The GLP-1 effect: How weight loss drugs can lead to unplanned pregnancies

New Delhi: In recent months, obstetricians and gynaecologists across cities in the country have noticed a quiet yet striking trend in their clinics: women who believed they had little or no chance of conceiving are arriving with unexpected positive pregnancy tests. A common thread in many of these narratives is significant weight loss achieved through newer injectable medications, such as GLP-1 receptor agonists, which are now widely referred to as weight loss drugs.

Dr Rujul Jhaveri, Consultant – Obstetrics & Gynaecology, Narayana Health SRCC Children’s Hospital, Mumbai, said that none of these "weight loss” medications actually result in pregnancy. What they do, however, is far more subtle – they restore metabolic balance. While they have been used in the treatment of diabetes in adults over the age of 18, their contribution to a healthier body and significant weight loss has made them popular among people who seek medical treatment for obesity and severe weight gain. The expert went on to talk about how this impact is relevant.

For years, excess weight, insulin resistance, and chronic inflammation have disrupted the reproductive health of countless women. Conditions that commonly affect reproductive health include: polycystic ovary syndrome (PCOS), irregular menstrual cycles, polycystic ovarian disease (PCOD), anovulation, which is when fertility declines due to erratic or total absence of ovulation, sometimes to the point where women can no longer conceive naturally.

All of these are hormonal and cause weight gain. In addition to lifestyle and diet changes, these conditions require medical treatment.

What changes with GLP-1 weight loss drugs

With GLP-1–based weight-loss drugs, we are seeing a rapid improvement in metabolic health. As insulin sensitivity improves and body weight decreases:

These weight loss treatments cannot be mistaken for a drug-induced fertility boost; rather, they help the body reclaim its natural reproductive rhythm. And this restoration is catching women by surprise, as many of them do not realise that their chances of conceiving could increase immediately following significant weight loss.

As a result, there is a rise in unplanned pregnancies. What is concerning is that in some of these cases, women are found actively taking the medication even when their pregnancy is detected.

GLP-1 and safe pregnancy

This is a topic that requires urgent and critical conversations – a pregnancy detected during GLP-1 treatment is a cause for concern, as these drugs (whether injectable or tablet form) are not recommended for pregnant women. The treatments are generally discontinued once pregnancy is planned or confirmed. Exposure to these weight loss drugs during early pregnancy requires timely medical intervention.

Why proactive counselling is important

Women of reproductive age who are using weight-loss injections should be counselled proactively — not only about weight goals, but also about:

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The absence of regular periods in the past does not guarantee protection against pregnancy once metabolic health improves. The rise in unplanned pregnancies linked to rapid weight loss is not a warning against these medications. Weight loss can be transformative for overall health, self-confidence, and long-term well-being. But it also brings hormonal and biological shifts that must be acknowledged and managed with care. Awareness, timely counselling and informed choices can ensure that a chance at renewed fertility becomes a positive outcome rather than a surprise.