Reflux Detox Weight-Loss Drugs Like Ozempic and Wegovy Cause Acid Reflux
At-A-Glance
- Originally, glucagon-like peptide 1 (GLP-1) receptor agonists were used for treatment for type 2 diabetes. GLP-1s decrease blood sugar levels after eating by augmenting pancreatic insulin. But today, GLP-1s are being taken for weight loss by more than ten million Americans … and the number is growing daily.
- The side-effects of GLP-1s are predominantly gastrointestinal, including nausea, vomiting, heartburn, and gastroparesis (stomach slowing or paralysis) … all symptoms which cause acid reflux. And most people on GLP-1s are also obese or overweight, increasing the likelihood of reflux.
- GLP-1-related acid reflux is being massively under-reported. This post will examine the adverse events associated with six GLP-1s. The side-effect profiles vary — all associated with gastrointestinal problems — but interestingly, the most popular brands (e.g., Ozempic, Wegovy) appear to be the worst.
Disclaimer: The author (JK) is neither a pharmacologist nor a specialist who uses GLP-1 drugs, and this blog does not address the efficacy of GLP-1 drugs for weight loss. Its purpose is to assess gastrointestinal side-effects. My information and opinions come from many sources, and I acknowledge that my analysis, opinions, and/or conclusions may be wrong.
The weight-loss drugs discussed in this post are glucagon-like peptide 1 (GLP-1) receptor agonists: these drugs are incretion (internal secretion) hormones that secrete directly into the bloodstream. Normally, the pancreas secretes a GLP-1 when food is ingested to stimulate insulin secretion from pancreas … and GLP-1 drugs augment this process. As of this writing, there are six GLP-1 formulations and twelve proprietary drugs. For example, the generic, semaglutide, has three associated brand-names, Ozempic, Rybelsus, and Wegovy.
There is a huge gap between the reported incidence of side-effects in the medical literature ― most of the studies sponsored by the drug manufactures ― and the apparent prevalence in the general population. Furthermore, being obese or overweight is a significant risk factor, even without weight-loss drugs.
Healthy women who have a BMI (Body Mass Index) of 18.5-24.9 report gastrointestinal symptoms associated with GLP-1 use of roughly 40%. Obese women (BMI, 25-30) are much more likely to have GLP-1 side-effects, including heartburn and acid reflux reflux (range 70%-90%). Click here to estimate your BMI.
Gastrointestinal Side Effects of GLP-1 Weight Loss Drugs
All of the most common GLP-1 side-effects are gastrointestinal, and all are associated with acid reflux, i.e., nausea, vomiting, burping, heartburn, gastroparesis (stomach paralysis). Even if studies do not query subjects for heartburn and reflux … and most don’t … all GI GLP-1 side-effects lead to acid reflux, both esophageal reflux and respiratory reflux. Gastroparesis is uncommon, but when the stomach slows down or stops working, one can expect championship level reflux.
Shown below in rank order, worst to best vis-a-vis GI side-effects are the six GLP-1 groups. Nausea is the most common side-effect GLP-1 symptom, followed by vomiting, sour burps, heartburn and gastroparesis
Side-Effect Profile of GLP-1s, from Worst to Best (% reflects estimated number of patients with GI side-effects)
50% Semaglutide (Ozempic, Rybelsus, Wegovy)
40% Tirzepatide (Saxenda, Mounjaro)
40% Liraglutide (Victoza, Saxenda)
30% Lixisenatide (Adlyxin USA, Lyxumia UK)
10% Dulaglutide (Trulicity)
10% Exenatide (Byetta, Bydureon)
Wegovy, Mounjaro, and Saxenda FDA-approved for weight loss; nevertheless, all of the other GLP-1s are being used “off-label” for patients who desire GLP-1 treatment.
Recommendations
You probably already have reflux; don’t make it worse. In a nutshell, I do not advocate use of any GLP-1 for weight loss unless you are morbidly obese (BMI >40). That said, there may be some that are better than others; see above.
If you are overweight, perhaps you are eating too much too late; see SNoRR: Silent Nocturnal Respiratory Reflux. I once weighed over 200 pounds; I was once a sugar addict and a snacker. I went vegan for three years and got off sugar … I’m now 5’9” 155 pounds … for more than two decades.
Reflux is not a medical condition in that there is no magic-bullet treatment to cure it … the only cure is a healthy diet and lifestyle.
References
Association between different GLP-1 receptor agonists and gastrointestinal adverse reactions
Incretin hormones: Their role in health and disease
What You Can Do If Ozempic Is Giving You Heartburn
Tirzepatide-Induced Gastrointestinal Manifestations: A Systematic Review and Meta-Analysis
Dulaglutide (Trulicity): The Third Once-Weekly GLP-1 Agonist
Body-Mass Index and Symptoms of Gastroesophageal Reflux in Women
For more information about diagnosis and treatment of reflux laryngitis, see my two companion books on Amazon: Dropping Acid: The Reflux Diet Cookbook & Cure and Dr. Koufman’s Acid Reflux Diet. And, if you would like to schedule a virtual consultation with me, you can book it online.
