REVEALED: How weight loss shots can be deadly. I worry that the wrong people are using them – and the side effects can be serious, says Professor Wasim Hanif

Any occasion where a drug intended to improve someone’s life ends up spoiling it should be considered an absolute tragedy.

But the sad death of nurse Susan McGowan after just two weight-loss injections was in many ways a tragedy waiting to happen.

Let’s be clear: powerful drugs such as Mounjaro, Ozempic or Wegovy are fantastically effective for weight loss. But like all medications, they can have side effects.

You must be very careful when using them and any patient taking these medications should be made aware of this.

And as they become more and more popular – and are used by millions of people rather than the smaller numbers involved in clinical trials – it’s likely that we’ll see more of these extreme (though still relatively rare) side effects that result in heartbreaking outcome.

Susan McGowan, 58, (left) died with her niece Jade Campbell (right) by her side two weeks after taking a weight-loss drug

Take pancreatitis, for example, cited as one of the causes of Susan McGowan’s death.

It is a dangerous inflammation of the pancreas, the pear-shaped organ at the back of the abdomen that produces enzymes (to help us digest food) and insulin, to control our blood sugar levels.

It can be caused by a number of things – from gallstones (small deposits that can block the duct leading from the pancreas to the intestines) to drinking too much alcohol. Plus certain medications such as Mounjaro (also known as tirzepatide) – but this is not a new finding.

In fact, we knew quite early in the clinical trials that Mounjaro was a potential treatment for adults with type 2 diabetes, that this could be a domino effect.

In studies, approximately 23 out of 1,000 patients prescribed Mounjaro developed acute, rapid-onset pancreatitis.

The thirty-year-old nurse went to the emergency room of the hospital where she worked with severe abdominal pain, but unfortunately her colleagues could not save her

Other successful weight-loss medications can have the same effect.

Semaglutide (the injectable drug used to make Ozempic and Wegovy) causes pancreatitis in about five in 1,000 of those who use it, and liraglutide (which goes under the brand names Victoza and Saxenda) affects about eight in 1,000. (All of their mechanisms of action target the pancreas, so it’s right in the line of fire.)

The NHS prescribing information provided to GPs and other medical professionals lists pancreatitis as one of the main side effects to be aware of.

It clearly states: ‘Patients should be informed about the symptoms of acute pancreatitis [nausea, fever, yellowing of the skin and tender or swollen abdomen] and tirzepatide should be discontinued.”

Weight loss jab Mounjaro was approved for use by NHS Scotland by the Scottish Medicines Consortium in June this year

And as has been widely reported, all of these medications can also have other unpleasant but less serious side effects.

For example, research shows that about one in a hundred people develop gastroparesis (or stomach paralysis), in which the contractions of the stomach muscles become too weak to pass food to the intestines; this can cause nausea and vomiting. About half of those who develop gastroparesis also become constipated.

Some users also complain of smelly ‘rotten egg’ burps – possibly because the drug increases the number of sulphur-producing bacteria in the intestines. Another theory is that food lingers longer than normal because it slows stomach emptying, creating more unpleasant aromas.

Then there is the so-called ‘Ozempic face’, in which accelerated facial aging – more wrinkles and sagging skin – occurs after a few months of using the drug.

This is likely due to rapid, significant weight loss, as facial fat smoothes out wrinkles and softens the skin.

And there are ongoing concerns about the possible (albeit extremely low) risk of thyroid cancer from taking Ozempic, although the European Medicines Agency ruled last year that there was no evidence of such a link.

I believe that when used under proper medical supervision, the risks of causing serious harm to patients are quite low. And for people with uncontrolled obesity or type 2 diabetes, the benefits will normally outweigh the risks.

Furthermore, doctors overseeing treatment will (hopefully) routinely warn of potential risks and, crucially, intervene if they do arise – usually by stopping treatment immediately.

But we live in a celebrity-driven culture, where people want instant access to the same weight-loss wonder drugs they see used by high-profile names like Oprah Winfrey, TV host Sharon Osbourne and pop star Boy George.

As a result, there is a booming market in unregulated online sales of the drugs (or, in some cases, dangerous counterfeit versions) for home use, without professional guidance on safety. And this is where I think the greatest danger lies.

Should we also be concerned about the long-term effects of these drugs, given that many people can remain on them for life?

I don’t think so. I’m pretty sure that in five years we’ll be talking about the long-term benefits, rather than seeing an increase in previously unrecognized long-term adverse effects.

The most important message to anyone taking these drugs is not to worry too much about these isolated – albeit tragic – examples of serious reactions.

But remember, these drugs work because they are powerful. We need to do more to limit their online sales so that only the type of patients in whom they have been tested – people with type 2 diabetes and obesity – and who are under strict medical supervision, actually receive them.

The risk is otherwise too great.

Wasim Hanif is professor of diabetes and endocrinology at University Hospital Birmingham

Interview by Pat Hagan