You’ve probably heard of Ozempic or Wegovy. These are the medicines injectables that became household names for weight loss and diabetes.
Now researchers are investigating whether these drugs known as GLP-1 agonists or GLP-1 drugs could treat everything from cancer and brain diseases to depressionaddiction and endometriosis.
Some discoveries are genuinely exciting. Others are being overvalued. See what the science really says.
First, how do these medications work?
GLP-1 (glucagon-like peptide-1) is a hormone that your gut naturally releases after eating. It tells the pancreas to produce insulin and signals the brain that you are full. These medications mimic this hormone.
But GLP-1 receptors aren’t just in the gut. They are found in the heart, kidneys, liver and brain. That’s what makes scientists think these medications can do much more than control weight.
Where the evidence is already solid
In addition to diabetes and obesity, GLP-1 drugs have now gained regulatory approval in several new areas.
One study with more than 17 thousand people found that semaglutide (the active ingredient in Ozempic/Wegovy) reduced the risk of heart attacks and serious strokes by 20%, even in people without diabetes.
In a study with almost 1,200 patients, semaglutide outperformed placebo in the treatment of a type of advanced liver disease.
Tirzepatide (the active ingredient in Mounjaro) has also been shown to significantly reduce the severity of sleep apnea, mainly because weight loss decreases pressure on the airways.
GLP-1 and cancer: promising, but no evidence from clinical trials
Obesity is a risk factor for at least 13 types of cancer, so reducing weight using GLP-1 medications may also limit your cancer risk. This was demonstrated in a study with 86,000 adults with obesity. GLP-1 users were found to have a 17% lower risk of cancer.
New data suggests that GLP-1 users were also less likely to see the Cancer spread to other organs, but this work still needs to be verified by other researchers. The anti-inflammatory effects of these medications, which appear to work independently of weight loss, may be playing a role.
However, there have not yet been well-controlled clinical trials that establish the link between GLP-1 medications and cancer prevention.
Endometriosis: early but promising signs
THE endometriosis affects approximately one in ten women of reproductive age. This is when tissue similar to the lining of the uterus grows outside of the uterus.
Since GLP-1 receptors are also present in reproductive tissue, these drugs have shown potential in improvement of symptomswith a survey of 161 women backing this up.
But similar to cancer, there are no randomized trials in humans.
Addiction and smoking
GLP-1 receptors are concentrated in the brain’s reward pathways. These same circuits drive cravings for alcohol, nicotine and drugs.
One analysis of more than 1.3 million people found that GLP-1 users had significantly lower rates of opioid overdose and alcohol poisoning.
A randomized trial found that semaglutide reduced alcohol consumption in people with alcohol use disorder.
Early smoking cessation studies are also encouraging.
This is where the story gets genuinely complicated.
There are real biological reasons why GLP-1 drugs could help with neurodegeneration and brain problems. health mental. They reduce brain inflammation, interact with dopamine (the brain’s motivation chemical), and support the gut-brain axis (the communication network that carries signals to and from the gut and brain).
However, current clinical evidence is conflicting.
For Alzheimer’s disease, researchers gave the 204 participants with mild to moderate disease liraglutide (a GLP-1 before Ozempic) and measured how much brain mass they lost. Those who took the drug showed significantly less shrinkage in key brain regions, including the temporal lobe and overall gray matter.
However, a large phase 3 trial with oral semaglutide found that it was not effective in slowing the clinical progression of the disease.
Similarly, exenatide (another previous GLP-1) showed no evidence of disease modification in a rehearsal phase 3 for Parkinson’s disease.
For mental health, current evidence is also mixed. Meta-analyses and large cohort studies show significant reductions in depression and anxiety scores among GLP-1 users.
But one observational study A separate study found that people using these medications had nearly double the risk of major depression.
Other article found that people with a genetic tendency toward low dopamine levels may face a greater risk of depression and suicidal thoughts with these medications.
There are also case reports of severe psychiatric episodes appearing weeks after starting treatment.
We don’t yet know who these drugs will help and who they could seriously harm.
What we need to be careful about
Crucially, most new uses for these drugs have not yet been tested in adequate clinical trials. Large real-world studies are useful, but they cannot rule out crucial confounders. This means that the effects could be due to external influences.
For example, most of the major GLP-1 trials have included people with obesity or diabetes. People with mental health conditions, neurodegenerative diseases or addiction were largely excluded. Yet these are exactly the populations now being considered for treatment.
The long-term effects are also unknown. One study with more than 200,000 patients found a 2 to 2.5 times higher risk of drug-induced pancreatitis (dangerous inflammation of the pancreas).
Rapid weight loss also eliminates lean muscle mass, not just fat, affecting strength and metabolism, especially in older adults.
Studies also indicated that these medications pose a risk of thyroid cancer, leading to a label warning, but the evidence is highly conflicting.
Time and more research will tell, but there are genuine safety concerns associated with the widespread use of these medications.
So while the science here is genuinely exciting, we must continue to approach it with informed caution.
This report was originally published on The Conversation. Click here to read.
