Rare brain disorder potentially linked to popular weight-loss drugs

Researchers are raising awareness about a rare but potentially life-threatening neurological condition that may be associated with popular GLP-1 weight-loss medications. A recent study identified 15 reported cases of Wernicke encephalopathy, a disorder caused by a severe deficiency in vitamin B1, in individuals taking these drugs.

The study, published in Clinical Nutrition, found that most of these cases involved semaglutide, known by brand names like Ozempic and Wegovy, and tirzepatide, marketed as Mounjaro and Zepbound. These cases were identified through the FDA’s Adverse Event Reporting System (FAERS), medical literature, and clinical observations.

Wernicke encephalopathy can manifest with symptoms such as confusion, difficulty walking, balance problems, and vision changes. If left untreated, the condition can lead to irreversible neurological damage or death. Vitamin B1 is crucial for proper brain function.

While the study cannot definitively prove causation, researchers noted that reports of the disorder appeared more frequently among GLP-1 medication users compared to those on other drugs. Experts suggest that the medications' effects on appetite, nausea, and vomiting could contribute to vitamin B1 deficiency.

“The drug shrinks your appetite. It doesn’t shrink your body’s requirements,” explained Karthik Achari, a Chicago-based clinician not involved in the study. “You can now eat very little without feeling it, which is the point of the medication, but your need for protein, vitamins, and fluids didn’t go anywhere.”

Achari indicated that individuals experiencing persistent gastrointestinal issues, rapid weight loss with minimal food intake, a history of bariatric surgery, or heavy alcohol use might be at a higher risk. Nutritionists emphasize the importance of maintaining proper nutrition and hydration while on these medications.

Erin Palinski-Wade, a New Jersey-based nutritionist, advised that ongoing vomiting or diarrhea can increase the risk of dehydration and other health problems. She urged patients not to dismiss severe or persistent symptoms as simply part of the medication's side effects and to seek medical advice.

The researchers acknowledged the limitations of their study, which relied heavily on reported events, and called for further investigation. Medical professionals advise patients not to discontinue their prescribed GLP-1 medications based solely on these findings.