Gastroparesis, Vision Loss, Bowel Obstruction, and Other Alleged Complications
Last updated: June 2026 | Covers: Ozempic, Wegovy, Mounjaro, Zepbound, The Ozempic Pill (aka Rybelsus), Trulicity, Saxenda, Victoza | Read time: ~13 min
The number of lawsuits involving GLP-1 weight-loss and diabetes medications continues to climb across the United States, and the scope of the alleged injuries has expanded considerably since the first cases were filed. Patients who used Ozempic, Wegovy, Mounjaro, Zepbound, Rybelsus, Trulicity, Saxenda, and Victoza now allege a range of severe complications that they say were not adequately disclosed in the drugs’ warning labels at the time they were prescribed.
The injuries described in these filings span several organ systems and several distinct legal theories, but they share a common thread: each lawsuit asks whether patients had the information they needed to make an informed decision before starting treatment. That question — not whether the drugs work, and not whether they were manufactured correctly — is the central legal issue driving this litigation.
Reported injuries across the pending cases include gastroparesis, ileus, intestinal obstruction, bowel rupture, gallbladder injury, chronic vomiting, severe abdominal pain, sudden vision loss, non-arteritic anterior ischemic optic neuropathy (NAION), and neurological complications linked to malnutrition. This page walks through what each of these claims involves, what plaintiffs and manufacturers each argue, and where the litigation currently stands.
What Are GLP-1 Drugs?
GLP-1 receptor agonists are medications that mimic glucagon-like peptide-1, a natural hormone involved in blood sugar regulation, appetite control, and digestion. By amplifying this hormone’s activity, these drugs slow stomach emptying, increase insulin release, reduce appetite, help patients feel full for longer, support weight loss, and improve blood sugar control. That combination of effects is what has made the drug class so widely prescribed — and, as this page explains, it is also the source of the complications now driving litigation. For more detail on the underlying pharmacology, see our GLP-1 drugs — how they work page.
The medications most frequently named in current litigation include:
- Ozempic (semaglutide injectable — Novo Nordisk)
- Wegovy (semaglutide injectable, higher dose — Novo Nordisk)
- Mounjaro (tirzepatide injectable — Eli Lilly)
- Zepbound (tirzepatide injectable — Eli Lilly)
- Rybelsus (oral semaglutide — Novo Nordisk)
- Trulicity (dulaglutide — Eli Lilly)
- Saxenda (liraglutide — Novo Nordisk)
- Victoza (liraglutide — Novo Nordisk)
These medications have been widely prescribed for Type 2 diabetes, obesity, cardiovascular risk reduction, and weight management, and their rapid expansion into a much larger patient population is part of what has driven the corresponding growth in adverse event reports and litigation.
Why Are GLP-1 Lawsuits Being Filed?
Plaintiffs in these cases generally allege that GLP-1 drug manufacturers did not adequately warn patients or healthcare providers about certain serious risks. The lawsuits commonly involve allegations of failure to warn, inadequate safety disclosures, delayed label updates, underreported gastrointestinal risks, and insufficient warnings about rare but severe injuries. Importantly, most lawsuits do not claim the drugs were improperly manufactured — the products are not alleged to be defective in the sense of containing the wrong ingredients or being made incorrectly. Instead, the claims focus on whether patients received enough information to make an informed decision before starting or continuing treatment. For a deeper explanation of how failure-to-warn claims work as a legal theory, see our failure to warn page.
How Many GLP-1 Lawsuits Have Been Filed?
Since the first major GLP-1 injury lawsuits were filed in 2023, thousands of patients have brought claims in both federal and state courts. Many federal cases have been consolidated into multidistrict litigation for coordinated pretrial proceedings, while additional state-court cases are moving forward separately in jurisdictions including New Jersey, Indiana, and Delaware. The litigation remains in the pretrial stage as of May 2026, and the number of filed cases continues to grow as more patients come forward and as awareness of the available legal options spreads. For an explanation of how multidistrict litigation differs from a class action — and what that structural distinction means for individual plaintiffs — see our MDL vs. class action page.
