Blockbuster weight-loss drugs linked to lower risk of addiction, schizophrenia, dementia, and more
Blockbuster weight loss drugs can help treat ailments as disparate as addiction, blood clotting, and dementia – but they also come with risks that might give some patients pause, a landmark new study has found.
The analysis used data from more than two million diabetes patients in the United States, including about 216,000 taking the popular drugs, to map out their risks and benefits across 175 possible health outcomes.
Wegovy, Ozempic, Zepbound, and related medicines belong to a class of drugs known as GLP-1 receptor agonists, which are diagnosed for obesity or type 2 diabetes and work by suppressing people’s appetites to help them lose weight.
But the medicines are also linked to a lower risk of drug and alcohol addiction, psychotic disorders such as schizophrenia, seizures, blood clotting problems, infections, several respiratory issues, chronic kidney disease, and neurocognitive disorders, according to the study, which was published in the journal Nature Medicine.
That includes a 12 per cent reduction in the risk of Alzheimer’s disease, which the study authors described as a small but significant impact given there are limited treatments and no cures for dementia.
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“We tend to think of drugs as sort of designed to do only one thing, but it’s almost never like this,” Dr Ziyad Al-Aly, the study’s lead author and director of the clinical epidemiology centre at a US veterans’ hospital, said during a press briefing.
The weight loss drugs appear to help in two ways: first by curbing obesity, which is a risk factor for many other health conditions, and second by reducing inflammation, affecting the brain’s reward signals and impulse control, and improving blood flow.
“However, their beneficial profile is not without risks,” Al-Aly said.
They were associated with a higher risk of gastrointestinal problems, low blood pressure, fainting, arthritis, kidney stones, a type of kidney disease, and drug-induced pancreatitis.
The increase in gastrointestinal problems has been well-documented, and the rise in low blood pressure and kidney stones is probably because GLP-1 patients could be “somewhat fluid-depleted” from not eating or drinking as much, said Dr Stephen O’Rahilly, co-director of the Institute of Metabolic Science at the University of Cambridge.
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Overall, “the study provides useful reassurance about the safety of this class of drugs,” O’Rahilly said in a statement.
Changing medical views on obesity
The findings come as our understanding of obesity’s impact on health evolves.
Last week, a global expert panel said that a high body mass index (BMI) is not enough to diagnose obesity and that greater focus should be given to how weight is distributed and how obesity affects organ function.
Dr Antonio Vidal-Puig, a professor of molecular nutrition and metabolism at the University of Cambridge, said the BMI update could change how researchers think about how well anti-obesity drugs work.
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“The increasing relevance of body composition and distribution makes the focus on weight and BMI less relevant,” Vidal-Puig told Euronews Health.
He also warned that people are increasingly accessing these drugs through uncontrolled sources, which could raise the risks of adverse side effects.
Counterfeit weight loss medicines have been circulating in Europe, the US, and Brazil, and some people who took compounded versions of the drugs have died or wound up in the hospital.
Limitations of the research
The new study did not analyse how dosage or compounds affected patients’ health outcomes, but Al-Aly said his team will be looking into this.
More research will be needed to verify some of the study’s other conclusions.
Dr Naveed Sattar, a professor of cardiometabolic medicine and an honorary consultant at the University of Glasgow, said the findings “cannot be considered anywhere near definitive” because they come from observational research, rather than the gold standard of randomised clinical trials.
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Meanwhile, O’Rahilly noted that because the data came from the US Department of Veterans Affairs, the patient group was skewed toward older white men, which could affect the results.
More research is also needed with patients who have obesity but not diabetes, he added.
Despite those limitations, Al-Aly said the findings shed new light on obesity as a disease.
“People used to think that [obesity is due to] a lack of willpower,” Al-Aly said. “It’s a disease that can be treated with a medication very effectively. And more than that, treating obesity and metabolic syndromes are likely to have broad benefits”.
