Can GLP-1s Go Beyond Diabetes and Weight Loss?

By now, you’ve probably heard about glucagon-like peptide-1 agonist (GLP-1) drugs. While they started as a medication indicated for diabetes management, they quickly became sought after as a weight loss solution. Brand names like Ozempic® and Mounjaro® rapidly rose in popularity, leading to alarming shortages. Insurance companies even feared the financial strain of adding GLP-1s to their prescription plans, with some limiting coverage as a result. 

However, it appears that GLP-1 uses aren't going away anytime soon. In fact, they seem to be expanding as researchers discover their ability to treat other conditions. We’ll explore what GLP-1 medications might be used for in the future based on recent studies and discussion.

GLP-1 use for chronic kidney disease

In a 2024 study, researchers wanted to evaluate the treatment effects of once-weekly semaglutide, the main ingredient in GLP-1s, on kidney disease outcomes. They assessed it against the Kidney Disease: Improving Global Outcomes (KDIGO) risk categories and compared it with the placebo. For clarity, the composite endpoints they used to assess the progression of the disease included: 

• Macroalbuminuria (UACR >300 mg/d)

• Doubling of serum creatinine level and eGFR

• Kidney replacement therapy

• Death due to kidney disease

The study included 3,238 participants who were monitored for almost two years. Researchers discovered that patients on semaglutide had decreased risks of kidney disease endpoints and were more likely to move to a lower KDIGO risk category. 

Then, the authors of a December 2024 study shared that semaglutide is currently the best GLP-1 medication for overweight/obesity, CVD risk, and kidney disease. They hinted that it could become the first-line kidney protective drug in those struggling with overweight/obesity without type 2 diabetes or CKD in the future.

By late January 2025, the Food and Drug Administration (FDA) approved Ozempic for patients with type 2 diabetes with CKD to decrease the risk of worsening kidney disease and cardiovascular death.  

Could GLP-1 usage help cure Alzheimers disease? 

This neurodegenerative disease leads to brain cell dysfunction, as neurons stop functioning and, after some time, die. However, it’s believed that addressing the dysfunctions of all brain cell types in Alzheimer’s disease may actually cure dementia. 

In a June 2024 article, researchers suggested that GLP-1 agonist drugs could help, as GLP-1 receptors are included in all the main brain cell types. They further mentioned how GLP-1 agonist drugs can reverse reactive oxygen species (ROS), which are unstable molecules that damage cells. 

At the Alzheimer’s Association International Conference, researchers reported data from a Phase 2b clinical trial showing that the GLP-1 drug liraglutide decreased cognitive decline. The study, which took place in the United Kingdom, included 204 participants who either received a placebo or daily injections of liraglutide for one year. Brain function in the liraglutide cohort appeared to decline 18% slower, and an MRI showed that they had 50% less volume loss in many parts of the brain. 

Substance use disorder and GLP-1 use

GLP-1 drugs could also play a role in treating alcohol and other substance use disorders (ASUDs). Previous studies have noted its role in stress regulation, reward processing and cognitive function, all of which make it an appealing therapeutic approach. 

There’s also evidence showing that GLP-1 medications may decrease addiction-related behaviors, but these studies have primarily been done on mice, rats, and non-human primates. 

An observational study in Sweden used data from January 2006 to December 2023 to assess if GLP-1 agonists were effective in treating alcohol use disorder (AUD). There were over 220,000 participants between the ages of 16 and 64 who had a documented diagnosis of (AUD). 

Researchers discovered that the risk of hospitalization due to alcohol or substance abuse was lower in those taking semaglutide and liraglutide. However, interestingly, the use of AUD medications, like naltrexone, disulfiram and acamprosate, was not correlated with a noticeably altered risk of ASUD hospitalization. 

The role of GLP-1 in rheumatoid and psoriatic arthritis

Weight loss can improve disease activity in some forms of inflammatory arthritis, as obesity promotes inflammation. Therefore, in a 2024 scoping review, researchers sought to assess the effect of GLP-1 drugs on weight and disease activity in patients with psoriasis or inflammatory arthritis. They found that patients with rheumatoid arthritis reported better disease activity, and those with psoriasis had less severe symptoms. 

A case report was also done in 2021 involving a 73-year-old patient with plaque psoriasis who didn’t respond to topical therapy and adalimumab. The patient also had type 2 diabetes, which may have hindered the effect of those therapies above. 

He was placed on semaglutide, and as expected, experienced weight loss and improved glycemic parameters. However, the authors noted that his psoriasis area and severity index went from 32.2 to 8.0 after 4 months and then to 2.6 after 10 months. 

Can GLP-1 drugs treat non-alcoholic fatty liver disease? 

Growing evidence suggests that GLP-1 medications may also help with non-alcoholic fatty liver disease, or NAFLD, for short. Given that one of the best treatments for NAFLD is weight loss, and GLP-1 medications promote weight reduction, it makes sense to explore its potential more. 

A 2023 study assessed the current evidence available on the efficacy of GLP-1 drugs for NAFLD. While researchers state that the mechanism of action isn’t fully understood, they’ve noted that patients with NAFLD taking GLP-1 drugs may experience the following: 

• Improved liver damage

• Decreased hepatic cytolysis enzymes (elevated levels indicate liver dysfunction) 

• Reduced inflammation

• Lowered steatosis (i.e., excessive fat accumulation in liver cells) 

• Lessened the degree of liver fibrosis 

Irritable bowel disease and GLP-1 therapy 

Millions of people are affected by irritable bowel disease (IBD), including ulcerative colitis, Crohn’s disease, and other chronic intestinal ailments. 

It’s believed that they’re caused by immune dysregulation and chronic inflammation. Because GLP-1-based therapies have been shown to aid with inflammation, researchers are beginning to explore their efficacy with IBD. 

One population-based cohort study included over 3,700 patients with IBD and type 2 diabetes. Researchers discovered that those treated with GLP-1 medications and/or DPP-4 inhibitors had a lower risk of adverse clinical events, such as: 

• Requiring oral corticosteroid treatment

• Needing TNF-α-inhibitor treatment

• IBD-related hospitalization

• IBD-related major surgery

These findings support that GLP-1 drugs may enhance the disease course of IBD. 

The future of GLP-1 uses is promising

Extensive research on GLP-1 therapies continues to grow, with multiple receptor agonists currently in development. These groundbreaking treatments have already expanded treatment options and improved disease outcomes, proving they are here to stay. As innovation advances, it will be interesting to see how they evolve in the coming years.