The explosive growth of semaglutide (Ozempic and Wegovy) we use after its FDA approval for chronic weight management in 2021 was accompanied by another trend that caught the attention of researchers: a dramatic increase in calls to poison control centers across the United States.
Jordan Miller, then an undergraduate at UT San Antonio, wanted to know if the increase in poison control cases was directly related to the FDA’s expanded approval of semaglutide or if the timing was simply a coincidence.
Originally introduced as a treatment for type 2 diabetes, glucagon-like peptide-1 receptor agonists (GLP-1RA) 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 sharp increase in calls, singling out semaglutide far above other medications.
“One of them was this rather strange category of semaglutide,” said David Han, Miller’s research mentor and the Romo Endowed Professor in the Department of Statistics and Data Science at UT San Antonio. “We suspected that call volume was skyrocketing due to misuse and mishandling of this medication and that this may be attributed to the FDA’s approval of this weight management medication.”
Working with Han through the Provost’s Undergraduate Research Fellowship, Miller collaborated with Long School of Medicine researchers Robert S. Miller, Pharm.D, senior poison information specialist, 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 Data conference, where the project took first place.
Calls to poison control increased dramatically
Before 2021, poison control centers across the country typically handled between 1,000 and 1,500 cases involving GLP-1RA each year. After mid-2021, that number nearly doubled, and by 2023, poison centers had recorded more than 8,000 calls related to GLP-1RA.
Although most incidents involved accidental dosing or therapeutic errors rather than intentional misuse, the magnitude of the increase surprised the research team.
“In that number that tracks the increase by specific drug, I didn’t expect semaglutide to be so incredibly dominant,” Jordan Miller recalled. “I thought he would lead the pack, but it was amazing. 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 rather than simply producing statistics.
“This work demonstrates the quantified impact of these medications on public health,” he said. “Statistics, data science, analytics, machine learning and artificial intelligence are meant to help people. We use them to transform data from any field into meaningful insights and informed actions. Without that focus, everything becomes empty: numbers with no real impact.”
A worthwhile research question
The project began after Miller decided to ask a professor about possible research opportunities, a step he almost skipped.
“You don’t lose anything by asking,” he said. “If you have a professor who you really get along with or admire, it doesn’t hurt to ask them what they’re working on or if they have room for a research assistant. I’ve had great luck with Dr. Han saying, ‘I’m here to help; you choose 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 LPG-1[RA] “Drugs are sold to diabetic patients, that’s a completely different story than when the drug is used for weight control,” Han explained. “So, we had to quantify this evidence to show that it came from the FDA approval and how to contain the risk. We need to better educate the public because it is not yet fully understood how this drug behaves in our body and its long-term safety.”
Avoidable dosing errors caused many cases
Researchers found that many of the poison control cases could have been prevented with better patient education. Semaglutide is designed to be injected once a week, not every day. Patients also start 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 schedule step by step.
“Can you imagine something you’re supposed to get to slowly, and you’re going full speed and seven times more often than you’re supposed to?” Jordan Miller said.
According to 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 appeared as a cover article in Meaningthe flagship journal of the Royal Statistical Society and the American Statistical Association. The findings were also published in the Journal of medical toxicologythe official journal of the American College of Medical Toxicology.