Are GLP-1 Drugs "the Greatest Medical Breakthrough of the 21st Century"?
Jan 31, 2025
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Ziyad Al-Aly, a physician-scientist from Washington University in St. Louis, co-authored a paper exploring the groundbreaking effects of GLP-1 drugs. The conversation highlights how these drugs extend beyond diabetes treatment, potentially aiding in reducing risks for substance abuse, neurocognitive disorders, and even conditions like Alzheimer's. Al-Aly discusses the implications of these findings on our understanding of free will and behavior. He also calls for more research to fully unlock the transformative potential of GLP-1 medications.
GLP-1 drugs not only aid in managing diabetes and weight but also show promise in treating substance use and cognitive disorders.
Recent studies suggest that GLP-1 usage is linked to reduced risks of neurocognitive issues and various health conditions, showcasing their broad therapeutic potential.
Despite their benefits, challenges like side effects and high costs contribute to discontinuation rates, highlighting the need for accessible healthcare solutions.
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GLP-1 Drugs: A Significant Medical Leap
Research into GLP-1 drugs like Ozempic has sparked interest, with scientists considering them among the most important medical breakthroughs of the 21st century. Their origins trace back to studies on the Gila monster's saliva, ultimately revealing their effectiveness in regulating appetite and managing diabetes. Furthermore, these drugs have demonstrated potential beyond weight loss, with studies suggesting benefits for various conditions like substance use disorders and cognitive diseases. This broad spectrum of effects showcases GLP-1s' promise in treating various ailments, akin to the revolutionary impact of penicillin.
Key Findings from GLP-1 Research
A comprehensive study revealed that GLP-1 usage correlates with a reduced risk of several substance use disorders, as well as neurocognitive conditions like Alzheimer's. The analysis highlighted a potential decrease in issues such as deep vein thrombosis and infections among users. Interestingly, while the reduction in neurocognitive issues was modest, it holds significance given the current lack of effective treatments for these disorders. This multifaceted impact positions GLP-1 drugs as essential therapeutic tools in multiple health contexts, warranting further exploration.
Understanding the Mechanisms and Risks of GLP-1
Despite the promising benefits of GLP-1 drugs, the need for caution emerges with associated risks like gastrointestinal issues, hypotension, and kidney stones. The high discontinuation rates of these medications further necessitate examination; many users face challenges due to side effects or costs. Research suggests that increased pricing leads more patients to abandon these drugs, pointing to a critical need for affordable access. Therefore, understanding these risks is key to fully harnessing the potential of GLP-1 therapies.
Future Directions in Medicine and Research Implications
The discussion underscores the need for ongoing research into GLP-1 and other drugs to unravel their broader therapeutic capabilities. As the landscape of treatment evolves, there are calls to explore old and new medications that may demonstrate similar pleiotropic effects. Insights gained from the GLP-1 experience emphasize the imperative to reconsider existing drugs’ potential, fostering innovative approaches in medicine. Ultimately, this research could lead to transformative advancements in treating a myriad of health conditions.
In the past few years, we've learned that GLP-1 drugs don’t just help with diabetes or increase people’s feelings of fullness to help them lose weight. They have broad effects on substance abuse and behavior. They even seem to help with otherwise incurable illnesses, like Alzheimer's and schizophrenia. This month, a team of scientists studying 2 million patients in the Veterans Affairs medical system found that GLP-1s were associated with “a reduced risk of substance use and psychotic disorders, seizures, neurocognitive disorders (including Alzheimer’s disease and dementia), coagulation disorders (clotting), cardiometabolic disorders (like strokes and heart attacks), infectious illnesses and several respiratory conditions.”
Today’s guest is a coauthor on the paper, Ziyad Al-Aly. He is a physician-scientist at Washington University in St. Louis. We talk about his new paper, the steps he took to make sure his findings were trustworthy, why GLP-1 drugs might work so well, what they’re teaching us about the brain and body, how they’re scrambling our sense of where volition begins and where free will ends, and what scientists should do next with the revelation that these drugs have effects that go far beyond obesity and diabetes.
If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com.
Host: Derek Thompson
Guest: Ziyad Al-Aly
Producer: Devon Baroldi
Links:
Al-Aly et al. on the effectiveness and risks of GLP-1 drugs [link]