What Injuries Are Alleged in GLP-1 Lawsuits?
Court filings and litigation reports indicate that the large majority of plaintiffs allege gastrointestinal injuries, though a growing and increasingly significant minority allege vision loss, and a smaller number allege neurological complications linked to malnutrition. Common gastrointestinal allegations include gastroparesis, ileus, intestinal obstruction, gallbladder injury, chronic vomiting, severe reflux, abdominal pain, and hospitalization for digestive complications. The sections below examine each major injury category in turn.
Gastroparesis Claims
Gastroparesis — sometimes called stomach paralysis — is the most commonly alleged injury in GLP-1 litigation. It occurs when the stomach empties too slowly or stops emptying normally, a pathological extension of the gastric-slowing mechanism that GLP-1 drugs are designed to produce in moderation. Symptoms can include nausea, vomiting, bloating, abdominal pain, early fullness, inability to tolerate food, and malnutrition in more advanced cases. Some plaintiffs allege that their symptoms continued even after they stopped using the medication, which has become a significant factual issue in evaluating the severity and permanence of individual claims. For a detailed account of gastroparesis claims and the diagnostic standards courts are applying, see our gastroparesis lawsuit page.
Ileus Claims
Ileus occurs when the intestines slow down or stop moving food and waste through the digestive tract — a functional shutdown rather than a physical blockage. Symptoms can include severe abdominal pain, bloating, vomiting, constipation, and an inability to pass gas or stool. Ileus can become serious and may require hospitalization, and in more severe or prolonged cases can progress toward complications requiring surgical intervention. For more detail on ileus claims and the related bowel obstruction litigation, see our ileus and bowel obstruction page.
Intestinal Obstruction Claims
Some lawsuits allege that GLP-1 drugs contributed to bowel obstruction or intestinal blockage — a physical barrier, distinct from ileus, that prevents food, fluid, or waste from moving through the intestines. Symptoms can include severe cramping, abdominal swelling, vomiting, constipation, inability to pass stool, and intense abdominal pain. In severe cases, obstruction can progress to rupture, sepsis, the need for emergency surgery, or permanent digestive complications. The seriousness of this potential progression is part of why intestinal obstruction claims are treated as one of the more significant injury categories in the litigation.
Gallbladder Injury Claims
Some plaintiffs allege gallbladder injuries following GLP-1 use, with reported complications including gallstones, gallbladder inflammation, acute gallbladder attacks, gallbladder removal surgery (cholecystectomy), and in more severe cases, gangrenous gallbladder tissue requiring emergency surgical intervention. The mechanism alleged in these claims is twofold: GLP-1 drugs slow digestive motility in ways that can allow bile to become more concentrated, and the rapid weight loss the drugs often produce is independently a recognized risk factor for gallstone formation. Clinical trial data cited in Ozempic’s own label showed elevated cholelithiasis rates compared to placebo, and gallbladder warnings were added to the label in March 2022.
Chronic Vomiting and Severe Abdominal Pain
A substantial number of lawsuits include allegations of persistent vomiting, chronic acid reflux, or severe stomach pain that go well beyond the mild, transient nausea that GLP-1 prescribing literature typically describes. These symptoms can lead to dehydration, electrolyte imbalance, kidney injury, malnutrition, repeated emergency room visits, and hospitalization. As with gastroparesis claims, some patients allege that their digestive symptoms continued long after they stopped taking the medication — a pattern that plaintiffs’ attorneys argue points toward lasting injury rather than a side effect that simply resolves with discontinuation. For more detail on these specific symptom categories, see our Ozempic vomiting page and our Ozempic stomach pain page.
