Beyond Weight Loss: Looking at the Future of GLP-1 Medications

A class of drugs called GLP-1 receptor agonists, known by brand names like Ozempic or Wegovy, have exploded in popularity with people hoping to lose weight. While these drugs were already being used to treat diabetes, evidence is emerging showing they may help with other conditions too.

How do GLP-1 RAs work?

GLP-1s mimic a protein naturally produced by the small intestine. The receptors for these medicines are located across the body. They help with weight loss because receptors in the gastrointestinal tract slow down and send signals to the brain signaling a sense of feeling full.

Side effects may include GI discomfort, abdominal pain, constipation and diarrhea, although symptoms are typically mild and improve over time. GLP-1s are not recommended for anyone with a history of pancreatitis.

Currently they’re approved for use in treating patients with diabetes, obesity and those with a history of cardiovascular disease who are also overweight. Vikas Gupta, MD, PhD, clinical director of the Yale Fatty Liver Program, says we are still learning about how these medications impact the body, which is why they may be beneficial for conditions like fatty liver disease.

Left untreated, inflammation and fat in the liver can lead to scarring and cirrhosis. Dr. Gupta says in the past, there weren’t a lot of treatment options for fatty liver. Mostly, patients were told to lose weight and exercise. Now, these medications can not only aid weight loss, but they may have additional benefits as well.

“We know not only from clinical studies but in our own hands and clinical experience that when we get patients to take these medications to lose weight, we see decreased liver inflammation,” said Dr. Gupta. “What else may come from it? We're not 100% sure. I've certainly seen reports of it helping patients with their addictions to alcohol and in my own clinical practice, I've had several patients that have told me that after starting it, they have had no feelings of wanting to drink alcohol. It’s something that they didn't expect and something that I didn't expect either.”

GLP-1 for weight loss

While GLP-1s have certainly been helpful for many, they’re not for everyone. Dr. Gupta says data shows many patients will regain weight after they stop taking a GLP-1, which is why it should not be viewed as a “quick fix.”

“I think it's one piece of the puzzle and an excellent tool that we can use to help patients; however, I think of it as being used in conjunction with other strategies,” said Dr. Gupta.

He stresses that those strategies must include long-term lifestyle changes including exercising and a healthy diet. Some patients may also need additional tools in their weight loss journey, such as bariatric surgery.

“I tell folks that their weight needs to be managed like any other chronic medical problem: with a multidisciplinary effort to find an appropriate strategy coupled with a strong focus upon lifelong dietary modifications,” said Dr. Gupta.

Anyone interested in finding out whether they would be a good candidate for a GLP-1 should talk to their doctor. A primary care clinician can prescribe them or make the appropriate referrals to a specialist.