Recent research indicates that GLP-1 (glucagon-like peptide-1) drugs, primarily prescribed for weight loss, may offer significant cognitive and cardiovascular benefits. Conducted by scientists at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System, the study reviewed health records of approximately 2 million veterans treated for diabetes from October 2017 to December 2023. This comprehensive analysis reveals that while these medications can improve cognition and reduce the risks of dementia and cardiovascular diseases, they may also present certain health risks.
The study's senior author, Dr. Ziyad Al-Aly, a clinical epidemiologist and nephrologist, emphasized the dual nature of GLP-1 drugs. He noted, “However, they are not without risks. Our findings underscore the possibility for wider applications for these medications but also highlight important risks that should be carefully monitored in people taking these drugs.” His insights shed light on the critical balance between the benefits and potential downsides of these increasingly popular treatments.
GLP-1 receptor agonists (GLP-1RA) have gained traction as effective treatments for many patients. They not only assist with weight management but also appear to promote brain health and lower the risk of serious conditions such as dementia and heart disease. Dr. Mir Ali, a bariatric surgeon and medical director, affirmed the effectiveness of these drugs, stating, “I believe the benefits outweigh the risks." He further mentioned that most gastrointestinal side effects, such as nausea and diarrhea, are manageable, while severe complications like pancreatitis are rare.
The study suggests that the advantages of GLP-1 drugs may be particularly pronounced among individuals with pre-existing conditions or those at high risk for cognitive decline and cardiovascular issues. Al-Aly highlighted that monitoring is crucial: “It’s important to decrease blood pressure medications while losing weight on GLP-1 meds as weight loss can lower blood pressure, and GLP-1 meds may also have direct effects to lower blood pressure.”
Nevertheless, as GLP-1 drugs become more prevalent, experts warn against overlooking their potential side effects. Al-Aly stated, “Many of the risks are known (GI disorders), and some potentially could have been prevented (hypotension).” He added that each patient’s health history is pivotal in determining whether the benefits outweigh the risks. “Some patients may find that benefits outweigh risks while others may feel that their personal health history is such that the risks may be too high to consider,” he explained.
The analysis has garnered attention for its timely relevance amidst a growing interest in GLP-1 medications. Kristin Kirkpatrick, president of KAK Consulting and a registered dietitian who was not involved in the study, remarked, “This is an interesting analysis that is much needed given what the authors cited as drugs that are ‘skyrocketing in popularity.’” She emphasized the importance of informed discussions between patients and healthcare providers regarding the potential risks and benefits of these drugs.
Kirkpatrick added that the study provides valuable insights for individuals contemplating GLP-1 treatments: “It provides a good assessment for individuals considering these drugs on what risks and benefits may occur, which can then prompt the right discussions with their healthcare providers related to potential individual benefits and risks.”
While there is a consensus on the efficacy of GLP-1 drugs, there is also an acknowledgment of a growing concern among patients regarding long-term use. Dr. Ali noted an emerging issue where patients express anxiety about discontinuing these medications after experiencing success. “I think one thing that could be discussed more is the exit strategy. I say this because so many of my patients have found success with these drugs but now tell me that they are ‘terrified to get off of them,’” he stated.
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