TNew weight-loss drugs Wegovy and Zepbound are in high demand, and the clamor will only grow in the coming years, experts predict. That’s because drugs like these, which rely, at least in part, on the appetite-regulating hormone GLP-1, are being investigated not just for weight loss and diabetes, but also for a wide range of other conditions.
“Weight loss is just part of that,” says Dr. Ian Neeland, chair of the American Heart Association’s obesity scientific committee and associate professor of medicine at Case Western Reserve University.
Here’s the latest (and still growing) list.
Heart disease
In March, the U.S. Food and Drug Administration (FDA) allowed doctors to prescribe Wegovy (semaglutide) to reduce the risk of heart attack or stroke in people who are overweight and have a history of heart problems. In one study, people who took Wegovy had a 20% lower risk of heart attack, stroke, or death from a cardiac event compared to people who didn’t take it.
Some of these heart benefits may come from weight loss itself, since weight can have an adverse effect on the heart. But in the study that Wegovy’s maker, Novo Nordisk, submitted to the FDA, some of the benefits appeared before people started losing weight — suggesting that the drugs are working in other ways to improve the cardiovascular system.
It’s possible that the new weight-loss drugs, which belong to a broader group of hormones called incretins, act directly on fat cells that promote inflammation and contribute to atherosclerosis, or narrowing of blood vessels. “Inflammation markers drop dramatically in patients taking tirzepatide [Zepbound] in testing,” says Dan Skovronsky, chief scientific officer at Eli Lilly, which makes Zepbound. (Zepbound combines two incretins: GLP-1 and GIP.) “This suggests there may be secondary effects to obesity, since visceral fat is inflammatory. It’s exciting to explore that.”
see more information: Is Ozempic the new anti-inflammatory miracle drug?
Lilly is also studying the potential cardiac benefits of Zepbound, focusing on people with heart failure, since “body mass puts a strain on the heart and weight reduction should have a profound effect on overall health,” says Skovronsky.
To better understand some of the broader effects the drugs are having on the body, Lilly is also running a large trial that monitors how Zepbound affects 15,000 people with obesity and their overall rates of a variety of illnesses and death. “We are studying death from any cause to see whether incretins may have life-saving or life-preserving benefits, which we hope is true,” says Skovronsky.
Fertility
Social media is full of stories of “Ozempic babies” who were born to people struggling with infertility and who managed to get pregnant after starting GLP-1 medications for diabetes or weight loss.
Reproductive health experts warn that the link may not be as direct as people think. “What wouldn’t surprise anyone is that bringing weight into the normal range will promote fertility,” says Dr. Zev Williams, director of the Columbia University Fertility Center. “Whether this is through diet, exercise or medication, the net result is that there is a common path from reducing obesity to improving fertility.”
see more information: How researchers are working to make IVF more effective
Extra weight can lead to abnormal menstrual cycles, which can also make pregnancy difficult, says Dr. William Dietz, director of the Stop Obesity Alliance at George Washington University. Losing weight can help restore cycles and increase the chances of pregnancy.
In addition, however, incretins could address some of the biological processes involved in fertility. About 10% of women of childbearing age in the U.S. have polycystic ovary syndrome (PCOS), which is the most common cause of infertility. PCOS is a hormonal disorder and can be caused by insulin resistance or increased insulin levels in the body. And because insulin is closely linked to weight, weight control — and the resulting normalization of insulin responses — can also resolve PCOS and, ultimately, a woman’s chance of getting pregnant.
Kidney disease
People with diabetes often develop kidney complications. Those who took the drug Ozempic (semaglutide – the same drug as Wegovy – but approved in different doses for diabetes) reduced their risk of dying from kidney or heart events by 24%according to data from Novo Nordisk, manufacturer of Ozempic.
see more information: 7 myths about kidney cancer, debunked
Lars Freurgaard Jorgensen, the company’s CEO, says he predicts that in the coming years, the market for drugs like Ozempic will become more specialized and diverse, due to the wide range of body systems affected by weight gain. “Today we look at obesity as one market, but from now on it will be made up of different segments – some people will have obesity and fatty liver, some will have obesity and cardiovascular disease, and others will have obesity and kidney disease,” he says. “Different products may provide slightly better results, so we may see more personalized obesity care over time.”
Liver
Over time, obesity can lead to the accumulation of fat cells in the liver, contributing to a condition called steatohepatitis associated with metabolic dysfunction (MASH). Excess fat causes inflammation that can damage the organ and potentially lead to liver failure. In early studies, Lilly scientists reported that tirzepatide may slow the progression of MASH, possibly preserving liver function. In the study involving 190 people with the disease, 74% who received the highest dose of the drug (three times the weight loss dose) were able to cure themselves of the disease after a year, compared with 13% of those who received a placebo.
Obstructive sleep apnea
About 40% of people with a BMI of 50 or more also have obstructive sleep apnea, which causes them to temporarily stop breathing. Weight loss can directly reduce the risk of sleep apnea, and results from a late-stage study by Lilly showed that tirzepatide led to 30 fewer such events, or a 63% reduction, every hour for people with obesity and sleep disorders. The drug could be a “practice changer” for these patients, says Skovronsky, since there are no effective medications currently available and most people rely on CPAP machines and other cumbersome, inconvenient devices.
see more information: Why waking up earlier isn’t necessarily better
Osteoarthritis
Excess weight has a detrimental effect on joints and can change the proportion of fat to muscle in the body, so weight loss can also affect the muscles and skeletal system. Researchers are study Whether incretins, which can reduce inflammation, represent a new group of potential treatments for diseases such as osteoarthritis, in which joints deteriorate as inflammation increases.
Addiction
Weight gain can also lead to changes in the brain, including increased inflammation that can affect the nerves. But research also suggests that incretins may have direct effects on brain pathways, in particular those involved in the reward system implicated in addictive behaviors. Animal studies show that incretins, and GLP-1 in particular, can dampen brain signals associated with reward and addiction, and lead to less intake of alcohol and addictive drugs. Scientists are now study whether the same effects occur in people.
The variety of conditions affected by incretins suggests the potential power they may have in treating a range of chronic diseases – and this has not gone unnoticed by scientists developing the next generation of these medicines, which combine multiple incretins. The goal also includes moving from injections to tablets to make them more convenient and accessible to more people.
The many conditions implicated by medications are “a good reminder of how important metabolism is to overall health and impacts our disease risk,” says Skovronsky. “It’s something we knew, but we never managed to improve with pharmacology. Now we can, so seeing all the benefits that can occur is very exciting.”
This story originally appeared on Time.com read the full story
