Plain Language Summary
Cross-sectional study of 254 GLP-1 RA users in Saudi Arabia (January–June 2025) characterizing hair loss frequency, characteristics, and predictors. Hair loss occurred in a subset of GLP-1 RA users; rapid weight loss magnitude and female sex were among the identified predictors. Provides epidemiological characterization of GLP-1 RA-associated alopecia—likely telogen effluvium from rapid weight loss rather than direct drug effect—giving clinicians data to counsel patients on this cosmetically significant but typically reversible adverse effect.
Abstract
BACKGROUND: The increasing use of GLP-1 receptor agonists for weight loss and metabolic improvements has led to the recognition of various side effects. One potential, yet underexplored, adverse effect is hair loss. This study aims to investigate the frequency, characteristics, and predictors of hair loss in patients using GLP-1RAs.
METHODS: This cross-sectional study, conducted uniquely in Saudi Arabia from January to June 2025, involved 254 participants who had used GLP-1RAs (Mounjaro, Ozempic, Saxenda, or Victoza) for weight loss purposes. Data were collected through structured questionnaires, ensuring comprehensive coverage of demographic information, clinical characteristics, and details of hair loss, including timing, severity, and progression. The data analysis was conducted using SPSS v29.
RESULTS: A total of 254 participants were included in the study, with the majority being female (71.3%) and an average age of 33.28 ± 9.73 years. Hair loss characteristics by injection type revealed no significant differences in prevalence (p = 0.116). However, severe hair loss was significantly more common in Mounjaro (43.4%) and Saxenda (42.9%) users compared to other groups (p < 0.001). Multivariable logistic regression analysis identified gender, marital status, and injection type as significant predictors of hair loss. Males were less likely to report hair loss compared to females (adjusted OR = 0.36, p = 0.003). Married participants had the highest odds of experiencing hair loss (adjusted odds ratio = 9.94, p = 0.004), and Mounjaro users had significantly higher odds of hair loss compared to the users of other injection types (adjusted odds ratio = 3.02, p = 0.009). The duration of injection use did not significantly predict hair loss, although a trend toward higher odds was noted for those using injections for 6-12 months (adjusted odds ratio = 3.50, p = 0.053).
CONCLUSION: Our study highlights the significant side effects of hair loss associated with GLP-1RA therapy, particularly in female patients and those using Mounjaro. Although this type of hair loss is typically non-scarring and reversible, it can lead to psychological distress and affect treatment adherence. These conclusions highlight the need for clinicians to be aware of this potential side effect and to provide appropriate support and guidance to their patients.
Authors
Argobi, Yahya; Jadaan, Norah Saad; Alshalhoob, Hind Bader; Alyousef, Manar Saleh; Alotaibi, Ghaid Mohammed; Alwesaibie, Hussain Sami; Alshehri, Ibtihal Sultan M