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A major U.S. professional group for obstetricians and gynecologists (ACOG) is warning pregnant people not to use a class of weight-loss drugs called GLP-1 receptor agonists. The new advice says these medicines should be stopped before becoming pregnant and avoided during pregnancy because there isn’t enough evidence about safety for the fetus. The recommendation is precautionary: it’s meant to protect babies while researchers gather more data. GLP-1 receptor agonists are a type of medicine that started as treatments for diabetes and are now widely used for weight loss. In plain terms, they act like a gut hormone that tells your brain you’re full and slows how fast your stomach empties, so people tend to eat less and lose weight. Popular brand examples you’ve probably heard of include Ozempic and Wegovy; they’re injected and are more powerful cousins of older diabetes drugs. They are not a single drug but a class that works in the same way. The guidance from ACOG isn’t based on a single big human trial proving harm; rather it comes from limited and mixed evidence and the principle of caution. Studies so far include some animal data and early reports from people who became pregnant while on these drugs. Those early signals raised concerns about possible risks to fetal development and pregnancy outcomes, but the data are small and not definitive. Because the evidence base is incomplete, ACOG recommends stopping the drugs before conception and not using them while pregnant until clearer safety data exist. Why this matters is straightforward: many people of childbearing age are using these medications for weight loss, and unintended pregnancies do happen. If a drug might affect a developing fetus, doctors want to be careful. The guidance affects patients planning pregnancy, those who might become pregnant, and their clinicians. It means doctors should discuss contraception and drug timing with patients who are using GLP-1 drugs and help people who want to stop them safely and manage weight and blood sugar in other ways during pregnancy. There are important caveats. Stopping these medicines can lead to weight regain and changes in blood sugar control, so patients shouldn’t abruptly stop without medical advice. The risks are not proven; ACOG’s stance is precautionary because data are limited. People with diabetes who need glucose control should talk with their obstetrician and endocrinologist about alternatives that have more established safety in pregnancy. Also, regulatory agencies may update advice as new studies come in, so recommendations could change. Bottom line: ACOG says don’t use GLP-1 weight-loss drugs during pregnancy or when trying to get pregnant, because we don’t yet have good evidence that they’re safe for the fetus.
Source: Contemporary OB/GYN