Subocclusive ileus following off-label high-dose semaglutide use

Endocrinol Diabetes Metab Case Rep. 2025 Nov 26;2025(4):e250081. doi: 10.1530/EDM-25-0081. Print 2025 Oct 1.

Abstract

Summary: Semaglutide, a GLP-1 receptor agonist (RA), is approved for the treatment of type 2 diabetes and obesity. However, its increasing off-label use, particularly for cosmetic weight loss, raises concerns considering its potential adverse effects. We report the case of a 37-year-old woman with normal body mass index who developed subocclusive ileus following unsupervised use of semaglutide.

Learning points: Our case highlights that semaglutide can lead to functional intestinal obstruction. Clinicians should maintain a high index of suspicion for GLP-1 RA related gastrointestinal complications.

Keywords: high-dose; ileus; off-label; semaglutide.