What are the long-term side effects of Ozempic?

When people ask about long-term side effects of Ozempic, they’re usually curious about problems that could show up after taking it for a while or side effects that may not go away. The main long-term side effects of Ozempic are:

1. Stomach paralysis

2. Intestinal blockage

3. Changes in body composition

4. Kidney damage and function loss

5. Vision problems and eye damage

6. Pancreatitis

7. Gallbladder disease and complications

8. Risk of thyroid tumor

9. Hair loss 

10. Mental health effects

However, not everyone will experience Ozempic risks long-term, and the side effects are usually temporary and mild for most people. The full list of possible risks is available in the prescribing information. Always discuss your individual risk and any concerning symptoms with your healthcare provider.

Let’s look at each of the long-term Ozempic issues in detail. 

Here are 10 potentially serious long-term side effects of semaglutide (Ozempic’s active ingredient). Keep in mind that these are not common side effects, but if they do occur, getting medical care right away can prevent long-term complications in most cases.

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1. Stomach paralysis (gastroparesis)

Gastroparesis happens when the stomach takes too long to empty food. This condition is rare but can cause long-term digestive problems.

A recent study of over 55,000 people with obesity (without diabetes) found that those taking semaglutide, including Ozempic, had a higher risk of being diagnosed with gastroparesis compared to people using other weight-loss treatments.

The study showed semaglutide users were about three times more likely to develop gastroparesis than people taking another weight-loss pill and about six times more likely than people who had weight-loss surgery.

Because Ozempic works in part by slowing how quickly food leaves the stomach, it is not recommended for people who already have gastroparesis. Gastroparesis symptoms can include nausea, vomiting, feeling full quickly, bloating, and stomach pain. If you notice these issues and they don’t go away, talk with your healthcare provider.

2. Intestinal blockage

Ozempic has been linked to rare cases of intestinal blockage (ileus). This happens when food can’t move through the intestines normally. If untreated, it can cause infection or even a rupture in the intestine, which can be life-threatening.

Because of these reports, the US Food and Drug Administration (FDA) updated Ozempic’s safety label to include this potential risk. The tricky part is that intestinal blockage symptoms can feel a lot like common Ozempic side effects. Symptoms may include stomach pain, nausea, vomiting, or the inability to pass stool.

If these symptoms persist, feel severe, or worsen, contact your healthcare provider right away. Regular check-ins can help make sure Ozempic stays safe for you.

3. Changes in body composition

Some people taking Ozempic notice changes in how their body looks, often described as “Ozempic face,” “Ozempic butt,” or “Ozempic body.” These terms have become popular on social media and are used to describe sagging skin or a more hollow appearance that can follow rapid weight loss.

These changes aren’t listed in Ozempic’s official prescribing information but are thought to happen when fat volume in certain areas drops quickly.

Skin and soft tissues may not adjust at the same pace, which can leave the face or body looking more deflated. Plastic surgeons have noted that this effect can sometimes make people look up to five years older, even if they’ve become healthier overall.

These effects are not medically dangerous, but they can feel discouraging. If body or facial changes are bothersome, a healthcare provider, or in some cases, a cosmetic specialist, can discuss supportive options to help address them.

4. Kidney problems

Vomiting and diarrhea are common side effects of Ozempic and can sometimes lead to dehydration and acute kidney injury, including cases that require dialysis. These effects are most likely to occur when starting Ozempic or when the dose is being increased.

Because of this risk, your healthcare provider may monitor your kidney function if you develop ongoing stomach issues or dehydration. If you have persistent nausea, vomiting, or diarrhea while taking Ozempic, let your provider know right away. In some cases, they may recommend stopping the medication or lowering the dose.

On the other hand, Ozempic was approved in 2025 to help protect kidney health in people with type 2 diabetes and chronic kidney disease. So, while there are risks, it can also be beneficial if closely monitored.

5. Vision problems and eye damage

Ozempic can sometimes affect the eyes, especially in people who already have an eye condition called diabetic retinopathy (damage to the blood vessels in the eye from diabetes). In one two-year study, 3% of people taking Ozempic for type 2 diabetes developed eye complications compared to 1.8% of people taking a placebo.

Researchers also suspect Ozempic may be linked to another eye condition called NAION (non-arteritic anterior ischemic optic neuropathy), which happens when the optic nerve doesn’t get enough blood.

Vision changes linked to Ozempic are still being studied, but they may be related to sudden drops in blood sugar levels. If you notice any changes in your eyesight, contact your healthcare provider right away and be sure to keep up with regular eye exams. 

6. Pancreatitis

Pancreatitis is inflammation of the pancreas, an organ that helps with digestion and blood sugar control. It’s rare but can be serious. 

Some cases of acute pancreatitis have been reported in people taking Ozempic, though research so far shows no clear evidence that the medication directly causes pancreatitis. In fact, one large analysis of more than 34,000 people found no increased risk compared to a placebo.

Even so, pancreatitis requires urgent care if it happens. Warning signs include severe stomach pain (especially if it spreads to your back), nausea, and vomiting. Most people recover with proper treatment within a couple of weeks, but in rare situations, it may become long-term.

