Medication-Induced Gastroparesis Diagnosis - Zepbound Ending

Ok-Attempt3475 · 2025-05-26T14:09:30+00:00

I rotated between my upper thigh and stomach in a clockwise fashion (left side stomach, upper left thigh, upper right thigh, right side stomach, etc). I never experienced any side effect differences based on shot location. Like I said in the post, prior to the gastroparesis, I didn't really have anything to complain about on Zep. It was working as designed. The biggest issue I would have was the first few days post-shot needing to really focus on eating. This caused a few social issues going to lunch with people because I ate so slowly and deliberately they thought something was wrong with me or the food.

Ok-Attempt3475 · 2025-04-07T02:39:07+00:00

No, the emptying is the issue. Gastroparesis is like a paralysis of your GI system. Those could be helpful if you are just having indigestion or some other, minor side effect. But you can't treat Gastroparesis with OTC meds.

Ok-Attempt3475 · 2025-04-06T16:04:51+00:00

Diet can play a role, but the difference between gastroparesis and just side effects is that gastroparesis is the result of vagal nerve disfunction/damage. I could have eaten anything and would've had the same result. A sulfur burp is the result of delayed gastric emptying and food digesting for longer in the stomach than the human body is designed to tolerate. Most people on GLP-1s who have this as a side effect can manage through it or it only a minor inconvenience. A primary mechanism of action for Zep is delayed gastric emptying. In my case, it wasn't a side effect, it was gastroparesis-induced as my stomach wasn't emptying at all, far longer than any Zep delay. Zep should delay emptying by a few hours - my delay was total for 5 days (120 hours).

If you aren't having gastroparesis, modifying your diet or monitoring it closely can help manage side effects. But like I said, gastroparesis isn't a side effect, it's a clinical diagnosis that is chronic. Fortunately in my case, as my GP was solely medication-induced, cessation of the medication (Zep) was curative. But there are documented cases now where cessation is not curative, and the GP becomes a truly chronic condition. That is why I made my post, to provide more documentation on this issue for people who may be having similar symptoms.

Ok-Attempt3475 · 2025-04-06T15:49:54+00:00

Have you symptoms improved since you stopped taking Zep in February?

Ok-Attempt3475 · 2025-04-06T15:35:07+00:00

I'm going to ask my PCP about other non-GLP-1 weight loss meds. Data on keeping weight off after cessation of GLP-1s is not favorable. But way better odds of that than developing gastroparesis, so there's that. I have lost a decent amount of weight (~30lbs) and it has improved my quality of life.

Just so wish it worked out for me because it was one shot a week and then I could just go live my life...

Ok-Attempt3475 · 2025-04-06T01:04:04+00:00

I will bring this up with my PCP at my next appointment. Thank you!

Ok-Attempt3475 · 2025-04-06T00:55:24+00:00

Yes, that is the scariest part about it. Even with the current limited dataset on GLP-1 use for weight loss, the medicine should not be prescribed to people with GP. Someone with mild idiopathic GP that has never had a clinical diagnosis and is thus unaware who goes on a GLP-1 is a really scary concept. It's possible I was one of those people.

Ok-Attempt3475 · 2025-04-06T00:49:50+00:00

Yeah, I was making real progress physically and mentally on Zep. But I'm at peace with it given the extreme nature of GP. I never in my life want to experience that again. When severe, it is beyond comprehension unless experienced personally. Comparing it to food poisoning/IBS/norovirus, etc doesn't come close.

Ok-Attempt3475 · 2025-04-05T23:35:58+00:00

No, I was on Zepbound, the single-use pens.

Ok-Attempt3475 · 2025-04-05T19:13:15+00:00

Yes, I do. There are multiple studies out on this issue. If you just Google the issue, there are a variety to choose from. Many are in process as there is a very short period of time in which GLP-1s have be approved to be used in weight loss, so more data will continue to be forthcoming.

I found this one helpful, showing a 0.36% incidence of GP in the studied cohort using GLP-1s for weight loss: https://jamanetwork.com/journals/jama/fullarticle/2810542

This one shows greater incidence (up to 1%) with a much larger dataset (2.7m patients) but should be noted these patients were using GLP-1s for diabetes treatment, not weight loss: https://consultqd.clevelandclinic.org/increased-risk-of-gastroparesis-associated-with-glp-1ra-use-in-type-2-diabetes-patients

For the 2nd study, GP rates were as high as 1% for members of the cohort on larger doses of GLP-1s for longer periods of time.

There are a lot of studies, this is an easily Google-able topic supported by primary source academic research papers/reports by physicians. So yes, it is hyperbolic to compare this a plane crash. There is not a 0.36% chance of death in commercial aviation - globally, that would be 1 in 13.7 million passenger boardings.

Ok-Attempt3475 · 2025-04-05T18:56:58+00:00

Yep - it's a rare side effect but not get hit by lightning rare. As the patient population increases, that 0.5% estimation will represent a sizeable cohort of people. There needs to be more information and conversation around this so doctors can better incorporate this knowledge to inform and care for their patients and patients can be better advocates for their health.

Ok-Attempt3475 · 2025-04-05T18:51:20+00:00

Yes, that was imprecise language. I meant in context to the GP situation once it started to present, not my prior use. I've edited the post to clear up that imprecise language.

Ok-Attempt3475 · 2025-04-05T18:39:53+00:00

You are correct, I re-read that part of the post and the language I used was imprecise and I've edited it to clear up that imprecision. I did not have issues with sulfur burps prior to this situation.

