Understanding the Real Risks: GLP-1 and Pancreatitis
- Jennifer Hardy
- Jun 28
- 7 min read
Updated: Jul 17
Can drugs like semaglutide and tirzepatide cause pancreatitis? Yes, they can. That part isn’t disputed. It’s listed in the official prescribing info from both Novo Nordisk and Eli Lilly. However, what those dramatic headlines don’t tell you is that the actual risk is low. There’s a ton of context missing.
You’re not going to suddenly develop pancreatitis without warning signs. It doesn’t just sneak up on you in the middle of the night like a ninja. The symptoms are obvious. If you know what to look for, you’ll know when to call your doctor.
Let’s walk through what the real risk looks like, who needs to pay closer attention, and how to spot the signs early.
What Is the Pancreas, and What Causes Pancreatitis?
The pancreas is a small but mighty organ that sits behind your stomach. It plays a crucial role in digestion and blood sugar control. The pancreas produces insulin, which helps manage glucose levels. It releases digestive enzymes that break down food in your small intestine. When the pancreas becomes inflamed, a condition called pancreatitis occurs. In this condition, those enzymes can start attacking the pancreas itself instead of doing their job.
Pancreatitis can be acute (sudden and severe) or chronic (long-term and recurring). Things like gallstones, heavy alcohol use, high triglycerides, or certain medications usually trigger it. In rare cases, GLP-1 medications have also been linked to it.
Early Warning Signs of Pancreatitis
The key point? It’s not random. Pancreatitis doesn’t pop up silently. It brings pain, nausea, and other symptoms that are hard to ignore. However, some of those warning signs overlap with the side effects of GLP-1s.
That’s why knowing the early signs matters and why most people catch it before it gets dangerous.
Why GLP-1s Are Linked to Pancreatitis
GLP-1 receptor agonists (that’s the full term) mimic a hormone that your body naturally makes after you eat. They help your pancreas release insulin, slow how fast your stomach empties, and reduce hunger. These are all beneficial effects, unless your pancreas gets pushed too far.
The Theories Behind the Risk
There are two main theories behind the pancreatitis link:
Pancreatic Overstimulation: GLP-1s activate receptors in the pancreas. In some individuals, this might overstimulate or cause the growth of pancreatic cells, triggering inflammation.
Slower Digestion: These medications delay how fast food leaves your stomach. In theory, that could lead to a backup of digestive enzymes in the pancreas, causing irritation.
Interestingly, some studies even suggest that GLP-1 medications may lower the risk of pancreatitis. One large study tracked nearly a million people with type 2 diabetes. It found that over five years, those on GLP-1s had a slightly lower rate of pancreatitis than those who weren’t. The difference was small—0.3% vs. 0.4%—but it counters the idea that these drugs increase risk.
Other Causes of Pancreatitis Not Related to GLP-1s
Here’s something most clickbait skips: people who qualify for GLP-1 medications often already carry risk factors for pancreatitis. It’s not just the drug; it’s the full health picture at play.
Common Causes
Gallstones and heavy alcohol use are the top causes of pancreatitis across the board. Other possible causes include:
High triglycerides
Insulin resistance
Type 2 diabetes
Fatty liver disease
These conditions are common in individuals dealing with obesity or metabolic syndrome.
In other words, just being a candidate for weight loss treatment puts you closer to the risk zone, even before you take the first dose.
Other non-GLP-1 causes include:
Extremely high triglycerides (over 1,000 mg/dL)
Gallbladder issues
Chronic alcohol use
Certain unrelated medications
Viral infections or autoimmune conditions
Trauma to the abdomen
Pancreatitis often doesn’t come out of nowhere. Most people who end up in the ER with it had something going on with their pancreas long before feeling that first wave of pain. If someone develops pancreatitis while using a GLP-1 med, it doesn’t automatically mean the drug caused it. The issue might have been brewing long before the weight loss attempt even started.
The GLP-1 and Pancreas Risk Statements from Wegovy and Tirzepatide
The FDA requires drug makers to report any plausible link between a medication and a serious health issue, even if that link isn’t fully proven. If there’s a pattern in clinical trials, post-marketing surveillance, or anecdotal reports suggesting a potential risk, they must disclose it.
Eli Lilly's Zepbound Pancreatic Risk Details
According to Eli Lilly, the rate of pancreatitis in Zepbound’s clinical trials was 0.2%. That's the same as the placebo group. Over time, the numbers remained low, with around 0.14 cases per 100 person-years on Zepbound and 0.15 for those not taking it.
