Novo Nordisk A/S produces Ozempic and a similar drug, Wegovy, while Eli Lilly & Co. manufactures Mounjaro. The medications are primarily used to treat type 2 diabetes by regulating blood sugar levels. Ozempic and other similar drugs work by mimicking the action of the hormone GLP-1, aiding in insulin secretion and reducing glucagon production. These drugs are commonly used off-label for weight loss due to their appetite-suppressing effects, an application that lacks FDA approval. 

Fertility 

GLP-1 drugs, like Ozempic and Wegovy, are being increasingly used to treat obesity, with a projected market value of $100 billion by 2030. While these injectable treatments are known to carry side effects like nausea, vomiting, and abdominal discomfort, they have also sparked discussions about their potential to increase fertility in certain individuals. 

One of those individuals is Torria Leggett, a 40-year-old social worker from Whiteville, North Carolina, who began taking Novo's Ozempic in 2022 and later switched to Lilly's Mounjaro. Leggett had been trying to conceive another child after her first was born in 2018.

Leggett told Bloomberg:

I thought I couldn't have any more kids. The weight loss, that's likely what jump-started it. I couldn't believe it.

This unexpected development is prompting doctors to consider using GLP-1 drugs to manage polycystic ovary syndrome (PCOS), a leading cause of infertility in women in the United States. However, this shift is happening without comprehensive data on how these drugs affect pregnancy, leading to a rush by independent researchers to collect data. U.S. regulators have also urged drug companies to gather data on the drugs' use during pregnancy.

While preliminary safety data appears promising, with no increase in birth defects from use in early pregnancy when compared to insulin users, concerns remain based on congenital abnormalities in animal studies and a lack of long-term safety data, particularly regarding pregnancy outcomes. Guidelines recommended stopping Ozempic and other GLP-1 drugs at least two months before planning pregnancy.

Intense Hunger and Weight Gain

During these unexpected "Ozempic-pregnancies," some women have reported intense symptoms of extreme hunger and rapid weight gain after abruptly discontinuing the GLP-1 drugs to protect their baby's health. These reports raise questions about how pregnancy and stopping the use of these weight-loss drugs affect each other.

Dr. Sahar Takkouche, a bariatrician and associate professor of medicine at Vanderbilt University Medical Center, suggests a gradual tapering off of these medications, telling USA Today:

Ideally, I recommend a gradual taper off of these medications, when clinically feasible. Pregnant women, in particular, may experience these symptoms more intensely due to hormonal changes that occur with pregnancy and blood sugar swings.

Deb Oliviara shared her experience of insatiable hunger and rapid weight gain after stopping Ozempic during her "surprise" pregnancy, gaining 20 pounds in just two months: 

It was an insatiable hunger that I have never felt in my life.

Amanda Brierley, 42, experienced a "surprise pregnancy" after 10 months of taking the drug to treat her insulin resistance. She stopped using the drug in early pregnancy in accordance with studies indicating potential risks of miscarriage and birth defects. A week later, she found herself grappling with an overwhelming hunger, saying:

I was a human garbage can. And I didn’t want sweets or anything. I wanted real food, like meats, cheese, and other rich protein, which was completely different from my first pregnancy. I was like a caveman. I couldn’t stop. It was crazy.

Brierley went on to gain 20 pounds in her first trimester, ultimately reaching a total weight gain of 65 pounds by the time she delivered her baby in January, far surpassing the 19 pounds she gained during her first pregnancy.

Rapid weight gain can lead to gestational diabetes and complicate pregnancy, as Dr. Allison Rodgers, an OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois, explains:

You don't want to not listen to your body, but you don’t want to overconsume either.

Rodgers emphasizes the importance of proper nutrition and medical follow-up, especially for diabetic patients: 

And if you are diabetic, follow up with your doctor to switch to a safer medication like metformin or insulin as soon as you find out you’re pregnant.

Lingering Questions

And, while some pregnant moms who stop taking the drug report an extreme increased appetite and weight gain, new mom Leggett has other questions about the effects, saying that her daughter is "teeny-tiny." She sometimes wonders why her daughter is smaller than other kids the same age, saying: 

I’d like to know more about that.

While initially intended for type 2 diabetes treatment, the rising popularity of weight loss through drugs like Ozempic has uncovered an unexpected side effect: increased fertility in certain women. This phenomenon of welcoming "surprise Ozempic babies" creates an urgent need for additional research. 

In this medical journey from diabetes management to a glamorized weight loss drug and unexpected fertility boost, Ozempic has indeed led us down an intriguing path, and there is still more to learn. 

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