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Being in the 12 Percent
Last Tuesday, I found myself in the pharmacy line behind a woman having an animated phone conversation about her “Ozempic face” while simultaneously clutching a family-size bottle of anti-nausea medication. The pharmacist looked completely unfazed, which told me everything I needed to know about how common this scene has become. When she hung up, she turned to me and said, “You on it too?” I shook my head, but her assumption was not unreasonable. According to recent data, one in eight American adults has tried a GLP-1 medication.
That chance encounter sent me down a research rabbit hole, and what I found was fascinating. The statistics around these medications tell a story that goes far beyond weight loss numbers and celebrity endorsements. They reveal the real, lived experiences of millions of people navigating a medical intervention that has exploded in popularity faster than almost any drug category in modern history.
The GLP-1 Boom: From Specialty Drug to Cultural Phenomenon
Between 2017 and 2021, GLP-1 drug use in the United States increased roughly 40-fold. By 2021, approximately 6 million Americans were using medications like Ozempic or Mounjaro. Fast forward to 2024, and a KFF poll found that 12% of U.S. adults report having taken a GLP-1 agonist at some point. To put that in perspective, that is roughly the same percentage of Americans who have green eyes or who are left-handed.
This surge has created what amounts to a massive real-world clinical trial, with millions of people experiencing effects that range from transformative to troublesome, and everything in between.
The Digestive Reality: What Most People Experience
If there is one universal truth about GLP-1 medications, it is this: your digestive system will have opinions. The numbers paint a clear picture of what to expect.
In weight loss studies of GLP-1 drugs, approximately 40.2% of users report nausea as a side effect, making it the most common gastrointestinal issue. Think about that for a moment. If you gathered 10 people taking these medications in a room, four of them would be dealing with nausea to some degree.
But nausea is just the beginning of the digestive story. About 20.9% of users report diarrhea, while 20% experience constipation. Yes, you read that correctly. Some people get one, some get the other, and the fact that both occur at nearly identical rates tells you something important about how differently these medications affect individual bodies. Another 16.3% report vomiting.
When you look at the bigger picture, the data becomes even more striking. In adult weight loss trials for Wegovy (a brand name for semaglutide), 73% of participants experienced some form of gastrointestinal side effect, compared to 47% in the placebo group. The severe GI events occurred in 4.1% of those taking the medication versus 0.9% on placebo.
For those considering tirzepatide (sold as Zepbound for weight loss or Mounjaro for diabetes), the phrase “any GI side effect” applied to 56% of participants taking the drug across various doses, compared to 30% on placebo.
When Side Effects Lead to Stopping: The Discontinuation Data
Not everyone who starts a GLP-1 medication stays on it. The permanent discontinuation rate due to adverse reactions was 6.8% for Wegovy users compared to 3.2% for placebo. Nausea alone accounted for 1.8% of people stopping the medication entirely.
The newer dual agonists, Zepbound and Mounjaro, show an interesting dose-dependent pattern when it comes to people quitting. Discontinuation rates increase with the dose: approximately 25% of people stop taking the 15 mg dose, compared to just 5.1% at the 5 mg dose. This suggests that for many people, there is a sweet spot where the benefits outweigh the discomfort, and crossing beyond that threshold becomes untenable.
For tirzepatide, severe GI events also tracked with dosage in weight loss trials: 1.7% at 5 mg, 2.5% at 10 mg, and 3.1% at 15 mg, compared to 1% for placebo. Discontinuation due to GI events reached up to 4.3% at the 15 mg dose.
The Hospitalization Reality: Rare but Real
While most side effects are manageable at home, some are not. In the United Kingdom, by October 2024, there were 7,228 reports of gastrointestinal side effects associated with GLP-1 receptor agonists used for weight management registered with the national regulator. Of those reports, 68 cases led to hospitalization.
That represents less than 1% of reported cases requiring hospital care, but it serves as a reminder that what seems like routine nausea or vomiting can occasionally escalate into dehydration or other complications requiring medical intervention.
Hair Loss: An Unexpected Side Effect with a Gender Split
One side effect that catches many users off guard is hair loss. In adult Wegovy trials, 3% of participants reported hair loss. For Zepbound, the data revealed a striking difference between sexes: 7.1% of women versus 0.5% of men experienced hair loss on the medication, compared to 1.3% of women and 0% of men on placebo.
This dramatic gender difference remains poorly understood but represents a meaningful quality-of-life concern for many women considering or taking these medications. The hair loss is generally thought to be related to rapid weight loss and nutritional changes rather than a direct drug effect, but the distinction matters little to someone watching their hair thin.
Quality Matters: The Compounding Problem
An important asterisk to all of this data: it comes primarily from studies of FDA-approved, pharmaceutical-grade medications. The FDA has flagged issues with compounded (sometimes called “rogue”) GLP-1 preparations, including injection site reactions such as redness, swelling, pain, and lumps that have been less commonly seen with approved formulations.
As these medications have become harder to obtain through traditional channels due to demand and cost, more people have turned to compounding pharmacies. The quality and safety profile of these preparations may differ from the data presented here.
What the Numbers Mean for Real People
After diving deep into these statistics, I think back to that woman in the pharmacy line. Was she among the 44% experiencing nausea? Had she dealt with the hair loss that affects 3% to 7% of users? Was she worried about being in the small percentage who develop gallstones or the even smaller fraction with more serious complications?
The data tells us that GLP-1 medications work remarkably well for many people, with transformative effects on weight, metabolic health, and likely cardiovascular outcomes. But the data also tells us that the journey is rarely smooth. Most users will experience at least some digestive upset. Some will face side effects serious enough to stop the medication. A small number will develop complications requiring medical attention.
The explosion in use, from a specialty diabetes medication to something that one in eight American adults has tried, means we are all participating in an unprecedented experiment. The good news is that the safety profile, while imperfect, has so far been acceptable to regulators, prescribers, and millions of patients. The statistics show real risks, but they also show that serious adverse events remain relatively uncommon.
For anyone considering these medications, these numbers provide a reality check. They strip away both the utopian promises of effortless weight loss and the catastrophic warnings that every user will face dire consequences. The truth, as usual, lives in the middle, expressed in percentages and odds ratios that represent real humans having real experiences.
And maybe, just maybe, they explain why that pharmacist did not even blink at the sight of someone buying industrial quantities of ginger ale and saltines.
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