It was a shocking story and a warning for people who want to get thin quickly. Last week it was reported that a 19-year-old American law student lived there London had died after taking a weight loss drug containing tirzepatide – the active ingredient in the NHS-approved Mounjaro.
Josephine Nasr, out Californiahad suffered a heart rhythm complication in her room at the University of East London in September 2025. A post-mortem examination concluded that she had an undiagnosed heart condition, but also suggested that a drop in blood sugar levels caused by the drug could have caused the complication.
She is among a growing number of deaths linked to weight-loss drugs. According to official figures, 216 people have now died in Britain due to possible side effects – although there is no way to know for sure that the drug was the primary cause, only that it was suspected.
But perhaps the most important of these cases is the death of Caroline Savage, a 73-year-old grandmother from Norfolk, as it highlights an under-researched risk.
Caroline started taking the shot in 2024, after years of failure to fall off. She also suffered from lipedema – a chronic condition that causes fat to accumulate in the legs, hips and arms, which Mounjaro alleviates.
Within four months Caroline had lost two stone. However, in October 2024 she suffered severe stomach pains before collapsing at home. She died in hospital.
What’s so important is the cause of death: fecal peritonitis, in which feces leak from the intestines. It is a condition that has not until now been associated with weight-loss medications.
However, I fear that countless Britons taking these drugs are at risk. This is because we know that one of the main risks is not normally life-threatening: constipation.
Josephine Nasr, from California, suffered a heart rhythm complication in her room at the University of East London in September 2025
Constipation – often defined as no more than three bowel movements per week – affects around one in five adults and a third of people over 60.
This is largely due to poor nutrition. Fiber is crucial for regular bowel movements, but less than 5 percent of Britons consume the recommended daily amount of 30 grams. Widespread dehydration is also believed to be a cause. And mounting evidence suggests that weight-loss shots can give constipation a boost. This is because they slow down the intestines, meaning it takes longer for the body to expel food.
Over time, this can cause the intestines to back up, which puts pressure on the intestinal wall and increases the risk of a tear developing and fecal matter entering the intestines. This is an even greater risk for the elderly.
It is possible that there are thousands of patients receiving weight loss shots at risk. The best way to protect yourself against constipation? Change your diet.
Kiwis and plums are particular favorites for constipation, but there are many high-fiber foods available, including nuts, seeds, legumes, legumes, oats and certain vegetables. We should all drink more water – at least six glasses or, in warm weather, at least eight.
Interestingly, there is also good evidence that regular exercise – such as walking, running and swimming – can relieve constipation.
But finally, there is one more important piece of advice for users of slimming injections: do not rush to increase your dose.
Caroline Savage, 73, was a grandmother who died after experiencing sudden and severe pain following an increase in the dose of her Mounjaro jab
Patients start on a low dose, which is slowly increased over several months. It is when patients make the jump to the next dose that the most uncomfortable symptoms, such as constipation, occur.
Taking a few extra weeks before increasing the dose, which gives the body more time to get used to the drug, may alleviate some side effects.
Or for anyone who thinks they are making good progress, it may not be necessary to increase the dose at all.
NHS cost-cutting patient cull means elderly people no longer see their GP
I fear that many thousands of people have been removed from their GP practice lists without their knowledge.
Over the past year, NHS GPs have been instructed to remove patients who have not come to the practice for a while. This is a cost-saving measure, as GP practices are paid for every patient they have on their books.
However, I have heard from colleagues that the software used to carry out this cull is overzealous and that many older, vulnerable patients have been evicted from their operating rooms – meaning they cannot get an appointment.
Patients who have not been to their GP for a while should check whether they are still on their list.
Have you recently been removed from your GP list? Sign up and let me know.
Your questions answered
I wake up every morning with a cough and mucus in my throat. It eventually goes away, but always returns. What could it be?
Dr. Ellie answers: A morning cough could be due to allergic reactions, heartburn – or something more sinister.
Coughing is one of the most common complaints encountered by GPs, and it can take some time to determine the cause. It is often a matter of trial and error.
Allergies can often be the culprit. Most people think of allergic reactions as a runny nose and itchy eyes, but it’s possible that a reaction to dust, hay fever, or animal hair could cause a cough and nothing more.
This is usually caused by postnasal drip, where mucus drips from the nose into the back of the throat. This can get worse when lying down, which is why the resulting cough can feel worse in the morning.
An easy way to find out if allergies are the cause is to try a daily antihistamine tablet, which you can buy at most major pharmacies. If the cough subsides after a few days, the cause is likely an allergy.
However, another cause of a morning cough can be heartburn. Also known as acid reflux, the condition occurs when stomach acid rises into the throat. As with post-nasal drip, this may be worse in the morning as the acid is more likely to enter the throat during sleep.
Heartburn is usually treated by dietary changes, such as eating fewer fatty foods, and avoiding alcohol and carbonated drinks.
In rarer cases, a morning cough can be caused by a serious lung condition called chronic bronchitis. This is where the airways remain inflamed, causing the body to produce excess mucus.
This mucus can build up in the lungs overnight, leading to morning coughs.
Other symptoms of chronic bronchitis include wheezing and chest pain. It is usually caused by smoking – and symptoms can often be relieved by simply quitting.
