Ozempic linked to increased risk of blindness

Ozempic and Vigovi, which contain the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide, continue to be blockbuster drugs for Danish pharmaceutical giant Novo Nordisk, which saw its total sales double year-over-year to a staggering $1.35 billion, according to a May 2024 report from Forbes.¹

While these options may seem convenient, obsession with weight loss “magic bullets” may be doing more harm than good.² Semaglutide has been shown to potentially increase the risk of serious gastrointestinal problems, and recent studies have suggested that these drugs may also pose a risk to vision.

Ozempic may increase risk of blindness

In a retrospective study³ In a paper published in JAMA Ophthalmology on July 3, 2024, researchers suggest there is an association between semaglutide intake and non-arteritic anterior ischemic optic neuropathy (NAION) in patients with type 2 diabetes and/or obese and overweight participants.

For background, NAION is a condition that causes a loss of blood flow to the optic nerve, the nerve pathway that connects the eye to the brain. When blood flow is blocked, sudden (and painless) blindness can occur. According to Brightman and Women’s Hospital, NAION causes “significant loss of vision in one eye the moment you wake up in the morning,” and once it develops, the vision loss remains stable.⁴

For the JAMA Ophthalmology study, the authors selected papers published between December 1, 2017 and November 30, 2023, with a total of 16,827 participants. Of this population, 710 people were diagnosed with type 2 diabetes, of which 194 were prescribed semaglutide. In addition, 979 people were overweight or obese, of which 361 were prescribed semaglutide.⁵

After accounting for covariates such as sex, age, systemic hypertension, and hyperlipidemia, the researchers determined the cumulative frequency of NAION in the population. Results showed that the subset with type 2 diabetes had 17 NAION events. The overweight/obese subset recorded 20 NAION events.⁶

An analysis using a model to calculate the risk of developing NAION showed surprising results: Semaglutide may significantly increase the risk of NAION compared to other conventional medications for diabetes and obesity. Researchers found that using the drug makes people 4.28 times more likely to develop NAION if they have diabetes, and 7.64 times more likely if they are overweight/obese.⁷

However, it should be noted that this is an observational study. The researchers did not go into detail about how semaglutide causes NAION, and stated that “future studies are needed to assess causality.” However, this study also has advantages: all NAION cases prescribed semaglutide were reviewed by experienced neuro-ophthalmologists. To the researchers’ knowledge, this is the first study to examine the association between semaglutide and NAION.⁸

A closer look at the link between semaglutide and retinopathy

While the JAMA Ophthalmology study was the first to investigate the link between semaglutide and NAION, it is not the first time other researchers have found an association between semaglutide and eye damage, specifically diabetic neuropathy.

For example, in a 2023 survey⁹ A study published in the journal Diabetes noted that during clinical trials of semaglutide (2016), the drug was observed to increase the risk of retinopathy, especially in people with diabetes.¹⁰ Semaglutide was associated with a significantly higher incidence of retinopathy complications, including blindness and vitreous hemorrhage.

What factors could be contributing to this complication? According to a study published in the World Journal of Diabetes, the factors that may be contributing to this complication in people taking semaglutide are uncontrolled type 2 diabetes, longer duration of diabetes, higher initial blood HbA1c levels, and higher rates of insulin treatment at the start of the study.¹¹ This means that if you already have chronic diabetes, taking Ozempic may significantly increase your risk of retinopathy.

Interestingly, this study highlights the important role of gut health in managing diabetes and that a healthy gut may help lower the risk of diabetic retinopathy.¹²

“Gut microbiota imbalance, i.e., chronic imbalance within many different microbial communities, appears to be associated with several inflammatory/metabolic diseases and central nervous system (CNS) disorders, including retinopathies, as a manifestation of the emerging concept of the so-called ‘microbiota-retinal axis.'”

Indeed, long-term diabetes is associated not only with retinopathy but also with significant gut microbiota dysbiosis, so that the associated changes in bacterial populations may affect the lipid content of retinal and central nervous system tissues, leading to the development of retinopathy…”

Blocking the GLP-1 receptor may cause other side effects

Taking GLP-1RAs May Have Adverse Health Effects: 2021 Study¹³ According to a study published in the Journal of Investigative Medicine, these drugs may increase the risk of gastroparesis, a condition that slows or stops the movement of food from the stomach to the small intestine.

Two patients were presented for the study. The first was a 52-year-old woman with well-controlled diabetes who visited the researchers’ clinic seeking treatment for postprandial upper abdominal pain accompanied by feelings of fullness, bloating and nausea. After tracing her medical history, it was discovered that she had been receiving semaglutide injections one month before her symptoms began.¹⁴

Tests showed that semaglutide slowed gastric emptying, so after stopping the drug for six weeks, repeat testing showed that gastric emptying had improved.¹⁵

The second patient, a 57-year-old woman, had a similar condition. She had had type 2 diabetes for 16 years and had been receiving weekly injections of dulaglutide (another GLP-1RA) for 15 months. Tests showed that the drug caused slowed gastric emptying, and that gastric motility normalized when the injections were stopped.¹⁶