Post-marketing reports include rare cases, but those are under 0.01% and don’t imply that the drug caused the pancreatitis. In other words, pancreatitis is on the warning label because it showed up, not because it’s common or clearly linked. The actual risk is tiny and looks about the same, whether you're on Zepbound or not.
The warning label on Zepbound also clearly states that inflammation of the pancreas is a known risk.
Zepbound may cause serious side effects, including: Inflammation of the pancreas (pancreatitis). Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.
The Eli Lilly label also states that anyone with pancreas issues should discuss their health concern with their provider before taking the medication.
It reads: "Review these questions with your healthcare provider: Do you have other medical conditions, including problems with your pancreas or kidneys, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?"
Novo Nordisk Pancreas Concerns Around Wegovy
The Wegovy website also details how individuals with pancreas problems should talk to their provider before starting the medication.
Wegovy® may cause serious side effects, including: Inflammation of your pancreas (pancreatitis). Stop using Wegovy® and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.
The label also states, "Before using Wegovy®, tell your healthcare provider if you have any other medical conditions, including if you have or have had problems with your pancreas or kidneys."
Why All the Pancreatitis Headlines Surrounding GLP-1s?
The headlines stem from a regulatory agency in the UK. They started flagging reports of pancreatitis in individuals taking GLP-1 medications like Ozempic, Wegovy, and Mounjaro. The MHRA collected hundreds of cases through its Yellow Card reporting system. Ten of those reported cases of pancreatitis led to death.
However, no evidence links GLP-1s directly to the pancreatitis injuries or deaths. In addition, the BBC pointed out that the baseline rate of pancreatitis in the general population isn’t far off. Right now, researchers are investigating whether some individuals might be genetically more prone. The science isn’t settled yet.
Looking at the FDA’s adverse event reporting from January 2022 to March 2024, semaglutide had a noticeably higher rate of reported pancreatitis compared to tirzepatide. The reporting odds ratio was 2.62, indicating that pancreatitis appeared in the data more than twice as often with semaglutide. That doesn’t confirm causation, but it’s enough to keep it on the radar.
Did You Know? You can report side effects directly to the FDA through their MedWatch program. These reports help the FDA spot trends and update warning labels when needed.
Signs of Pancreatitis
Nausea, bloating, mild stomach cramps—those are all common and expected when starting a GLP-1 medication. Annoying? Yes. Dangerous? Usually not. But pancreatitis is a different story, and its symptoms hit differently.
Typical GLP-1 Side Effects
These include:
Mild to moderate nausea, especially after dosing
Feeling full quickly or reduced appetite
Occasional heartburn or indigestion
Mild constipation or diarrhea
Red Flags for Pancreatitis
Be alert for these warning signs:
Severe upper abdominal pain that doesn’t go away and may spread to your back
Pain that worsens after eating
Persistent vomiting, not just nausea
Fever, chills, or rapid heart rate
Jaundice (yellowing of the skin or eyes)
Abdominal swelling or tenderness
Feeling dizzy, faint, or confused
If the pain is sharp, unrelenting, or paired with vomiting or fever, get checked out right away. GLP-1 side effects are temporary. Pancreatitis needs urgent care.
How Worried Should a GLP-1 User Be About Pancreatitis?
That depends on your health situation. For the average person without major risk factors, the chance of developing pancreatitis from a GLP-1 med is low—less than 1%. However, it’s not zero.
If you have diabetes, kidney disease, or smoke, you might want to have a more detailed conversation with your doctor before starting or continuing one of these medications. If you've had pancreatitis before, definitely mention that during your consultation. Although it doesn’t seem to drastically raise your recurrence risk, it remains relevant.
Kidney issues are another health risk associated with GLP-1s. As a Zepbound user for more than six months, I can tell you that my Stage 4 chronic kidney disease has improved to Stage 2 while using the medication. However, it can also go the other way if you don't follow the doctor's orders, especially if you end up dehydrated a lot.
The Future of Pancreatitis Risk Reduction
Genetic testing could play a crucial role in spotting who’s more likely to develop side effects like pancreatitis from GLP-1 medications. Recent evidence suggests that nearly a third of all medication side effects may be preventable through genetic screening.
In the UK, researchers are utilizing data from the Yellow Card Biobank to determine which people are more prone to adverse drug reactions. The goal is to help avoid serious side effects before they happen and reduce the billions spent on avoidable hospital stays.
Your health is crucial. As you consider using medications like GLP-1s, staying informed and engaged with your healthcare provider is vital.