If you experience these symptoms, stop taking Ozempic and seek medical help right away. Your provider can run tests to confirm the cause and decide if it’s safe to restart treatment later.

7. Gallbladder disease and complications

Ozempic may raise the risk of gallstones and gallbladder disease. In clinical trials, about 1.9% of people taking Ozempic developed gallstones compared to none taking a placebo.

Gallstones can block the normal flow of bile, which may cause pain and, in some cases, serious infection. Watch for symptoms like nausea, vomiting, fever, and sudden and severe abdominal pain.

If you notice any of these signs, contact your healthcare provider right away. Gallbladder problems can be treated, but they often require medical care to prevent complications.

8. Risk of thyroid tumor

Animal studies have linked semaglutide to thyroid C-cell tumors, but it’s not clear if this risk applies to humans. Because of this uncertainty, Ozempic carries a boxed warning, the strongest type the FDA issues, for the potential risk of certain thyroid cancers, including medullary thyroid carcinoma.

A 2024 review of over 14,000 participants found the actual incidence of thyroid cancer with semaglutide to be less than 1%, suggesting no clear increased risk.

Still, people with a personal or family history of thyroid cancer are advised not to take Ozempic. Warning signs to look out for include a lump in the neck, difficulty swallowing, sudden hoarseness, or shortness of breath.

If you notice any of these symptoms, contact your healthcare provider right away for further evaluation.

9. Long-term cardiovascular effects

Heart disease and heart failure are more common in people with overweight or obesity, and treatment options have often been limited. Recent studies show that semaglutide may play a positive role in heart health.

In the large SELECT trial, which followed over 17,000 people, semaglutide was found to lower the risk of major heart problems such as heart attack, stroke, and cardiovascular death.

It also reduced hospital visits for heart failure and lowered the risk of death from any cause. These benefits were seen in people with different types of heart failure, and the medication did not lead to more serious side effects.

Overall, studies suggest that semaglutide may support heart health in people with obesity and heart disease. If you have a history of heart problems, your healthcare provider can help you decide if Ozempic is a safe and effective option for you.

9. Hair loss

Some people have experienced hair loss or thinning hair while taking Ozempic. 

Though not observed as a side effect in Ozempic’s initial clinical trials, more than 1,000 cases of hair loss (alopecia) have been reported in the US Food and Drug Administration Adverse Event Reporting System (FAERS). More research is needed to determine if Ozempic affects hair follicles or plays a role in hair loss. 

Speak with your healthcare provider if you’re experiencing hair loss while taking Ozempic. They can help figure out why it’s happening and talk to you about options.

10. Mental health effects

There is ongoing concern that medications like Ozempic may be linked to mental health side effects such as depression, anxiety, or thoughts of self-harm.

Because of this, it’s recommended that anyone starting treatment be screened for existing mental health conditions and closely monitored for changes in mood or behavior over time.

Researchers and regulators are still studying this potential connection, and ongoing monitoring is in place. For now, the safest approach is open communication: stay aware of how you’re feeling emotionally during treatment and keep your care team informed.

If you or someone close to you notices shifts in your mood, increased anxiety, or thoughts of harming yourself while taking Ozempic, it’s important to let your healthcare provider know right away.

Semaglutide side effects usually last for the first 8 to 12 weeks of treatment. Most symptoms, like nausea, diarrhea, or vomiting, are mild and improve over time as the body adjusts. Some side effects, like gallbladder problems, may appear later and require medical attention.

Most people tolerate the medication well, especially with regular medical monitoring, which helps determine whether any side effects experienced are temporary or long-term.

Effects that develop after 3+ months of use

If you’re worried about Ozempic side effects after 3 months, know that most symptoms settle down by this point, but regular check-ins with your provider are still important.

Long-term studies, like the STEP 5 trial, followed patients for two years and found that most people tolerated semaglutide well, with less than 4% stopping due to side effects.

Rare issues such as gallbladder problems or pancreatitis can occur at any point, but they aren’t common.

Effects that persist after stopping Ozempic

Most short-term side effects, like stomach upset or nausea, go away once you stop taking Ozempic.

Keep in mind that the benefits also seem to go away after stopping treatment. In clinical trials, people who stopped semaglutide often regained much of the weight they had lost. For example, in the STEP 4 study, people who switched to placebo after 20 weeks gained an average of 6.8% of their body weight back, while those who continued semaglutide lost additional weight. While this study evaluated 2.4 mg of semaglutide, which is the maximum dose of Wegovy, similar regain can happen after stopping Ozempic. 

There’s little known about the gender-specific side effects of semaglutide. Data from large adverse event reporting systems suggest that women may report more side effects from antidiabetic drugs (like Ozempic), but the exact mechanisms are not fully understood.

Why women experience more gastrointestinal effects

Women may be more likely to report gastrointestinal side effects with Ozempic, partly because stomach issues are more common in women to begin with. For example, conditions like irritable bowel syndrome (IBS) are about twice as common in women as in men.

Research suggests that shifts in ovarian hormones, such as estrogen and progesterone, can influence how the gut processes pain, responds to stress, and regulates movement. These hormone changes don’t directly cause IBS, but they may make women more sensitive to digestive symptoms.

