Use of GLP-1 Analogues and Gastrointestinal Effects in Patients Outside the Classical Profile

Abstract

This study aimed to analyze, through a literature review, the gastrointestinal adverse effects associated with the use of glucagon-like peptide-1 (GLP-1) receptor agonists, with emphasis on semaglutide and tirzepatide, in patients outside the classical indication profile. This is a descriptive and analytical review conducted through searches in the PubMed/MEDLINE, SciELO, LILACS, and Google Scholar databases, using descriptors related to GLP-1, semaglutide, tirzepatide, gastrointestinal adverse events, and off-label use. Original studies, systematic reviews, and meta-analyses published in recent years and available in full text were included. The results showed that gastrointestinal symptoms represent the most frequent adverse events, particularly nausea, vomiting, diarrhea, constipation, abdominal pain, and early satiety, occurring predominantly during the first weeks of treatment and during dose escalation. A significant impact on tolerability, treatment adherence, and therapy discontinuation was observed, especially among individuals without continuous professional follow-up. It is concluded that although semaglutide and tirzepatide demonstrate high efficacy for weight loss, the occurrence of gastrointestinal effects requires appropriate clinical management, safe guidance, and monitoring, particularly in populations outside the classical indications.