11 Wegovy long-term side effects (semaglutide)

Whether you recently started taking Wegovy (semaglutide) or are considering it, you may be curious about its long-term side effects. 

Long-term side effects are issues that could linger after stopping the medication or ones that appear after long-term use — or any side effects that could have a lasting impact on your health. 

In this guide, we’ll discuss the long-term side effects of Wegovy in detail, the research on semaglutide's long-term safety, and practical steps you can take to minimize risks while getting the most out of treatment.

Before digging into each one in detail, the potentially serious or  long-term side effects of Wegovy are:

1. Gallbladder problems

2. Kidney damage and function problems

3. Stomach paralysis (gastroparesis)

4. Vision problems and eye damage

5. Pancreatitis and pancreatic inflammation

6. Intestinal blockage (ileus)

7. Heart rate changes and cardiovascular effects

8. Mental health effects

9. Body composition changes

10. Thyroid tumor risk (animal studies)

11. Hypersensitivity reactions

You may be familiar with the short-term and common side effects of Wegovy, such as nausea, diarrhea, vomiting, and constipation. However, when it comes to longer-term effects or potential complications, the list is a bit different. Here are 11 potential long-term side effects, but remember, most are not common, and most side effects go away once you stop the medication. 

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Long-term Wegovy side effects

Long-term side effects of Wegovy (semaglutide) are still being studied, but current evidence shows most people tolerate it well under medical supervision. Most of these side effects are rare but can become serious if left untreated.

1. Gallbladder problems

There is a link between Wegovy and gallbladder problems. Rapid weight loss itself raises gallbladder risks, but some studies suggest Wegovy can also play a role. 

In the SELECT trial, gallbladder-related disorders were reported slightly more often in people taking semaglutide compared to those on a placebo (2.8% vs. 2.3%).

This difference was mainly due to gallstones (1.4% vs. 1.1%), while rates of gallbladder inflammation (cholecystitis) were the same in both groups (0.6%). These findings suggest that gallbladder problems can occur in a small percentage of people on semaglutide.

If you develop abdominal pain, skin yellowing, or fever while taking Wegovy, contact a healthcare provider for evaluation and treatment.

2. Kidney problems

Wegovy may cause sudden kidney problems (acute kidney injury). Acute kidney injury means the kidneys suddenly stop working as well as they should. This has sometimes happened when Wegovy side effects like nausea, vomiting, or diarrhea caused dehydration. In some cases, people needed dialysis to help their kidneys recover. 

This is considered a short-term risk and is most likely to occur when starting or increasing the dose, especially if dehydration isn’t treated quickly. Staying hydrated and seeking care for persistent symptoms can help protect kidney health during Wegovy treatment.

It’s important to watch for symptoms like nausea, vomiting, or diarrhea and notify a healthcare provider if these symptoms don’t seem to go away.

3. Stomach paralysis (gastroparesis)

Semaglutide can slow gastric emptying, which helps control appetite. But this may also, in rare cases, progress to gastroparesis. A large study looking at people with obesity but without type 2 diabetes found that those taking semaglutide had higher rates of gastroparesis compared to other weight management options.

Gastroparesis symptoms can include nausea, bloating, vomiting, or feeling uncomfortably full after only a small meal. While still uncommon, these findings highlight the importance of recognizing early signs so that treatment can be adjusted if needed.

4. Vision problems and eye damage

Semaglutide has been linked to eye health concerns in people with type 2 diabetes, especially those who already have diabetic retinopathy. (Diabetic retinopathy is an eye condition caused by damage to the blood vessels in the retina from high blood sugar.) Some trials, including SUSTAIN-6, found a higher rate of retinopathy complications in people taking semaglutide compared with a placebo.

When researchers looked at results across many studies, they found that semaglutide was not tied to an overall higher risk of eye problems. But the risk appeared slightly higher in older adults and in people who had diabetes for 10 years or longer.

For anyone with diabetes, regular eye exams remain important, particularly if you already have vision changes or long-standing disease.

5. Pancreatitis and pancreatic inflammation

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

Some cases of acute pancreatitis have been reported in people taking semaglutide, though large studies have not shown a clear increase in risk compared with a placebo.

