Diabetes and weight loss injectables Ozempic and Wegovy, the brand names for semaglutide, get dramatic results because they slow the movement of food through the digestive system. That’s how the drugs work. They keep you feeling full and satisfied – and your blood sugar stable – on less food and for much longer after a meal.
Other medicines in this drug class, known as GLP-1 receptor agonists, work in the same way. They include liraglutide (Saxenda, Victoza) and tirzepatide (Mounjaro, Zepbound).
While the slowing down of the digestive system is necessary for Ozempic and these other drugs to work, if it slows down too much, you can get a serious problem: stomach paralysis.
What Is Stomach Paralysis?
When food enters a healthy stomach that’s working as it should, the stomach contracts repeatedly in order to push the food along into the intestines within minutes. When the stomach is paralyzed, a condition called gastroparesis, it is no longer able to contract and push the food out and on its way along the digestive tract.
To understand why Ozempic and similar drugs might lead to stomach paralysis, you have to first answer the question, “What does Ozempic do to your stomach?”
Ozempic and other GLP-1 drugs slow the speed at which food leaves the stomach and enters the intestines. They have to slow digestion to lower blood sugar, curb appetite, and cause weight loss.
One small study compared the stomach-emptying time of people on another GLP-1 agonist (the same drug class, but not Ozempic) and people on a placebo (an inactive treatment that’s used as a control in drug testing). In the placebo group, within 4 minutes of finishing a meal, half the food had already moved out of the stomach and into the intestines. For those in their first month on GLP-1s, the process took more than an hour. By the 4-month mark, the process took about 30 minutes.
But sometimes, the movement of food out of the stomach slows down way too much. That’s when Ozempic stomach paralysis happens. According to new research, as many as 1 in 20 new users of GLP-1s who are obese or have diabetes go on to develop stomach paralysis. You're almost four times as likely to get stomach paralysis on Ozempic or another GLP-1 than you are on a non-GLP-1 weight loss med like bupropion-naltrexone (Contrave).
With Ozempic stomach paralysis, whole pieces of food stick around in your stomach for much longer than they should. When food doesn’t make it all the way through the digestive tract, it can lead to malnutrition, dehydration, and abnormal changes in your blood sugar. Lingering food can harden into solid masses called bezoars that can cause nausea, vomiting, and, rarely, even death.
The ongoing uncomfortable symptoms of stomach paralysis, including constant nausea and vomiting, can have a serious impact on your quality of life and ability to complete your daily responsibilities.
Ozempic Stomach Paralysis Symptoms
GI problems, like nausea and vomiting, are common when you first start taking Ozempic. They should clear up within the first month or so after your body gets used to the medicine. Symptoms of Ozempic stomach paralysis may be similar to those common GI side effects, but they are more severe and keep going even after you’ve been on the drug for a while.
Here’s what to look out for:
- Throwing up, especially whole pieces of food that you ate hours or more before
- Nausea
- Heartburn or acid reflux
- Belly bloating
- Belly pain, especially in the upper belly
- Feeling full after you’ve eaten only a few bites
- Feeling full for a long time after eating
- Loss of appetite
- Unusual changes in your blood sugar
- Constipation
- Undigested food in your poop
What to Do if You Suspect You Have Ozempic Stomach Paralysis
Untreated, Ozempic stomach paralysis can lead to serious problems with your health and your quality of life. The sooner you get a diagnosis and treatment, the better off you’ll be. Call your doctor to let them know you have symptoms of Ozempic stomach paralysis as soon as you get them.
If you have severe pain in your stomach or belly area that keeps you from going about your day, eating, drinking, moving, or sleeping, you should go to the ER or urgent care.
You should also go to the ER if:
- You are throwing up and have signs of dehydration like extreme thirst, dry mouth, peeing infrequently, dark pee, dizziness, lightheadedness when you stand, or weakness.
- You see blood in your vomit or poop.
- Your abdominal or stomach pain came on suddenly.
Ozempic Stomach Paralysis Diagnosis
Your doctor may order one or more of these tests to be sure you have Ozempic stomach paralysis:
Scintigraphy. You eat a small meal that contains trace amounts of a radioactive material. The doctor will place a scanner on your belly to follow the radioactive material as it moves through your gut. This will show whether food is hanging around in your stomach for too long.
Breath tests. You eat food containing a special substance that your body absorbs and that later shows up in your breath. After you eat it, you do breath tests over the next few hours to see how long it takes the substance to show up in your breath.