Vision Loss and NAION Claims
A growing category of lawsuits alleges that GLP-1 drugs may be linked to sudden vision loss, with some plaintiffs claiming they developed Non-Arteritic Anterior Ischemic Optic Neuropathy, commonly abbreviated as NAION. NAION is sometimes described as an “eye stroke” because it involves a sudden reduction in blood flow to the optic nerve, and the resulting damage is typically permanent because optic nerve tissue does not regenerate. Reported symptoms include sudden vision loss, loss of vision in one eye, blurred vision, dark spots in the visual field, and permanent visual impairment. Multiple peer-reviewed studies have suggested a possible statistical association between semaglutide use and NAION, though medical authorities have been careful to note that an association identified in observational research is not the same as established causation. For a comprehensive discussion of the NAION litigation, the underlying research, and the separate federal MDL handling these claims, see our NAION and vision loss page.
Neurological Complications Linked to Malnutrition
A smaller but clinically serious category of lawsuits alleges that severe vomiting and digestive dysfunction caused malnutrition severe enough to produce neurological complications. The most frequently cited condition in this category is Wernicke’s encephalopathy — a serious brain disorder caused by thiamine, or vitamin B1, deficiency. Symptoms can include confusion, memory problems, poor coordination, vision changes, difficulty walking, and in severe or delayed-treatment cases, long-term cognitive impairment.
This type of claim typically involves a multi-step chain of alleged injury that plaintiffs’ attorneys must establish through medical evidence: GLP-1 use leads to severe vomiting or gastroparesis, which leads to malnutrition, which leads to vitamin deficiency, which in turn leads to neurological injury. Because each link in that chain requires its own supporting medical documentation, these cases tend to involve more extensive expert testimony than claims involving a single, more directly observed injury.
What Drugmakers Say
Manufacturers of GLP-1 drugs deny that they failed to warn patients adequately. Novo Nordisk and Eli Lilly generally argue that their GLP-1 drugs were studied extensively in clinical trials, that safety profiles are accurately reflected in FDA-approved labels, that warnings have been updated appropriately and in cooperation with regulators as new safety data emerged, that gastrointestinal side effects are known and disclosed risks of the drug class, and that patients with diabetes or obesity may already face elevated baseline risk for certain complications independent of medication use.
Both companies continue to defend the overall safety and benefit-risk profile of their medications when used according to approved labeling, and neither has conceded liability in any of the pending litigation.
Label Updates and Warning Changes
As more post-market adverse event data has emerged, certain GLP-1 drug labels have been updated to reflect newly recognized risks. Examples of warnings added over time include language addressing ileus, intestinal obstruction, severe constipation, pancreatitis, gallbladder complications, and broader gastrointestinal adverse reactions. Plaintiffs argue that these earlier warnings did not go far enough, and that patients were not adequately informed about the possibility of severe or permanent injury before each respective label update was issued. The timing of each addition — measured against when patients began reporting the underlying complication — is one of the central factual questions the litigation is working through.
Why Causation Will Be a Major Legal Issue
One of the central legal questions running through GLP-1 litigation is causation. To succeed, plaintiffs must generally show that they used a GLP-1 drug, that they developed a qualifying injury, that the injury occurred after drug exposure, that medical evidence supports a connection between the drug and the injury, and that the warning provided at the time was inadequate given what was known or knowable. Manufacturers, in turn, may argue that conditions such as gastroparesis, vision loss, and intestinal dysfunction can also be caused independently by diabetes, obesity, vascular disease, preexisting gastrointestinal disorders, or other unrelated medical conditions that many GLP-1 patients already have. Because of this evidentiary contest, medical records and diagnostic testing will be critical to how individual cases are ultimately resolved.
Gastric Emptying Studies and Gastroparesis Claims
In some cases, courts have focused specifically on whether plaintiffs claiming gastroparesis have objective diagnostic evidence supporting that diagnosis, rather than relying solely on reported symptoms. A gastric emptying study — a nuclear medicine test that directly measures how quickly food leaves the stomach — can be important because it provides objective confirmation of delayed gastric emptying rather than a diagnosis based on clinical impression alone. This evidentiary requirement has become a significant threshold issue in determining which gastroparesis cases are positioned to proceed and which may face early challenges.
