Health Benefits of GLP-1s Beyond Weight Loss

Improving liver health

A study published in April in The New England Journal of Medicine found that Wegovy helped improve liver health, or kept it from worsening, in 63 percent of participants with a form of liver disease known as MASH.

Approximately 15 million Americans have MASH, which occurs when fat builds up in the liver, leading to inflammation and scarring. Over time, MASH can lead to liver fibrosis, cirrhosis and even liver failure. Obesity, type 2 diabetes and high cholesterol can contribute to the development of MASH.

“The results from this landmark study across 37 countries provide strong evidence that semaglutide [the active ingredient in Ozempic and Wegovy] can help patients with MASH by not only improving liver health, but also addressing the underlying metabolic issues that contribute to the disease,” said Dr. Arun J. Sanyal, Director of the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University’s School of Medicine, in a news release.

A few months after the study’s publication, the Food and Drug Administration approved Wegovy for the treatment of MASH in adults with moderate-to-advanced scarring, making it the second approved treatment option for the liver condition, which is increasing in prevalence.

Heart health benefits

In a large clinical trial, researchers found that semaglutide can reduce the risk of heart attacks and strokes by 20 percent in adults with heart disease and obesity. These results led the FDA in 2024 to approve Wegovy, initially green-lit for weight loss, for a second indication: to reduce the risk of serious heart problems in adults with cardiovascular disease who are overweight or have obesity. 

“This patient population has a higher risk of cardiovascular death, heart attack and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health,” Dr. John Sharretts, director of the division of Diabetes, Lipid Disorders and Obesity in the FDA’s Center for Drug Evaluation and Research, said in a news release.

What’s more, a study published in 2024 in the journal Hypertension found that tirzepatide, the active ingredient in Mounjaro (a diabetes drug) and Zepbound (approved for weight loss), significantly lowered the systolic blood pressure of nearly 500 adults who had obesity and took the medication for about eight months. The reduction in the top number in a blood pressure reading ranged from an average of 7.4 mm Hg to an average of 10.6 mm Hg, depending on the dose of medication.

“While it is not known if the impact on blood pressure was due to the medication or the participants’ weight loss, the lower blood pressure measures seen with tirzepatide rivaled what is seen for many hypertension medications,” lead study author Dr. James A. de Lemos, a professor of medicine at UT Southwestern Medical Center in Dallas, said in a news release.

Sleep apnea

In 2024, the FDA approved Zepbound for the treatment of moderate to severe obstructive sleep apnea in adults with obesity, making it the first medication approved for sleep apnea.

In clinical trials, participants who took the medication saw significant improvements in their breathing during sleep. They also lost more weight than participants assigned the placebo, and researchers say their weight loss was likely the reason for the other positive outcomes.

About 30 million people in the United States have sleep apnea, according to the American Medical Association, and the condition is more likely to occur in older adults.

Cutting kidney risks

The FDA recently approved the diabetes drug Ozempic to reduce the risk of worsening kidney and cardiovascular issues in people with type 2 diabetes and chronic kidney disease.

The approval came after researchers leading a clinical trial of more than 3,500 participants found that a weekly dose of semaglutide reduced the risk of serious kidney complications and contributed to cardiovascular benefits in participants. The study results were published in 2024 in The New England Journal of Medicine.

Protecting the brain

The recently published Nature Medicine study found an association between GLP-1s and a lower risk of Alzheimer’s disease and dementia. Al-Aly says researchers don’t fully understand why, but a reduction in inflammation and weight, known dementia risk factors, could have something to do with it. 

Al-Aly emphasizes that the risk reduction is modest, but in the absence of a proven effective treatment, “this is definitely welcome news and a big deal,” and one that researchers will continue to study.

Results from a phase 2 study presented at the 2024 Alzheimer’s Association International Conference suggest that liraglutide, an older GLP-1 medication that’s the active ingredient in Victoza and Saxenda, may help protect the brain and slow cognitive decline.

The study included 204 people with mild Alzheimer’s disease; half of the participants received liraglutide, and half received a placebo. Researchers found that those who received liraglutide had a slower loss of brain volume, including in areas that control memory, learning, language and decision-making. The liraglutide group also had a slower decline in cognitive function over one year, compared with those who got the placebo.

“The slower loss of brain volume suggests liraglutide protects the brain, much like statins protect the heart,” lead researcher Dr. Paul Edison, a professor of science at Imperial College London, said in a news release. “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.”

Breast cancer

New research suggests there may be a link between GLP-1s and lower breast cancer risk and recurrence.

In a study published June 2 in the journal JCO Oncology Practice, women on GLP-1s were about 30 percent less likely to develop breast cancer than those who did not take the drugs. The more than 110,000 women included in the study were between the ages of 45 and 80, and had a body mass index (BMI) of 25 or above.

Dr. Elizabeth McDonald, a study author, professor of radiology at the University of Pennsylvania Perelman School of Medicine and practicing breast radiologist at Penn’s Abramson Cancer Center, said the findings don’t mean that GLP-1s can prevent breast cancer, but the association between drug use and lower breast cancer risk warrants more research.

More approvals for additional health conditions?

While the benefits of GLP-1s continue to mount, it’s important not to ignore potential risks, doctors say. Like all medications, these drugs can cause side effects, some of which can be serious. (Read more on AARP: Side Effects of Weight Loss Drugs.)

For older adults, a key concern is muscle loss, “and whether the loss of muscle is out of proportion to the amount of weight that’s lost by people,” Neeland says. 

Older individuals are already at risk for age-related muscle loss, which can make them more prone to falls and fractures. “So it’s important that the older adults who take these medications have strategies to maintain and preserve muscle, whether through resistance exercise training or protein supplementation or optimizing their nutrition,” he adds.

Designing a GLP-1 that can preserve muscle mass is something scientists are actively studying, along with other ways to improve the medications, Neeland says. In the meantime, he and Al-Aly expect that researchers will uncover more health conditions that could be helped by the current suite of drugs.

“It's very, very clear where this ship is heading. It's very, very clear that they have, by serendipity, a significant, broad health effect,” Al-Aly says. “And that should translate into expanded indications.”

Editor’s note: This story, first published Jan. 31, 2025, has been updated.