What You Need to Know About GLP-1 Medications: Part 3

In the first Part of this blog series, we discussed the rise of GLP-1 medications, such as Ozempic® and Wegovy®, and how the surge in obesity rates has driven their widespread use and popularity. In Part 2 last week, we explored how these medications work and why they’re so effective.

Now, let’s discuss the long-term effects and promise of GLP-1 medications. 

Benefits of GLP-1 Medications

GLP-1 agonists were first approved for treatment of type 2 diabetes in 2005. And they are effective in helping to manage this condition, significantly improving blood sugar levels in a relatively short period of time. This makes sense given that GLP-1 has multiple effects on our biochemistries that culminate in the reduction of circulating glucose levels.

Since that time, GP-1s have gained FDA approval and have established significant roles in the treatment of cardiovascular disease, obesity, sleep apnea and kidney disease. Emerging data suggest that this class of medications may even have roles in other—somewhat unrelated—conditions.   

The Downstream Benefits of Weight Loss

One big reason that GLP-1s have positive effects on a whole host of health conditions is that obesity is a major driver of what ails us! And GLP-1s most definitely help people lose weight. So, for example, it’s not surprising that sleep apnea or fatty liver disease is helped by these medications – after all, weight loss can reverse both in a large proportion of patients. So ANY condition that is positively impacted by weight reduction will be positively impacted by GLP-1s.  

But all the benefits do not emanate from weight loss alone. What we’re discovering is that GLP-1 receptors are not just present in the brain, gut and pancreas. They’re present all over.  

Benefits of GLP-1s Beyond Weight Loss: Cardiovascular Disease

They are present in the kidney and, as it happens, are important to regulating blood pressure levels. GLP-1 receptors are also present in atherosclerotic plaque. Stimulating those helps reduce inflammation and thus promotes plaque stability. Put the BP lowering and plaque stabilizing effects together and you have a medication that helps prevent heart attacks and strokes – especially in those with established heart disease (who are at highest risk for additional cardiovascular events). It’s only a matter of time before treatment guidelines tell us to put every patient with established heart disease on Ozempic®.

Benefits of GLP-1s Beyond Weight Loss: Neurodegenerative and Joint Disorders

There’s even interesting data emerging around neurodegenerative conditions such as Parkinson’s and Alzheimer’s disease. We already know that GLP-1 receptors are present in the brain. What we’re finding is that the same anti-inflammatory effects that can help stabilize plaque can also reduce inflammation in the brain and reduce the likelihood of developing one of these conditions.  

Animal trials testing injecting GLP-1 drugs into arthritic joints have also been undertaken. And so far, the results are promising. The anti-inflammatory properties of these drugs could open another line of therapeutics for osteoarthritis, the most common joint disorder affecting people as they age.

Benefits of GLP-1s Beyond Weight Loss: Addiction and Chemical Dependency

What’s more, these drugs even have an impact on addictive behaviors. The GLP-1 mediated signaling in the brain that makes us less hungry and less interested in food, makes us less compulsive - not just about eating but about a lot of different things.  Like alcohol use and gambling. Not necessarily providing a cure for alcohol-use disorder or compulsive gambling. But representing a potential tool in the tool box for helping treat these self-destructive disorders.

All good. No – great, actually. Miracle drugs transforming disease care. Apparently, there is nothing these medications can’t do! Or conditions it could be approved for. I’m pretty sure neither Novo Nordisk (the company behind Ozempic® and Wegovy®) or Eli Lilly (the manufacturer of Mounjaro® and Zepbound®) would object to all of us having at least one indication for taking these drugs.

But what about the downsides?  They are not small or infrequent. And we will cover those in the next blog of this series.