Beyond the Scale

Blockbuster Diabetes and Weight Loss Drugs: An Even Broader Future May Be on the Horizon
By Jessica M. Scully

The following article was featured in the Fall-Winter issue of El Camino Healthcare District Connect. Click here to read the full publication.

Medications like Ozempic and Wegovy are making headlines for weight loss, but their potential goes far beyond the scale. Discover how these diabetes drugs could soon help treat addiction, Alzheimer’s, and even cancer—while researchers race to unlock their full promise.

A group of medications now used for type 2 diabetes, obesity, and health issues linked to obesity could one day treat or prevent many other health conditions, from alcohol and opioid use disorders to Alzheimer’s disease.

Initially developed through research on Gila monster venom, the medications mimic a hormone made in the small intestine, glucagon-like peptide-1 (GLP-1), and are called GLP-1 receptor agonists (GLP-1 RAs). They trigger insulin release, prevent blood sugar increases, slow stomach emptying, and increase feelings of fullness.

The well-known medications include semaglutide (Wegovy/Ozempic), lixisenatide (Adlyxin), and liraglutide (Victoza/Saxenda). A newer medication, tirzepatide (Mounjaro), also mimics a second hormone.

“These medications have become a key treatment option for type 2 diabetes,” said Dr. Archana Bindra, an endocrinologist with El Camino Health Medical Network. The medications lower blood sugar and help protect kidney function, she noted. “After metformin, they are now considered first-line agents for managing type 2 diabetes,” she said.

“Type 2 diabetes patients who have cardiovascular disease with plaque buildup or chronic kidney disease, or those at high risk for these conditions, benefit the most from the slowing of disease progression that the drugs provide,” she said.

In recent years, the medications have become popular for obesity management because they can promote significant weight loss. For example, a June 2022 article in the New England Journal of Medicine found people lost up to 21% of their total body weight with tirzepatide.

GLP-1 drugs are FDA-approved to treat type 2 diabetes. The FDA has also approved some of the drugs to treat obesity, and one, Wegovy, to prevent heart attack and stroke in adults who are overweight or obese.

But physicians can prescribe these medications for other conditions in a practice called off-label use. Current off-label uses for GLP-1 drugs at El Camino Health include treating and preventing obesity-associated conditions.

Uses for the medications could eventually be much broader. A January 2025 study in the scientific journal Nature analyzed data from two million people served by the Veterans Affairs Administration. It found GLP-1 RAs were linked with a reduced risk of substance use and psychotic disorders, seizures, Alzheimer’s disease and dementia, and some infectious diseases. Results from initial research, including clinical trials, on whether, how, and why the medications might be effective for these and other conditions are promising. But much more research remains to be done.

Current Off-Label Uses: Preventing and Treating Obesity-Associated Conditions

Part of why the medications are so effective for weight loss is that they change how the brain reacts to food, said Dr. Patricia Sitnitsky, an internal medicine physician and obesity medicine specialist at El Camino Health Medical Network. Just as people who are addicted to narcotics have changed brain chemistry that makes them crave the drugs, the brains of people with obesity can signal them to eat more and to crave higher-calorie and less nutritious foods, Dr.Sitnitsky said.

“People describe it as ‘food noise’: a feeling of needing food and not noticing how much food they’re eating,” she said. GLP-1 medications quiet that noise and make other changes in the brain that make weight loss possible.

A primary reason that obesity is a health risk is that it increases fat surrounding internal organs, called visceral fat. Much research has found that visceral fat leads to inflammation and insulin resistance, Dr. Sitnitsky noted. She and other physicians at El Camino Health prescribe GLP-1 medications for women with polycystic ovary syndrome who have high levels of visceral fat to improve their fertility and reduce their symptoms. “That reduction in visceral fat and reduction in inflammation improves quality of life for folks,” Dr. Sitnitsky said.

