A new study compares the risks and benefits of using GLP-1 medications.
- The use of glucagon-like peptide-1 receptor agonists (GLP-1
agonists) for weight loss has been greatly increasing.
- Past studies show there are positive and negative side effects from
GLP-1 medications.
- A new study reports that GLP-1 medications may provide benefits to
cognitive and behavioral health, including lowered addiction risk.
- Scientists also confirmed that the use of these medications may
increase a person’s risk of pancreatitis and gastrointestinal problems, as
well as kidney issues.
As recent
studies show the amount of people taking glucagon-like peptide-1 receptor agonists (GLP-1 agonists) for weight loss, and not for managing type 2
diabetes as originally used, researchers have been examining these
medications for potential positive and negative side effects.
Examples of GLP-1 medications include Ozempic, Wegovy, Mounjaro,
and Zepbound.
For example, a study published in October 2023 found that the
use of GLP-1 drugs for weight loss was associated with an increased
risk for pancreatitis, gastroparesis,
and bowel obstruction.
On the flip side, recent studies show that GLP-1 medications
may decrease a person’s risk for cardiovascular
disease and dementia.
Now, a new study
recently published in the journal Nature Medicine reports that
taking GLP-1 medications may provide benefits to cognitive and behavioral
health, including lowered dementia and addiction risks.
Scientists also confirmed that the use of these medications
may increase a person’s risk of pancreatitis and gastrointestinal problems, as
well as kidney issues.
GLP-1 vs. traditional diabetes drug users
For this study, researchers analyzed medical records from
more than 2 million people taking diabetes medications, including over 215,000
who took GLP-1 medications, from October 2017 through December 2023 via a
database maintained by the U.S. Department of Veterans Affairs.
Scientists compared 175 different health outcomes between
those who took GLP-1 drugs to those who took traditional diabetes medications
such as Jardiance.
“We saw skyrocketing utilization of GLP-1s, and we saw a few
reports investigating one outcome or another,” Ziyad Al-Aly, MD, clinical epidemiologist, Washington
University in St. Louis, chief of research at the VA St. Louis Health Care
System, and senior author of this study told Medical News Today. “We
realized that no one had comprehensively investigated (the) effectiveness and
risks of GLP-1RA across all possible health outcomes. So we decided to do this
comprehensive study looking at all 175 possible health outcomes, leaving no stone
unturned.”
“GLP1s represent a new landscape; we simply wanted to
comprehensively understand this new landscape. We wanted to build an atlas
mapping the associations with all health outcomes,” Al-Aly said.
Lower risk of substance addiction, neurocognitive diseases
Upon analysis,
researchers found that participants who took GLP-1 medications experienced
significant neurological and behavioral health benefits, including a reduced
risk of substance
addiction to alcohol, cannabis, opioids,
and stimulants, compared to those taking traditional diabetes medications.
Those using GLP-1 medications also had a reduced risk
of seizures, suicidal
ideation, self-harm, bulimia,
and psychotic disorders such as schizophrenia.
Additionally, Al-Aly and his team reconfirmed a potential
dementia-protecting benefit when they found participants taking GLP-1 drugs had
a decreased risk of neurocognitive conditions such as dementia and Alzheimer’s
disease.
“GLP-1 reduces neuroinflammation and
also affects centers in the brain that are responsible for impulse control and
reward signaling — there are many studies showing that we indeed have GLP-1
receptors in our brain. These are likely mechanisms by which GLP-1 may impact
neuropsychiatric conditions.”
— Ziyad Al-Aly, MD
“I think there is clearly (an) added benefit for several
conditions. For example, a person with obesity who also wants to quit
smoking — getting GLP-1 may help that person hit two birds (with) one
stone — simultaneously addressing obesity and also help them quit smoking.
Clearly, the added benefits are welcome news,” he explained.
Increased risk of stomach problems, arthritis, kidney stones
On the reverse
side, researchers found GLP-1 use was associated with an increased risk of
gastrointestinal problems, including nausea, vomiting, diarrhea, and, in rare
cases, paralysis of the stomach.
Scientists also found a link between GLP-1 use and an
increased risk of arthritic disorders, pancreatitis, sleep
disturbances, hypotension, and nephrolithiasis, normally known as kidney
stones.
“We think this is important — people taking GLP-1s and
doctors prescribing them should be on the lookout for these side effects. Some
can be quite serious and land people in the hospital,” Al-Aly said.
Benefits beyond weight loss
MNT had the opportunity to speak with Babak
Firoozi, MD, a board certified gastroenterologist at MemorialCare Orange
Coast Medical Center in Fountain Valley, CA, about this study.
“I was surprised and encouraged about
all the positive impact the medication has on patients, specifically in
reducing risk of cognitive decline. It is becoming clear that the benefits of
these medications go beyond weight loss and diabetes control. And, of course,
safety is important as more and more indications to use this group of
medications arise. The negative effects seem minimal.”
— Babak Firoozi, MD
MNT also spoke with Seth Kipnis, MD, FACS, FASMBS, medical director of
Bariatric and Robotic Surgery at Hackensack Meridian Jersey Shore University
Medical Center in New Jersey, about this research.
“This study confirms what we are seeing clinically. People
with real weight loss are happier overall. They feel empowered that they can
finally control their weight. Decreased obesity has long been linked with less
inflammation in every body system. GI problems and renal problems will always
be seen if people are not eating correctly and maintaining hydration. If you
take these medications without nutritional education, they can be harmful,”
Kipnis said.
“These drugs will only become more common and will increase
in use. They are very effective at causing weight loss and improving health. We
have been prescribing many long-term drugs for hypertension,
heart disease, high cholesterol, diabetes, arthritis, reflux,
and many other diseases without hesitation. People are on all of these other
drugs for years. This new class of drug, as it lowers obesity, has the
potential to lower the use of every other drug that is used to treat
obesity-related conditions,” he added.
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