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In a sweeping analysis of more than 400,000 Reddit posts, researchers have revealed some little-known GLP-1 side effects.
GLP-1 receptor agonists — such as semaglutide (Ozempic and Wegovy), and tirzepatide (Mounjaro and Zepbound) — have been most commonly associated withgastrointestinal side effects, such as nausea, vomiting, diarrhea and constipation.
A new study published in Nature Health, however, uncovered some overlooked effects.
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University of Pennsylvania researchers usedartificial intelligenceto analyze more than five years of Reddit posts from more than 67,000 people taking the popular drugs for diabetes or weight loss.
While clinical trials are still the “gold standard,” the researchers noted that Reddit community feedback reflects a different population.

GLP-1 receptor agonists — such as semaglutide (Ozempic and Wegovy), and tirzepatide (Mounjaro and Zepbound) — have been most commonly associated with gastrointestinal side effects, such as nausea, vomiting, diarrhea and constipation.(iStock)
“People oftenuse medicationsdifferently than they’re prescribed, so it’s also important to look at real-world usage, which can diverge from usage in a clinical trial,�“So there are many possible reasons we’re seeing signals that the trials may have missed.”
Overlooked effects
Nearly half of the users reported one or more side effects.The most common were nausea, vomiting and constipation, which aligned with what clinical trials found, according to Sehgal.
“We’re almost certainly capturing a skewed slice of the full picture.”
“We did notice a few side effects that have not previously been reported for these drugs,�
“For example, about 4% of users who described side effects reportedmenstrual irregularities.Other Redditors described unusual temperature-related symptoms, like chills or hot flashes.”
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Nearly 13% of users also experiencedpsychiatric symptoms, such as anxiety, depression and insomnia.More than 5% also complained of abdominal pain, acid reflux, headache and dizziness.
“Fatigue was also the second most commonly reported symptom overall, but has met relatively few reporting thresholds in existing trials,” Sehgal noted.“This gap between what patients are self-reporting online and what gets captured in trials is really what motivated this whole line of work.”
Clinical context
Dr.Sue Decotiis, a New York City-based board-certifiedweight-loss physician, noted that many of the reported symptoms, such as disorientation and fatigue, are most likely due to dehydration and hypoglycemia (low blood sugar).

“People often use medications differently than they’re prescribed, so it’s also important to look at real-world usage, which can diverge from usage in a clinical trial,” the lead researcher said.(iStock)
“Patients should be carefully monitored using a structured protocol that ensuresproper nutritionand adequate hydration, ideally under the direct supervision of a physician experienced in metabolism and weight loss,�
“Additionally, body composition analysis can help identify issues such as muscle loss, excessive water loss or insufficient fat loss.”
GLP-1 medications, complications are rare and typically occur only when patients are noncompliant,” she added.
Study limitations
As the data came from Reddit users, who tend to be younger,primarily maleand mostly based in the U.S., it may not represent everyone taking these medications, the researchers noted.

“In my experience treating thousands of patients with various GLP-1 medications, complications are rare and typically occur only when patients are noncompliant,” a weight-loss doctor shared.(iStock)
“And even within Reddit, the people who post about their side effects are probably not typical of everyone on the medication,” Sehgal said.“If you had a good experience, you’re less likely to be writing about it online.So we’re almost certainly capturing a skewed slice of the full picture.”
The researchers also noted that the study can’t prove the drug caused the reported symptoms.
do more research.”

The researchers noted that the study can’t prove the drug caused the reported symptoms.(iStock)
The study also didn’t include GLP-1 dosage, duration of the medication and symptoms, or other health conditions the users experienced.There is also the chance that the AI tools misunderstood meanings or context, the researchers noted.
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The results must be confirmed with more rigorous research, Sehgal said.“That’s how we’ll get real answers about prevalence and causality, which social media data alone can’t provide.”
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“These are signals, not conclusions – but I do think it’s always worthtalking to your doctorabout anything unexpected you’re experiencing while on a new medication, even if you’re not sure if it’s related,” he advised.“So if something feels off, say something.”
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