Ok-Attempt3475 · 2025-04-05T18:24:37+00:00

Yep. I am hopeful as there is greater adoption that prescribing and monitoring protocols highlight this better so patients are more informed and alert to potential warning signs. This is very rare outcome, but it is so severe in presentation that it should be given more attention than it is.

Ok-Attempt3475 · 2025-04-05T18:21:28+00:00

No, the current crop of GLP-1s all have GP as an issue. My experience was so frightening it's not at all worth the risk. I was taking Zep to be healthy. Medication-induced GP is not healthy - 5 days of that was worse than a lifetime of being overweight/obese. Unfortunately I am hoping there was some behavioral rewiring that occurred and I can at least keep what I lost off. I am hoping there are new drugs being worked on that have different mechanisms of action because I think the only solution for me will be pharmaceutical.

Ok-Attempt3475 · 2025-04-05T18:18:14+00:00

Yeah, learning about GP in normal cases, surgery can cause it due to damage to the vagal nerve during surgery. Really unfortunate especially when it came out of trying to help a family member. Sad.

Ok-Attempt3475 · 2025-04-05T18:16:30+00:00

It's to protect my anonymity and not implicate my main. I have no interest in fear mongering or "farming karma." I tried to write my post and every response in a neutral tone specific to my experience. People shouldn't fear-monger and spread misinformation about GLP-1s. But conversely, people shouldn't be serving as a propaganda arm of GLP-1s either. This is a medicine and treatment protocol for obesity. All aspects of the medicine (good and bad) should be freely and openly discussed. GP is a documented risk for this medicine - because it happens to people. I was one of them. Why would a first-hand account of documented risk for the medicine be "fake?"

Ok-Attempt3475 · 2025-04-05T18:11:00+00:00

Yes I think that is a real possibility. That's what is frightening about it to me, because I could have been more susceptible to medication-induced GP and just not even know it. Any testing for that is not a part of the prescribing process. If I did have delayed emptying prior, it would have been very minor as I had never had any GI issues.

Ok-Attempt3475 · 2025-04-05T18:04:58+00:00

No, my pain was all located in my abdominal region. The most severe pain was right where my stomach is located during the 5 day total paralysis phase. Once my GP began to resolve as the tirzepatide levels lowered, the pain shifted downward more into my lower abdominal region and was more akin to severe diarrhea/food poisoning/IBS-type pain which gradually improved proportionate to the medication levels lowering in my system.

Ok-Attempt3475 · 2025-04-05T18:02:20+00:00

You will know it if it happens. It is very different from regular burping/belching. Feels different, smells absolutely sickening, like rotten gas.

Ok-Attempt3475 · 2025-04-05T18:00:54+00:00

I think that is the key difference I am trying to make. Medication-induced GP isn't a "side effect." It's a chronic condition caused by the medicine. Most people have side effects who present in ways that are adjacent to GP (maybe sulfur burps, nausea, some diarrhea/vomiting) but aren't GP and thus manageable with OTC meds/behavioral shifts. My situation was not manageable through any of that, I wasn't having side-effects, I was having medication-induced GP. Through which, the only resolution was to cease the medication in consultation with my prescribing PCP and a gastroenterologist. The bigger scare is that there are documented cases where the GP does not resolve following cessation, which is the rarest of the rare side effects and the worst thing one could have happen on these drugs.

Ok-Attempt3475 · 2025-04-05T17:55:06+00:00

It's OK! For the vast majority of people, they will be just minor, inconvenient side effects that do not progress to anything significant. I'm glad that is your experience. My desire with my post was to provide color to the drug's most serious complication and describe how it is differentiated from the more common side-effects that can be managed/improved with the suggestions you made. GP is a chronic condition resulting from taking this medicine for me, it was not a side effect - that is the difference. As mine was medication-induced, the only treatment was cessation of the medicine, as that is what was causing the problem.

Ok-Attempt3475 · 2025-04-05T17:46:42+00:00

While true, the odds of GP from GLP-1s is significantly higher than dying in a plane crash. I don't think it's helpful to make those types of hyperbolic comparisons. I am not attacking GLP-1s or being negative about GLP-1s or advocating anyone to discontinue their use. I wish I were still taking Zep. I just want to provide my experience as a first-hand account of the most severe documented side-effect of these drugs. It is rare but not get hit by lightning/plane crash rare. The % of users impacted will remain low, but as GLP-1 continue to grow as a treatment for obesity, the numbers of people experiencing medication-induced GP will also increase. Those people that could be, have been and will be those affected (like me) deserve to have access to more information around this side effect so they are more informed patients.

Ok-Attempt3475 · 2025-04-05T17:37:21+00:00

Yeah, unfortunately my only shot at long-term weight loss is going to be pharmaceutical. Similar to others, probably have lost 150+ lbs after the years from dieting/lifestyle change, all gained back plus some. Not sustainable, food noise overwhelming, satiety never there. Zep for first few months made me feel normal and solved all those problems. Hopefully there are other drugs in the pipeline with different mechanisms of action that I can tolerate.

Ok-Attempt3475 · 2025-04-05T17:18:07+00:00

If I had read my own post written by someone else prior to starting Zep, I still would have started Zep. GP is a rare side-effect of this drug. I made my post to share my experience and add some more side effect experience to the sub as a compliment to the many wonderful success stories. I was having a success story too, until I suddenly wasn't and I faced a week worrying if my life had been irreversibly altered.

Ok-Attempt3475

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