Anecdotal evidence suggests that taking GLP-1 agonists such as Ozempic and Wegovy, causes weight loss by generating a continuous level of sub-clinical nausea. Journalist Johann Hari, author of the new book Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs, told TODAY:

I went to KFC in Las Vegas and I did what I would have done before I was taking Ozempic — I ordered a bucket of fried chicken. I had one of the chicken drumsticks, and I suddenly thought, “I can’t eat this.” On Ozempic, you can’t overeat.

Hari started injecting himself with semaglutide in January 2023 — first Ozempic, then Wegovy — and maintained a diary of the side effects. He lost 42 lbs. in total, but he almost went off the drugs due to the psychological side effects:

I realized how much of my eating was about the need to comfort myself — stuffing myself to calm myself. And I couldn’t do that when I was on Ozempic.

How bad is the intestinal discomfort and nausea when using GLP-1 drugs? In a study of patients without diabetes who were prescribed GLP-1 drugs off-label for obesity:

• 58% reported side effects mostly concerning the gastrointestinal tract
• 70% discontinued treatment during the course of the study
• 28% discontinued due to lack of significant weight loss
• 21% discontinued due to intolerable side effects

Another study of GLP-1 drugs, this time with 735 patients diagnosed with type 2 diabetes, had a 30% drop-out rate with 14% of patients reporting adverse gastrointestinal events. Writer Marion Winik, documenting her trial of semaglutide for the Baltimore Fishbowl, reports that within 24 hours of her first injection, she could eat only half her normal serving size at her next meal. In two months, she went from 145 lbs to 125 lbs. without any vomiting or gastric distress.

A systematic review of GLP-1 adverse drug reports in 2022 found that “Gastrointestinal problems, particularly pancreatitis, was the more frequently reported adverse drug reaction associated with GLP-1 agonist. The most adverse drug reactions were observed with liraglutide and exenatide.” The study concluded: “Nausea and vomiting may be associated with glucagon-like peptides-1 agonist use.”

None of these studies adequately addresses the anecdotal evidence that weight loss from GLP-1 drugs such as Ozempic and Wegovy is due to inducing a state of subclinical nausea. We will continue to piece together the puzzle of “the magic pill.”

Written by Steve O’Keefe. First published July 2, 2024.

Sources:

“Is Ozempic a ‘magic’ drug? Author who lost 42 pounds on benefits, ‘very real concerns’,” TODAY, June 20, 2024.

“Off-Label Antiobesity Treatment in Patients without Diabetes with GLP-1 Agonists in Clinical Practice,” Hormone and Metabolic Research, 2015.

“Real-world GLP-1 RA therapy in type 2 diabetes: A long-term effectiveness observational study,” Endocrinology, Diabetes & Metabolism, November 2018.

“Welcome to the Land of Oz, aka Ozempic, Where Weight Loss Dreams Come True,” Baltimore Fishbowl, February 27, 2024.

“Adverse drug reactions of GLP-1 agonists: A systematic review of case reports,” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, March 2022.

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