GLP-1 drugs like Ozempic and Wegovy dominated medical headlines in 2025 as researchers uncovered a surprisingly broad range of both safety concerns and unexpected benefits beyond their original diabetes and weight-loss indications. The worrying safety signals included potential eye problems (a blinding condition called NAION), dental issues dubbed "Ozempic teeth," hair loss in women, and complications in specific populations like pregnant women and lung transplant recipients. On the flip side, these drugs showed promise for conditions nobody expected—from reducing fracture risk and certain cancers to helping with fibromyalgia pain, rheumatoid arthritis, skin conditions, alcohol addiction, and even lowering death rates in dialysis patients.
Article Link: https://www.medpagetoday.com/endocrinology/obesity/119252
Author: Kristen Monaco, Senior Staff Writer at MedPage Today (focusing on endocrinology, psychiatry, and nephrology news)
Institution: MedPage Today (medical news publication)
Conflicts of Interest: None apparent—this is a journalistic review article, not industry-sponsored research
This article reviews approximately 15-20 different studies published throughout 2025, ranging from small cohort studies to massive observational analyses involving hundreds of thousands to millions of patients.
| Outcome | Study Type/Reference | Data Strength Commentary |
|---|---|---|
| Reduced fracture risk (vertebral, hip, wrist) | 350,000-person observational study over 2 years<sup>[11,12]</sup> | Moderate-Strong: Very large sample size and multiple fracture types examined; however, observational design can't rule out that GLP-1 users simply have better bone health to begin with |
| Lower cancer risk (12 of 13 obesity-related cancers plus lung) | Large retrospective study; 17% lower overall risk<sup>[13]</sup> | Moderate: Large numbers but retrospective design; could be confounded by weight loss itself or healthier behaviors in GLP-1 users |
| Reduced obesity-related cancer risk vs. DPP-4 inhibitors | Target trial emulation (HR 0.93)<sup>[14]</sup> | Moderate-Strong: Target trial emulation is sophisticated observational method that mimics randomized trials; head-to-head comparison strengthens findings |
| Improved fibromyalgia symptoms (less pain, fatigue, opioid use) | Analysis of medical records<sup>[15]</sup> | Weak-Moderate: Observational records; fibromyalgia symptoms are subjective and could be influenced by weight loss or other factors |
| Rheumatoid arthritis disease improvement | Small study: 32% improved vs. 17% in non-starters<sup>[16]</sup> | Weak: Small sample size and comparing users to "prescribed but didn't start" creates selection bias |
| Better hidradenitis suppurativa outcomes | Small study over 6 months<sup>[17]</sup> | Weak-Moderate: Small sample and short duration; unclear if benefits are from weight loss or direct drug effect |
| 10% lower depression risk vs. DPP-4 inhibitors | Target trial emulation of Medicare data<sup>[18]</sup> | Moderate-Strong: Large Medicare dataset and sophisticated analysis method; reassuring psychiatric safety signal |
| Lower epilepsy risk in diabetes patients | Study mentioned (link provided in article)<sup>[19]</sup> | Unknown: Insufficient detail in summary article to assess |
| Benefits in asthma and cardiopulmonary conditions | Real-world data study<sup>[20]</sup> | Moderate: Real-world data helpful but mechanism unclear—could be weight-related |
| Potential for alcohol addiction treatment | Clinical trial<sup>[21]</sup> | Moderate-Strong: Actual trial (not just observational) is encouraging, but details not provided |
| Reduced risk of GI conditions | Study mentioned<sup>[22]</sup> | Unknown: Insufficient detail to assess |
| Lower risk of death in dialysis patients | Observational study<sup>[23]</sup> | Moderate: Highly relevant to nephrology but observational; dialysis patients taking GLP-1s may be healthier overall |
| Possible reduced uveitis risk | Study mentioned<sup>[24]</sup> | Unknown: Insufficient detail to assess |
| Adverse Effect | Study Type/Reference | Data Strength Commentary |
|---|---|---|
| NAION (potentially blinding eye condition) - 4x higher risk initially | 2024 report followed by 2025 data showing smaller risk<sup>[2,3,4]</sup> | Moderate: European Medicines Agency issued warning; signal persists across multiple analyses but risk magnitude uncertain; FDA monitoring but no official warning yet |
| Dental problems ("Ozempic teeth") - periodontal disease, decay | Expert opinion/mechanistic hypothesis<sup>[5]</sup> | Weak: Based on known side effect (dry mouth) and theoretical mechanism; no controlled studies; anecdotal reports only |
| Hair loss in women (2x higher risk vs. bupropion-naltrexone) | 16 million patient study plus clinical trial reports<sup>[7]</sup> | Moderate-Strong: Very large observational study confirmed by clinical trial data; gender-specific finding (not seen in men) strengthens signal |
| Thyroid cancer (85% higher risk in first year) | 350,000-person analysis in 2025<sup>[6]</sup> | Weak-Moderate: Large study but researchers suggest surveillance bias; most GLP-1s carry black box warning already; timing (first year spike) suggests detection bias |
| Pregnancy complications (preeclampsia, HELLP syndrome, eclampsia) | Large observational study, February 2025<sup>[8]</sup> | Moderate: Large sample but complicated by fact that preterm delivery was lower; unclear if net benefit or harm |
| Preterm delivery | Same pregnancy study<sup>[8]</sup> | Protective effect: Lower preterm delivery despite other complications creates confusing picture |
| Antibody-mediated rejection in lung transplant recipients (15-fold higher odds) | Small cohort study: 34 GLP-1 users among 301 transplants<sup>[9]</sup> | Moderate: Small numbers but extremely high odds ratio is alarming for this specific population; mechanistically plausible given immune effects |
| Chronic cough lasting >8 weeks (12% higher risk) | Chronic cough investigation<sup>[10]</sup> | Moderate: Signal persisted even after removing GERD patients; large enough study to detect but mechanism unclear |
| Frequent vomiting (known class effect) | Established side effect mentioned re: dental damage<sup>[5]</sup> | Strong: Well-documented class effect from clinical trials |
Note: This is a journalistic review article by MedPage Today summarizing multiple studies from 2025. Complete citations for individual studies were not provided in the original article. References 19-24 are titles of linked articles within the MedPage Today piece but without full study details.
The GLP-1 story in 2025 shows us that blockbuster drugs often have effects we never anticipated—both good and bad. While doctors and patients focus on weight loss and blood sugar, these drugs appear to be doing something fundamental throughout the body that we still don't fully understand. The American Medical Association even proposed creating a special registry to track side effects, though it hasn't happened yet. The challenge is that most of this data comes from observational studies—researchers watching what happens rather than running controlled experiments—so it's hard to know which associations are real and which are coincidental. For now, the safety signals warrant caution in certain populations (pregnant women, lung transplant patients), while the unexpected benefits need confirmation through more rigorous testing before anyone should take these drugs specifically for conditions like fibromyalgia or cancer prevention.