Patients are asking if recent side effect claims with GLP-1 agonists (semaglutide, etc) are true...especially when used for weight loss.
We know GLP-1 agonists can cause GI side effects (nausea, constipation, etc). But stay informed about emerging adverse effects in the news, online, etc...and help patients weigh the pros and cons.
Hair loss. Evidence is mixed.
Some observational studies show an association, NOT causation.
But know that studies didn’t control for genetic causes of some hair conditions (androgenic alopecia, etc). Nutrition changes from GLP-1 therapy could also play a role in hair loss, which might be reversible.
Plus a handful of reports and observational studies suggest GLP-1s may IMPROVE hair growth in some cases...and evidence is evolving.
For now, advise to watch for hair loss. Help address nutrition factors if it occurs...and weigh treatment options (minoxidil, etc).
Erectile dysfunction (ED). Rumor, with conditions.
Explain that only a few observational studies suggest an increased risk of ED. In fact, most other studies show a DECREASED risk.
Share that a recent randomized controlled trial of 24 men using dulaglutide for weight loss also didn’t show an increase in ED.
But remember that obesity and diabetes alone can increase ED, leading patients to need evidence-based treatments (sildenafil, etc).
Aspiration during surgery. Rumor, with conditions.
We have some evidence that peri-op patients on GLP-1s are more likely to have residual food in their stomach prior to surgery. But several large studies suggest GLP-1s do NOT increase aspiration events.
To be on the safe side, recent guidelines prioritize holding GLP-1s for patients with high aspiration risk (Parkinson disease, etc).
Refer to our Perioperative Management of Diabetes chart for guidance on how long to hold GLP-1 agonists around surgery, if needed.
Suicide. Rumor.
Emphasize that several large studies and meta-analyses haven’t shown an increased risk of suicide despite concerning initial reports.
Still advise any patient to report mood changes, suicidal thoughts, etc...and refer them to resources ASAP (call or text 988, etc) if needed.
Listen to our December 2025 Rumor vs Truth podcast where our editors dive deeper into the evidence behind GLP-1 side effect claims.
- Alsuwailem OA, Alanazi R, Almutairi HM, et al. Hair Loss Associated With Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Use: A Systematic Review. Cureus. 2025 Sep 16;17(9):e92454.
- Yang B, Cheng H, Hu Y, et al. Effects of Anti-Diabetic Drugs on Erectile Dysfunction: A Systematic Review and Meta-Analysis. Diabetes Metab Syndr Obes. 2025 Feb 17;18:467-478.
- Kindel TL, Wang AY, Wadhwa A, et al. Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Obes Relat Dis. 2024 Dec;20(12):1183-1186.
- Ebrahimi P, Batlle JC, Ayati A, et al. Suicide and Self-Harm Events With GLP-1 Receptor Agonists in Adults With Diabetes or Obesity: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2025 Sep 1;82(9):888-895.