Gastroparesis means the stomach empties too slowly even though nothing is blocking its exit. Ozempic, a brand of semaglutide, slows stomach emptying as part of how it works. That overlap is why the phrase “Ozempic stomach paralysis” took hold.
This page sets out what the label says, what a direct measurement in people showed, and how often gastroparesis was recorded in large studies. The drug itself is covered in the semaglutide guide.
What gastroparesis is
A 2026 review in JAMA defines gastroparesis as delayed gastric emptying without an obstruction at the stomach outlet [3]. It typically causes nausea, vomiting, early fullness, bloating and abdominal pain or discomfort.
The review gives the diagnostic standard as a gastric emptying scan. More than 10% of a test meal still in the stomach at 4 hours, in someone with symptoms, meets the definition.
In a US study of 82.6 million patients cited by the review, type 2 diabetes was the most common cause, at 51.7%. Medication-induced cases made up 11.8%.
What the Ozempic label says
The label states that Ozempic “delays gastric emptying” [1]. Its pharmacology section describes this as a delay of early emptying after a meal, which slows how fast glucose reaches the blood.
Section 5.7 covers severe gastrointestinal reactions. In the Ozempic trials these were reported in 0.4% of people on 0.5 mg and 0.8% on 1 mg, against 0% on placebo. The label ends that section plainly: Ozempic “is not recommended in patients with severe gastroparesis.”
The Medication Guide asks patients to tell their provider before starting if they “have severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis).” It also says to tell a provider about stomach problems “that are severe or will not go away.”
The label’s postmarketing list names ileus, intestinal obstruction and severe constipation including fecal impaction. It does not list gastroparesis by name as a reported reaction.
One line in the label points the other way. In a separate study, “no apparent effect on the rate of gastric emptying was observed with semaglutide 2.4 mg.” The label does not describe that study’s method.
The Wegovy label, for the higher-dose weight-loss product, carries the same gastroparesis statement [2]. Severe gastrointestinal reactions ran at 4.1% on Wegovy injection versus 0.9% on placebo in its adult weight trials.
What a direct measurement showed
A 2023 trial measured emptying with scintigraphy, the reference method [4]. It randomized 20 women with obesity and polycystic ovary syndrome to semaglutide 1.0 mg weekly or placebo for 12 weeks.
Four hours after a labeled solid meal, the semaglutide group still held 37% of it in the stomach. The placebo group held none. Time for half the meal to leave the stomach was 171 minutes on semaglutide and 118 on placebo.
These women were not diagnosed with gastroparesis, and the trial did not test for symptoms of it. But the average retention was well above the 10% cut-off the JAMA review uses for diagnosis [3].
How often gastroparesis was recorded
A 2023 research letter used US insurance claims for people prescribed a GLP-1 drug for weight loss, without diabetes [5]. It compared 613 semaglutide users and 4,144 liraglutide users with 654 users of bupropion-naltrexone.
Gastroparesis was counted from a diagnosis code or a prescription for a drug that speeds stomach emptying. It ran at 9.1 cases per 1,000 person-years on semaglutide, 7.3 on liraglutide and 3.1 on bupropion-naltrexone.
The adjusted hazard ratio for the GLP-1 drugs was 3.67, with a 95% confidence interval from 1.15 to 11.90. That wide interval reflects the counts: 4 cases on semaglutide and 3 in the comparator group.
A 2026 cohort study was far larger, with 313,342 matched pairs of adults with type 2 diabetes [6]. It compared people starting a GLP-1-based drug, including tirzepatide, with people starting an SGLT2 inhibitor.
Its outcome combined severe constipation, gastroparesis and gastrointestinal obstruction. The rate was 1.02 per 100 person-years on GLP-1-based drugs and 0.75 on SGLT2 inhibitors (hazard ratio 1.37, 95% CI 1.30 to 1.45).
The authors reported a higher risk for each of the three components, including gastroparesis. They also noted the absolute risk was 1% or less.
| Study | Design | Who | Finding |
|---|---|---|---|
| Jensterle 2023 | Randomized trial, gastric scintigraphy | 20 women with PCOS and obesity, 12 weeks | 37% of meal retained at 4 hours vs none on placebo |
| Sodhi 2023 | US claims cohort, weight loss | 613 semaglutide, 4,144 liraglutide, 654 comparator | HR 3.67 (1.15 to 11.90); 4 vs 3 cases |
| Alkabbani 2026 | US claims cohort, type 2 diabetes | 313,342 matched pairs vs SGLT2 inhibitors | HR 1.37 (1.30 to 1.45) for a motility composite |
| Olubodun 2026 | Systematic review of case reports | 13 patients in 12 reports | Symptoms resolved after stopping in all 13 |
Symptoms, and how they overlap with ordinary side effects
The JAMA review lists nausea, vomiting, early fullness, bloating and abdominal pain as typical of gastroparesis [3]. Nausea, vomiting and abdominal pain are also among the most common Ozempic side effects on the label [1].
That overlap is why symptoms alone cannot separate the two. The label’s own line is severity and persistence. The common, milder pattern is covered in Ozempic nausea.
A 2026 systematic review found 12 published case reports describing 13 patients with GLP-1-associated gastroparesis [7]. Semaglutide was the drug most often involved.
Symptoms began anywhere from hours to several months after starting, often after a dose increase or an inappropriate restart. Imaging or endoscopy often showed a distended stomach or retained food without a blockage.
Does it go away?
In that review, stopping the GLP-1 drug led to symptom resolution in all 13 patients [7]. Most care was supportive treatment of the symptoms.
The JAMA review also lists stopping drugs that slow emptying, including GLP-1 receptor agonists, as part of gastroparesis treatment [3]. It names opioids, cannabis and anticholinergics in the same list.
A case series has a built-in limit. Doctors tend to publish unusual or clearly resolved cases, so 13 of 13 says nothing about how often full recovery happens in everyone affected.
Related stomach effects are covered in semaglutide constipation and the full list in semaglutide side effects.