Gastroparesis

NIDDK defines gastroparesis, also called delayed gastric emptying, as a disorder that slows or stops the movement of food from the stomach into the small intestine. Normally the stomach muscles grind food and push it onward; in gastroparesis those muscles work poorly or not at all, and the stomach takes too long to empty. The result is nausea, vomiting, feeling full after a few bites, bloating and abdominal pain.

The numbers are worth knowing because they cut against the panic. NIDDK describes gastroparesis as not common: out of 100,000 people, about 10 men and about 40 women have it. Meanwhile, symptoms resembling gastroparesis occur in roughly one in four US adults. Feeling uncomfortably full is not the same as having the diagnosis.

The overlap with GLP-1 therapy is mechanistic, not accidental. Slowing gastric emptying is part of how these drugs create fullness, so a degree of delay is the intended effect. The clinical question is whether it crosses into a symptomatic disorder, and it does so more often when doses are escalated quickly. The Wegovy label addresses this directly: severe gastrointestinal reactions have been reported, and Wegovy is not recommended in patients with severe gastroparesis.

Two risk factors from NIDDK matter here. Diabetes is the leading identified cause, and prior surgery on the esophagus, stomach or small intestine can injure the vagus nerve that controls these muscles — so people with long-standing diabetes or a surgical history start from a different baseline than someone with none.

Worth asking your clinician: whether your symptoms warrant a gastric emptying study rather than assumption, whether slowing your titration would help, and whether a smaller-meal, lower-fat, lower-fiber eating pattern is worth trying first. Our gastroparesis evidence review, pre-existing gastroparesis page and side-effect timeline cover what is typical and what is not.