Wegovy linked to 5x risk of sudden sight loss

A study in the British Journal of Ophthalmology reported that people using Wegovy for weight loss faced a fivefold greater chance of developing non-arteritic anterior ischemic optic neuropathy (Naion) compared with those on the diabetes drug Ozempic, and men showed a three times greater risk than women.

How does it make sense that Ozempic causes it while Wegovy doesn't? Walk me through that logic.

They mention the speed of dosing? And I'm not following the part about formulation either?
 
Wegovy targets obesity and can be dosed as high as 2.4mg weekly, whereas Ozempic treats diabetes and maxes out at 1mg weekly. Same medication, different strengths, most likely. That leads me to think the claim is that risk rises with larger doses compared to 1mg/w or less.

GLP research focused on vision problems is plentiful, and findings often conflict. When it comes to diabetes, bringing elevated blood glucose down quickly may set off diabetic retinal harm, yet across a longer horizon these drugs decelerate the condition's worsening.

NAION is uncommon. Even granting that GLP's raise its likelihood, in practice their influence on far more prevalent eye conditions, such as cataracts, macular degeneration, diabetic eye complications, or glaucoma, is probably far greater. The studies still do not give me a definitive answer.
 
I located the study. Turns out my earlier claim was mistaken: Ozempic can be dosed as high as 2mg. What stands out is that tirzepatide showed no signal at all. In retrospective work like this, separating genuine findings from statistical noise at those sample sizes is a real challenge, so I expect plenty of follow-up research on this same question.
 
lessthanhalf said:

I located the study. Turns out my earlier claim was mistaken: Ozempic can be dosed as high as 2mg. What stands out is that tirzepatide showed no signal at all. In retrospective work like this, separating genuine findings from statistical noise at those sample sizes is a real challenge, so I expect plenty of follow-up research on this same question.
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My wife has diabetes and her doctor put her on tirzepatide. (I won't go into the battle I had with the insurance company just to get it approved.)

Her doctors are keeping a close watch on her eyes for any indication of these vision problems. She goes in for eye exams 2x per year.

It could just be that since ozempic was found to cause eye problems, they figure tirzepatide might do the same thing, but they are certainly monitoring her for it
 
At this stage I wouldn't read too much into it. From what I understand, the finding concerned tirzepatide and NAION specifically — the likely mechanism being that GLP drugs bring blood sugar down too fast, though anything that drops glucose quickly could presumably pose a risk to the eyes. I'm aware that rapid correction can set off strange neuropathy issues, which is why a slower approach to blood sugar control may sometimes be preferable. In any case, diabetic eyes warrant specialist follow-up.

What worries me about NAION is that while it's uncommon, it can take away vision. Once millions of people who are basically healthy but carrying extra weight start taking GLP's, those cases could accumulate — and a healthy person going blind in 1 eye because of a medication is exactly the sort of outcome that provokes outrage, even though the subtler consequences for very widespread eye conditions probably amount to a far bigger toll in total.
 
Wegovy trial participants gather to mark 1 year together.





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1-year anniversary of the Wegovy trial group.
 
Rezn8 said:

lessthanhalf said:

I located the study. Turns out my earlier claim was mistaken: Ozempic can be dosed as high as 2mg. What stands out is that tirzepatide showed no signal at all. In retrospective work like this, separating genuine findings from statistical noise at those sample sizes is a real challenge, so I expect plenty of follow-up research on this same question.
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My wife has diabetes and her doctor put her on tirzepatide. (I won't go into the battle I had with the insurance company just to get it approved.)

Her doctors are keeping a close watch on her eyes for any indication of these vision problems. She goes in for eye exams 2x per year.

It could just be that since ozempic was found to cause eye problems, they figure tirzepatide might do the same thing, but they are certainly monitoring her for it
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In the US, people with diabetes typically get eye exams once a year or every 6 months. This isn't tied to glp/gip use.

I was diagnosed with t2 in 2019 and have been in remission since 2021. I've had eye exams every 6 months since 2019. Once a year since 2024.
 
Taken from the paper (Ischemic optic neuropathy with semaglutide: global observational analysis of sex- and formulation-specific risk):

Although Wegovy produced fewer ION reports than Ozempic, its lower overall reporting yielded a higher ROR. Disproportionality reflects relative reporting rather than incidence and may be influenced by exposure, indication or media attention...This supports the suggestion that Wegovy’s stronger disproportionality signal reflects higher reporting intensity rather than volume.

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According to them, the gap between Wegovy and Ozempic figures is probably a statistical artifact. On top of that, the FAERS dataset that supplies all of this has serious drawbacks:

As FAERS lacks denominator data, we could not determine true incidence or assess whether reports

clustered following regulatory recognition. It also lacks comorbidity data (eg, diabetes) for adjustment and does not capture disease severity, laterality or other granular phenotypic characteristics.

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The data cannot reveal the true risk ratio, cannot show how much is fueled by media coverage, cannot establish if cases cluster among diabetics, cannot say whether the condition is more or less severe...in short, there is very little they can determine.
 
Before making the change to Reta, I noticed tirz was causing frequent blurriness in my vision, and during my final few weeks on it there were some odd episodes where my eyes just felt strained — tough to put into words. While transitioning, I ran tirz and Reta together for about 2 months, and things improved somewhat. Then roughly 4 weeks after cutting out tirz for good, my vision returned to how it was before, and I haven't had any trouble since.
 
A large share of these problems, I suspect, stem from how little monitoring and how few exams patients receive these days. How many of those individuals actually underwent a dilated eye exam within the past 12 months, I have to ask? These days some physicians hardly even lay hands on their patients during routine visits, much less perform a genuine physical examination. I accompany a relative to their appointments, and even though their leg weakness has been getting worse, just 1 doctor has bothered to confirm that their reflexes are still intact.

On a related note, among 10,000 people with obesity, roughly 70-100 additional cancer cases would be expected because of the obesity, and about 7-20 of those would probably be fatal. The potential eyesight danger deserves consideration, yes, but it has to be viewed in context. Scary headlines of the sort that article uses can end up harming plenty of people.
 
CathyGoesFar said:

A large share of these problems, I suspect, stem from how little monitoring and how few exams patients receive these days. How many of those individuals actually underwent a dilated eye exam within the past 12 months, I have to ask? These days some physicians hardly even lay hands on their patients during routine visits, much less perform a genuine physical examination. I accompany a relative to their appointments, and even though their leg weakness has been getting worse, just 1 doctor has bothered to confirm that their reflexes are still intact.

On a related note, among 10,000 people with obesity, roughly 70-100 additional cancer cases would be expected because of the obesity, and about 7-20 of those would probably be fatal. The potential eyesight danger deserves consideration, yes, but it has to be viewed in context. Scary headlines of the sort that article uses can end up harming plenty of people.
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That's generally how I look at these kinds of articles too. GLP risks don't exist in isolation — they need to be weighed against what obesity itself brings to the table (and at minimum, you could throw in the dangers of yo-yo dieting, bro-science weight loss, and so on). For the overwhelming majority of people, the downsides of GLP use are far smaller than the downsides of obesity.
 
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