Dr. Sitnitsky also uses the medications for preventing and treating nonalcoholic fatty liver disease. Asian Americans can be at particularly high risk for the disease because they can have high levels of visceral fat at what’s considered a “normal” BMI, she said.

Dr. Sitnitsky notes that research shows the medications may help reduce the risk for cancers associated with being overweight or obese. These 13 cancers, which include breast, colon and rectal, and uterine cancers, make up 40% of all cancers diagnosed in the US, according to the Centers for Disease Control and Prevention.

A study published in July 2024 in the journal JAMA Network Open of 1.6 million patients with type 2 diabetes found those treated with GLP-1 medications had less risk of developing 10 of the 13 cancers compared with those treated with insulin.

Because cancer development and progression are strongly associated with inflammation, Dr. Sitnitsky prescribes GLP-1 medications for some patients who’ve had colon cancer or breast cancer.

“Surviving cancer is about anti-inflammation,” she said, “and we should be thinking more about off-label uses of these medications for cancer survivorship.”

Research on Future Uses

Alcohol and Substance Use Disorders

Addiction researchers have wondered whether the drugs’ effect on satiety and food cravings could mean they’d also reduce cravings for addictive substances. Small studies seem to support this. One with about 50 people with alcohol use disorder found those given a low dose of semaglutide drank less than those given a placebo. The research was published in JAMA Psychiatry in February 2025. Another trial with 20 people with opioid use disorder found those who got liraglutide had a 40% reduction in cravings compared with those who received a placebo. The trial was presented at the 2025 annual American Association for the Advancement of Science meeting.

Neurological Conditions, Including Alzheimer’s Disease

GLP-1 drugs’ influence on brain function, their ability to reduce inflammation, and the links between type 2 diabetes and neurological diseases have led researchers to wonder whether the medications could be useful to prevent and treat neurological conditions. This includes Alzheimer’s disease, the most common cause of dementia.

People with Alzheimer’s have memory loss, trouble with daily, familiar tasks, and often changes in mood or behavior. For reasons not entirely understood, proteins in their brains don’t work correctly, and disrupt and injure brain cells. The cells eventually die, leading many parts of the brain to shrink. Studies have shown that people with type 2 diabetes are about 50% more likely to develop Alzheimer’s disease.

GLP-1 drugs could prove to be helpful medications for the condition. A December 2024 study in the journal Alzheimer’s and Dementia found a 40 to 70% reduction in the likelihood of an Alzheimer’s diagnosis in people with type 2 diabetes taking GLP-1 drugs compared with other diabetes medications. And a study with 204 people with mild Alzheimer’s disease found liraglutide seemed to reduce shrinkage in parts of the brain affected by the disease and to reduce cognitive decline by up to 18%. The research was presented at the International Alzheimer’s Association 2025 meeting.

Side Effects and Other Cautions

While this early research is promising, much work remains: results must be replicated in larger studies, and research will be needed to determine doses and other issues. Although the drugs have a strong safety profile, nausea, constipation, vomiting, and heartburn are common side effects and can be hard for some people to tolerate.

The drugs are also not safe for everyone, including people who have gastroparesis, a condition in which the stomach doesn’t empty properly, or other forms of stomach dysfunction, Dr. Sitnitsky noted. Dialysis patients and people who have had recurrent pancreatitis or worsening retinopathy, an eye complication of diabetes, shouldn’t take the medications, Dr. Bindra cautioned.

And not everyone has access to GLP-1 drugs, which can be very expensive.

“Socioeconomic status, including higher income and education, is strongly associated with increased use, while lower socioeconomic status and public or no insurance are linked to lower use,” Dr. Bindra said.

ABOUT THE AUTHOR

Jessica M. Scully is an Oakland-based medical and public health writer. She has written for Yale School of Medicine and Yale School of Public Health, JAMA and the JAMA Network, and the Johns Hopkins Bloomberg School of Public Health.

This article first appeared in the March 2026 edition of the HealthPerks newsletter.