Weight loss drugs, pregnancies clash
Side effects appear for women quitting medications cold turkey
Women across the country are bonding online over their “Ozempic babies” − surprise pregnancies while taking weight loss medications, despite being on birth control or having a history of fertility problems. Some say they’re experiencing intense symptoms such as extreme hunger and rapid weight gain after quitting these drugs cold turkey to protect their baby’s health.
Although hunger and weight gain are typical during pregnancy, these women say that the intensity of their symptoms is unlike that of their previous pregnancies. It’s unclear whether pregnancy worsens weight loss medication withdrawal, but fertility and bariatric experts say pregnancy’s hormonal changes could explain the fierce effects.
Drug manufacturers recommend that women stop taking weight loss drugs at least two months before a planned pregnancy. When a nonpregnant person quits these medicines, doctors typically help them wean off to mitigate side effects. But people who find out they’re expecting must stop immediately.
As more and more women become pregnant while taking weight loss drugs, experts recommend they talk to their doctors right away, especially if they’re taking drugs like Ozempic to treat diabetes.
When Ozempic and pregnancy symptoms collide
Amanda Brierley, 42, started taking semaglutide, the active ingredient in Ozempic, last year to treat her insulin resistance caused by polycystic ovary syndrome. Within a month, her menstrual period returned “like clockwork” after several years of dysregulation. Nine months later, Brierley learned she was pregnant, which was shocking news considering doctors told her she wouldn’t be able to conceive on her own following her last high-risk pregnancy over two decades ago.
Medications like Ozempic, Mounjaro, Wegovy and Zepbound appear to boost fertility because the weight loss they induce corrects hormonal imbalances caused by obesity and metabolic disorders. Some of them may also reduce the efficacy of birth control pills.
Brierley stopped taking semaglutide right away, per recommendations based on animal studies that found it could cause miscarriage and birth defects if taken while pregnant. A week later, she was possessed with an insatiable hunger.
“I was a human garbage can. And I didn’t want sweets or anything. I wanted real food, like meats, cheese and other rich protein, which was completely different from my first pregnancy. I was like a caveman. I couldn’t stop. It was crazy,” she said.
Brierley gained 20 pounds during her first trimester. By the time she gave birth, she had put on 65 pounds. While pregnant with her older son, Brierley gained 19 pounds total.
Deb Oliviara, 32, said she also experienced extreme hunger and weight gain after stopping Ozempic when she learned of her unexpected pregnancy.
“It was very clear that it wasn’t just from the pregnancy because I’ve been pregnant six times, so this is not new to me,” Oliviara said. “I understand how that normally feels, but it was an insatiable hunger that I have never felt in my life.”
She gained 20 pounds in just two months despite continuing a healthy diet and lifestyle. Oliviara said the rapid weight gain affected her mentally because of how physically uncomfortable she became. Her symptoms calmed down after about three months.
What’s going on?
Most women gain anywhere between 25 and 35 pounds throughout their pregnancy, according to the National Institutes of Health. How much depends on the person’s body mass index before they get pregnant, as well as certain health conditions that may make pregnancy weight gain more or less likely, said Dr. Allison Rodgers, an OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois.
Stopping weight loss medications is known to cause intense hunger pangs, weight gain and blood sugar swings, all of which can be mitigated by slowly weaning off the drugs with a doctor’s guidance. Rodgers said no studies to date have analyzed how this withdrawal interferes with pregnancy symptoms, and vice versa.
“Do weight loss medications suppress some pregnancy symptoms that then return more intensely when a person gets off of them? Or does pregnancy worsen withdrawal symptoms?” Rodgers said. “It’s really hard to tease out.”
Dr. Sahar Takkouche, a bariatrician and associate professor of medicine with the Vanderbilt University Medical Center, said that quitting weight loss drugs disrupts the systems in the body responsible for blood glucose and appetite control. So it’s possible that quitting these drugs cold turkey, as opposed to weaning, plus pregnancy, may be intensifying the symptoms that both experiences share.
“Pregnant women, in particular, may experience these symptoms more intensely due to hormonal changes that occur with pregnancy and blood sugar swings,” Takkouche said. “Ideally, I recommend a gradual taper off of these medications, when clinically feasible.”
Cautions for people with diabetes
In some scenarios, rapid weight gain during pregnancy could introduce health risks to mother and baby, Rodgers said: “You don’t want to not listen to your body, but you don’t want to overconsume either.”
Developing gestational diabetes, for example, can increase risks of high blood pressure and having a large baby that needs to be delivered by cesarean section, which has more complications like blood clots and infections, the Centers for Disease Control and Prevention says. Gestational diabetes also puts babies at higher risk of preterm birth, low blood sugar and developing Type 2 diabetes later in life.
It’s especially important for people who are taking drugs like Ozempic to treat their existing diabetes to ensure they keep their condition under control after quitting the drug when they learn they’re pregnant, Rodgers said. If blood sugar levels are too high, particularly during the first 10 weeks of pregnancy, babies face increased risks of birth defects.
“Regardless of whether you just stopped Ozempic, it’s important to take care of yourself while pregnant – make sure you get proper nutrition and don’t have too little or too much weight gain,” Rodgers said.