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Op. Dr. Murat Üstün
GLP-1 İlaçlar

GLP-1 Agonist Side Effects: What You Need to Know About Semaglutide and Tirzepatide

GLP-1 receptor agonists including semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro) are increasingly used for type 2 diabetes and obesity. This guide outlines practical strategies for managing their adverse effects based on latest clinical evidence.

1. Gastrointestinal Side Effects

Nausea, vomiting, diarrhoea, constipation, abdominal pain, and bloating are the most common adverse effects. They occur most frequently during dose escalation and tend to fade over time. Practical tips: eat slowly, choose smaller portions, avoid late-night eating, follow a low-fat diet, and drink at least 2-2.5 litres of water daily.

2. Acute Pancreatitis Risk

Rarely but seriously, GLP-1 agonists can cause acute pancreatitis. Warning signs: severe abdominal pain radiating to the back, nausea and vomiting. If suspected, the medication must be stopped immediately.

For perspective: Between 2007 and 2025 in the UK, 1,296 pancreatitis cases (19 fatal) were reported against 25 million+ GLP-1 packs dispensed.

3. Hair Loss (Telogen Effluvium)

Up to 1 in 10 patients experience temporary hair loss due to rapid weight loss (telogen effluvium). It appears 3-4 months after starting treatment and resolves within 3-6 months.

4. NAION Vision Risk

A UK regulatory warning flagged increased NAION risk with all semaglutide forms. NAION causes sudden painless vision loss. If this occurs, semaglutide must be stopped immediately and an ophthalmologist consulted urgently.

In context: NAION is very rare - approximately 1 in 10,000 people on semaglutide. Only 3 cases since 2018 across 10 million+ packs.

5. Drug Interactions

GLP-1 agonists slow gastric emptying, potentially affecting absorption of narrow-therapeutic-index medications (digoxin, lithium, warfarin). For women on oral HRT, transdermal oestrogen and a levonorgestrel-releasing IUD are recommended.

GLP-1 Drugs vs Bariatric Surgery

GLP-1 agonists are valuable for mild-to-moderate obesity (BMI 27-35). For severe obesity (BMI 40+), gastric bypass or sleeve gastrectomy offer far more durable results, including 70-80% type 2 diabetes remission rates.

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Frequently Asked Questions

How long do GLP-1 side effects last?

GI side effects fade over time. Hair loss appears at 3-4 months and resolves by 3-6 months. Serious effects (pancreatitis, NAION) require immediate discontinuation.

Can GLP-1 drugs replace bariatric surgery?

For mild-to-moderate obesity they may help, but for severe obesity and serious comorbidities, bariatric surgery delivers far more durable results. Weight regain on cessation is also an important consideration.

Source: Kevin Fernando, MBChB. Medscape Family Medicine, 18 March 2026. MHRA Safety Updates 2024-2025.