GLP-1 / Ozempic / Wegovy Litigation (Gastroparesis & Gastrointestinal Injury)

GLP-1 (glucagon-like peptide-1) receptor agonists have become some of the most widely prescribed drugs in pharmaceutical history. Originally developed for type 2 diabetes management, these drugs — particularly semaglutide (marketed as Ozempic for diabetes and Wegovy for weight loss by Novo Nordisk) and tirzepatide (marketed as Mounjaro and Zepbound by Eli Lilly) — have generated tens of billions in annual revenue as their use for weight loss has exploded.

GLP-1 drugs work by mimicking a natural hormone that slows gastric emptying, increases insulin secretion, and reduces appetite. The slowing of gastric emptying — while therapeutically beneficial for glucose control and appetite suppression — is the core mechanism alleged to cause harm in the litigation.

Plaintiffs allege that GLP-1 drugs cause gastroparesis — a condition in which the stomach cannot properly empty its contents, leading to severe nausea, vomiting, abdominal pain, and malnutrition. In its most severe form, gastroparesis can cause food to remain in the stomach for dangerously long periods, creating a risk of aspiration (food entering the lungs) during surgical anesthesia. Multiple cases of aspiration pneumonia during surgery in patients taking GLP-1 drugs have been reported, including fatalities.

The American Society of Anesthesiologists issued guidance in June 2023 recommending that patients hold GLP-1 medications before elective surgery due to aspiration risk — an unprecedented step that highlighted the clinical significance of the gastroparesis concern.

The Master Complaint filed in November 2024 spans 244 pages and alleges that Novo Nordisk and Eli Lilly knew about the gastroparesis risk but failed to adequately warn patients and prescribing physicians, and that the drugs' labeling understated the severity and persistence of gastrointestinal side effects.

GLP-1 receptor agonists reduce gastric motility as a core mechanism of action — the same property that makes them effective for weight loss and glucose control. The key question in the litigation is whether this gastric slowing crosses from therapeutic effect to pathological injury in some patients.

Gastroparesis is diagnosed when gastric emptying is objectively delayed (typically measured by a gastric emptying study showing >10% meal retention at 4 hours). The condition can be temporary or permanent. Plaintiffs allege that for some patients, GLP-1-induced gastroparesis persists even after discontinuing the drug — potentially because the drugs cause lasting changes to gastric nerve function.

Reports to the FDA Adverse Event Reporting System (FAERS) have documented thousands of gastrointestinal adverse events associated with GLP-1 drugs, including gastroparesis, ileus (intestinal obstruction), pancreatitis, and gallbladder disease.

A CNN investigation in 2023 brought significant public attention to cases of severe gastroparesis in Ozempic and Wegovy users, including patients who required hospitalization and long-term treatment.

The science on causation is still developing. Defendants are expected to argue that temporary slowing of gastric emptying is a known and labeled effect of GLP-1 drugs, that true gastroparesis is rare, and that the benefits of the drugs for diabetes management and obesity treatment outweigh the gastrointestinal risks. The litigation will hinge on whether the labeling adequately warned about the severity and duration of gastrointestinal effects.

Individuals who used semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound, Trulicity) and were subsequently diagnosed with gastroparesis, experienced severe persistent gastrointestinal symptoms (vomiting, nausea, abdominal pain), suffered aspiration pneumonia during surgery, developed pancreatitis, gallbladder disease, or bowel obstruction may be affected.

IMPORTANT: This is emerging litigation. The science on causation is still developing. Not all gastrointestinal side effects from GLP-1 drugs will constitute viable legal claims. Whether an individual has a claim depends on the severity and persistence of symptoms, the adequacy of drug labeling at the time of prescription, and the specific facts of each case.

This eligibility information is general and informational only. Consult a licensed attorney.

MDL No. 3094 has been established in the Eastern District of Pennsylvania for federal GLP-1/semaglutide cases. As of April 2025, over 1,600 cases are pending.

The 244-page Master Complaint was filed on November 13, 2024. Defendants Novo Nordisk and Eli Lilly filed motions to dismiss in January 2025. Monthly status conferences are being held throughout 2025.

This litigation is very early-stage. No discovery has been completed, no Daubert rulings have been issued, and no bellwether trials have been scheduled. The outcome remains highly uncertain.

The litigation is high-profile because of the massive and rapidly growing use of GLP-1 drugs for weight loss — tens of millions of prescriptions are written annually — meaning even a small adverse event rate translates to a large number of potentially affected individuals.

Novo Nordisk has stated that the gastrointestinal effects of GLP-1 receptor agonists — including nausea, vomiting, and delayed gastric emptying — are well-known, labeled effects of the drug class, and that the company has provided appropriate warnings. Novo Nordisk argues that these effects are typically transient, dose-related, and manageable.

Eli Lilly has similarly defended its GLP-1/GIP drugs (Mounjaro, Zepbound), arguing that the products have favorable benefit-risk profiles and that the labeling adequately describes gastrointestinal side effects.

Both companies have filed motions to dismiss arguing that the plaintiffs' claims are preempted by federal drug labeling requirements and that the companies cannot be held liable for effects that are inherent to the drug's mechanism of action.

Given the enormous commercial stakes — GLP-1 drugs represent a multi-billion-dollar annual revenue category growing at double-digit rates — both companies are expected to mount aggressive defenses.

No settlements have been reached. This litigation is in its earliest stages. The motions to dismiss have not yet been resolved, and no discovery has been completed.

Past settlement amounts in other pharmaceutical mass torts are not a guarantee of results in this case. Given the early stage and the unresolved causation questions, settlement discussions are unlikely to begin until after significant procedural milestones.