USA Today reports[i] thousands of lawsuits filed against major GLP-1 RA manufacturers Novo Nordisk and Eli Lilly. Plaintiffs cite serious side-effects caused by trending weight loss drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists, sold under popular labels such as Ozempic, Wegovy, Mounjaro, and Zepbound.
Serious and Life-Threatening Gastrointestinal Health Risks
Lawsuits filed date back to 2023, with initial allegations focusing on gastrointestinal complications. Plaintiffs claim that Novo Nordisk and Eli Lilly failed to adequately warn users of serious risks[ii], such as:
- Gastroparesis, or “stomach paralysis”, a chronic condition caused by vagus nerve damage, resulting in delayed stomach emptying
- Ileus, a disruption of bowel muscle contraction leading to intestinal blockage
- One plaintiff, interviewed by USA Today, points to Wegovy as the cause of a ruptured colon following intestinal blockage
- Gallbladder issues, such as gallstones, bile stasis[iii], and injury; some patients requiring surgical removal of gangrenous tissue
- Other serious gastrointestinal side-effects, such as chronic acid reflux, severe nausea and vomiting, and abdominal pain
NAION Litigation: Possible Link Between GLP-1 RA’s and Blindness
The reported health risks are not limited to gastrointestinal complications.
Recent research suggests a connection between semaglutide-based GP-1 receptor agonists, such as Ozempic and Wegovy, and a rare, but serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION), characterized by blood loss in the optic nerve. NAION can cause sudden, painless loss of vision, and is sometimes referred to as an “eye stroke”. Because the blindness can be permanent with few treatment options, many argue that warnings should be added to these products.
Reuters[iv] cites a March 2025 study of roughly 350,000 diabetes patients, where researchers found that patients were twice as likely to develop NAION after two years of Ozempic use, compared to patients taking diabetes medications belonging to other drug classes.
Another study, published in 2024 by JAMA Ophthalmology, analyzed data from nearly 17,000 patients with type II diabetes. The results suggested that patients taking semaglutide medications had a higher risk of developing NAION compared to those on other treatments, though the study did not establish a causal relationship.
In June 2025, the European Medicines Agency recommended updating semaglutide product information to list non-arteritic anterior ischemic optic neuropathy (NAION) as a very rare side effect (potentially affecting 1 out of 10,000 users) and advised discontinuation of the drug if diagnosed by a physician. However, the American Academy of Ophthalmology[v] criticized this as a blanket recommendation, warning that stopping semaglutide for all patients could pose serious health risks.
Product Labeling: Should a Black Box Warning Be Added?
The FDA has often added a “black box” warning to drugs. This is a highlighted warning in a black box that will appear in all drug literature. There is no stronger warning method.
In a 2024 joint court filing, defendants Novo Nordisk and Eli Lilly argued, “the safety profile of GLP-1 RAs has been well-established in hundreds of clinical trials, large-scale observational studies, and nearly two decades of real-world use. The known risks associated with these medicines are reflected in their FDA-approved product labeling which, collectively, FDA has reviewed more than 40 times and are discussed in textbooks, treatment guidelines and journals.”
The plaintiffs contend that although some gastrointestinal side effects were listed, the labels did not adequately warn of severe or chronic GI conditions requiring hospitalization.
As of early 2026, the FDA has not issued a formal, black-box warning specifically linking GLP-1 receptor agonists to NAION.
Multidistrict Litigation: Where Are Lawsuits Being Filed?
Since the initial filing, thousands of GLP-1 users have pursued legal action against the drug manufacturers, with more than 4,400 cases now grouped into consolidated federal and state proceedings. That number is projected to rise as litigation continues over the next several years.
A federal multidistrict litigation (MDL No. 3094) was established in February 2024 to consolidate claims of gastrointestinal injury.
The blindness injuries are so new and severe that a second MDL (MDL No. 3094), established in December 2025, focuses on Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION).
Both are overseen by The U.S. District Court for the Eastern District of Pennsylvania[vi] and are in the pretrial phase.
Federal multidistrict litigations are designed to move litigation efficiently and fairly. Judges have many avenues to push for settlements: individual trials, joint trials, appointing mediators (often a magistrate or retired judge), and in some cases dragging the lawyers into chambers and hammering out a fair settlement for all plaintiffs.
What This Means for Patients
Thousands of lawsuits involving GLP-1 receptor agonists are now moving through federal and state courts. Patients who developed serious side effects after using GLP-1’s like Ozempic, Wegovy, Mounjaro, or Zepbound may have legal options as litigation continues. It is important for affected individuals to document diagnoses, symptoms, prescriptions, and medical records related to any side effects. An experienced legal professional can help determine whether a case may qualify for review.
Sources
[iii] https://pmc.ncbi.nlm.nih.gov/articles/PMC12739101
[v] https://www.aao.org/newsroom/news-releases/detail/should-you-stop-taking-glp-1-drugs-like-ozempic
