Legal analysts estimate GLP-1 liability could top $2 billion

Analysts following two multidistrict litigation cases involving GLP-1 drugs estimate combined potential liability could exceed $2 billion, according to a September 2026 update on the litigation.^[1] The estimate spans two separate federal court proceedings: one covering gastrointestinal injuries and one covering vision loss. No case in either MDL has been tried, and no settlements have been announced.^[1]

The larger case, MDL-3094, now has 4,022 pending lawsuits and 4,056 total filed as of September 2026, a 202% increase since January 2025.^[1] About 75% of the complaints allege gastroparesis, or stomach paralysis; 18% allege ileus, a blockage of the intestines; and 8% allege gallbladder injuries.^[1] The suits name Novo Nordisk, maker of Ozempic and Wegovy, and Eli Lilly, maker of Mounjaro, as defendants, and are overseen by Judge Karen S. Marston in the Eastern District of Pennsylvania.^[1]

A related but separate case, MDL-3163, was created in December 2025 to handle claims that GLP-1 drugs caused NAION, a form of sudden vision loss sometimes called an "eye stroke."^[1] That case had grown to about 200 pending lawsuits by September 2026, up from roughly 30 when it was formed and 130 by early July 2026.^[1][2] A lawsuit filed in that case in late July 2026 cited published research, including a 2024 JAMA Ophthalmology study and Danish-Norwegian registry data, reporting semaglutide users faced several times the risk of NAION compared with patients on other medications.^[2] European regulators concluded in June 2025 that NAION is a rare but real side effect of semaglutide and recommended it be added to European drug labels; as of the July 2026 filing, U.S. labels for Ozempic, Wegovy and Rybelsus still carried no NAION warning.^[2]

On the gastrointestinal side, the FDA updated Ozempic's label in October 2025 to state the drug "is not recommended in patients with severe gastroparesis," a change that came after thousands of injury reports were filed.^[1] A 2023 JAMA study cited in the litigation found patients using GLP-1 drugs for weight loss had a 3.67 times higher risk of gastroparesis, a 4.22 times higher risk of bowel obstruction, and a 9.09 times higher risk of pancreatitis compared with other patients.^[1]

A viral video that circulated in late August 2026 claimed a specific "$2 billion" Ozempic lawsuit, but as of publication those claims had not been independently verified and no such specific case or settlement had been confirmed in court filings.^[2] The $2 billion figure attributed to legal analysts refers to an estimate of combined potential liability across both MDLs, not a confirmed settlement or verdict.^[1]

Why it matters for patients

For patients currently taking or considering semaglutide or tirzepatide drugs, the litigation does not change what is approved or recommended by the FDA today. The lawsuits are civil claims that have not yet been tested at trial, and legal analysts caution that no liability has been established in court.^[1] The FDA's October 2025 label change on severe gastroparesis reflects updated safety information available to prescribers now, separate from the pending litigation.^[1] Patients who have experienced gastroparesis, intestinal obstruction, or sudden vision loss after taking these drugs may want to know that separate legal processes exist for each type of claim, with gastroparesis claims generally requiring objective diagnostic testing.^[1]

What happens next

Summary judgment briefing in MDL-3094 continues through July 2026, with bellwether trial selection expected around mid-2026 and the first trials possible in late 2026.^[1] Legal analysts do not expect mass settlements before late 2027.^[1] In MDL-3163, bellwether trials are anticipated for late 2026 or 2027.^[2] No U.S. label change addressing NAION risk had been made as of the most recent filings.^[2]