The popularity of drugs like Ozempic and Mounjaro could grow exponentially in the next few years, both for weight loss and a growing list of potential uses that are being studied.
GLP-1 agonists, a class of medication typically used to treat Type 2 diabetes and obesity, have been available since 2005, but only in the past few years have they transformed weight loss treatment, as well as making billions for the companies that produce the drugs. Health policy research group KFF polling from earlier this year found that 1 in 8 adults have previously taken a GLP-1 agonist and 6 percent of adults are currently on a regimen.
Medicines like semaglutide, tirzepatide and dulaglutide, commercially marketed as Ozempic, Mounjaro and Trulicity respectively, all fall within this class of drugs.
They work by mimicking a hormone produced by the body — glucagon-like peptide-1 — that stimulates insulin secretion and reduces appetite. These drugs are currently prescribed for treating diabetes and obesity, but early research is pointing to possible benefits for a myriad of other conditions.
These include clinical trials looking into the medication’s potential use in treating conditions like Alzheimer’s disease and liver disease.
According to Marijane Hynes, founder of the Weight Loss Clinic at the George Washington University Medical Faculty Associates, the mechanism through which GLP-1s may be able to treat conditions outside of obesity and diabetes is not yet well understood.
“We don’t know exactly how all these things work so well, but it must hit an addiction center in the brain,” Hynes said of some of the observed side effects, noting how her patients report a cessation of “food noise,” constant recurring thoughts about food, when they start on GLP-1 medications.
Here are some conditions that drugs like Ozempic may be prescribed for in the future:
Addiction
A rodent study published last year found that semaglutide use was linked to reduced binge-like alcohol drinking in mice. Researchers theorized this was due to the drug targeting parts of the brain associated with binge eating that also overlap with the urge to ingest substances like alcohol.
Anecdotally, Hynes has observed a similar phenomenon among “plenty of patients.”
“I see people that drink, you know, a bottle a day stop drinking with this stuff,” she said.
Brianna Johnson-Rabbett, an endocrinologist and obesity medicine physician at Nebraska Medicine, echoed these observations, noting her patients “don’t really have any desire to drink alcohol and that … certainly has a quite positive benefit.”
An analysis published in the Annals of Internal Medicine last month found an association between semaglutide and a lower rate of smoking cessation prescriptions and counseling.
Neurodegenerative diseases
Novo Nordisk is currently conducting a Phase 3 multinational study to see whether semaglutide has a positive effect on early Alzheimer’s disease. The trial is currently set to end in 2026.
Some small studies have indicated a positive effect between GLP-1s and cognitive decline. The findings of a U.K.-based study were recently presented at the Alzheimer’s Association International Conference.
The study, which looked at the use of another GLP-1 agonist called liraglutide, involved 204 patients with Alzheimer’s disease. Researchers observed an 18 percent slower cognitive decline over a year compared to trial participants taking placebos.
According to Paul Edison, trial lead and professor of science at Imperial College London, “While further research is needed, liraglutide may work through various mechanisms, such as reducing inflammation in the brain, lowering insulin resistance and the toxic effects of Alzheimer’s biomarkers amyloid-beta and tau, and improving how the brain’s nerve cells communicate.”
This study has yet to be peer reviewed.
The results of a yearlong, Phase 2 trial published in The New England Journal of Medicine this year found that another GLP-1 agonist called lixisenatide, manufactured by Sanofi, was linked to less progression of motor disability among people with Parkinson’s disease.
Heart disease
Earlier this year, the Food and Drug Administration approved Wegovy, a form of semaglutide originally indicated for treating obesity, for reducing the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.
This marked the first time a weight loss drug was specifically approved for treating heart disease. Subsequent findings have further supported these drugs’ use in supporting cardiovascular health.
Eli Lilly published findings last week from a Phase 3 trial that found that tirzepatide, the active ingredient in Mounjaro, reduced the risk of heart failure outcomes by 38 percent when compared to a placebo.
According to Johnson-Rabbett, the benefits observed in these studies are likely a combined result of the weight loss caused by GLP-1 agonist intake as well as a separate mechanism that hasn’t been fully ascertained.
“We do have evidence that there are GLP-1 receptors present in the heart and in the blood vessels. That could potentially explain some of the evidence, for example, in risk of major cardiovascular events,” Johnson-Rabbett said.
“We have evidence of effects on inflammation which, you know, again potentially due in part to effects on weight, but [there is] some evidence of specific effects on inflammatory cells in the body. So, it is very exciting,” she added.
Kidney disease
A study published in The New England Journal of Medicine this year found that semaglutide use may help reduce the risk of kidney failure in those with Type 2 diabetes and chronic kidney disease.
Also funded by Novo Nordisk, this study found kidney disease events were 24 percent lower in the semaglutide group than the placebo group.
This trial was halted earlier than expected, with the company saying the results were already meeting “certain pre-specified criteria.”
Eli Lilly, the manufacturer of Mounjaro, is also conducting its own study looking into whether its GLP-1 product can help overweight or obese people who also have kidney disease.
Liver disease
Findings presented at the Conference on Retroviruses and Opportunistic Infections earlier this year noted a 31 percent reduction of liver fat in people with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) after taking semaglutide.
HIV can often affect the liver, leading to a buildup of fat in the organ. This in turn can cause scar tissue and inflammation, potentially resulting in cirrhosis. MASLD, previously known as nonalcoholic fatty liver disease, is characterized by an excess accumulation of fat in the liver not caused by alcohol consumption or hepatitis.
Semaglutide use resulted in 29 percent of participants in the study experiencing a complete resolution of MASLD.
Novo Nordisk is conducting another Phase 3 trial looking into whether semaglutide can help with metabolic dysfunction-associated steatohepatitis, the advanced form of MASLD.