Most people recover from acute pancreatitis with proper treatment, but severe cases can lead to serious complications. Still, because pancreatitis can be life-threatening, it’s important to recognize warning signs early. These include sudden, severe stomach pain (sometimes spreading to the back), nausea, and vomiting.

If you ever notice these symptoms, stop using Wegovy and seek medical help from a provider. 

6. Intestinal blockage (ileus)

In 2023, the US Food and Drug Administration (FDA) added intestinal blockage (ileus) as a rare but serious risk for medications like Wegovy. This condition prevents food from moving through the intestines normally and can become life-threatening if untreated.

Symptoms may include stomach pain or swelling, constipation, nausea, and vomiting. Because these signs can overlap with common side effects, it’s important to seek medical care if they’re severe, persistent, or worsening.

7. Heart rate changes and cardiovascular effects

Semaglutide can raise resting heart rate by about 1-4 beats per minute, but this has yet to be linked to more heart attacks, strokes, or heart failure. That said, increased heart rate can be a concern for people who have heart conditions such as atrial fibrillation or heart failure, so always consult a provider before starting Wegovy. 

Your healthcare provider will check your heart rate regularly while you’re on Wegovy. Let them know if you notice palpitations or a racing heartbeat when you’re at rest. If your resting heart rate stays high, your provider may stop the medication.

On the flip side, the benefits of semaglutide for heart health may outweigh the risks for some people. In the SELECT trial, adults with heart disease and overweight or obesity who took semaglutide had about a 20% lower risk of heart attack, stroke, or dying from cardiovascular disease compared with those who took a placebo.

8. Mental health effects

The FDA label for Wegovy notes reports of suicidal thoughts in people using weight management medications.  It’s important to pay attention to how you’re feeling while on treatment.

If you notice new or worsening depression, unusual mood changes, or thoughts of self-harm, reach out for help right away and inform your healthcare provider. This medication isn’t recommended for people with a history of suicide attempts or active suicidal thoughts.

9. Body composition changes

One effect of rapid weight loss is often visible changes in body composition. Social media terms like “Ozempic face” or “Ozempic butt” highlight how weight loss can sometimes make the face or other areas look thinner or more hollow.

Some people may notice a more drawn appearance or loose skin. Even if weight is regained later, fat often doesn’t return to the same areas, so features may look different than before.

That said, similar body changes can occur in any rapid weight loss, with or without Wegovy. Talking with your healthcare provider can also guide you to safe ways to support muscle and skin health during weight loss.

10. Thyroid cancer (animal studies)

Wegovy carries an FDA black box warning about a rare type of thyroid cancer because semaglutide caused certain types of thyroid tumors in long-term animal studies. It isn’t known whether this risk applies to people, and so far, studies in humans haven’t confirmed a direct link.

Out of caution, Wegovy isn’t recommended for people with a personal or family history of medullary thyroid cancer or a rare condition called Multiple Endocrine Neoplasia type 2.

If you notice a lump or swelling in your neck, persistent hoarseness, trouble swallowing, or shortness of breath, tell your healthcare provider. It’s a good idea to get checked.

11. Hypersensitivity reactions

Like many medications, Wegovy may trigger allergic reactions. Some people have reported swelling of the face, lips, tongue, or throat, sudden rash, or trouble breathing. These reactions are very uncommon, but because they can be serious, you should get medical attention right away if they occur.

Wegovy should be avoided by people who have had a previous severe allergic reaction to semaglutide or to any of its ingredients.

Common Wegovy side effects

On the other hand, the most common side effects of Wegovy can include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Stomach pain

• Heartburn

• Feeling bloated or gassy

• Headache or dizziness

• Fatigue (tiredness)

Here are some practical steps to minimize the risk of semaglutide long-term side effects and get the most out of Wegovy:

1. Follow the dose amount and schedule carefully: Wegovy is a weekly injection that works best when taken consistently, at the correct dose. Dosage begins at 0.25 mg once weekly for the first month, then gradually increases every four weeks until the full 2.4 mg maintenance dose is reached. This gradual increase helps reduce stomach-related side effects. Do not skip steps or increase your dose faster than directed by your provider.

2. Inspect your dose before injecting: Wegovy should be clear, colorless, and without particles.

3. Take your injection correctly: Wegovy should be injected under the skin of the stomach, thigh, or upper arm, not into a muscle or vein. Always rotate injection sites to avoid irritation.

