Todd Engel worked with heavy machinery around warehouses and highways in suburban Maryland for over 40 years. In early 2023, his doctor prescribed Ozempic, a GLP-1 medication, for diabetes. On New Year’s Eve, Engel woke up unable to see from his right eye. His doctor diagnosed it as a form of optic neuropathy called NAION, a condition caused by minor strokes restricting blood flow to the eye. When asked if Ozempic was a possible cause, the doctor had no information regarding a connection.
Several months later, JAMA Ophthalmology published research indicating higher NAION rates among diabetic patients using Ozempic or semaglutide. Neither Engel nor his doctor were aware of the findings. Engel continued his weekly injections until he lost vision in his left eye, similarly to the first.
Many Americans are using GLP-1 drugs, often for weight loss. A Gallup analysis reveals over one in ten Americans use them, and one in seven have at some point. These medications are prescribed for various conditions and have numerous side effects. Engel has filed a lawsuit claiming Ozempic’s manufacturer, Novo Nordisk, failed to warn about potential NAION risks. This suit is part of larger legal actions concerning harm from GLP-1 drugs.
Novo Nordisk disputes such claims, citing research questioning the connection between their drug and NAION. Legal proceedings will determine if GLP-1 drugs are the cause of these harms. Observational data show possible correlation but cannot prove causation without further investigation. Despite the study correlating NAION with Ozempic, medical societies emphasize that such studies do not prove causation and recommend continued use until more data is available.
The FDA maintains a database for adverse event reports, used to track potential pharmaceutical side effects. Although reporting is voluntary and unverified, it helps initiate further research. The FDA found over 1,000 reports of optic neuropathy linked to GLP-1 drugs since 2024, among nearly 190,000 total reports, primarily citing lesser side effects.
Novo Nordisk argues NAION and other serious conditions are rare in clinical trials. The company shares ongoing side effect data with the FDA, who have not updated warning labels, pending an internal study and assessment.
Attorney Jonathan Orent, leading major multi-district litigation against GLP-1 drug manufacturers, claims they should update warnings, as is done in Europe, despite the rarity of such conditions. Orent’s cases involve numerous plaintiffs with serious conditions like NAION and pancreatitis, asserting such warnings could have significantly impacted affected individuals.
Eli Lilly, a GLP-1 drug manufacturer, intends to defend against such claims. NPR’s analysis shows nearly 2,000 reports of pancreatitis since 2024. Engel insists knowledge of potential blindness risks would have prompted discontinuing Ozempic, which now affects his work and everyday life.
Obesity and diabetes complicate pinpointing exact drug side effect causes due to their broad health impacts. Dr. Mohammed Ali, a diabetes specialist, has not reported severe patient issues on GLP-1s to the FDA, citing uncertainty about the drug’s role given possible preexisting conditions.
The rise in online drug sales further complicates safety monitoring, according to Robert Miller from the West Texas Poison Control Center. He notes growing instances of side effect calls following internet purchases and a lack of medical oversight.
Shelley Engel, Todd’s wife, advocates for increased side effect warnings, believing they could have prevented her husband’s situation. She reflects on the profound changes in their lives, noting, ‘This could have been prevented if we only knew.’