Large study: The benefits and risks of obesity medications
Av In a recent American study, published in Nature Medicine, researchers analyzed data from nearly two million people with diabetes to identify new insights into GLP-1 receptor agonists (GLP-1 RA). These include medications like Ozempic and Mounjaro, which have become widely discussed in recent years for their substantial weight loss effects.
Patients treated with GLP-1 RA were compared with patients who received usual care or other medications. The researchers tracked the effects by comparing the usage with 175 different health outcomes.
The results of the study partly point to positive associations. The use of GLP-1 medications was linked to a reduced risk of Alzheimer’s disease, psychotic disorders, addiction issues and stroke. Compared to usual care, the addition of GLP-1 medications was associated with a reduced risk of 42 different health outcomes.
At the same time, the study indicated links to an increased risk of 19 other conditions. The researchers reported, among other things, connections to a higher risk of arthritis and an increased risk of pancreatitis. Kidney stones and inflammation of the intestines and stomach were also associated with GLP-1 RA.
Although the researchers only studied individuals with diabetes, they suggest that there is no reason to believe that the overall risks or benefits would differ for those using GLP-1 RA as a treatment for obesity, according to an article in The Guardian. The same substances used in medications like Ozempic and Mounjaro have also been approved for obesity but under different brand names.
Ylva Trolle Lagerros, a professor of cardiovascular prevention at the Karolinska Institute and doctor at the Center for obesity in Stockholm, comments on the study in an interview with Life Science Sweden.
– It is an impressively large epidemiological study. What can be said is that it confirms many things we already knew and some that we suspected, she says.
That GLP-1 RA reduce the risk of conditions such as cardiovascular disease and liver disease is nothing new, she says. That these medications increase the risk of gastrointestinal inflammation (gastroenteritis) and inflammation of the pancreas (pancreatitis) is also something that has been known for some time.
That these substances reduce the risk of dementia, Alzheimer's, and addictive disorders is something that smaller studies have previously indicated, and areas that are being increasingly investigated. The large study now published with similar results is therefore a step closer to confirming such an effect, according to Ylva Trolle Lagerros.
– Other findings in the study are new and should perhaps be seen as hypothesis-generating. For example, the increased risk of arthritis and joint issues observed in this group with diabetes. This might be something that will be investigated further.
At the same time, she says it is important to remember that these are associations and not direct causal links, and that the results need to be confirmed with more and different types of studies. She also points out that the study's data is collected from the U.S. Department of Veterans Affairs and that the research thus primarily refers to older, white men.
Is it possible to say that it is the substance itself that has an effect on health outcomes? Or could it be related to the weight loss?
– We don't really know from this study. But we do know that GLP-1 receptors are found in many parts of the body, including the brain, liver, kidneys, heart, and lungs. So it’s reasonable to think that there are connections that aren't just about the weight loss.
Overall, the researchers collected data in the cohort study from over 1.9 million diabetics, of which about 216,000 were treated with GLP-1 RA. The information was gathered from the U.S. Department of Veterans Affairs database, and the patients were followed for an average of 3.5 years.
The study is published in Nature Medicine and can be found here:
Mapping the effectiveness and risks of GLP-1 receptor agonists.
About GLP 1 RA
GLP-1 is short for glucagon-like peptide-1. It is a natural hormone released from cells in the intestines. It works in the body in various ways, including helping the body release more insulin during meals to keep blood sugar levels balanced. For individuals with type 2 diabetes, it is common that the body doesn't respond properly to GLP-1.
A GLP-1 receptor agonist (GLP-1 RA) is a non-insulin medication that mimics the hormone GLP-1. The substance stimulates a response in the body by acting on a specific receptor.
Medications classified as GLP-1 RA, are used in the treatment of type 2 diabetes. These substances have additional effects on other organ systems, which can also lead to weight loss, and are therefore also used as obesity medications.
Source: Novo Nordisk
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