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. GLP-1s rapidly rose in popularity.

However, 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 evaluated the treatment effects of once-weekly semaglutide, a key 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 a 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 for 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 and CKD to decrease the risk of worsening kidney disease and cardiovascular death.

Could GLP-1 usage help Alzheimer's disease?

This neurodegenerative disease leads to brain cell dysfunction, as neurons stop functioning and, over time, die. However, it’s believed that addressing dysfunctions across all brain cell types in Alzheimer’s disease may actually help slow or even halt cognitive decline.

In a June 2024 article, researchers suggested that GLP-1 agonist drugs could play a role, as GLP-1 receptors are present in all major 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, conducted 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 MRI scans showed 50% less volume loss in multiple regions 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 their impact on stress regulation, reward processing, and cognitive function, making them an appealing therapeutic approach.

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

An observational study in Sweden used data from January 2006 to December 2023 to assess whether GLP-1 agonists were effective in treating alcohol use disorder (AUD). The study included 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. Interestingly, however, the use of AUD medications like naltrexone, disulfiram, and acamprosate was not associated with a significantly 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. 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 from 2021 involved 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 effectiveness of those therapies.

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 four months and then to 2.6 after ten 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 (NAFLD). Since one of the most effective treatments for NAFLD is weight loss, and GLP-1 medications promote weight reduction, researchers are exploring their potential further.

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

• Improved liver function

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

• Reduced inflammation

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

• Lessened liver fibrosis progression

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.

IBD is believed to result from immune dysregulation and chronic inflammation. Since GLP-1-based therapies have been shown to help reduce inflammation, researchers are beginning to explore their efficacy for IBD treatment.

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 suggest that GLP-1 drugs may help improve 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 fascinating to see how they evolve in the coming years.