Bellwether Trials and the Future of the Litigation
The federal GLP-1 litigation remains in the pretrial phase as of May 2026. Eventually, the presiding court is expected to select a small number of bellwether cases to proceed to trial. Bellwether trials are representative test cases used to evaluate the strength of the evidence and legal arguments on both sides, measure how juries respond to the facts presented, and generate the kind of outcome data that typically guides global settlement discussions in large pharmaceutical mass tort litigation. These early trials often have an outsized influence on the future direction of the broader litigation, since both plaintiffs’ counsel and the manufacturers use the results to recalibrate their expectations for the remaining cases. For more on how this process works structurally, see our MDL vs. class action page.
Why GLP-1 Use Has Grown So Rapidly
It would be incomplete to discuss this litigation without acknowledging why these drugs became so widely used in the first place: GLP-1 medications offer meaningful, well-documented benefits for many patients. Potential benefits include improved blood sugar control, significant weight loss, reduced cardiovascular risk in certain patient populations, and improved overall metabolic health. Ongoing research is also exploring whether GLP-1 drugs may help with kidney disease, liver disease, sleep apnea, addiction, and dementia or Alzheimer’s disease — an expanding body of evidence that has further accelerated prescribing. However, as this page documents, no medication is free of risk, and that tension between genuine benefit and genuine harm is precisely what the current litigation is working through. For a balanced overview of both sides of that equation, see our benefits vs. risks page.
Balancing Benefits and Risks
For many patients, GLP-1 drugs provide substantial medical benefit. For others, side effects may be severe, disabling, or life-altering. This is precisely why patients should discuss their full medical history, any digestive symptoms, any vision changes, the specific risks of their prescribed medication, dosage changes, and alternative treatment options with a healthcare provider before starting or continuing GLP-1 therapy. Patients should not stop or change a prescribed medication without medical guidance, as doing so without appropriate clinical oversight can carry its own risks, particularly for patients managing diabetes.
What Patients Should Watch For
Patients using GLP-1 drugs should seek medical advice if they experience any of the following symptoms, which may indicate a complication requiring urgent evaluation rather than a routine and self-resolving side effect:
- Persistent vomiting
- Severe stomach pain
- Inability to eat or drink
- Dehydration
- Constipation lasting several days
- Abdominal swelling
- Sudden vision changes
- Confusion
- Difficulty walking
- Repeated emergency room visits for digestive symptoms
These symptoms may require urgent medical evaluation. Sudden vision changes, confusion, or difficulty walking in particular should prompt immediate medical attention rather than a wait-and-see approach, as they may indicate a serious complication requiring prompt diagnosis and treatment.
Key Takeaways
For patients, families, and legal professionals following the growth of GLP-1 litigation, the following points summarize the current state of the cases and the issues driving them:
- Thousands of lawsuits have been filed nationwide alleging that GLP-1 drug manufacturers failed to adequately warn patients of serious risks
- Most claims involve gastrointestinal injuries, including gastroparesis, ileus, intestinal obstruction, and gallbladder disease, though vision loss and malnutrition-related neurological injury claims are growing categories
- Drugmakers deny wrongdoing and continue to defend the safety and benefit-risk profile of their medications
- Causation and the adequacy of warnings at the time of each patient’s injury will be central legal issues throughout the litigation
- Objective diagnostic evidence — including gastric emptying studies for gastroparesis claims — is becoming an important threshold issue in determining which cases proceed
- The litigation is proceeding as individual claims coordinated through multidistrict litigation and parallel state court proceedings — not as a class action — meaning compensation will be evaluated on the specific facts of each plaintiff’s case
- The litigation is expected to continue for several years, with bellwether trials anticipated to be a major driver of eventual settlement discussions
GLP-1 drugs have meaningfully changed the treatment landscape for diabetes, obesity, and metabolic disease, and millions of patients continue to use them safely and effectively. At the same time, thousands of pending lawsuits document a real and serious pattern of severe complications that some patients allege they were never adequately warned about. As the litigation progresses, courts will work through the central questions of warning adequacy and medical causation that will determine how these claims are ultimately resolved.