Good News About GLP-1 Agonists

A little over a year ago, I posted my thoughts on GLP-1 agonist medications (that’s things like Ozempic, Wegovy, Mounjaro, and Zepbound). In all, I offered some serious criticisms and concerns of these medication. You can read my initial post by clicking here.

I want to return to the topic of GLP-1 medications today, because since that post my thinking on these medications has evolved. That’s not because I’ve changed my philosophy. I still have many of the concerns that I outlined in my initial post. However, science constantly makes new discoveries, and it’s a professional obligation of mine to keep an open mind and evaluate new pieces of data as they come in, constantly weighing the risks versus the benefits of various treatments.

The fact is that over the past year, a string of new studies have come out suggesting that there may be far more benefits to GLP-1 medications than were previously realized. I’ll briefly touch on just a few here:

In a database review of Crohn’s disease patients, there appeared to be fewer Crohn’s exacerbations and less need for disease controlling medications in those taking a GLP-1 agonist.

We’ve long know that weight loss can really help treat arthritis, and certainly many overweight patients who go on medications like Wegovy will end up having less arthritic pain. But a new study (in mice, so not definitive evidence) shows that semaglutide (the main ingredient in Wegovy and Ozempic) can actually help to regrow cartilage. This suggests that the arthritis benefits of drugs like Wegovy may be due to more than just weight loss.

Several studies have suggested beneficial effects with regards to cancer. 

For example, in a large database review, GLP-1 users had lower risks of ovarian and endometrial cancer as well as a trend toward less pancreatic or breast cancer (the later two did not reach statistical significance meaning that while there was a benefit, it was too small to say with certainty that it wasn’t due to random chance). 

Another recent study suggested that patients with stage 1, 2, or 3 cancer might have a reduced chance of “graduating” to stage 4 cancer if they are on a GLP-1 medication.

There have been a number of other studies likewise showing possible benefits of GLP-1 agonists for a variety of chronic illnesses, but for brevity’s sake (as well as my own sanity!) I will not review them here today. 

It’s important to point out that these are all observational studies, and if you regularly read this blog, you will already know that I place only limited faith in these. Observational studies are always prone to bias, and cannot prove beyond a reasonable doubt a cause-effect relationship. But, when an accumulating number of such studies suggest that there may be benefits to these medications beyond simply weigh loss and improved blood sugar, it’s reassuring. 

As I pointed out in my initial post last year, one of my concerns was (and remains) the possibility of unknown side effects from these medications. It will never be possible to 100% put that concern to rest. But the more experience we gain with these medications and the more we find that takers of them are living longer and suffering less from chronic illness, the more confident we can be that they are probably safe for the vast majority of patients.