The Ozempic and Wegovy mistake sending thousands to poison control

Semaglutide's weight loss boom triggered a surprising spike in preventable poison control calls, revealing a major need for better patient education.

The explosive growth in semaglutide (Ozempic and Wegovy) We use after its FDA approval for chronic weight management in 2021 was accompanied by another trend that drew researchers' attention: a dramatic increase in calls to poison control centers across the United States.

Jordan Miller, then an undergraduate student at UT San Antonio, wanted to find out whether the surge in poison control cases was directly connected to the FDA's expanded approval of semaglutide or if the timing was merely coincidental.

Originally introduced as a treatment for type 2 diabetes, Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) quickly gained widespread popularity after the FDA approved semaglutide for weight management. As demand for the drug accelerated, poison control centers also began reporting a steep increase in calls, with semaglutide standing out far above other medications.

"One of them was this quite odd category of semaglutide," said David Han, Miller's research mentor and Romo Endowed Professor in the UT San Antonio Department of Statistics & Data Science. "We suspected that the call volume was skyrocketing because of the misuse and mishandling of this drug and that it may be attributed to the FDA approval of this drug for weight management."

Working with Han through the Provost's Undergraduate Research Fellowship, Miller collaborated with Long School of Medicine researchers Robert S. Miller, Pharm.D, senior specialist in poison information, and Shawn M. Varney, MD, professor in the Department of Emergency Medicine and medical director of the South Texas Poison Center, to analyze national poison control data.

Miller later presented the research at UT San Antonio's Los Datos conference, where the project earned first place.

Poison Control Calls Climbed Dramatically

Before 2021, poison control centers nationwide typically handled between 1,000 and 1,500 GLP-1RA related cases each year. After the middle of 2021, that number nearly doubled, and by 2023 poison centers had recorded more than 8,000 GLP-1RA related calls.

Although most incidents involved accidental dosing or therapeutic mistakes rather than intentional misuse, the sheer size of the increase surprised the research team.

"In that figure that tracks the increase by specific drug, I wasn't expecting semaglutide to be so incredibly dominant," Jordan Miller recalled. "I figured that it would lead the pack, but it was staggering. On the other hand, it makes sense with all the media attention."

Han said the project illustrates how data science can uncover meaningful public health trends instead of simply producing statistics.

"This work demonstrates the quantified impact of these drugs on public health," he said. "Statistics, data science, analytics, machine learning and AI are meant to help people. We use them to transform data from any field into meaningful insight and informed action. Without that focus, it becomes hollow — numbers without real impact."

A Research Question That Paid Off

The project began after Miller decided to ask a professor about possible research opportunities, a step she nearly skipped.

"You lose nothing by asking," she said. "If you have a professor, you really get along with or admire, you lose nothing by asking them what they're working on or if they have space for a research assistant. I got really lucky with Dr. Han saying, 'I'm here to help — you pick what you want to work on.'"

The team's analysis showed that the FDA's approval of semaglutide for weight management marked a clear turning point. Both the number and type of poison control calls changed significantly after approval, reflecting the rapid expansion of semaglutide use beyond people with diabetes to a much larger population seeking weight loss.

"When the GLP-1[RA] drugs are being sold to diabetic patients, that's a completely different story versus when the drug is used for weight management," Han explained. "So, we had to quantify this evidence to show that it stemmed from the FDA approval and how to contain the risk. We need to better educate the public because how this drug behaves in our body and its long-term safety are not yet fully understood."

Preventable Dosing Mistakes Drove Many Cases

The researchers found that many of the poison control cases could have been avoided with better patient education. Semaglutide is designed to be injected once a week, not every day. Patients also begin treatment with a low dose that is gradually increased over time.

The data showed that two of the most common mistakes were taking the medication daily instead of weekly and starting immediately with the highest dose instead of following the recommended step by step schedule.

"Can you imagine something you're supposed to trickle up to, and you're going full blast and seven times more often than you're supposed to?" Jordan Miller said.

According to both Miller and Han, improving education at every step of the prescribing process, from the doctor's office to the pharmacy counter, could help prevent many of these medication errors.

The research was featured as the cover story in Significance, the flagship magazine of the Royal Statistical Society and the American Statistical Association. The findings were also published in the Journal of Medical Toxicology, the official journal of the American College of Medical Toxicology.