GLP-1 drugs start to show benefits beyond weight loss and diabetes

GLP-1 drugs show benefits beyond weight loss

You’ve probably heard about GLP-1 drugs. These are the “weight-loss” drugs with names like Wegovy, Ozempic and Mounjaro. They’re weekly injections and they help people lose weight—a lot of weight—by suppressing their appetite. These drugs have helped millions of people shed pounds, even if they’ve struggled with obesity for their whole lives.

You might also know that the discovery of these drugs was a bit of a surprise. Drug companies initially developed GLP-1’s to treat type 2 diabetes. But patients taking them for diabetes discovered a pleasant side effect: they no longer suffered from food cravings, they had lower appetites, and they lost a significant amount of fat. The drugmakers then pivoted to market GLP-1 drugs for weight loss.

But what you might not know is that GLP-1’s have benefits that go even beyond diabetes and weight loss. These drugs appear to help with a range of other conditions that have no obvious connection to weight or blood sugar.

Several of those effects, like the weight loss before them, were only discovered by accident when doctors and patients noticed that other health problems were getting better on their own.

We’ll start with the most serious. People taking GLP-1’s have significantly lower rates of heart attacks and strokes. Heart attacks are clearly related to obesity, so it’s natural that someone losing weight would have better cardiovascular health. But the interesting thing here is that the benefit is larger than what weight loss alone would explain.

It’s a similar story with fatty liver disease, a condition where fat accumulates in the liver. It’s serious and can lead to liver failure. But just like with heart attacks and strokes, researchers observed a decline in fatty liver disease over and above what would be expected by weight loss alone. GLP-1’s also appear to help with kidney disease.

Patients with conditions affecting their lifestyle have also seen a benefit. People with sleep apnea, for example, repeatedly stop breathing during sleep, jolting them awake. Many patients need a specialized machine called a CPAP just to get a full night’s sleep. In trials, one GLP-1 drug reduced sleep apnea episodes by about 60 percent and some patients said they didn’t need their CPAP machine at all. This is a real quality of life improvement.

Patients also say these drugs help with addiction. Some patients, even those who had been heavy drinkers, said they lost interest in alcohol. Others said they were finally able to stop smoking. In many cases, nobody even asked them about this; they just volunteered the information.

What could be going on? The obvious explanation is weight loss. Obesity drives a lot of chronic conditions and health risks. So if you remove the obesity, then other things are bound to improve. But that only explains part of the benefit that researchers have observed. Addiction, for example, has nothing to do with body weight.

One possible explanation is inflammation. When you sprain your ankle, it swells. That’s your body rushing resources to the injury. It’s useful in the short term, but the swelling should eventually go down. Inflammation can happen inside the body, too, in organs like the heart, liver, and kidneys. Some people suffer from chronic, low-level inflammation in their internal organs. GLP-1’s appear to help with this low-level, internal inflammation.

If GLP-1’s do indeed reduce general inflammation, then the drugs might address the underlying biology of a whole host of conditions. Some patients report their arthritis and ulcers are less painful; others who had suffered from post-COVID “brain fog” said they could think more clearly. Researchers are already studying whether they may help with Alzheimer’s and Parkinson’s diseases in the long run. Preliminary studies on mice show that GLP-1 drugs extend “healthspan,” or how long an animal is in good health.

There is reason to be optimistic, but it’s still early days. The majority of patients on GLP-1’s suffer from obesity or diabetes. That’s who the drugs are designed for, and who they’re prescribed to. But that means it’s very hard to study whether the drugs can affect people who don’t suffer from obesity or diabetes. There just haven’t been enough trials yet.

Another potential worry is the question of muscle loss. When patients lose weight rapidly, they often lose muscle mass as well as fat. But how would GLP-1’s affect a person who is already at their target weight? For example, if a person at a healthy body mass wanted help with addictive impulses, would that person lose an unhealthy amount of weight on a GLP-1? That tradeoff hasn’t yet been studied in the population.

But that’s not stopping the population from conducting its own, less-than-scientific experiments. Some patients report that they cycle themselves on and off GLP-1 drugs to manage their addictive cravings based on their stress levels. Others have decided to take GLP-1’s as a preventative measure to delay aging.

Jeff’s take

This could turn into a much, much bigger story than just weight loss. And here I will admit, I am much, much more optimistic now than I was at the beginning. My first exposure to weight-loss drugs—maybe we should stop calling them weight-loss drugs now—my first experience with these drugs was a few years ago.

They had just come out, and they were extremely popular on Instagram and TikTok. Rich housewives, celebrities, and influencers were buying up most of the supply—they even had a name for the drugs. They called them the “skinny pen.” And I thought, society is doomed. Here is a potentially lifesaving drug for people with obesity and the whole supply went to self-absorbed rich people trying to lose a few pounds for a wedding or a photo shoot.

But the problem was not with the drugs, obviously, but with how they were distributed and used. They’re still priced very high, too high for many people in the world. But prices are coming down. And now it seems they may have a great many other benefits. One doctor said she lost count of how many marriages GLP-1’s have saved…because they helped one partner overcome addiction. Other people can now sleep through the night. Fewer people will have heart attacks or strokes.

If indeed this does improve human “healthspan,” then GLP-1’s could be just one more accidental discovery that changed history.