Ozempic 'oops' babies spark debate about weight-loss drugs' safety

A surprising thing is happening to some women on weight-loss drugs who have struggled with fertility issues: They’re getting pregnant. That’s leading to questions about the safety of medications from Novo Nordisk and Eli Lilly during pregnancy.

“I thought I couldn’t have any more kids,” said Torria Leggett, 40, who had been trying for another after her first child was born in 2018. In 2022, the social worker from Whiteville, North Carolina, began taking Novo’s Ozempic to treat obesity, then switched to Lilly’s Mounjaro. As the pounds melted off, there was soon another reason to celebrate. She was expecting.

“I couldn’t believe it,” she said.

So-called GLP-1 drugs have been marketed for nearly 20 years to treat diabetes, and their use in obesity is fueling a new market that’s expected to hit $100 billion by 2030.

Stories like Leggett’s are now encouraging doctors to use these drugs to treat polycystic ovary syndrome, one of the leading causes of infertility in U.S. women. Weight loss is known to boost fertility in women with the disorder, and studies have shown that Saxenda, an older obesity drug, also raised pregnancy rates in women with polycystic ovary syndrome who were overweight.

The problem is, companies haven’t systematically studied GLP-1’s use in people with the disorder.

The active ingredient in Novo’s drugs, semaglutide, has been linked to increased birth defects in animals. Similar studies of Lilly’s drugs have shown there “may be risks to the fetus” from exposure during pregnancy, the company said.

The label of Wegovy, from Novo, says people should stop taking the drug at least two months before trying to get pregnant; Zepbound, from Lilly, recommends that people who become pregnant stop the drug.

But so far, the safety data look promising. A recent study of the health records of 50,000 women with type 2 diabetes found no increase in birth defects among those who used the drugs in very early pregnancy compared with those who took insulin.

Still, the study’s authors said additional confirmation is needed, especially in women without diabetes. Researchers from Copenhagen concurred last year in a review of GLP-1 drugs, saying that there’s “limited information on their long-term safety, particularly concerning pregnancy outcomes.”

“The ‘oops’ babies on Ozempic and Wegovy are happening all over the place,” said Melanie Cree, director of the polycystic ovary syndrome clinic at Children’s Hospital Colorado in Aurora. “It’s very exciting, but it’s a bit scary because we’re moving forward without all the data.”