A new study published in Nature Medicine provides an overview of the benefits and potential risks associated with GLP-1 receptor agonists, medications that gained popularity for weight loss. The research examined 175 health conditions to identify both advantages and possible drawbacks.
Researchers from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System analyzed anonymous medical records from a database maintained by the US Department of Veterans Affairs. They focused on 2.4 million people with diabetes, including 215,970 patients who used GLP-1 receptor agonists for treatment. The study mapped the effects of GLP-1 receptor agonists across the human body, uncovering benefits and risks.
GLP-1 receptor agonists were originally designed for diabetes but were approved for weight loss in non-diabetic patients after being found to enable weight loss in some individuals, leading to expanded indications for obesity management. These medications mimic the action of the GLP-1 hormone, which is involved in insulin secretion and the sensation of fullness through brain mechanisms, reducing the urge to overeat and providing a prolonged feeling of fullness.
According to the study, patients taking GLP-1 medications showed a lower risk of neurocognitive disorders, including a 12% reduction in the risk of developing Alzheimer's disease. Additionally, the group exhibited a lower risk of substance use disorders, psychiatric or convulsive disorders, and cardiovascular problems.
"The data suggest that GLP-1s have an impact on multiple systems of the body, beyond weight control," said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine, in an interview with USA Today. He emphasized the importance of further research to better understand how GLP-1 drugs can impact multiple parts of the body.
However, the study also revealed potential risks associated with GLP-1 receptor agonists. Users experienced an increased risk of gastrointestinal problems ranging from nausea and vomiting to diarrhea and, in rare cases, stomach paralysis. There was also a 146% increase in the risk of pancreatitis among users. Moreover, the analysis noted that GLP-1 agonists could increase the risk of sleep problems, headaches, and arthritis by 11%.
"These drugs are not without risk. Our findings highlight the possibility of broader applications of these drugs, but also draw attention to the need for ongoing monitoring of this risk," Dr. Al-Aly noted. He added that while the medications have broad health benefits, careful monitoring is essential.
The researchers found that GLP-1 receptor agonists have anti-inflammatory properties that help stabilize blood vessel cells and demonstrate a favorable effect on inflammation, though the effects are often mild. They also discovered that these medications act on receptors expressed in brain areas involved in impulse control, reward, and addiction. This mechanism may explain their efficacy in curbing appetite and addictive disorders.
Unexpectedly, the study found that patients using GLP-1 medications experienced a reduction in the risk of seizures and substance addiction, including addiction to alcohol, cannabis, stimulants, and opioids. "GLP-1 drugs may bring wide health benefits," Dr. Al-Aly said, as reported by Discover Magazine.
Despite the findings, experts caution that the report should be viewed carefully. "Studies like this must be interpreted with great caution, as the studied individuals were not randomly assigned to treatment with GLP-1 receptor agonists, so any difference between those who take and do not take these medications could be attributable to factors other than the drug," said Stephen O'Rahilly, a metabolic research expert at the University of Cambridge.
The study focused on patients with a specific profile, generally older men with diabetes, which may limit the generalizability of the results. Furthermore, the research was observational and does not allow for concluding a causal relationship between GLP-1 medications and the listed diseases. The authors emphasized that the data should be interpreted with caution.
Nevertheless, the findings open the possibility of developing GLP-1 agonist treatments for conditions like dementia, alcoholism, or Alzheimer's in the future. "It's like when Christopher Columbus arrived in America and thought of mapping it to orient himself. That's what we are doing, drawing a landscape of benefits and risks," Dr. Al-Aly explained.
This article was written in collaboration with generative AI company Alchemiq