GLP-1 medications, widely prescribed for weight loss, show promise in improving brain and heart health, but may pose risks to the kidneys, pancreas, and gastrointestinal (GI) system, according to a recent study.
Drugs like Ozempic, Wegovy, and Mounjaro have gained popularity as effective treatments for weight loss and diabetes. However, researchers from the Washington University School of Medicine and the Veterans Affairs St. Louis Health Care System caution that these medications require careful monitoring due to potential side effects.
The study, published in Nature Medicine, analyzed the health records of 2 million U.S. veterans to assess the impact of GLP-1 drugs on 175 health outcomes.
Brain and Heart Benefits of GLP-1 Drugs
GLP-1 receptor agonists, such as Ozempic and Wegovy, work by mimicking hormones that regulate appetite and digestion. Beyond aiding weight loss, these drugs also appear to provide cognitive and cardiovascular benefits:
Improved brain health: The study found GLP-1 drugs reduced risks of neurocognitive disorders like Alzheimer’s disease and dementia.
Behavioral benefits: Users of GLP-1 medications were less likely to experience substance addiction (e.g., alcohol, cannabis, opioids), suicidal ideation, or psychiatric disorders like schizophrenia.
Heart health: Researchers confirmed a modest reduction (10–20%) in risks of heart attack, stroke, and cardiovascular disease.
Dr. Ziyad Al-Aly, the study’s senior author, noted that GLP-1 drugs act on brain regions associated with impulse control, reward, and addiction. “These drugs reduce inflammation in the brain and promote weight loss, both of which are linked to better brain health,” he explained.
Kristin Kirkpatrick, a registered dietitian from the Cleveland Clinic, said these findings are critical as GLP-1 medications grow in popularity. “This research provides valuable insights into both the benefits and risks, allowing patients and healthcare providers to make informed decisions,” she said.
Potential Risks of GLP-1 Drugs
Despite their advantages, GLP-1 drugs may cause notable side effects:
Gastrointestinal issues: Nausea, vomiting, diarrhea, and, in rare cases, gastroparesis (paralysis of the stomach) have been reported.
Kidney problems: Researchers observed increased risks of kidney dysfunction. These conditions may remain asymptomatic until they progress to advanced stages, requiring careful monitoring.
Pancreatitis: The drugs were also linked to an increased risk of inflammation in the pancreas.
The researchers emphasized that while most side effects are mild or manageable, some, like kidney or pancreatic complications, could have severe consequences if not detected early.
“GLP-1 receptor agonists offer significant health benefits, but they are not without risks,” Al-Aly said. “Physicians should remain vigilant, especially as these drugs become more widely prescribed.”
Weighing the Risks and Benefits
Medical experts agree that whether GLP-1 drugs are suitable for an individual depends on personal health history and treatment goals.
Sun Kim, MD, an associate professor at Stanford University, said the benefits outweigh the risks for most people. “The known risks, like GI side effects, are manageable. However, it’s important for healthcare providers to adjust other medications like blood pressure drugs, as GLP-1 medications can lower blood pressure directly and through weight loss,” she explained.
Mir Ali, MD, a bariatric surgeon in California, highlighted the importance of individualized care. “For many patients, the benefits far outweigh the risks. Gastrointestinal side effects are common but manageable, and serious risks like pancreatitis are rare,” he said.
Kristin Kirkpatrick emphasized the need for long-term strategies when prescribing GLP-1 drugs. “Many patients are reluctant to stop taking these medications because of their success. Healthcare providers should create clear exit strategies for safely discontinuing the drugs once patients reach their goals,” she advised.
Understanding GLP-1 Medications
GLP-1 medications, which are injected, include:
Ozempic and Wegovy (active ingredient: semaglutide): Approved for type 2 diabetes and obesity treatment, respectively.
Mounjaro and Zepbound (active ingredient: tirzepatide): Used for diabetes and weight management.
These drugs work by mimicking hormones that curb appetite and slow digestion, often in conjunction with diet and exercise.
Studies have also shown that GLP-1 medications may reduce risks of heart attack, stroke, colon cancer, and Alzheimer’s disease.
Future Outlook for GLP-1 Drugs
As obesity rates rise—affecting 40% of U.S. adults—the demand for effective weight-loss treatments like GLP-1 drugs is expected to grow.
“GLP-1 medications represent a groundbreaking shift in obesity treatment,” Kim said. “They offer the first class of drugs with significant, clinically proven weight-loss effects.”
Ali echoed this sentiment, adding, “The medical community is increasingly viewing obesity as a chronic disease, akin to hypertension or diabetes. As a result, GLP-1 drugs are likely to be prescribed long-term.”
However, experts stress that further research is needed to explore the long-term effects and potential new applications of these medications.
“While the future of GLP-1 drugs is promising, a balanced approach is crucial,” Kirkpatrick concluded. “Patients and providers must weigh the risks and benefits carefully and plan for the long term.”
