A number of years in the past, a little-known drug named Ozempic—beforehand used solely to deal with diabetes—emerged as a promising new drug for weight administration.
The Meals and Drug Administration’s approval of Ozempic in 2021 for weight loss treatment ushered in a brand new period for the category of medicine known as glucagon-like peptide-1 agonists, or GLP-1.
Right this moment, GLP-1 medicine, together with Wegovy, Mounjaro, and Zepbound, have turn out to be family names and key instruments within the combat in opposition to weight problems: 1 in 8 American adults say they’ve used a GLP-1 drug, and forecasts present that by 2030, 1 in 10 People will probably be using these medications.
Now, analysis from my lab and others means that GLP-1 medicine might assist deal with dozens of different illnesses as properly, together with cognitive points and dependancy issues. Nevertheless, my colleagues and I additionally discovered beforehand unidentified dangers.
I’m a physician-scientist and I direct a medical epidemiology middle centered on addressing public well being’s most pressing questions. My group works to handle crucial data gaps about COVID-19, lengthy COVID, influenza, vaccines, effectiveness and dangers of generally used medicine, and extra.
On January 20, 2025, my group printed a examine of greater than 2.4 million folks that evaluated the risks and benefits of GLP-1 drugs throughout 175 attainable well being outcomes. We discovered that these medicine lowered dangers of 42 well being outcomes, practically 1 / 4 of the overall that we analyzed. These embody neurocognitive problems reminiscent of Alzheimer’s illness and dementia, substance use and dependancy problems, clotting problems, and a number of other different situations.
Sadly, we additionally discovered that GLP-1 medicine include important negative effects and improve the chance of 19 well being situations we studied, reminiscent of gastrointestinal points, kidney stones, and acute pancreatitis, by which the pancreas turns into infected and dysfunctional.
Cognitive advantages
One of the essential well being advantages we discovered was that the GLP-1 medicine lowered the chance of neurodegenerative problems, together with Alzheimer’s illness and dementia. These findings align with different analysis, together with proof from preclinical research displaying that these medicine might scale back irritation within the mind and improve the mind’s skill to kind and strengthen connections between its cells, enhancing how they impart with each other. These results contribute to mitigating cognitive decline.
Two different key research have proven that patients treated with a GLP-1 drug for diabetes had a lower risk of dementia.
All of those research strongly level to a possible therapeutic use of GLP-1 medicine in remedy of the cognitive decline. Ongoing randomized trials—the gold customary for evaluating new makes use of of medicine—are trying on the results of GLP-1 medicine in early Alzheimer’s illness, with outcomes anticipated later in 2025.
Curbing dependancy and suicidal ideation
GLP-1 medicine have additionally demonstrated potential in lowering dangers of a number of substance use problems reminiscent of these involving alcohol, tobacco, hashish, opioids, and stimulants. This can be as a result of skill of those medicine to modulate reward pathways, impulse management, and inflammatory processes within the mind.
The effectiveness of GLP-1 medicine in curbing addictive conduct might clarify their spectacular success in treating weight problems, a continual illness state that many have steered is indeed a food addiction disorder.
Our examine demonstrated a decreased threat of suicidal ideas and self-harm amongst individuals utilizing GLP-1 medicine. This discovering is especially important given earlier reports of suicidal thoughts and self-injury in individuals utilizing GLP-1 medicine. In response to these experiences, the European Medicines Company carried out a evaluate of all accessible information and concluded that there was no evidence of increased risk of suicidality in individuals utilizing GLP-1 medicine.
Now at the least two research, together with our personal, present that GLP-1 medicine really reduce the risk of suicidality.
Different advantages
Along with the well-documented results of GLP-1 medicine in lowering dangers of adverse cardiovascular and kidney outcomes, our examine reveals a major impact in lowering threat of blood clotting in addition to deep vein thrombosis and pulmonary embolism.
One puzzling discovering in our examine is the decreased threat of infectious illnesses reminiscent of pneumonia and sepsis. Our information enhances one other current examine that got here to an identical conclusion displaying that GLP-1 medicine decreased threat of cardiovascular death and death due to infectious causes, primarily COVID-19.
That is particularly essential since COVID-19 is thought to be a significant cardiovascular risk factor. Whether or not GLP-1 medicine utterly offset the elevated threat of heart problems related to COVID-19 must be completely evaluated.
GLP-1 medicine can also be helpful in treating fatty liver disease and situations starting from bronchial asthma to chronic obstructive pulmonary disease, sleep apnea, osteoarthritis, despair, and eye problems.
Dangers and challenges
Regardless of their broad therapeutic potential, GLP-1 medicine aren’t with out dangers.
Gastrointestinal points, reminiscent of nausea, vomiting, constipation, and gastroesophageal reflux disease are among the many commonest opposed results related to GLP-1 medicine.
Our examine additionally recognized different dangers, together with low blood strain, sleep issues, complications, formation of kidney stones, and gall bladder disease and diseases associated with the bile ducts. We additionally noticed elevated dangers of drug-induced irritation of the kidneys and pancreas—each severe situations that can lead to long-term well being issues. These findings underscore the significance of cautious monitoring in people who find themselves taking GLP-1 drugs.
A major problem with utilizing GLP-1 medicine is the high rates at which patients stop using them, typically pushed by their exorbitant value or the emergence of opposed results. Discontinuation can result in fast weight achieve.
That’s an issue, as a result of weight problems is a continual illness. GLP-1 medicine present efficient remedy however don’t tackle the underlying causes of weight problems and metabolic dysfunction. Because of this, GLP-1 medicine have to be taken long run to maintain their effectiveness and stop rebound weight achieve.
As well as, many questions stay in regards to the long-term effectiveness and dangers of those medicine in addition to whether or not there are variations between GLP-1 formulations. Addressing these questions is crucial to information medical observe.
Ziyad Al-Aly is a medical epidemiologist at Washington University in St. Louis.
This text is republished from The Conversation beneath a Inventive Commons license. Learn the original article.
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