Neurologists Issue Caution on GLP-1 Drugs and Neurodegenerative Diseases

Neurologists are raising alarms about the possible adverse effects that popular weight loss medications may have on neurodegenerative diseases like ALS.

Dr. Jincy Andrews, a neurologist and director at the NYU Langone ALS Center, points out that while these drugs promote quick weight loss—something that attracts many people—their effects might not be suitable for those with neuromuscular disorders.

GLP-1 agonists are known for their effectiveness in managing diabetes and obesity, which are significant health issues in society. However, Andrews highlights that the guidelines shift when it comes to treating ALS specifically.

These medications have been shown to alleviate some inflammation tied to obesity and diabetes, and they carry additional benefits such as reducing risks for heart disease, stroke, liver ailments, and even certain addictions, according to Andrews.

But for patients facing incurable neurodegenerative diseases, the weight loss and reduction in body fat that these medications induce can actually worsen their condition. In the context of ALS, for instance, losing weight could accelerate symptom progression, as losing calories can pose a serious threat to these patients’ health.

Interestingly, the standard recommendations for ALS treatment often suggest that patients should focus on maintaining or even increasing their weight to preserve muscle and nerve function. “In some situations, losing weight could exacerbate the disease and lead to quicker deterioration,” Andrews explained.

In a notable case, a 52-year-old ALS patient who received semaglutide for type 2 diabetes experienced a concerning drop in physical function after losing 25 pounds within three months. This shift in health was significant enough to be noted in a medical journal.

After discontinuing the semaglutide on medical advice, her health stabilized. Andrews emphasizes that this instance, paired with other data regarding ALS patients with diabetes, suggests that healthcare providers need to approach prescribing GLP-1 receptor agonists with great caution.

While weight loss medications can greatly benefit many, maintaining weight and muscle mass is a vital consideration for those dealing with neurodegenerative diseases.