The Lamen

Could Ozempic do more than just weight loss?

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Ozempic leads to “miraculous” weight-loss, but what if it could cure much more than obesity?

Image: Generated with Bing AI

Published on Jan 2, 2024

The idea that being overweight can instantly be fixed is infectious, and Hollywood’s approval of these anti-obesity medications has “taken Ozempic from medicine to status symbol.” The diabetes medication turned weight-loss drug quickly turned into a blockbuster — predicted to become a $100 billion market by 2030.

These drugs — known as GLP-1 receptor agonists — mimic a gut hormone called glucagon-like peptide-1 (GLP-1), inducing weight loss primarily through delaying gastric emptying and increasing satiety.

Their impact is startling — with patients losing an average of 15 percent of their body mass over a few months. While widely considered the scientific breakthrough of the year, many experts believe we’ve barely scratched the surface. This new class of drugs supposedly holds the potential to do much more beyond weight loss.

Heart disease

A recent study suggested that Wegovy slashed the risk of adverse cardiovascular events, such as heart attack or stroke, by 20 percent in overweight or obese adults.

One of the biggest questions scientists are looking to answer is whether cardiovascular benefits from the drug are just a result of weight loss. Evidence shows that these drugs reduce inflammation and improve fatty-acid metabolism — both of which could contribute to the results.

Substance abuse disorder and dementia

Semaglutide — the active ingredient in these drugs — doesn’t directly target your fat deposits, it “tricks” your brain into feeling full. This made researchers explore whether Ozempic could also affect the “reward centers” of the brain.

The area interested scientists after people on weight-loss drugs reported an aversion to alcohol. The current idea is that GPL-1 analogs reduce alcohol consumption by “reducing the rewarding effects of alcohol.”

As for addressing dementia, experts are still reluctant. Type 2 diabetes does share a strong association with dementia, and a Danish study found that semaglutide could lower this risk. Nono Nordisk is testing whether semaglutide helps people with early Alzheimer’s — a study expected to conclude in 2026.

Meanwhile, some psychiatrists have already started prescribing weight-loss drugs to their patients to counteract the weight gain caused by antipsychotic drugs — describing them as a “game changer.” However, clinical trials testing whether semaglutide can slow neurodegenerative diseases are still in their early stages.

PCOS

There’s also the hope that semaglutide could also help in treating polycystic ovary syndrome (PCOS), one of the leading causes of infertility among women.

Insulin resistance is believed to be a major cause of PCOS and scientists believe that targeting excess weight and insulin function can help alleviate PCOS symptoms. Some women are already posting about their experiences, and results from preliminary studies have also been positive.

“Because these medications approved for diabetes [and weight management] cause significant weight loss and improve insulin resistance, it makes sense biologically that they would be helpful for women with PCOS, and small studies have shown that to be true,” said endocrinologist Florencia Halperin.

More hypotheticals

The already intensified demand of GLP-1 drugs could just be the tip of the iceberg, as researchers explore more hypothetical pathways by which these drugs could safeguard health.

These drugs have a protective effect on the liver and kidneys, could even be effective against a severe form of liver disease, reduce inflammation, and boost immune cells that help fight cancer.

Ozempic has already become a top-selling prescription drug in the U.S., and racking up more approved uses would mean greater profits. What drugmakers now need to work out is the next generation of weight-loss drugs: cheaper, more accessible, and with fewer side effects.

Why it matters: While most private health insurers are reluctant to cover weight-loss drugs, a rebranding would almost instantly alter the course.

  • Drugs like Ozempic and Wegovy have not yet been approved for weight-loss, but their off-label use has prompted extraordinary demand and consequent shortages.
  • Doctors are still grappling with high costs and limited insurance coverage when prescribing these drugs.

Without insurance coverage, these drugs can cost upwards of $1,000 a month — with most patients having to take the once-a-week injection perpetually to keep off the excess body mass.