Adam’s Journal
Here’s a question from an Oklahoma Medical Research Foundation coworker:
I’ve seen articles claiming semaglutides like Ozempic and Wegovy can reduce the risk for a rash of conditions, including dementia and alcohol use disorder. Is it the medicine having this impact, or is it the resulting weight loss?
Dr. Scofield Prescribes
The class of drugs known technically as semaglutides or GLP-1 receptor agonists have proved almost miraculous in treating weight loss. And as their use has increased, research has found more and more evidence that the drugs – sold commercially as Ozempic, Zepbound, Wegovy and Mounjaro – benefit many other health conditions.
For some conditions, such as heart disease and diabetes, the link to weight loss is obvious: Excess weight is a primary risk factor for these illnesses, so weight reduction directly correlates with a reduction in disease levels.
In addition to the obvious, though, there may be other factors at work. Those who study these GLP-1 drugs and the ways in which they work believe the drugs may lower inflammation throughout the body.
Chronic inflammation contributes to heart disease and diabetes, as well as a host of other diseases. If the drugs really do reduce inflammation, this could also be a reason they’re helping in heart disease, diabetes and other conditions.
As you note, studies have also found potential benefits in alcohol use disorder. If these findings prove out, those impacts are likely independent of weight loss.
GLP-1 drugs target areas of the brain that regulate appetite. However, there’s mounting evidence that they do other things in the brain, especially when it comes to addiction.
While a randomized trial has yet to be performed, a number of studies suggest that GLP-1 drugs can reduce a wide range of urges, including for alcohol and other addictive substances. As just one example, a study last year in the journal Addiction even found that among a half million people with opioid use disorder, those taking GLP-1 drugs had a 40% lower overdose rate than those not using the drugs.
The data for Alzheimer’s also offers some hope. But because the studies to date are observational rather than what we’d call mechanistic – which means examining the underlying mechanism by which GLP-1 drugs might impact the Alzheimer’s disease process – we don’t know for sure what’s causing any benefits.
Nevertheless, from what we understand, if the drugs do help combat Alzheimer’s or other forms of dementia, it’s likely a combination of factors. One of those may be improvements in metabolic health, which is directly tied to weight loss. But, as with other conditions, additional drivers could be a reduction in inflammation, as well as the drugs’ direct impact on the brain itself.
GLP-1 drugs are not a magic bullet, and we’re learning their limits. For instance, earlier this year, a clinical trial found they had no effects in patients with Parkinson’s disease.
Still, there is an awful lot of promising data coming out. GLP-1 drugs seem to have health benefits that few dreamed of when they were first introduced less than a decade ago. As their full potential continues to emerge, we’ll keep digging deeper to understand not only what they do, but how they do it.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
