Weight-loss drugs show promising health benefits but carry risks
The first comprehensive study examining how weight-loss drugs impact overall health has revealed surprising benefits, and some potential risks, according to research involving two million participants.
The findings suggest that medications like Ozempic, Wegovy, and Mounjaro, originally developed for type 2 diabetes, could significantly improve heart health, reduce infections, and even lower the risk of dementia. However, they may also increase joint pain and the risk of inflammation in the pancreas, highlighting the need for careful consideration when prescribing these treatments.
Led by Dr. Ziyad al-Aly of Washington University, the study analysed U.S. veterans with type 2 diabetes to explore the effects of weight-loss drugs on 175 health conditions. Participants taking semaglutide-based drugs (Ozempic or Wegovy) experienced reduced rates of heart attacks, strokes, heart failure, and high blood pressure. Additionally, researchers observed lower risks of substance abuse, schizophrenia, suicidal thoughts, and seizures.
Interestingly, a 12 per cent reduction in Alzheimer’s disease was noted, despite the relatively short 3.5-year study period. Other benefits included fewer cases of liver cancer, bacterial infections, and chronic kidney disease.
However, side effects such as nausea, digestive issues, inflammation, and joint pain were more common among those taking these drugs. Some participants also reported fainting, disturbed sleep, and kidney stones.
The benefits likely stem from both weight loss and the drugs' direct effects on cells and tissues. Semaglutide, the active ingredient in these medications, mimics the hormone GLP-1, which influences hunger signals and metabolism. GLP-1 receptors are found throughout the body, including in the heart and immune system, which may explain the drugs’ far-reaching impact.
For example, losing excess weight around the throat can reduce sleep apnoea, while lower inflammation levels may improve overall health. Intriguingly, the drugs may also suppress reward mechanisms in the brain, reducing cravings for substances like alcohol and tobacco.
The study's focus on U.S. veterans, predominantly white men, leaves questions about how these drugs affect women and other demographic groups. Anecdotal reports, such as improved fertility and unexpected pregnancies ("Ozempic babies"), warrant further exploration.
More rigorous clinical trials are underway to verify findings like the protective effect against Alzheimer’s disease and researchers caution against over interpreting the results until these trials are complete.
While these findings strengthen the case for using weight-loss drugs in people with obesity-related health risks, experts advise caution. For those without significant health concerns related to weight, the potential risks may outweigh the benefits. Professor Naveed Sattar of the University of Glasgow and Professor Sir Stephen O’Rahilly of the University of Cambridge agree that these results provide reassurance about the drugs’ safety in specific groups but stress the need for further research to understand their full impact.