The meteoric rise of semaglutide for weight loss has triggered an unexpected crisis at poison control centers across the country, with researchers now sounding the alarm about a pattern of dangerous misuse that could largely be prevented through better patient education.
When the FDA approved semaglutide, sold under brand names Ozempic and Wegovy, for chronic weight management in 2021, calls to poison control centers began climbing at an alarming rate. Before that approval, poison centers handled roughly 1,000 to 1,500 calls annually related to GLP-1 receptor agonists, the drug class semaglutide belongs to. By mid-2021, that number nearly doubled. By 2023, poison centers had recorded more than 8,000 GLP-1RA related calls, with semaglutide dominating the statistics.
A research team at the University of Texas at San Antonio, led by undergraduate student Jordan Miller under the guidance of David Han and Long School of Medicine researchers, analyzed national poison control data to understand what was driving the surge. The answer was clear: the drug's expansion from diabetes treatment to the broader weight loss market created a wave of preventable medication errors.
Most incidents involved neither intentional overdoses nor street drug misuse. Instead, patients were making the same mistakes repeatedly. The most common error was taking semaglutide daily instead of once weekly. Another frequent problem was patients skipping the manufacturer's step-by-step dose escalation schedule and injecting the maximum dose immediately.
"Can you imagine something you're supposed to trickle up to, and you're going full blast and seven times more often than you're supposed to," Miller said when describing the scale of dosing violations.
Han emphasized that the shift in how semaglutide is prescribed and used created the dangerous gap. "When the GLP-1 drugs are being sold to diabetic patients, that's a completely different story versus when the drug is used for weight management," he explained. "We had to quantify this evidence to show that it stemmed from the FDA approval and how to contain the risk."
The research revealed that patient education throughout the prescribing process remains inadequate. From doctor's offices to pharmacy counters, the instructions and warnings about semaglutide's proper use are not reaching patients effectively. Han called for better public education, noting that "how this drug behaves in our body and its long-term safety are not yet fully understood."
The team's findings were published in the Journal of Medical Toxicology and featured as the cover story in Significance, the flagship publication of the Royal Statistical Society and the American Statistical Association. The research earned first place at the university's Los Datos conference, recognizing its contribution to public health understanding.
Author Jessica Williams: "This is exactly the kind of preventable harm that emerges when demand runs faster than infrastructure, and nobody's bothering to actually explain how to use a drug correctly."
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