Evidence-graded answer
Does Ozempic cause stomach paralysis (gastroparesis)?
GLP-1 medications delay gastric emptying as part of their mechanism — that is not stomach paralysis. True gastroparesis after GLP-1 use is rare and the absolute risk in pharmacovigilance data is small. Symptoms (severe nausea, vomiting, abdominal pain past week 8) warrant evaluation.
Delayed gastric emptying is the deliberate mechanism — it produces satiety and slower nutrient absorption. This is reversible on stopping the drug.
True gastroparesis (chronically delayed emptying that persists off-drug) has been reported in case series but the causal attribution is debated; many cases involve pre-existing diabetes-related gastroparesis.
Persistent severe GI symptoms past week 8 at a stable dose warrants a gastric-emptying study and discussion of dose reduction or molecule switch.