GLP-1 Receptor Agonists and Temporary Hair Loss: A Review of Emerging Clinical Evidence

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide (Ozempic®, Wegovy®), have transformed the management of type 2 diabetes mellitus and obesity by improving glycemic control and promoting significant weight loss. Recent evidence, however, has highlighted an emerging concern regarding temporary hair loss associated with these therapies. A large observational study published in The BMJ (2026) reported a higher incidence of non-scarring alopecia among GLP-1 RA users compared with users of SGLT-2 inhibitors and DPP-4 inhibitors, although the absolute risk remained low. Current evidence suggests that this adverse effect is primarily related to rapid weight loss, reduced caloric intake, and nutritional deficiencies involving protein, iron, zinc, biotin, and vitamin B12, leading to telogen effluvium rather than permanent follicular damage. This review summarizes the latest clinical evidence, explores the proposed mechanisms, identifies populations at increased risk, and discusses strategies for prevention and management. Patient education, gradual weight reduction, adequate nutritional support, and regular clinical monitoring are essential to minimize this complication. Overall, the metabolic benefits of GLP-1 receptor agonists continue to outweigh the small risk of reversible hair loss, emphasizing the importance of individualized patient care and informed therapeutic decision-making.