| Ask your doctor about side effects of obesity drugs, and digestive revolt is likely to top the list of possible unpleasantness. But when Novo Nordisk recently tested a high-dose version of its shots Ozempic and Wegovy, it was a different unintended outcome that spiked the most: skin sensations that can range from itching and numbness to burning. About 23% of people who injected a dose three times as high as the strongest currently approved Wegovy shot experienced the side effect, called dysaesthesia, Novo said in a large clinical trial published in the medical journal The Lancet Diabetes & Endocrinology. The rate was 19% among diabetes patients who got the high dose in a separate study, also published in the journal. The triple dose isn’t on the market yet, though Novo is seeking approval to sell it in Europe as a counter to rival Eli Lilly & Co.’s Zepbound. Skin issues are a relatively newly-recognized side effect for Ozempic and Wegovy. They can show up some time after an injection, and patients may not have initially connected the dots between a burning sensation on the shoulder and the shot they took a few days prior, said Daniel Rosen, a bariatric surgeon and obesity-management specialist in New York. Rosen took to TikTok late last year to report that some of his patients taking GLP-1 weight-loss medicines were experiencing a form of dysaesthesia called allodynia, in which people feel pain from touch that’s actually gentle. He said his patients described burning sensations from wind or clothing brushing across their skin. GLP-1 medications can sensitize nerves in the skin and make people hypersensitive to stimuli, Rosen said on TikTok. “The grass-roots responsiveness was eye-opening,” he told me. “People were saying, ‘Me too! That’s me!” Rosen wasn’t involved in Novo’s trial, but in his own practice, he said he’s seen skin side effects more frequently in patients taking higher doses of GLP-1s, both on Wegovy and Zepbound. Most patients are able to address it by dosing down or taking another drug to treat nerve pain, he said. Four out of 230 high-dose patients who reported dysaesthesia in the Novo study quit due to the side effects, while about one in five reduced their dose. Though skin issues were more common in the high-dose trial, most cases were mild to moderate, and most patients recovered while on treatment, according to a Novo spokeswoman. The company will continue to monitor for the side effect, she said. — Naomi Kresge | 
