Doctors are warning against treating GLP-1 medications prescribed for weight loss and Type 2 diabetes as a “miracle drug” for a range of ailments.
Physicians, analysts and patients introduced the label in sources such as Fortune, the Motley Fool and an Indiana University bioethics blog.
Clinical trials are underway to study drugmakers’ claims that GLP-1s could help cure alcoholism, slow aging and eliminate opioid drug addiction. Other trials seek to assess how GLP-1s affect arthritis, depression, smoking, cocaine, schizophrenia, psoriasis and Parkinson’s disease.
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Most medical experts interviewed by The Washington Times said it will take at least five years to assess such claims. But that’s unlikely to discourage the increasing number of people using the drugs, which have become a multibillion-dollar industry, they added.
“People are voting with their feet,” said Joseph Levy, a health economist at the Johns Hopkins Bloomberg School of Public Health. “Perhaps the significant number who continue using these drugs show that the benefits outweigh the side effects.”
Mr. Levy said improvements in sleep apnea, chronic kidney disease and congestive heart failure among users have fueled the growing belief that GLP-1s convey more “health benefits beyond the weight loss.”
“‘Miracle drug’ is not a useful prescribing category,” said Dr. Pooja Gidwani, a weight-loss physician based in Beverly Hills, California. “The strongest evidence is impressive enough without promising that they prevent dementia or slow aging.”
Danish drugmaker Novo Nordisk analyzed 10,052 patients in five early trials using its Ozempic and Wegovy drugs. It found that the blood-protein readings of GLP-1 users showed their hearts were biologically two to four years younger than those receiving a placebo.
Similar biomarkers showed that their kidneys, brains, pancreas and lungs were 1 to 4 years younger.
Indianapolis-based drugmaker Eli Lilly found that 71 overweight patients over 50 who took its Mounjaro and Zepbound drugs for 72 weeks showed signs of physically aging 0.7 to 1.1 years. That was lower than the 1.38 years the company expected.
Medical experts say such studies do not justify nonobese people experimenting with the drugs.
“I would not call GLP-1s miracle drugs,” said Dr. Alberto Rodriguez-Navarro, a bariatric surgeon based in California’s Silicon Valley. “The real breakthrough is recognizing obesity as a chronic biological disease and giving patients more choices, including medications and less invasive surgical approaches.”
Roughly 4 in 10 Americans are obese, according to the Centers for Disease Control and Prevention. Various estimates place the number of GLP-1 users at 10% to 18% of U.S. residents.
Prescribed as injectables, the drugs became available in pill form over the summer. Observers widely expect the number of users to increase in the next year as more pills hit the market.
The drugs in any form require lifetime use, a healthy diet and rigorous physical exercise to be fully effective. Physicians note side effects such as nausea, constipation, bloating, acid reflux and muscle loss as particular risk factors for women after menopause and elderly patients.
“The bigger risk is losing muscle along with fat, so protein and strength training matter,” said Dr. Kevin R. Gendreau, an obesity medicine physician based in Fall River, Massachusetts.
He recommends at least 15 to 30 minutes of intensive strength training twice a week for patients using the drugs.
“In people who aren’t overweight, there’s less to gain and more to lose, and we have very little long-term data in that group,” he added.
Pros and cons
The consumer website Everyday Health recently reported that an online survey of 858 U.S. adults, including 608 GLP-1 users, found 61% of those who stopped using the drugs regained an average of 31.5 pounds.
Just 12% of respondents with obesity who previously took GLP-1s said they recalled their doctor explaining what would happen if they stopped, according to the Aug. 5-15 poll.
“The public awareness and acceptance of these drugs has outpaced many of the important support resources that consumers rely on,” said Nan-Kirsten Forte, Everyday Health’s general manager.
Dr. Irene Muratides, a Tampa-based internist, noted that a trial study of 108 adults this year found that obese and alcoholic GLP-1 users reported fewer heavy drinking days after using semaglutide, the active ingredient in Wegovy and Ozempic.
At the same time, she highlighted other large trials that found no effect on early-onset dementia patients who received oral semaglutide for two years. She also emphasized that existing studies exclude users who are not obese or overweight.
“That is particularly relevant for older adults and women after menopause, who may have less muscle and bone reserve,” Dr. Muratides said. “We still need longer-term data on safety, body composition, and use in people without established indications, including those seeking cosmetic weight loss or longevity benefits.”
Existing research limits the benefits of GLP-1 use to obesity-related conditions such as heart problems and sleep apnea.
One large trial involving 17,604 adults found semaglutide reduced the combined risk of stroke, heart attack and cardiovascular death by 20% relative to non-users.
Another trial found that tirzepatide, the active ingredient in Lilly’s Mounjaro and Zepbound, substantially reduced sleep apnea in obese patients.
“For addiction and other possible uses, we’re still learning,” said Dr. Craig Zebuda, chief medical officer at Yunara Life, a New York-based preventive healthcare and longevity company.
Future trends
Other research stresses that cosmetic weight loss is not a sustainable reason to use the GLP-1 drugs.
A large Danish study published Aug. 28 in JAMA Network Open found that nearly half of adults who started using semaglutide for obesity stopped within a year. The highest rates of discontinuation occurred among men, adults under 30 years and users with histories of taking gastrointestinal or psychiatric medications.
“A big reason is that many patients rely on medication alone without making lifestyle changes,” said Kimberly Barefield, a professor in the Philadelphia College of Osteopathic Medicine’s Department of Pharmacy Practice.
Dr. Kenneth Spielvogel, an addiction specialist based in Los Angeles, urged people to learn what the medications do.
“We also cannot assume that cardiovascular, kidney or addiction benefits persist after treatment stops,” Dr. Spielvogel said. “Stopping requires a follow-up plan.”
Dr. Cory Calendine, an orthopedic surgeon at the Bone and Joint Institute of Tennessee, noted that GLP-1 users lose 15% of their body weight, significantly reducing joint pain.
“The hype I worry about is the drug alone — no protein target, no lifting, no plan for the day it stops — and compounded versions bought online with nobody checking the muscle or the bone,” Dr. Calendine said.
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