Advantages and dangers of common weight-loss medication revealed

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Demand for weight-loss drugs offered underneath model names equivalent to Ozempic and Wegovy continues to surge, with a latest examine reporting one in eight People has taken or is presently utilizing the medication to deal with diabetes, coronary heart illness or weight problems.

Formally, these medication are generally known as glucagon-like peptide-1 receptor agonists (GLP-1RA) and embody Mounjaro and Zepbound. Informally, media, sufferers and even some physicians have dubbed GLP-1 drugs as “miracle medication” due to the profound weight reduction amongst customers. Whereas these well being advantages are nicely established, data is sparse on the medication’ results throughout the physique’s organ programs.

Now, scientists at Washington College College of Drugs in St. Louis and the Veterans Affairs (VA) St. Louis Well being Care System have systematically evaluated well being outcomes amongst greater than 2 million folks with diabetes taking the favored weight-loss medication. They discovered widespread associations with advantages to cognitive and behavioral well being, whereas additionally revealing elevated dangers for pancreatitis and kidney circumstances, amongst others.

The examine is printed Jan. 20 within the journal Nature Drugs.

“Given the medication’ newness and skyrocketing recognition, you will need to systematically study their results on all physique programs – leaving no stone unturned – to know what they do and what they do not do,” stated the examine’s senior creator, Ziyad Al-Aly, MD, a medical epidemiologist and nephrologist who treats sufferers on the WashU Drugs-affiliated John J. Cochran Veterans Hospital in St. Louis.

Our method has allowed us to construct a complete atlas mapping the associations of GLP-1RA spanning all organ programs. The examine’s outcomes present insights into some recognized and beforehand unrecognized advantages and dangers of GLP-1RA that could be helpful to tell medical care and information analysis agendas.”


Ziyad Al-Aly, MD, medical epidemiologist and nephrologist 

The medication, taken as soon as per week by injection, simulate naturally produced hormones that curb urge for food and gradual digestion, creating longer-lasting satiety. A nutritious diet and train additionally help with weight reduction.

For the examine, WashU Drugs researchers analyzed de-identified medical data in a database maintained by the U.S. Division of Veterans Affairs. They in contrast 175 well being outcomes between veterans who took GLP-1RA medication to deal with their diabetes and those that took extra conventional drugs offered underneath model names equivalent to Jardiance, Glipizide and Januvia.

Altogether, the dataset examined greater than 2 million veterans who had been handled for diabetes from Oct. 1, 2017, to Dec. 31, 2023. Sufferers included folks of various ages, races and sexes.

GLP-1RA medication had been related to vital advantages to neurological and behavioral well being, with decreased dangers of seizures and dependancy to substances equivalent to alcohol, hashish, stimulants and opioids. Individuals taking the weight-loss medication additionally skilled decreased dangers of suicidal ideation, self-harm, bulimia and psychotic issues equivalent to schizophrenia.

WashU Drugs’s findings additionally confirmed a decreased danger of neurocognitive issues equivalent to Alzheimer’s and dementia.

“Curiously, GLP-1RA medication act on receptors which can be expressed in mind areas concerned in impulse management, reward and dependancy – probably explaining their effectiveness in curbing urge for food and dependancy issues,” stated Al-Aly, the director of the Scientific Epidemiology Heart on the VA St. Louis Well being Care System, the place he’s head of the analysis and growth service. “These medication additionally cut back irritation within the mind and lead to weight reduction; each these elements might enhance mind well being and clarify the decreased danger of circumstances like Alzheimer’s illness and dementia.”

Whereas GLP-1RA medication show effectiveness in opposition to a wide selection of well being issues, the magnitude of related advantages is modest – a couple of 10 p.c to twenty p.c discount for many outcomes. “Nevertheless, the modest impact doesn’t negate the potential worth of those medication, particularly for circumstances the place few efficient therapy choices exist, for instance, dementia,” Al-Aly stated. “This will additionally indicate that these medication are most useful when used at the side of different interventions, equivalent to life-style adjustments or different drugs.”

The examine additionally confirmed previous analysis findings detailing the medication’ potential to decrease the danger of coronary heart assault, stroke and different cardiovascular considerations.

Al-Aly emphasised that his examine additionally highlighted potential downsides to the drugs, together with an elevated danger of gastrointestinal issues equivalent to nausea, vomiting, diarrhea, and in uncommon circumstances paralysis of the abdomen. “These have been nicely documented within the analysis and anecdotally,” Al-Aly stated. “Our examine confirmed such findings.”

However what’s novel is the potential methods GLP-1RA medication can negatively have an effect on the pancreas and kidneys. Whereas these antagonistic results are unusual, they are often very critical; physicians have to be vigilant for indicators of pancreatitis and monitor kidney operate amongst folks taking GLP-1RA drugs. Kidney issues can happen with out signs till the situation is at a sophisticated stage with restricted therapy choices.

“GLP-1RA medication can have broad well being advantages,” Al-Aly stated. “Nevertheless, they aren’t with out dangers. Our findings underscore the chance for wider purposes for these drugs but in addition spotlight essential dangers that ought to be rigorously monitored in folks taking these medication.”

Supply:

Journal reference:

Xie, Y, et al. (2025) . Mapping the effectiveness and dangers of GLP-1 receptor agonists. Nature Drugs. doi.org/10.1038/s41591-024-03412-w.

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