There is a medical condition called gastroparesis: severe, chronic delayed stomach emptying, usually diagnosed in people with long-standing diabetes or after certain abdominal surgeries. Routine delayed emptying on semaglutide is not the same as diagnosed severe gastroparesis. The label does say semaglutide delays gastric emptying, and rare severe or persistent retention-like presentations belong in clinical evaluation.

In adult Wegovy injection weight-reduction trials and the pooled STEP 1-3 semaglutide 2.4 mg analysis, severe gastrointestinal adverse reactions were reported in 4.1% of semaglutide-treated adults versus 0.9% on placebo. That rate is not the same thing as stomach paralysis or gastroparesis. A specific semaglutide 2.4 mg substudy in adults with obesity assessed gastric emptying at week 20 indirectly using paracetamol absorption and found no evidence of delayed gastric emptying at that point. The Wegovy label says it is not recommended in patients with severe gastroparesis.