JAMA Research Letter

Journal of the American Medical Association, November 14, 2023

A cohort study based on a random sample of 16 million patients in the PharMetrics Plus database, a large health claims database that captures 93% of all out-patient prescriptions and physician diagnoses in the U.S.

What’s Interesting about this article?

  • Studies have found increased risks of gastrointestinal adverse events (biliary disease, pancreatitis, bowel obstruction and gastroparesis) in patients with diabetes who take GLP-1 agonists.
  • Diabetics have a higher baseline risk for adverse GI effects and studies are lacking for normal adults taking this class of drugs for weight loss, so risk in latter group not known.
  • This study found that use of GLP-1 agonists for weight loss, in comparison with use of bupropion-naltrexone, was associated with increased risk of pancreatitis, gastroparesis and bowel obstruction, but not biliary disease.

JournalDoc Comments:

  • Doctors and patients without diabetes should be aware of adverse GI effects with the use of GLP-1 agonists.
  • Large, randomized-controlled studies will be needed to establish risk of adverse GI effects with use of GLP-1 agonists in obese individuals without diabetes.  However, since these adverse effects can be quite serious, caution should be used in using this class of drugs in normal adults.
  • Risk-Benefit analysis GLP-1 agonists in obese individuals should balance significant weight loss of 20-30 %  with cost of drugs, life-time commitment, and side effects.


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