Correcting the Record on GLP-1 Deaths: What the Safety Data Actually Shows

If you've been researching GLP-1 medications, you've probably encountered alarming headlines about deaths and serious adverse events. It's natural to feel concerned. But as with most medical topics covered in the news, the reality is more nuanced—and generally more reassuring—than the headlines suggest.

Understanding the Headlines

Reports citing deaths "linked to" GLP-1 medications typically come from adverse event reporting systems like the FDA's FAERS (FDA Adverse Event Reporting System) in the United States or the UK's Yellow Card scheme. Here's the crucial context often missing from headlines:

• Reported ≠ Caused: These systems collect reports of health events that happened while someone was taking a medication. The event is "associated with" the drug but not necessarily "caused by" it.
• Population context matters: Millions of people take these medications. The population taking GLP-1s tends to have obesity and related conditions (diabetes, heart disease) that independently increase health risks.
• Underreporting happens: At the same time, adverse event reports represent only a fraction of actual events because reporting is voluntary.

What the Actual Data Shows

Clinical Trial Evidence

The gold standard for safety data comes from controlled clinical trials, where GLP-1 medications have been studied in tens of thousands of participants:

• The landmark SELECT trial (semaglutide for cardiovascular risk reduction) demonstrated that semaglutide actually reduced major cardiovascular events by 20% compared to placebo in high-risk patients.
• The SOUL trial showed oral semaglutide reduced cardiovascular events by 14% compared to placebo.
• Serious adverse events were lower in the semaglutide groups compared to placebo groups in multiple trials.

In other words, large-scale clinical trials suggest these medications may actually save lives by reducing cardiovascular events—the opposite of what sensationalized headlines imply.

FDA Adverse Event Reports

As of April 2025, the FDA had received approximately 520 adverse event reports related to compounded semaglutide and 480 reports concerning compounded tirzepatide. However, these numbers require context:

• Millions of people have used GLP-1 medications
• Many reports involve gastrointestinal symptoms (nausea, vomiting)—uncomfortable but not life-threatening
• A significant portion of serious reports involved dosing errors with compounded products, not problems with the medication itself
• True numbers are likely higher due to underreporting, but so is the denominator of total users

The Compounding-Specific Risks

Here's an important distinction: reported problems with compounded GLP-1s are often different from those with FDA-approved versions. Novo Nordisk (maker of Ozempic and Wegovy) has tracked adverse events specifically linked to compounded versions, citing concerns about dosing errors and quality inconsistency.

The FDA has issued alerts about hospitalizations resulting from patients accidentally injecting 5 to 20 times their intended dose from compounded vials. These are dosing errors, not problems inherent to the medication. They underscore the importance of proper calculation and administration—covered in our dosing guide.

Real Risks to Know About

This doesn't mean GLP-1 medications are risk-free. Every medication has potential side effects. Here's what the evidence actually supports:

Common Side Effects

These affect a meaningful percentage of users, especially during dose escalation:

• Nausea (often temporary as body adjusts)
• Vomiting
• Diarrhea or constipation
• Abdominal discomfort

While unpleasant, these typically improve with time and proper titration. Most people find them manageable.

Less Common but Notable Risks

• Pancreatitis: Inflammation of the pancreas has been reported. Clinical trials show rates of about 0.4% in both medication and placebo groups, suggesting it may relate more to the underlying population than the medication itself.
• Gallbladder issues: Rapid weight loss (from any cause) increases gallstone risk. GLP-1 users may be at slightly elevated risk.
• Hypoglycemia: Primarily a concern when combined with other diabetes medications, especially insulin or sulfonylureas.

Theoretical Concerns Under Investigation

• Thyroid tumors: GLP-1s carry a boxed warning about thyroid C-cell tumors based on animal studies. Human data hasn't confirmed this risk, but people with personal or family history of medullary thyroid carcinoma shouldn't use these medications.
• Mental health: Early reports of suicidal thoughts were investigated; a 2024 FDA review found no evidence linking GLP-1s to increased suicide risk.
• Eye conditions: Some observational data suggests a possible link to rare eye conditions; research is ongoing.

Putting It in Perspective

No medication is perfectly safe for everyone. The question isn't "is there zero risk?" but rather "do the benefits outweigh the risks for me?"

Consider what untreated obesity itself causes:

• Significantly increased risk of heart disease, stroke, and heart failure
• Higher rates of type 2 diabetes and its complications
• Elevated cancer risk for multiple cancer types
• Joint problems, sleep apnea, and reduced quality of life
• Shortened life expectancy

For many people, the documented cardiovascular benefits of GLP-1 medications—reducing heart attacks and strokes—likely outweigh the medication risks. That calculation is individual and should be made with your healthcare provider.

How to Minimize Your Risks

If you decide GLP-1 medications are right for you, these practices help ensure the safest possible experience:

1. Work with a qualified provider who takes a complete medical history and monitors your progress
2. Follow proper titration—don't rush to higher doses
3. If using compounded products, double-check all dose calculations and use reputable pharmacies
4. Stay hydrated—dehydration from GI side effects can lead to kidney problems
5. Report problems to your provider promptly
6. Keep your primary care doctor informed about your GLP-1 use

The Bottom Line

GLP-1 medications are among the most effective weight loss treatments ever developed, with documented cardiovascular benefits. Like all medications, they have risks—but those risks are generally well-understood and manageable with proper medical supervision.

Headlines about deaths "linked to" these medications often lack crucial context about causation, population risk factors, and the distinction between medication problems and dosing errors. The clinical trial evidence tells a more reassuring story: in controlled studies, these medications reduced cardiovascular events and serious adverse events were similar to or lower than placebo.

The most dangerous thing many people can do is not address their obesity due to fear generated by sensationalized reporting. If you're considering GLP-1 treatment, work with a qualified healthcare provider to evaluate whether the benefits outweigh the risks for your individual situation.