Unanswered Questions Regarding Weight-Loss Medications

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But this week we also learned that, disappointingly, GLP-1 drugs don’t seem to help people with Alzheimer’s disease. Additionally, individuals who discontinue the drugs upon becoming pregnant can face potentially harmful levels of weight gain during their pregnancies. Researchers are also concerned that some individuals are using the drugs postpartum to shed pregnancy weight without fully understanding the associated risks.

All this information serves as a reminder that there’s still much we don’t know about these drugs. This week, let’s explore the ongoing questions surrounding GLP-1 agonist medications.

First, a quick recap. Glucagon-like peptide-1 is a hormone produced in the gut that helps regulate blood sugar levels. It appears to have effects throughout the body; receptors for GLP-1 have been identified in multiple organs and within the brain, according to Daniel Drucker, an endocrinologist at the University of Toronto who has studied the hormone for decades.

GLP-1 agonist drugs essentially mimic the action of this hormone. Several alternatives have been developed, including semaglutide, tirzepatide, liraglutide, and exenatide. Some of these are recommended for specific individuals with diabetes.

However, due to their appetite-suppressing effects, these drugs have gained popularity as weight loss aids. Studies show that many users, whether for diabetes management or weight loss, report unexpected side effects; for instance, improvements in mental health or a reduced inclination to smoke or consume alcohol. Research has also indicated that the drugs may stimulate the growth of brain cells in laboratory animals.

So far, so promising. Yet, several important questions remain. Are they beneficial for our brains? Novo Nordisk, a competitor of Eli Lilly, produces GLP-1 drugs like Wegovy and Saxenda. The company recently conducted a trial of oral semaglutide in people with Alzheimer’s disease who exhibited mild cognitive impairment or mild dementia. The placebo-controlled study included 3,808 volunteers.