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Serious and Potentially Dangerous Side Effects More severe side effects reported with Rybelsus and other semaglutide drugs include: Severe Gastrointestinal Injury persistent vomiting inability to tolerate food gastroparesis (stomach paralysis) bowel shutdown or ileus intestinal obstruction Related: Motility Disorders Dehydration & Kidney Injury Prolonged vomiting or diarrhea can lead to: dehydration electrolyte imbalance acute kidney injury (AKI) worsening chronic kidney disease Related: Dehydration and Kidney Damage Gallbladder Disease Rapid weight loss and digestive disruption may contribute to: gallstones gallbladder inflammation gallbladder removal surgery Related: Gallbladder Removal Pancreatitis Some patients report: severe abdominal pain elevated pancreatic enzymes hospitalization for pancreatitis Related: Pancreatitis Vision Problems / NAION Reports of sudden vision loss, including Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) , have emerged across the GLP-1 drug class

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This is a legitimate worry because traditional calorie restriction, even without medications, typically results in some degree of lean tissue loss alongside fat loss

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