GLP-1 receptor agonist -hair loss is a low risk side effect with more common GI symptoms.  2026 British Medical Journal found in adults with Type 2 diabetes GLP-1 use was associated with 37% higher risk of alopecia versus SGLT-2 inhibitors and 68% higher than DPP-4 inhibitors.

Non-scarring alopecia absolute incidence of hair loss was low 6-7 cases per 1,000 person for GLP-1 users versus 4-5 for comparators. Relative risk for telogen effluvium ((TE), androgenetic alopecia (AGA), and overall nonscarring hair loss, with signals strongest for semaglutide and tirzepatide.  Wegovy alopecia occurred in about 3% of adults versus 1% on placebo.  Higher rates 5% in tirzepatide data for obesity in women. 

Weight loss associated with caloric restriction or nutrient shortfalls such as iron, zinc, or protein, trigger telogen effluvium shedding that starts 2-3 months after the stressor and is usually temporary.  Hair follicles remain intact, so regrowth often occurs once weight stabilizers in 3-6 months.  Absolute risk is low since not everyone experiences it.  Not always listed in lower diabetes doses than higher dose obesity trials.  

Management focuses on supporting nutrition, adequate protein and micronutrients, gentle hair care and time.  Persistent cases warrant evaluation by a clinician or dermatologist to rule out other causes.  Gastrointestinal effects dominate and is the main reason for dose titration and discontinuation.  Including nause, vomiting, diarrhea and constipation.  Less common but more serious risks include pancreatitis, acute kidney injury, gall bladder issues, thyroid C-cell tumors (contraindicated with MEN2 syndrome), and liver dysfunction. Delayed gastric emptying, which can increase aspiration risk during anesthesia and has to be discontinued at least 2 weeks preop.  

Staying hydrated help people tolerate GI effects.  Slower titration, dietary adjustments and if any vision changes or significant hair shedding should prompt to be seen by a healthcare provider.