Two Patients Develop Foot Drop from Rapid Weight Loss on GLP-1 Drugs | Research

The takeaway

Two non-diabetic patients developed peroneal nerve palsy (foot drop) after losing 14-18% of body weight on semaglutide and tirzepatide, highlighting "Slimmer's Palsy" as an underrecognized GLP-1 drug complication.

14-18% weight loss
Rapid fat loss in the knee area left the peroneal nerve unprotected, causing foot drop in both patients

What the researchers found

Two non-diabetic patients developed common peroneal neuropathy (foot drop) after losing 14% and 18% of body weight over 3-6 months on semaglutide and tirzepatide, respectively.

Why it matters

With millions of people rapidly losing weight on GLP-1 drugs, peripheral nerve complications may become increasingly common. Early recognition and intervention can prevent permanent nerve damage.

How the study worked

Case report of two patients with clinical, electrodiagnostic, and imaging documentation of peroneal nerve injury after GLP-1 RA-induced weight loss.

What this study cannot tell us

Only two cases reported; cannot estimate incidence. Both patients were non-diabetic; diabetic patients may have different risk profiles due to pre-existing neuropathy.

How to read the evidence

Case report documenting a predictable but underrecognized complication. Raises awareness but cannot establish incidence.

When this study was published

Published in 2025, alerting clinicians to a complication becoming more relevant as GLP-1 drug use expands.

The bigger picture

As GLP-1 drugs produce weight loss rivaling bariatric surgery, the surgical complications associated with rapid weight loss—including nerve damage—are now appearing in the pharmacotherapy setting.

Questions still open

How common is peroneal neuropathy among rapid weight-losers on GLP-1 drugs?
Should patients losing weight rapidly on GLP-1 drugs receive periodic nerve function screening?
Does slower dose titration (and thus slower weight loss) reduce nerve compression risk?

Common questions

What is Slimmer's Palsy?

It's a condition where rapid weight loss removes protective fat around the peroneal nerve at the knee, causing it to be compressed. This leads to foot drop—difficulty lifting the front of the foot—which can be treated if caught early.

Should I worry about this on Ozempic or Mounjaro?

This appears to be rare and is associated with very rapid weight loss. If you notice numbness, tingling, or weakness in your foot or lower leg while losing weight rapidly, contact your doctor promptly for evaluation.

Read the original research

GLP-1 Receptor Agonist-Associated Slimmer's Palsy: Implications for the Peripheral Nerve Surgeon.

Annals of plastic surgery, 96(1), 69-74

View on PubMed ↗Publisher’s paper ↗

Citation

Dhupati, Pooja; Kisiel, Sara C; Unadkat, Krishna; Noland, Shelley S. (2026). GLP-1 Receptor Agonist-Associated Slimmer's Palsy: Implications for the Peripheral Nerve Surgeon.. Annals of plastic surgery, 96(1), 69-74. https://doi.org/10.1097/SAP.0000000000004570