Upper gastrointestinal endoscopy. While you’re sedated, a doctor will place a flexible tube with a camera at the end down your throat. The camera will probe your esophagus, stomach, and the top end of your intestines to see if stomach paralysis or something else – like an ulcer – is causing your symptoms.
Ultrasound. A technician will put cool gel on your midsection and then move a device all over the area to create images on a screen of everything that’s going on inside. An ultrasound may pick up blockages or kidney or gallbladder problems that may be causing your symptoms.
Ozempic Stomach Paralysis Treatment
Studies of a few people who’ve gotten Ozempic stomach paralysis have shown that stopping the medication usually takes care of the problem. But there isn’t a lot of data on people who’ve had this side effect. Media reports and ongoing lawsuits, on the other hand, describe people that continue to have problems long after they stop the medication.
You might require other treatment besides stopping Ozempic. These are some approaches doctors might try.
Diet changes
You might need to change what you eat and the way you eat.
First, you may need to take a multivitamin every day to head off any potential malnourishment.
Your health care provider may also recommend that you:
- Eat low-fat, low-fiber foods, which are easier to digest.
- Eat five to six small meals throughout the day rather than three larger ones.
- Eat soft, well-cooked foods.
- Chew thoroughly.
- Avoid carbonated or alcoholic beverages.
- Drink plenty of liquids containing glucose and electrolytes, such as low-fat clear soups, low-fiber fruit and vegetable juices, and sports drinks.
The doctor might also suggest gentle physical activity, like an easy stroll, after meals to help move things along. You’ll also need to stay upright, either sitting up or standing, for 2 hours after a meal to promote the downward flow of food through your digestive system.
If your symptoms are more severe, your doctor might recommend a diet of only liquid or pureed foods.
Controlling blood sugar
If you have Ozempic stomach paralysis and diabetes, you’ll need to take extra care to keep your blood sugar under control. High blood sugar, also called hyperglycemia, can make food move through your stomach even more slowly.
You and your doctor will need to get your medicines just right to keep your blood sugar stable – not too high and not too low.
Depending on your diabetes and how severe your Ozempic stomach paralysis is, you might:
- Take insulin more often.
- Change the kind of insulin you take.
- Take insulin after you eat rather than before.
- Check your blood sugar after you eat and take insulin if you need it.
Medication
You might take medicine to help your stomach muscles contract. Other medicines for stomach paralysis help with nausea, vomiting, and pain.
You doctor may prescribe:
Metoclopramide. This medicine increases stomach contractions to help push food along. It might also help with nausea and throwing up.
Erythromycin. This antibiotic, used for preventing and treating infections, also ramps up the pumping of the stomach muscles.
Antiemetics. These prescription and over-the-counter drugs relieve nausea and help keep you from throwing up.
Antidepressants. Some drugs used to treat depression, such as mirtazapine, have the added benefit of relieving nausea and vomiting.
Pain medicines. Certain pain medicines can help with the stomach pain that can come with Ozempic stomach paralysis, but not narcotics, like opioids. Those can make the problem worse.
How Long Does Ozempic Stomach Paralysis Last?
It’s unclear how long Ozempic stomach paralysis lasts. Published research of a few individual cases says that it goes away after you stop the drug. But lawsuits are underway to defend people who say their symptoms lasted long after they quit taking Ozempic.
Takeaways
- Up to 1 in 20 new users of Ozempic and other GLP-1s may develop stomach paralysis.
- GLP-1s come with a higher risk of stomach paralysis than other weight loss drugs do.
- A few published reports say it goes away after you stop the medicine.
- Ongoing lawsuits say the symptoms can continue after stopping the medicine.
- Stomach paralysis can be serious and take a major toll on your life.
Ozempic and Stomach Paralysis FAQs
Q: Does Ozempic cause gastric paralysis?
A: Studies show it puts you at risk of getting this condition.
Q: What does Ozempic do to your stomach?
A: It slows the movement of food from your stomach into your intestines, which curbs your appetite and makes blood sugar stable.
Q: What is a paralyzed stomach?
A: A paralyzed stomach, or gastroparesis, is when your stomach can no longer contract enough to push food through. Food then stays in your stomach for too long, which can lead to malnourishment, dehydration, and abnormal blood sugar changes. Stiff chunks of food can form and cause nausea, vomiting, and death.
Q: Is there a lawsuit for Ozempic gastroparesis?
A: Yes, there are lawsuits defending GLP-1 users who had severe gastroparesis and say the drugmakers knew or should have known there was a significant risk of stomach paralysis.
