the gallbladder,' pharmacist Dr. Dan explained in a viral TikTok video.
Gallbladder inflammation is characterized by enduring pain that originates in the right upper abdomen and radiates around the sides. This inflammation can be life-threatening and patients who experience these symptoms are urged to seek medical care.
For those who find themselves in the ER, it is imperative to tell providers that they are taking GLP-1 drugs.
Experts also note that side effects tend to flare up in GLP-1 patients after eating. Consuming smaller, lighter, fiber-rich meals and avoiding fatty, fried of processed foods can help mitigate these effects.