Some Risks of Gastrointestinal Adverse Events Associated With Glucagon-Like PEPTIDE-1 Receptor Agonists Are Likely Explained by BMI.

We performed a re-analysis of the gastrointestinal risks of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in obese US adult patients without diabetes using the TriNetX database (GLP-1 RA n = 8792; Bupropion-naltrexone n = 8792) after accounting for initial BMI. GLP-1 RA users had higher risks of gastroparesis (aHR 2.30; 95% CI 1.19-4.46) and biliary disease (aHR 1.27; 95% CI 0.96-1.39) but did not have a conclusively elevated risk of acute pancreatitis or obstruction. Not matching for BMI suggested an elevated pancreatitis risk (aHR 1.75; 95% CI 1.13-2.70). Semaglutide conferred superior weight loss but increased biliary risk.