4. Stick to a routine: Use Wegovy on the same day each week, at any time of day, with or without food. If you need to change your dosing day, make sure your last injection was at least two days before.

5. Handle missed doses safely: If you miss a dose and your next one is more than 48 hours away, take the missed dose as soon as possible. If the next one is less than 48 hours away, skip the missed dose and return to your regular schedule. If you miss doses for more than two weeks, call your healthcare provider for guidance before restarting.

6. Be alert to signs of overdose: Taking too much Wegovy may cause severe nausea, vomiting, or dangerously low blood sugar. If this happens, call your healthcare provider or go to the nearest hospital immediately.

Who can use Wegovy?

Wegovy is approved for weight loss and long-term weight management, alongside healthy eating and regular physical activity. More specifically, Wegovy is approved for:

• Adults and children 12 years and older with obesity

• Adults with overweight who also have at least one weight-related health condition, such as type 2 diabetes, high blood pressure, or high cholesterol

• Adults with cardiovascular disease and overweight or obesity to help lower the risk of serious heart problems like heart attack or stroke

• Adults with a fatty liver condition called MASH (metabolic dysfunction-associated steatohepatitis), when it has caused moderate to serious liver scarring (fibrosis)

Who shouldn’t use Wegovy?

Wegovy isn’t safe for everyone. You should not use it if:

• You have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).

• You have ever had a serious allergic reaction to semaglutide or any of the ingredients in Wegovy.

• You’re pregnant or trying to conceive. The medication should be stopped as soon as pregnancy is recognized, unless your provider decides the benefits outweigh the risks. If you’re planning a pregnancy, Wegovy should be stopped at least two months beforehand in most cases.

Neither is necessarily safer because they are the same medication (semaglutide) but with slightly different dosages. That said, Wegovy is specifically tested and approved for weight loss. Ozempic may be used for weight loss when appropriate, but only under a healthcare provider’s guidance.

Wegovy and Ozempic contain the same active ingredient (semaglutide), but they’re FDA-approved for different uses:

• Wegovy is FDA-approved for weight management in adults and children 12 years and older with obesity, adults with overweight and at least one related health condition, for reducing cardiovascular risk in certain adults, and for the treatment of fatty liver (MASH).

• Ozempic is FDA-approved for type 2 diabetes and for reducing cardiovascular risks or kidney decline in certain adults with type 2 diabetes. It’s sometimes prescribed off-label for weight loss, but it hasn’t been approved for this purpose. Safety and effectiveness haven’t been established in people under 18.

Wegovy works best when taken long-term, and its effects weaken once the drug leaves your system. After stopping treatment, people may notice an increase in weight and appetite, and much of their weight loss progress and other health benefits may be reversed. 

In the STEP 1 trial, people who used semaglutide for more than a year lost an average of about 17% of their body weight. But after treatment was stopped, about two-thirds of that lost weight gradually returned within the following year.

The same pattern was seen with health benefits like lower blood pressure, cholesterol, and blood sugar. Once treatment ended, many of these improvements returned to their initial levels.

If you’re considering stopping Wegovy, it’s important to speak with your healthcare provider about how to transition safely and support your health in other ways.

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While semaglutide has shown effectiveness in sustained weight loss, a few rare complications can develop over time and should be watched closely. The main Wegovy long-term side effects are:

• Digestive risks: Gastroparesis (stomach paralysis) and intestinal blockage are rare but serious complications. Persistent nausea, vomiting, or abdominal pain should be evaluated promptly.

• Organ health: Pancreatitis, gallbladder disease, and kidney problems may occur, though studies suggest the risks are low overall. Staying hydrated and reporting unusual symptoms can help prevent complications.

• Vision and eye health: People with diabetes-related eye disease may be at higher risk for worsening vision problems, making regular eye exams essential.

• Body composition changes: Rapid weight loss can lead to visible changes in appearance, such as loose skin or a thinner face, which are cosmetic rather than medical concerns.

Overall, most people tolerate Wegovy long-term. The safest approach is to follow dosing guidelines carefully, maintain open communication with a healthcare provider, and keep up with routine monitoring to identify and manage any side effects early.