What’s the Risk of Gastric Paralysis with Weight Loss Drugs?

This blog explores a presentation at the medical conference of Digestive Disease Week 2024 in Washington.

They looked at GLP-1 agonists (like semaglutide and tirzepatide). Twenty-five thousand patients are starting this medication weekly in the US alone. GLP-1 agonists work in part by slowing the progression of food through the stomach so you feel fuller longer. One of the side effects of the medication can be vomiting or too much slowing of the stomach progression causing gastroparesis.

For most, the gastric paralysis will improve after stopping the medication. But there are some people who said their condition did not get better — even months after stopping semaglutide or tirzepatide.

What Were the Results of the Study?

At this conference, there were 3 studies presented:

• The risk of gastroparesis is rare but consistent
• There is 50% greater risk of gastric paralysis for those on GLP-1 medications than the general population
• There is a risk of gastric paralysis in diabetics more than the normal population, particularly if poorly controlled.
• What did the studies find?
  • STUDY 1
    • 286,000 records were included
    • 10/10,000 (0.1%) were diagnosed with gastroparesis at least 6 months later (the rate in the general non-medicated population is 0.04%)
  • STUDY 2
    • Compared those on GLP-1 meds vs. those with diabetes or obesity but no medication (300,000 patients in the study)
      • Those on GLP-1 meds were 66% more likely to have gastroparesis
      • 0.53% of patients had paralysis — that is the equivalent of 1 in every 200 people on semaglutide or tirzepatide
      • They were more likely to have nausea, vomition, or reflux and be prescribed a proton pump inhibitor
      • They were more likely to have drug-induced pancreatitis and need gallbladder removal.
      • They state “There is a 30% of GI side effects… some side effects will diminish over time as people get used to their doses”
  • STUDY 3
    • 80,000 patients in Mayo Clinic
    • 839 patients with gastroparesis
    • Of these, 241 had food in their stomach four hours after eating a test meal
    • More likely to be seen in women and those with constipation
• They state that the risk was not seen in the original studies as you need hundreds of thousands of patients to see these small numbers.

How Can Biohackr Health Help?

• We understand these weight loss drugs. We offer Tirzepatide and Semaglutide. We monitor you closely.
• Try to be on the lowest effective dose. The higher the dose, the higher the risk of issues.
• Take our probiotic supplement. We had this specially formulated to help in two ways. First, the probiotic strains are ones that help with glucose resistance. Second, we added components to aid with digestion and to avoid some of the GI effects of the medications.
• Remember the numbers. The risk of gastric paralysis is small. In all the studies, it is 0.53% – 0.1%.  If you are symptomatic with a lot of GI issues, particularly constipation, you are at risk.