Effect of the weight loss injections: “Ozempic-Babys”-Desired Children with Risk?

At first there were a few reports in specialist circles, then the topic suddenly circulated on social media: “Ozempic babies”. What is meant are pregnancies of women who have reduced their weight under the diabetes and weight loss Semaglutid- known among the trade names Ozempic or Wegovy- and apparently increased their fertility.

The term sounds charming, but there is a complex topic behind it. At least it is clear that too many pounds can limit fertility. “Overweight women have much more frequent cyclical disorders and less often ice jumps,” explains Katharina Laubner, diabetologist and endocrinologist at the University Hospital Freiburg. The cause is an insulin resistance: the body cells are no longer sufficiently responding to insulin, the blood sugar level increases, and the hormonal control of the ovaries gets out of the beat.

Fertility can also lower too much body fat, because it is not just any tissue, but a highly active organ. It produces inflammatory messenger substances and also messes up the hormonal balance.

This is exactly where GLP-1 agonists such as Semaglutid start: they slow down the appetite, lower the blood sugar level and in many cases lead to a significant weight loss. “The effect arises above all through the improved insulin sensitivity,” explains Laubner. “Five to ten percent less weight can regulate the cycle and improve fertility, whether through lifestyle changes, medication or a stomach -reducing operation.”

This causes discussions in reproductive medicine: Wouldn’t it make sense to set women with desire to have children and high body mass index (BMI) specifically for a few months on Semaglutid, for example to improve the opportunities of artificial fertilization? “Experts see this a great chance,” says Laubner. However, she has not yet met a patient who took the medication for this reason.

The doctor sees that the topic is currently so present in the media: “I think it is overestimated. We are doing a lot of consultation here, and so far I have only two women who have become pregnant under Semaglutid,” says the expert. An important reason for this is that the weight loss injections are not allowed during pregnancy. “Women must be pointed out to safe contraception before therapy,” says Laubner.

If the desire to have children, the official recommendation is to stop Semaglutid two months before a planned pregnancy, Tirepatide, which looks similar, four weeks before.

But what if a woman gets pregnant unnoticed during a weight loss therapy? So far there are two large register analyzes from 2024 with soothing results: the children did not show any increased risk of malformations. Smaller follow-up studies confirm this. An important reason: GLP 1 agonists are large molecules that hardly get over the placenta in early pregnancy. “However, this data is not a guarantee,” warns Laubner. Because: Real comparison studies are missing. It will never exist, since medication must not be tested on pregnant women for ethical reasons.

The effects of the drug during pregnancy have hardly been examined. The greatest risk seems to be that the child is not adequately cared for. The same is known when women get pregnant shortly after a stomach reduction and the children tend to be born smaller. The reason is clear: due to the treatment, women eat so little that the embryo gets too few nutrients and cannot grow properly.

However, Laubner, however, is almost even worried than taking it during pregnancy: “You have to tell the women clearly that the weight can rise again quickly after stopping.” This applies to medication as well as to diets or a gastric reduction that has been reversed. After all, obesity is a chronic disease.

The quick weight gain from the yo-yo effect can have fatal consequences, such as pregnancy diabetes and pregnancy poisoning, very large children who lead to birth problems or premature birth. How big this effect is is hardly researched. One thing is certain: The weight of the mother during pregnancy also decides whether the child later has a greater risk of becoming overweight.

Newer active ingredients that control up to four different hormone receptors promise even greater effects on the weight. The same applies to them as for Semaglutid: No application during pregnancy due to the lack of data, warns Laubner. Orforlipron, the first pill for losing weight, for which manufacturers Eli Lilly has just published promising data again, is no exception.

SEMAGLUTID and comparable funds can be a possible way to the child of the choice for women with obesity, type 2 diabetes or the hormone disorder PCOS. For which woman it is the right one is always an individual decision – with a view to the risks and with medical support.

The data situation is getting better, but can never give final security. It is therefore important to use the opportunities through the funds without forgetting the basis: a healthy lifestyle that should also be maintained after birth.