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Possible long-term risks include: Gallstones or gallbladder inflammation, especially with rapid weight loss Pancreatitis, which is inflammation of the pancreas Kidney stress or acute kidney injury linked with dehydration from vomiting or diarrhoea Severe constipation or worsening digestive symptoms Delayed stomach emptying or gastroparesis-like symptoms Possible worsening of diabetic retinopathy in some people with type 2 diabetes, especially if blood sugar improves very quickly Increased heart rate in some people Allergic reactions, such as swelling, rash, itching, or breathing difficulty Mood changes or suicidal thoughts, which need immediate medical attention Loss of lean muscle mass if weight loss happens without enough protein and strength training Facial volume loss due to rapid weight loss, sometimes called Ozempic face, although this can happen with rapid weight loss from any cause Some GLP-1 medicines carry a warning related to thyroid C-cell tumours seen in animal studies
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Neuroimaging research supports these clinical observations