The FDA's 2024-2025 updates to the Ozempic and Wegovy (semaglutide) prescribing information added warnings for ileus/intestinal blockage, pulmonary aspiration during anesthesia, and ongoing gastroparesis surveillance, reflecting accumulating postmarketing reports - including roughly 20 ileus reports with two deaths. A 2025 observational study found an increased gastroparesis incidence in semaglutide users versus a comparator weight-loss drug, and federal GLP-1 gastroparesis litigation (MDL 3094) has consolidated hundreds of claims. The label changes underscore that delayed gastric emptying - the drug's mechanism - has real downstream safety consequences that prescribers must manage.