GLP-1 receptor agonists cause serious gastrointestinal and biliary adverse events.
- Current status
- EstablishedEvidence stable · Gastrointestinal
- Why
- Gallbladder/biliary disease is increased in a meta-analysis of 76 RCTs (RR 1.37; higher with weight-loss doses, RR 2.29). Cohort data show increased pancreatitis, gastroparesis and bowel obstruction versus bupropion-naltrexone. The VA atlas adds drug-induced pancreatitis, nephrolithiasis and interstitial nephritis signals. GI intolerance drives discontinuation (16.6% vs 8.2% in SELECT).
- What would change it
- Not applicable for the established components; pancreatitis and obstruction estimates need larger randomized confirmation.
- Linked studies
- 4 · 4 supports
- Last updated
- Sep 13, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
01The evidence
The evidence, sorted by what it shows
Supports (4)
- Mapping the effectiveness and risks of GLP-1 receptor agonistsRetrospective cohort · 2025 · Study tier 3 · Different population · Mixed
VA atlas: GI disorders, drug-induced pancreatitis increased.
- Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight LossRetrospective cohort · 2023 · Study tier 3 · Different population · Harm direction
Claims cohort: elevated pancreatitis, bowel obstruction, gastroparesis vs bupropion-naltrexone (wide CIs).
- Semaglutide and Cardiovascular Outcomes in Obesity without DiabetesRandomized trial · 2023 · Study tier 1 · Different population · Benefit · Industry funded
SELECT: discontinuation for adverse events 16.6% vs 8.2%, mainly GI.
- Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical TrialsMeta-analysis · 2022 · Study tier 1 · Different population · Harm direction
RCT meta-analysis: gallbladder/biliary RR 1.37; dose and duration dependent.
02History
How this assessment has changed
- EstablishedSep 13, 2026 · Evidence stable
initial curated status