Weight-loss drugs like Ozempic could also help fight dementia but raise other health risks, study says

Ozempic was first approved to treat diabetes in Canada seven years ago. Now the largest study of its kind suggests it and other medications like it have a host of other potential health benefits beyond obesity, but could also bring increased risk of other conditions.

The class of medications called GLP-1 agonists mimic the actions of a natural hormone that helps curb appetite and slows digestion. The GLP-1 medications approved by Health Canada include Ozempic and Wegovy. These drugs have become popular in the past few years thanks to their weight-loss benefits by extending how long people feel full.

A study released Monday of 200,000 people in the U.S. taking GLP-1s suggested the drugs' potential benefits extend beyond those currently recognized, such as a lower risk of Alzheimer's disease.

"This is a great study, but don't go buying the medications yet" for conditions other than diabetes and obesity, said Dr. Abraham Snaiderman, a psychiatrist with the Toronto Rehabilitation Institute at the University Health Network. He was not involved in the study.

For those already prescribed GLP-1 medications to lose weight, Dr. Ziyad Al-Aly, the study's senior author, said they may find other benefits, such as curbing addictions.

"It will also help them to stop smoking," said Al-Aly, clinical epidemiologist at Washington University in Saint Louis, Mo. "In effect, they will be hitting two birds in one stone."

For the study, published in the journal Nature Medicine, researchers tracked associations between GLP-1 drugs and 175 health conditions over 3½ years among people with diabetes.

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The study also suggested that Ozempic and similar drugs can lead to an increase in the risk of nausea and vomiting, as well as arthritis and low blood pressure that can lead to fainting.

Effects in the brain?

In the study, GLP-1 drugs were also linked to a lower risk of addiction disorders.

"GLP-1s suppress appetite by working not only on the stomach, but also on areas in the brain that are involved in impulse control, that are involved in reward-signalling, therefore curbing one's appetite, and are resulting in weight loss but also reducing appetite for cigarettes, appetite for alcohol, appetite for illicit drugs," Al-Aly said.

Other benefits included lower risk for heart disease, stroke, most kidney diseases as well as lower incidence of schizophrenia and less suicidal ideation.

As for why this class of drugs seem to be tied to such a wide array of potential benefits and risks, Al-Aly pointed to how the GLP 1 receptor isn't just found in the gut. The receptors are also common in the brain and in other organ systems.

Dr. Daniel Drucker, a clinician-scientist who develops treatments for diabetes, obesity and intestinal disorders, cautions that GLP-1 medications aren't for everyone. (Craig Chivers/CBC)

For neurological disorders like Alzheimer's disease, Type 2 diabetes is a known risk factor.

"A promising agent which is revolutionizing the treatment of Type 2 diabetes would of course be considered as a logical option for the treatment of Alzheimer's disease," said Dr. Donald Weaver, senior scientist at the Krembil Research Institute at Toronto's University Health Network.

But the researchers also found new risks associated with GLP-1 use, such as pancreatitis — an inflammation of the pancreas that can lead to life-threatening complications.

Al-Aly said an increased risk of inflammation of the kidney could be because people taking the medications end up drinking less water.

A finding of increased joint pain associated with the medications is complex, Al-Aly said, considering that losing weight usually improves arthritis.

Dr. Daniel Drucker, a clinician-scientist at the Lunenfeld-Tanenbaum Research Institute at Toronto's Mount Sinai Hospital who helped lay the foundation for these drugs, called the study a powerful analysis.

All of the physicians cautioned against broader use of the drugs until data supports it, such as from clinical trials that show cause-and-effect relationships beyond the associations in this study.

"These drugs are expensive," Drucker said. "They have side-effects. They're not for everyone."

Al-Aly and his team acknowledged future studies should include more diverse groups, as they relied on data from U.S. Veterans, who are mainly older, white men.