GLP-1 weight loss drugs can cause Eustachian tube dysfunction leading to autophony and hearing problems | Research

The takeaway

Seven patients developed patulous Eustachian tube (hearing own voice/breathing) after 4-10 months of GLP-1 therapy with 8-19% weight loss, requiring Eustachian tube injections in 6 of 7 cases.

New GLP-1 side effect identified
7 patients developed patulous Eustachian tube (hearing own voice/breathing) after 8-19% weight loss from GLP-1 drugs—a previously unreported otologic complication

What the researchers found

7 patients (5F, 2M; age 28-56); bilateral PET in 5. 4-10 months GLP-1 therapy; 8.2-18.7% weight loss. Symptoms: autophony (7/7), aural fullness (6/7), hearing breathing (5/7). Treatment: 6/7 needed VOX-Implant injections; 1/7 conservative improvement.

Why it matters

As millions lose weight on GLP-1 drugs, this previously unrecognized otologic side effect could become common. Clinicians need to recognize and refer these patients early.

How the study worked

Retrospective case series (June 2024-June 2025). Otolaryngology clinic. Diagnosis: otoscopy, DVT, tympanometry, tubomanometry.

What this study cannot tell us

Small case series. No control comparison. Cannot prove causation vs coincidence. PET diagnosis can be subjective.

How to read the evidence

First case series—establishes a new adverse effect. Important for safety awareness.

When this study was published

Published in 2025; cases June 2024-June 2025.

The bigger picture

PET from rapid weight loss is known in bariatric surgery but has never been reported with GLP-1 drugs. As "Ozempic face" revealed facial fat loss, PET reveals fat loss in another critical anatomical area.

Questions still open

How common is PET among GLP-1 users who lose >10% body weight?
Does slower weight loss reduce PET risk?
Would weight regain resolve PET without surgical intervention?

Common questions

What is patulous Eustachian tube?

It is a condition where the tube connecting your ear to your throat stays abnormally open instead of closing. This causes you to hear your own voice and breathing amplified inside your head (autophony), feel ear fullness, and may affect hearing. It can be very distressing.

Why does weight loss cause ear problems?

Fat pads around the Eustachian tube help keep it closed. Rapid weight loss—including from GLP-1 drugs—can shrink these fat pads, leaving the tube permanently open. This is similar to how facial fat loss causes "Ozempic face" but affecting the ears instead.

Read the original research

First report on a case series of Patulous Eustachian tube following GLP-1 receptor agonist-induced weight loss.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 282(12), 6533-6538

View on PubMed ↗Publisher’s paper ↗

Citation

Sudhoff, Holger. (2025). First report on a case series of Patulous Eustachian tube following GLP-1 receptor agonist-induced weight loss.. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 282(12), 6533-6538. https://doi.org/10.1007/s00405-025-09604-5