School of Podiatric Medicine - Student Research

Document Type

Report

Publication Date

11-2025

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have transformed obesity management by producing substantial and sustained weight loss. However, rapid weight reduction has been increasingly associated with peroneal neuropathy, or “slimmer’s paralysis.” This review summarizes the pathophysiology, recent case reports, and clinical implications of this emerging complication. Slimmer’s paralysis arises indirectly through loss of protective adipose tissue around the fibular head and nutritional deficiencies, rather than direct neurotoxic effects of GLP-1 agents. Recognition is critical, as timely intervention with conservative or surgical management can restore function. Clinicians should maintain vigilance in patients undergoing rapid pharmacologic weight loss, counsel on modifiable risk factors, and monitor for neurological symptoms.

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