Several years ago, a little-known drug called Ozempic – previously used only to treat diabetes – emerged as a promising new medication for weight management.
The Food and Drug Administration’s approval of Ozempic in 2021 for weight loss treatment marked the start of a new era for the class of drugs called glucagon-like peptide-1, or GLP-1, agonists.
Today, GLP-1 drugs, including Wegovy, Mounjaro and Zepbound, have become household names and key tools in the fight against obesity: 1 in 8 American adults report having used a GLP-1 drug, and Predictions show that by 2030, 1 in 10 Americans will likely use these medications.
Today, research from my lab and others suggests that GLP-1 drugs could also help treat dozens of other diseases, including cognitive problems and addiction problems. However, my colleagues and I also discovered previously unidentified risks.
I am a physician-scientist and direct a clinical epidemiology center focused on the most pressing public health questions. My team is working to fill critical knowledge gaps about COVID-19, long COVID, influenza, vaccines, the effectiveness and risks of commonly used medications, and much more.
On January 20, 2025, my team published a study of more than 2.4 million people assessing the risks and benefits of GLP-1 drugs across 175 possible health outcomes. We found that these medications reduced the risks of 42 health conditions, almost a quarter of the total we analyzed. These include neurocognitive disorders such as Alzheimer’s disease and dementia, substance use and addiction disorders, bleeding disorders, and several other conditions.
Unfortunately, we also found that GLP-1 drugs cause significant side effects and increase the risk of 19 health problems we studied, such as gastrointestinal problems, kidney stones and acute pancreatitis, in which the pancreas becomes inflamed and dysfunctional.
Cognitive benefits
One of the most important health benefits we discovered was that GLP-1 drugs reduced the risk of neurodegenerative disorders, including Alzheimer’s disease and dementia. These findings are consistent with other research, including evidence from preclinical studies showing that these drugs can reduce inflammation in the brain and improve the brain’s ability to form and strengthen connections between its cells, thereby improving how how they communicate with each other. These effects help to attenuate cognitive decline.
Two other key studies showed that patients treated with diabetes drug GLP-1 had a lower risk of dementia.
All of these studies strongly suggest a potential therapeutic use of GLP-1 drugs in the treatment of cognitive decline. Ongoing randomized trials – the gold standard for evaluating new drug uses – are examining the effects of GLP-1 drugs in early Alzheimer’s disease, with results expected later in 2025.
Fighting addiction and suicidal thoughts
GLP-1 medications have also demonstrated potential in reducing the risks of several substance use disorders, such as those involving alcohol, tobacco, cannabis, opioids, and stimulants. This may be due to the ability of these drugs to modulate reward pathways, impulse control, and inflammatory processes in the brain.
The effectiveness of GLP-1 drugs in combating addictive behaviors may explain their dramatic success in treating obesity, a chronic condition that many believe is actually a food addiction disorder.
Our study demonstrated a reduced risk of suicidal thoughts and self-harm in people using GLP-1 medications. This finding is particularly significant given previous reports of suicidal thoughts and self-harm in people using GLP-1 medications. In response to these reports, the European Medicines Agency carried out a review of all available data and concluded that there was no evidence of an increased risk of suicidal tendencies in people using GLP-1 medicines. .
Today, at least two studies, including ours, show that GLP-1 drugs actually reduce the risk of suicide.
Other benefits
In addition to the well-documented effects of GLP-1 drugs on reducing the risk of cardiovascular and renal adverse effects, our study shows a significant effect on reducing the risk of blood clotting as well as deep vein thrombosis and pulmonary embolism.
A surprising finding from our study is the reduced risk of infectious diseases such as pneumonia and sepsis. Our data complements another recent study that came to a similar conclusion showing that GLP-1 drugs reduced the risk of cardiovascular death and death from infectious causes, primarily COVID-19.
This is particularly important since COVID-19 is considered a significant cardiovascular risk factor. Whether GLP-1 medications fully compensate for the increased risk of cardiovascular disease associated with COVID-19 needs to be carefully evaluated.
GLP-1 drugs may also be useful in treating fatty liver disease and conditions ranging from asthma to chronic obstructive pulmonary disease, sleep apnea, osteoarthritis, depression, and chronic obstructive pulmonary disease. eyepieces.
Risks and challenges
Despite their broad therapeutic potential, GLP-1 drugs are not without risks.
Gastrointestinal problems, such as nausea, vomiting, constipation, and gastroesophageal reflux, are among the most common side effects associated with GLP-1 medications.
Our study also identified other risks, including low blood pressure, sleep problems, headaches, kidney stone formation, gallbladder disease, and diseases associated with the bile ducts. We also saw an increased risk of drug-induced inflammation of the kidneys and pancreas – two serious conditions that can lead to long-term health problems. These findings highlight the importance of close monitoring in people taking GLP-1 medications.
A significant challenge with the use of GLP-1 drugs is the high rate of patient dropout, often due to their exorbitant cost or the emergence of adverse effects. Stopping treatment may cause rapid weight gain.
This is a problem because obesity is a chronic disease. GLP-1 drugs offer effective treatment but do not address the underlying causes of obesity and metabolic dysfunction. As a result, GLP-1 medications must be taken long-term to maintain their effectiveness and avoid rebound weight gain.
Additionally, many questions remain about the long-term effectiveness and risks of these drugs, as well as whether there are differences between GLP-1 formulations. Answering these questions is essential to guide clinical practice.