At least 216 deaths in the United Kingdom have been linked to weight-loss drugs like Mounjaro after American student Josephine Nasr died in London.
Official figures show that 216 people across the UK have died due to suspected side effects of weight-loss medications, although health authorities note there is no way to verify if the medicine was the primary cause of death in every instance.
Josephine Nasr, a 19-year-old law student from California who was living in London, died in her room at the University of East London in September 2025. She had taken a weight-loss drug containing tirzepatide, the active ingredient in NHS-approved Mounjaro.
A post-mortem examination concluded that Nasr suffered a heart rhythm complication linked to an undiagnosed heart condition. However, examiners also suggested that a drop in blood sugar caused by the weight-loss drug could have triggered the fatal complication.
Mounjaro, manufactured by Eli Lilly, is an injectable prescription medicine approved by the National Health Service for weight management and type 2 diabetes. The drug utilizes tirzepatide to mimic metabolic hormones, suppressing appetite and delaying stomach emptying. The University of East London is a public university with campuses in East London.
Bowel perforation risk in Norfolk grandmother death
General practitioner Dr Ellie highlighted the case of Caroline Savage, a 73-year-old grandmother from Norfolk, as a significant example revealing an under-discussed danger associated with weight-loss jabs.
Savage began taking the weight-loss jab in 2024 after struggling to lose weight for years. She also suffered from lipedema, a chronic medical condition that causes painful fat build-up in the legs, hips, and arms, which tirzepatide treatments have been shown to help ease. Within four months of starting the medication, Savage successfully lost two stone.
However, in October 2024, Savage developed severe stomach pain and collapsed at her home before being rushed to hospital, where she died. Her official cause of death was recorded as faecal peritonitis, a condition where faecal matter leaks through tears in the intestinal wall into the abdominal cavity.
Lipedema is a long-term condition affecting millions of women worldwide, characterized by irregular adipose tissue accumulation. Faecal peritonitis is a life-threatening surgical emergency that causes severe intra-abdominal infection and systemic sepsis. Dr Ellie noted that intestinal leakage had not previously been associated with weight-loss medications.
Constipation risks and gut slowing mechanisms
Dr Ellie warned that thousands of British patients taking weight-loss injections could be at risk of severe bowel complications. The primary underlying factor is constipation, a common side effect that is ordinarily not life-threatening but can escalate when gut motility is dramatically reduced.
Constipation, defined medically as having no more than three bowel movements a week, currently affects around one in five adults and a third of people aged over 60 in the UK. Widespread dehydration and poor dietary habits are major contributors, with fewer than 5 per cent of Britons consuming the recommended daily target of 30 grams of dietary fibre.
Evidence indicates that weight-loss jabs can super-charge constipation by slowing down gut contractions, extending the time required for the digestive system to expel food waste. Over time, the bowel becomes backed up, generating extreme pressure against the bowel lining and increasing the risk of a perforation that allows faeces into the abdomen. Older patients face an elevated risk of bowel tearing.
Dietary remedies and dose management guidelines
To protect against severe constipation, Dr Ellie advises patients to modify their diets by increasing fibre intake. Specific anti-constipation foods include kiwis and prunes, along with nuts, seeds, pulses, legumes, oats, and fibrous vegetables. Patients should also drink a minimum of six glasses of water daily, increasing to at least eight glasses during hot weather.
In addition to dietary changes, evidence shows that regular physical activity such as walking, running, and swimming helps stimulate bowel motility and ease chronic constipation.
For weight-loss jab users, Dr Ellie emphasized that patients must avoid rushing to raise their medication dosage. Patients typically start on a low dose that is gradually increased over several months. However, jumping to the next dose level frequently triggers the most uncomfortable side effects, including severe constipation.
Taking a few extra weeks before increasing the dosage gives the body additional time to adapt, which may ease uncomfortable side effects. Dr Ellie added that patients who are making good progress on their current dose may not need to increase their dosage at all.
NHS cost-cutting and GP patient list removals
Dr Ellie expressed concern that thousands of people across the UK may have been removed from their GP surgery registration lists without their knowledge. Over the past year, general practices have been instructed by the NHS to remove patients who have not attended their surgery recently.
The removals are part of an NHS cost-cutting initiative, as GP surgeries receive capitation payments based on the total number of registered patients on their books. However, reports from medical colleagues indicate that automated software used to execute the list clean-up is overzealous, resulting in elderly and vulnerable patients being deregistered and left unable to book medical appointments.
Patients who have not visited their doctor recently are urged to contact their GP surgery to verify they remain on the practice list. Dr Ellie invited readers who have experienced unexpected deregistration to write in and share their experiences.
Causes and remedies for morning coughs
Addressing general health questions, Dr Ellie offered medical guidance for readers who experience a recurring morning cough accompanied by a phlegmy throat that clears later in the day. Morning coughs are a common complaint seen by general practitioners, often requiring trial and error to establish an accurate diagnosis.
Allergies to dust, pollen, or animal dander are a frequent culprit. While allergic reactions are commonly associated with itchy eyes and a runny nose, they can also trigger a cough without other symptoms through post-nasal drip, where mucus drips from the nasal passages into the back of the throat. This condition worsens when lying down flat, making morning coughing fits more severe.
To determine if allergies are responsible, Dr Ellie suggests taking a daily over-the-counter antihistamine tablet from a high street pharmacy for a few days. If the cough subsides, an allergic reaction is the likely cause.
Heartburn, also known as acid reflux, is another potential cause of morning coughing. Acid reflux occurs when stomach acid flows upward into the oesophagus and throat. Like post-nasal drip, acid reflux is exacerbated during sleep when lying down. Treating heartburn typically involves lifestyle and dietary modifications, such as reducing intake of fatty foods, alcohol, and carbonated drinks.
In rarer cases, a morning cough can signal chronic bronchitis, a serious long-term lung condition involving persistent airway inflammation and excessive mucus production. Mucus accumulates in the lungs overnight, causing morning coughing, wheezing, and chest discomfort. Chronic bronchitis is primarily caused by smoking, and symptoms can often be relieved by quitting smoking completely.
