Ozempic and Wegovy could improve health, from addiction to dementia

The first study to assess the impact of weight-loss drugs on overall human health has found an “eye-opening” impact on the body, researchers say.

The analysis, involving about two million people, linked the drugs to better heart health, fewer infections, a lower risk of substance abuse and fewer cases of dementia.

The US researchers also warned that the drugs were “not without risk” and appeared to increase joint pain and potentially fatal inflammation of the pancreas.

However, the results require very careful interpretation.

Weight loss drugs have exploded in popularity, but a complete understanding of everything they touch in the body is still developing.

“This is new territory,” said lead researcher Dr. Ziyad al-Aly, a clinical epidemiologist at the University of Washington.

Initially, they were a proven treatment for type 2 diabetes. Then weight loss was seen as an important side effect – and Ozempic and Wegovy became household names.

The study used data on US veterans with type 2 diabetes, some of whom received Ozempic or Wegovy and other more standard drugs – to measure their effect on 175 other conditions.

There appears to be a significant benefit for heart health, with lower levels of heart attacks, strokes, heart failure and high blood pressure, among those taking the new weight loss drugs.

They also reduce the risk of substance abuse (including alcohol, opioids and cannabis), as well as schizophrenia, suicidal thoughts and seizures.

Although the study was short and people had been taking the drugs for only 3.5 years due to their novelty, it reported a 12% reduction in Alzheimer’s disease.

There was also less liver cancer, muscle pain and chronic kidney disease, as well as a noted reduction in bacterial infections and fever.

On the other hand, people were more likely to have problems with their digestive system. Nausea, stomach pain, stomach inflammation, diverticulitis (bulges in the intestines that can be painful), and hemorrhoids were more common on Ozempic or Wegovy.

The data, published in the journal Nature Medicinealso showed low blood pressure, including fainting, headaches, trouble sleeping, kidney stones, inflammation of the kidneys, and various bone or joint pains, including arthritis, have become more common.

“It was really eye-opening for me to see all these different attacks in different organ systems,” Dr Aly told BBC News.

Explanations for the seemingly widespread impact of these drugs are both obvious and mysterious.

Losing excess weight would in turn improve health. For example, decreased levels of sleep apnea – when breathing stops and starts again during sleep – are thought to be due to weight loss around the tongue and throat, which can block the airways .

But the drugs also appear to directly change the behavior of the body’s cells and tissues.

Dr Aly said: “Obesity is bad for the brain. Obesity is bad for mental health. Obesity is bad for the heart. Obesity could be the mother of all evils. »

Ozempic and Wegovy contain the same active ingredient, semaglutide, in different doses, and mimic the glucagon-like hormone peptide-1.

Released by the intestine after eating, GLP-1 circulates in the blood and sticks to small receptors on the surface of brain cells.

This tells the brain that there is food in the stomach and is why people feel less hungry after eating.

However, receptors that respond to GLP-1 are found throughout the body, including in the heart and parts of the immune system.

“It’s very clear that this class of drugs seems to suppress reward mechanisms (in the brain), which inhibits the urge to seek out alcohol, to seek out tobacco, to seek out gambling,” said Dr. Aly.

Meanwhile, lower levels of inflammation, the immune system’s alarm bell, could have a wide range of health impacts.

The range of health benefits could strengthen the case for some people using these drugs, Dr. Aly said.

“When you add more benefits, for people who are actually at risk for these diseases, it’s an added benefit,” he said.

But for those whose weight doesn’t affect their health, “maybe the risk of them buying themselves is actually much higher than the benefit.”

However, the study has drawbacks that limit its conclusions.

Most of the veterans were white men, so this did not include any effects specific to women, such as the anecdotal phenomenon of improved fertility and unexpected “Ozempic babies.”

And there could be reasons why some were prescribed Ozempic or Weygovy, rather than other drugs, that could provide alternative explanations for some results.

Extensive clinical trials have already proven its benefits for heart health – and nausea is a known side effect – but further results will need to undergo similar rigorous testing.

Alzheimer’s disease appears more than a decade before symptoms appear, but this study suggests that just a few years of semaglutide treatment has a protective effect.

The tests are already in progress to determine if this effect is real.

“Such trials will bring us much closer to the truth,” said Professor Naveed Sattar, of the University of Glasgow.

“Fortunately…several will report within the next four years.”

And while “interesting,” he said the results of this latest study were not strong enough to influence how the drugs were prescribed.

Professor Sir Stephen O’Rahilly, from the University of Cambridge, said the study should be interpreted “with caution” but provided “useful reassurance” about the safety of the drugs in people with diabetes.

And further studies in other patients were “awaited with interest”.

The “most surprising result” was the increase in joint pain, as weight loss should reduce pressure on the joints.

But the fact that some immune system cells have GLP-1 receptors means that the impact of these drugs is “somewhat unpredictable” and that while some inflammatory disorders may be alleviated, “others could potentially be exacerbated.” , said Professor O’Rahilly.