The phrase is used online for several different foot complaints after weight loss on semaglutide or tirzepatide: a foot that drags, soles that ache, and tingling or numb toes. These have different causes, and the evidence for each is very different in strength.
This page takes them one at a time: what the labels list, what has been reported in the nerves, what is known about heel pain, and what has never been measured.
What the labels say
Neither the Wegovy nor the Zepbound label contains the words foot, feet or neuropathy [1] [2]. The nearest entry is on the Wegovy label, which lists dysesthesia, a group of altered skin sensations.
The label describes “altered skin sensations including paresthesia, pain of skin, sensitive skin, and burning skin sensation.” It was reported in 22% of people on the 7.2 mg injection, 6% on 2.4 mg and 0.3% on placebo [1].
The label does not say where on the body these sensations occurred, so it cannot be read as a foot finding. The wider side-effect picture is in semaglutide side effects and tirzepatide side effects.
Foot drop after fast weight loss
Foot drop means the front of the foot cannot be lifted, so it slaps or drags when walking. Its usual cause in this setting is pressure on the fibular nerve, also called the peroneal nerve, where it wraps the outside of the knee.
A 2026 systematic review explains the link: the fat over that nerve varies with body mass index, and rapid weight loss “may precipitate entrapment” there [3]. The problem was described long before these drugs, after dieting, starvation and illness.
The review found 31 individual cases linked to weight-loss drugs, 83% involving semaglutide or tirzepatide. The median loss was 20.4 kg, or 21.8% of starting weight, at a median 3.7 kg a month.
Ten of those cases were fibular neuropathy with foot drop, and nine began without pain. Six were managed without surgery, and three of those reported complete recovery within one to four months.
| Study | Design | Who | Finding |
|---|---|---|---|
| O'Gorman 2026 | Systematic review of case reports | 31 cases, 83% semaglutide or tirzepatide | 10 fibular neuropathy with foot drop; 7 numbness starting in the feet |
| Triplett 2025 | Case-control, one health system | 77 people with fibular neuropathy | GLP-1 users more likely to develop it: OR 1.3 |
| Tanyous 2026 | Case series | 2 men on tirzepatide | Foot drop after habitual leg crossing; resolved in 3 to 4 months |
| Yang 2025 | Cohort plus uncontrolled pilot | 92 semaglutide users with heel pain | Pain scores improved more than in non-users |
How often does it happen?
Nobody knows. The systematic review states that it “cannot assess prevalence” and expects these nerve problems to be “an uncommon adverse effect,” while warning that “recovery is not guaranteed” [3].
The largest controlled look is a case-control study from one U.S. academic neurology department [4]. It found 77 people with fibular neuropathy after starting a GLP-1 drug, with a median weight loss of 15.7%.
Against matched controls, GLP-1 users were 30% more likely to develop the nerve injury (odds ratio 1.3, 95% CI 1.0 to 1.5). The authors describe it as compressive and “more influenced by weight loss” than by blood sugar changes.
The leg-crossing cases
Two recent case reports describe how it can happen. In one series, two men on tirzepatide developed foot drop over 24 to 72 hours after losing 30 and 50 pounds [5].
Both habitually crossed their legs, which presses on the nerve at the knee. The authors describe treatment with avoiding leg crossing and physical therapy, plus an ankle brace in one case, and the foot drop resolved over three to four months.
A plastic surgery report adds two more patients without diabetes, who lost 14% and 18% of their weight over three to six months [6]. The authors call slimmer’s palsy “a predictable and treatable complication of rapid weight loss.”
Numb or tingling feet
The same review found seven cases of distal symmetric polyneuropathy, the pattern that starts in both feet. They presented with “length-dependent paresthesia and numbness” [3].
Most people in the review had prediabetes or diabetes, 67% of the 31 cases. Its authors advise avoiding “ultrarapid HbA1c and weight loss,” treating a fast fall in blood sugar as a risk of its own. Seven cases cannot show whether the drug, the weight loss or the sugar change was responsible.
Heel pain and the fat pad
One study points the other way. A cohort from two medical centers in China followed 2,902 adults with chronic heel pain, of whom 92 took semaglutide for diabetes or weight loss [7].
After at least two years, pain scores on a foot health questionnaire improved by 14.86 points more in the semaglutide group (95% CI 9.97 to 19.75). A 30-person pilot without a control group also improved.
That is an observational finding, and the authors call for a randomized trial. It does not show that semaglutide treats heel pain.
The worry about the fat pad under the foot has less behind it. A small ultrasound study of 35 healthy young adults found fat pad thickness correlated with body mass index at only one of five points on the forefoot (r = 0.358) [8].
Related reading
The same question asked of other parts of the body is covered in Ozempic butt, Ozempic breasts and Ozempic face.