TL;DR - As of August 3, 2026, reporting counted 3,928 lawsuits in the federal GLP-1 gastroparesis and gastrointestinal injury MDL and 200 in the separate NAION (vision loss) MDL, about 4,128 in total. - The NAION docket grew from 86 cases in May to 146 in July to 200. - The NAION court (Judge Karen Marston) ruled on July 2, 2026 that the first issues to be decided are whether GLP-1 drugs can cause NAION and whether federal law preempts the failure-to-warn claims. - On July 29, 2026, Australia's drug regulator added NAION warnings to the product information for GLP-1 medicines including Ozempic and Wegovy.
What the cases allege
Plaintiffs allege that semaglutide and other GLP-1 receptor agonists caused severe gastrointestinal injuries such as gastroparesis, and in a second set of cases non-arteritic anterior ischemic optic neuropathy (NAION), a form of sudden vision loss. Manufacturers dispute the claims and point to the labeling and the benefits of the drugs.
Why the NAION ruling matters
By putting general causation and preemption first, the court is deciding questions that would affect every NAION case before spending time on individual plaintiffs. A ruling that federal law preempts the warning claims would be a major obstacle; a ruling that the drugs can cause NAION would strengthen the plaintiffs.
The regulatory backdrop
The Australian regulator's July 2026 action says epidemiological studies indicate an increased risk of NAION during semaglutide treatment and tells doctors to refer patients with sudden vision loss urgently for an eye examination. Regulatory warnings in other countries can be cited in U.S. litigation, but they do not decide a U.S. case. People taking GLP-1 medicines should not stop them without speaking to their doctor.
For the litigation history, see our GLP-1 case guide.
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