Fertility impacts

For women of reproductive age, medications like semaglutide can be effective for weight loss and type 2 diabetes but raise special considerations.

Healthcare providers are advised to weigh both the cardiometabolic benefits and potential risks when prescribing to this group. Animal studies suggest possible risks during pregnancy, but there is limited data in humans.

Some medications may interfere with oral contraceptives or affect fertility, while others may improve it. Because of these uncertainties, more research is needed to understand the full impact of semaglutide on fertility, pregnancy, and breastfeeding.

Postmenopausal considerations

Postmenopausal women often experience reduced metabolism, higher fat mass, and increased risk of diabetes and heart disease. Semaglutide has been shown to help manage these risks.

One study found that postmenopausal women using hormone therapy (HT) lost more weight with semaglutide than those not on HT. After 12 months, women on HT lost about 16% of their body weight, compared to about 12% in women not using HT.

Male vs. female recovery

When people stop taking Ozempic, both men and women appear to recover from side effects at a similar rate. There is little to no reporting on major long-term differences in recovery between the two groups.

The safest way to take Ozempic long-term is to use it exactly as prescribed, stay in regular contact with your healthcare team, and make healthy diet and lifestyle changes. These habits can help you avoid semaglutide long-term side effects:

1. Follow a safe dosing plan

Ozempic dosing is designed to be increased gradually. Most people start at 0.25 mg once a week for the first month, then step up gradually to the recommended maintenance dose of 0.5 mg, 1 mg, or 2 mg. .

An overdose of Ozempic is rare, but it can happen if too much medication is taken at once. Reported complications have included low blood sugar, severe diarrhea, stomach ulcers, and even organ problems. Some people have required hospitalization but recovered with medical care.

One of the biggest concerns with an Ozempic overdose is severe hypoglycemia (very low blood sugar), especially if you’re also taking insulin or certain other diabetes medications.

Symptoms of hypoglycemia can include palpitations, anxiety, sweating, hunger, tremors, confusion, or sudden changes in behavior. If blood sugar drops further, it can cause seizures, fainting, or coma.

Because of these risks, it’s essential to only use Ozempic exactly as prescribed and never inject more than your scheduled weekly dose. If you think you’ve taken too much, seek emergency medical care right away.

2. Get tested regularly to catch problems early

Routine monitoring helps flag issues before they become serious. Your provider may run blood sugar checks to keep glucose stable, kidney tests if dehydration is a concern, or imaging to rule out gallstones if you develop sudden abdominal pain.

Eye exams are important if you have diabetic retinopathy, and any new lumps or hoarseness in your neck should be checked for thyroid changes.

3. Make healthy diet and lifestyle changes

Ozempic works best alongside healthy habits. Tracking meals and activity levels can help you notice patterns in your own lifestyle. 

A balanced diet that includes protein, healthy fats, and complex carbohydrates can help support energy levels and weight management.

Along with that, most experts suggest that you aim for at least 150 minutes of exercise per week, and gradually increase toward 250 minutes if you can. 

Structured programs that include regular sessions with a trained coach can make these changes more effective. Studies show that with consistent effort, most people lose 5–10% of their starting weight after a year of lifestyle changes alone, which can significantly improve heart health, quality of life, and reduce the risk of type 2 diabetes.

Here are seven serious Ozempic warning signs. Contact your healthcare provider right away if you notice any of the following:

1. Signs of a possible thyroid tumor: These include a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

2. Symptoms of pancreatitis: This may feel like severe pain in your stomach area that will not go away. The pain may move to your back and can happen with or without vomiting.

3. Gallbladder problems: Warning signs include pain in your upper stomach area, fever, yellowing of your skin or the whites of your eyes, or clay-colored stools.

4. Kidney problems: Symptoms include changes in urination or swelling in your legs or ankles.

5. A serious allergic reaction: Signs may include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, or fainting and feeling dizzy.

6. Changes in vision: Let your provider know if your eyesight gets worse while using Ozempic.

7. Severe stomach problems: Get help if you have ongoing pain, vomiting, or cannot keep fluids down.

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So, to summarize, what are the possible long-term side effects of Ozempic? 

• Digestive risks: Gastroparesis and intestinal blockage might be side effects of Ozempic. Persistent nausea, vomiting, or stomach pain should be reported right away.

• Organ health: Pancreatitis, gallbladder disease, and kidney problems can develop in some users, though the risks are low. Monitoring symptoms and lab tests helps catch issues early.

• Cosmetic effects: Rapid fat loss may change body appearance, sometimes making the face or body look older, though this is not a medical danger.

• Hormonal and cancer concerns: Animal studies suggest a possible link to thyroid tumors, leading to a boxed FDA warning, though human risk remains uncertain.

Overall, most people tolerate Ozempic well, but it carries some risks that require ongoing attention. While most side effects are mild and temporary, a few rare complications can become serious if left unchecked.

To avoid long-term effects, make sure you prioritize close communication with a healthcare provider, gradual dose increases, and routine monitoring to catch issues early.