In a real-world cohort from 13 South Korean hospitals, adults starting semaglutide or liraglutide for weight loss had higher risks of psychiatric disorders, gastrointestinal problems, and other selected safety outcomes than similar non-initiators. Semaglutide was associated with especially large increases in depressive disorder and gastrointestinal dysmotility or obstruction, while liraglutide showed broader but somewhat smaller elevations across psychiatric, hepatic, and pancreatobiliary outcomes.
Observational study — Multicentre retrospective cohort study. Population: Adults with weight management initiating semaglutide or liraglutide at 13 South Korean hospitals, 2018-2025. Sample size: 2357 semaglutide and 6953 liraglutide initiators, compared with 22,602 and 68,001 matched non-initiators. Interventions: semaglutide; liraglutide.
Semaglutide initiators (n=2357) had significantly increased risks of psychiatric disorders overall (HR 2.02), anxiety disorder (HR 2.39), depressive disorder (HR 3.42), gastrointestinal dysmotility or obstruction (HR 3.91), and vision impairment (HR 1.58) relative to matched non-initiators. Liraglutide initiators (n=6953) showed significant increases in psychiatric disorders overall (HR 1.66), anxiety (HR 1.68), depressive disorder (HR 1.51), hepatic impairment (HR 1.46), pancreatobiliary disorder (HR 1.33), pancreatitis/cholangitis/cholelithiasis (HR 1.40), and vision impairment (HR 1.34). Sensitivity analyses were mostly consistent, though semaglutide-associated vision impairment and liraglutide-associated hepatic impairment lost significance in some analyses. No safety outcome was significantly reduced by either drug.
For researchers studying semaglutide or liraglutide, this paper provides real-world, head-to-head safety signals in a weight-loss population, showing that the two agents differ in their associated risk profiles. It does not establish causality and cannot be used for dosing or individual treatment decisions, but it identifies psychiatric, gastrointestinal, hepatic, and vision outcomes that warrant closer monitoring and further investigation.
Peptide profiles: Semaglutide, Liraglutide.
All indexed evidence: Semaglutide trials & papers, Liraglutide trials & papers.
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