What You Need to Know About the Medical Risks of Weight Loss Drugs

The popularity of weight loss medications like Ozempic (semaglutide), Wegovy, and Mounjaro (tirzepatide) has surged in recent years. Originally developed to treat type 2 diabetes, these drugs have also been approved for chronic weight management and are making headlines for their dramatic effects on weight loss.

But while these medications can be powerful tools—especially for people struggling with obesity—they are not without risks. Understanding the potential side effects and long-term implications is essential for anyone considering or currently using these drugs. And as always, a doctor should ALWAYS be consulted when considering using any of these medications.

How These Drugs Work

Semaglutide and tirzepatide belong to a class of drugs known as GLP-1 receptor agonists (glucagon-like peptide-1). They work by mimicking a hormone that helps regulate appetite and blood sugar. This leads to reduced hunger, slower digestion, and ultimately, fewer calories consumed.

For many, the results are significant: clinical trials show an average of 15% body weight loss with semaglutide over 68 weeks (Wilding et al., 2021). However, these medications alter powerful hormonal systems—and that means side effects are possible.

Common Side Effects

1. Gastrointestinal Issues

The most frequently reported side effects are digestive-related. These include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Stomach pain
• Bloating and gas

These symptoms are usually mild to moderate and tend to subside over time, especially when the medication dose is increased slowly. But for some people, the discomfort can be severe enough to stop treatment.

Fun fact: The term “Ozempic burp” has trended online due to the unusual sulfur-like burping reported by some users.

2. Gallbladder Problems

Rapid weight loss, especially when combined with hormonal changes, can increase the risk of gallstones and gallbladder inflammation (cholecystitis). In clinical studies, gallbladder-related disorders were more common in people using GLP-1 drugs (Davies et al., 2015).

3. Pancreatitis

Though rare, there is a potential risk of pancreatitis, an inflammation of the pancreas that can be serious and painful. People with a history of pancreatitis are typically advised not to use GLP-1 drugs.

Symptoms to watch for: severe abdominal pain, especially if it radiates to the back, nausea, and vomiting.

4. Kidney Issues

Dehydration from vomiting or diarrhea can lead to acute kidney injury, especially in people with pre-existing kidney problems. Staying hydrated and reporting side effects promptly to a healthcare provider can help reduce this risk.

5. Thyroid Concerns

Studies in rodents have shown an increased risk of medullary thyroid carcinoma (MTC) with GLP-1 medications. While this risk has not been proven in humans, people with a family or personal history of thyroid cancer are generally advised to avoid these drugs (FDA, 2021).

Less Common, But Concerning Effects

6. Depression or Suicidal Thoughts

There have been reports of mood changes, including depression and suicidal ideation, particularly in some people taking GLP-1 drugs. While the evidence is limited, the FDA has recommended monitoring mental health closely, especially in people with a history of mood disorders.

7. Muscle Loss

Rapid weight loss—especially without exercise—can lead to muscle loss rather than just fat loss. This can reduce strength and metabolism, which may increase the chance of regaining weight once the medication is stopped (Weinheimer et al., 2010).

Who Should Be Cautious?

Certain groups should talk carefully with a healthcare provider before starting these medications:

• People with a history of pancreatitis or gallbladder disease
• Those with severe gastrointestinal disorders
• Individuals with kidney disease
• Anyone with a family history of medullary thyroid cancer or MEN2 syndrome
• People with a history of eating disorders or mental health conditions

What Happens When You Stop?

Weight loss medications are typically long-term treatments. If stopped abruptly, many people experience rebound weight gain, often regaining the weight lost within months (Rubino et al., 2022). For this reason, experts stress that lifestyle changes—like healthier eating and exercise—must be part of the plan.

Balancing the Risks and Benefits

Like any medication, weight loss drugs have both benefits and risks. For people with obesity or weight-related health conditions like type 2 diabetes, high blood pressure, or sleep apnea, the benefits often outweigh the risks. These drugs can reduce the risk of heart disease, improve blood sugar control, and boost quality of life.

But they’re not for everyone—and they’re not a shortcut. They should always be used under the guidance of a medical provider, with regular monitoring for side effects.

Weight loss drugs offer real hope for many people, but they aren’t a one-size-fits-all solution. Understanding the risks, listening to your body, and partnering with a healthcare team are the best ways to navigate this new frontier in obesity treatment.

If you’re thinking about starting or stopping weight loss medication, make sure to have an open conversation with your doctor. Ask about side effects, how to manage them, and whether you’re a good candidate for this type of treatment. Your health is personal—and your approach to weight loss should be too.