BATON ROUGE, La. – Doctors have been utilizing GLP-1 medications for weight management for roughly five years now, and researchers are finding some unexpected benefits associated with them.
Dr. Steven Heymsfield, a noted professor at the Pennington Biomedical Research Center and director of the Metabolism Body Composition Laboratory, has dedicated the last 15 years to studying these drugs.
“There are some outcomes we anticipated and others that have completely caught us off guard,” Heymsfield mentioned. “For example, it’s well-known that obese individuals are more likely to develop diabetes.”
“However, an unforeseen effect seems to be a reduced desire for alcohol among these patients,” he added. “New studies are starting to substantiate that finding.”
Benefits beyond weight loss
Heymsfield pointed out that individuals with arthritis have surprisingly reported significant improvements—less pain, reduced inflammation, and enhanced walking ability. Research indicates that fewer knee replacements are needed as a result of these improvements.
He also highlighted cardiovascular advantages, stating, “We’ve established that GLP-1 drugs lower the risk of heart attacks, cardiovascular diseases, and mortality rates. It’s believed that it’s not solely due to weight loss; improved inflammation processes might contribute as well.”
It appears that the positive outcomes aren’t just linked to weight loss. “The evidence suggests that these drugs possess their own mechanisms that help reduce inflammation,” he elaborated, noting that this aspect is currently being investigated further.
Heymsfield believes that GLP-1 medications might already be prescribed for off-label uses, like treating inflammation in individuals who aren’t overweight. He cautioned, though, that this off-label use poses risks since the effects of these drugs are not well understood outside their approved use.
Regarding the decline in alcohol and substance consumption, Heymsfield acknowledged there’s still uncertainty about the exact mechanisms at play, but he suspects that GLP-1s may influence specific brain areas associated with those behaviors.
Adverse effects reported
According to Heymsfield, some patients taking GLP-1 drugs struggle with adequate nutrition, leading to unusual vitamin deficiencies, including cases of scurvy from vitamin C deficiency. This is largely due to changes in appetite brought on by the drugs.
He explained that some individuals may even lose the joy of eating entirely, a situation he referred to as hedonia, or a lack of interest in food. “Eating is generally an enjoyable experience for people. It’s not just about sustaining life; it’s pleasurable,” he stressed. “If they lose that enjoyment, some choose to stop taking the medication because that aspect of their life is diminished.”
Heymsfield also noted that these drugs could diminish what he called “food noise,” which can be beneficial but, in some cases, can feel overly intense.
Concerns about muscle and bone loss also surfaced, which occurs in everyone who sheds pounds using these medications. He mentioned that Pennington researchers are exploring ways to tackle this issue by promoting increased protein intake, resistance training, and other drugs aimed at preventing muscle depletion, like androgen-related medications.
For frail patients—like a 75-year-old with excess weight who begins GLP-1 treatment—muscle loss could exacerbate mobility issues and heighten fracture risks.
New drug in trials
Researchers at Pennington are testing retatrutide, a triple agonist that combines GLP-1, GIP, and glucagon. Heymsfield noted that it has demonstrated the most significant weight loss in its category, reaching around 25% to 30%, comparable to outcomes after bariatric surgery.
“That’s significant,” he emphasized.
However, this drug is associated with a higher incidence of side effects. Currently in phase three trials—the final stage before approval—retatrutide could be on the market within the next few years. The approval process for GLP-1 medications has been speeding up, evidenced by two oral formulations that recently became available quickly.
Safety and long-term use
Heymsfield reassured that GLP-1 medications are generally safe when used as directed, with well-documented gastrointestinal effects and a low overall risk, particularly at lower dosages.
He clarified that the effects of the medication cease once a patient stops taking it unless they have adopted permanent changes to their diet and exercise habits during the treatment period. He warned that weight cycling—losing weight, discontinuing the drug, and regaining it—is a frequent occurrence and is not a healthy lifestyle, especially since the regained weight is typically not lean muscle.
Looking ahead, Heymsfield mentioned that more targeted GLP-1 medications are in the pipeline, including potential monthly injections and options aimed at preserving muscle and bone.