In another study,¹⁷ In addition to gastroparesis, the JAMA paper noted that GLP-1RAs may also increase the risk of biliary tract disease, pancreatitis, and intestinal obstruction. EudraVigilance, the European Medicines Agency’s drug side effect monitoring system, also notes metabolic, nutritional, urinary, cardiac, and eye disorders associated with semaglutide.¹⁸

Other published studies have shown that GLP-1RAs are associated with the development of pancreatic cancer.¹⁹ Acute kidney injury.²⁰ Rodent studies have also shown that Wegoby can cause thyroid C-cell tumors at doses similar to those used in humans, making it contraindicated in patients with a history of medullary thyroid cancer.^{twenty one} Additionally, Wegovy’s product label warns users about side effects, including:^{twenty two}

Instead, boost your GLP-1 receptors with polyphenol-rich foods

Returning to the role of the gut microbiome, enhancing rather than suppressing GLP-1 expression may be more effective for weight loss. One way to do this is to colonize the gut with Akkermansia muciniphila, a type of bacteria that naturally secretes GLP-1-inducing proteins. As the researchers wrote in a study published in Nature Microbiology:

“A. muciniphila increases thermogenesis and glucagon-like peptide-1 (GLP-1) secretion in high-fat diet (HFD)-induced C57BL/6J mice through induction of uncoupling protein 1 in brown adipose tissue and systemic GLP-1 secretion.”

The importance of Akkermansia in supporting gut health cannot be overstated. In my interview with George Dinkoff, I explain why Akkermansia is an important species: However, many people are deficient in this particular microbe, and I believe this is due to insufficient energy production and oxygen leakage into the gut.

Certain foods, particularly those rich in polyphenols, may encourage the growth of Akkermansia in the gut and support overall health. Healthy sources include berries, broccoli, apples, ginger, onions, green tea and carrots.^{twenty three} the study^{twenty four} A paper published in the International Journal of Molecular Science explains why Akkermansia may be linked to health benefits.

“Akkermansia muciniphila is a mucosal commensal bacteria that is considered a gut microbial marker in healthy individuals. Its relative abundance is significantly decreased in individuals with intestinal inflammation and metabolic disorders.”

Dietary polyphenols clearly stimulate the relative abundance of A. muciniphila and contribute to the alleviation of several diseases, including obesity, type 2 diabetes, inflammatory bowel disease, and liver damage.”

Ozempic already exists in nature

Berberine, a natural compound found in goldenseal, barberry, Oregon grape, and turmeric, has been called “nature’s azempic” for its ability to support natural weight loss.^{twenty five} According to a study published in the journal Molecules:²⁶ Its properties may help manage type 2 diabetes, obesity, atherosclerosis, cancer and cardiovascular complications. Researchers have outlined how these benefits may arise.

“Berberine positively impacts fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin levels, and reduces insulin resistance. It stimulates glycolysis, improves insulin secretion, and inhibits hepatic gluconeogenesis and lipogenesis. By reducing insulin resistance, berberine also improves ovulation.”

The anti-obesity effects of berberine are also well documented. Berberine acts as an anti-sclerotic agent and reduces LDL and testosterone levels. This alkaloid exerts an anti-inflammatory effect by inhibiting the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2.”

These findings have been validated in other published studies. One systematic review found that berberine may help regulate blood sugar levels and improve insulin sensitivity.²⁷ This is important because insulin resistance is closely linked to weight gain and obesity, and addressing this can improve insulin sensitivity and lead to weight loss.²⁸

Another study²⁹ A paper published in Frontiers in Cellular and Infection Microbiology found that berberine “helps alleviate the pathology of metabolic disorders, and the mechanism is related to the regulation of the gut microbiota.” Furthermore, berberine’s ability to regulate the gut microbiota may enhance its absorption.

Minimize your intake of linoleic acid for better long-term results

I believe that the magic pill for losing weight that the world is chasing will not exist in our lifetime. Evidence shows that relying on drugs that alter the basic functions of the body puts you at risk for debilitating health problems. And once you stop taking Ozempic/Wegovi, you will likely regain any weight you have lost. According to one report:³⁰ Most people who stop semaglutide injections regain two-thirds of the weight they lost, a phenomenon known as “Ozempic rebound.”

For safer, healthier weight loss, it’s important to address one of the biggest contributors to the current obesity epidemic: excessive intake of linoleic acid (LA). Linoleic acid is an omega-6 fat found in seed oils commonly used in cooking, including soybean oil, cottonseed oil, sunflower oil, rapeseed oil (canola oil), corn oil, and safflower oil.³¹

In addition to avoiding these oily dishes and foods, eliminate processed foods, fast foods, and restaurant foods. If you must eat out, check out the Templeton List.³² The list features restaurants known for serving healthy food, taking into account criteria such as using locally sourced, sustainably sourced ingredients and healthy oils in cooking.

Finally, we recommend limiting your LA intake to less than 5 grams per day (preferably less than 2 grams), which is similar to what our ancestors consumed before the widespread chronic health problems that plague modern society. For more information on the dangers of LA, read my article “Linoleic Acid — The Most Harmful Ingredient in Your Diet.”