A new study of glucagon-like peptide-1 receptor agonists (GLP-1RA) effects revealed that they have proven benefits for weight management. However, less is known about their impact on various organs and body systems.
Carissa Wong, New Scientist Health Reporter, in her recent article, offered her takeaway:
Drugs like Ozempic and Wegovy, called GLP-1 agonists, carry more benefits than risks when taken for their approved uses, according to a comprehensive analysis of their effects on 175 conditions. The same may not be true for people taking the drugs for other uses, however.
News Medical also reported on the study, mentioning that demand for weight-loss medications like Ozempic and Wegovy continues to rise, with one in eight Americans using (or had used) them to treat conditions such as diabetes, heart disease, or obesity. Often referred to as “miracle drugs” by the media, patients, and some doctors due to their significant weight loss effects, GLP-1RAs also include drugs like Mounjaro and Zepbound.
The study’s findings
A new study conducted by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) St. Louis Health Care System assessed health outcomes in over two million people with diabetes who were using these weight-loss drugs. The study found notable improvements in cognitive and behavioral health, but also uncovered potential risks, such as an increased likelihood of pancreatitis and kidney issues. The study was published on January 20 in Nature Medicine.
The study’s senior author, Dr. Ziyad Al-Aly, a clinical epidemiologist and nephrologist at WashU Medicine, emphasized the importance of thoroughly examining the effects of these drugs, given their rapid rise in popularity and relatively recent emergence.
For the study, WashU Medicine researchers analyzed de-identified health records from the U.S. Department of Veterans Affairs, comparing outcomes between veterans using GLP-1RAs for diabetes and those on traditional medications like Jardiance, Glipizide, and Januvia. The dataset included over two million veterans treated for diabetes between 2017 and 2023, spanning various ages, races, and genders.
The benefits and the risks
The results showed that GLP-1RA drugs were linked to significant improvements in mental and behavioral health, including a reduced risk of seizures, addiction to substances like alcohol, cannabis, stimulants, and opioids, and even a lower likelihood of suicidal thoughts, self-harm, bulimia, and psychotic disorders like schizophrenia. These medications were also associated with a decreased risk of neurocognitive conditions such as Alzheimer’s and dementia.
Dr. Al-Aly explained that these drugs work on brain areas involved in impulse control and reward, which could help explain their effectiveness in reducing both appetite and addiction behaviors. Additionally, they seem to reduce brain inflammation, which may contribute to improved brain health and a reduced risk of Alzheimer’s and dementia.
However, the benefits, while meaningful, are modest, with reductions of around 10% to 20% for most outcomes. Despite this, Dr. Al-Aly emphasized that even small improvements can be valuable, particularly for conditions like dementia, where effective treatments are limited. These drugs may also be more beneficial when combined with lifestyle changes or other medications.
The study reaffirmed previous findings that GLP-1RA drugs can lower the risk of heart attacks, strokes, and other cardiovascular issues. However, it also highlighted some negative side effects, including gastrointestinal problems like nausea, vomiting, diarrhea, and, in rare cases, stomach paralysis. These side effects are already well-known in the medical literature and have been observed anecdotally.
More concerning, though, are the potential risks to the pancreas and kidneys. While these adverse effects are relatively rare, they can be severe, and Dr. Al-Aly stressed that doctors need to monitor patients carefully for signs of pancreatitis and kidney issues, which can develop without obvious symptoms until they are advanced and harder to treat.
An unexpected self-reported side effect
Journalist Johann Hari was recently interviewed by A. Pawlowski, TODAY Health Reporter, about his journey of taking Ozempic and Wegovy. He was prescribed the drugs in 2023, for weight loss, as Hari weighed 203 pounds and had a body fat percentage of 32%. Eventually, Hari lost 42 pounds and wrote a book, “Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs.”
To the interviewer’s question about what specifically bothered Hari about taking the meds, he replied:
For myself, the one risk that I didn’t see coming was the psychological effect. That was really strange. For the first six months I was taking the drug, I was getting what I wanted — I was losing loads of weight, my back pain went away, all sorts of good things happened.
But I didn’t actually feel better in my emotions. If anything, I felt slightly worse. I realized it was about my inability to comfort eat, and how bad that was making me feel.
No longer being able to use food as a stress-coping mechanism, Hari had to face “the deep underlying emotional reasons why you ate in the first place.” He said,
I realized how much of my eating was about the need to comfort myself — stuffing myself to calm myself. And I couldn’t do that when I was on Ozempic.
The bottom line remains the same. While GLP-1RA medications offer broad health benefits, the study underscores that they are not without risks. Their potential applications are vast, but careful monitoring is essential to manage the associated risks.
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Source: “How GLP-1 drugs like Ozempic and Wegovy affect risk of 175 conditions,” New Scientist, 1/20/25
Source: “Benefits and risks of popular weight-loss drugs revealed,” News-Medical, 1/20/25
Source: “Is Ozempic a ‘magic’ drug? Author who lost 42 pounds on benefits, ‘very real concerns’,” TODAY, 6/20/25
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