GLP-1 may protect against heart attacks and strokes, UK study finds
The popular diabetes and weight-loss drugs may also help prevent Alzheimer's, according to one study
Everybody knows by now that GLP-1 drugs — you know, Ozempic, Wegovy, Mounjaro and Zepbound — can help you lose weight but what about side effects? There’ve been some reports of such relatively minor effects as stomach upset and dry skin but is there anything good to report?
Well, there may be. New research has shown that GLP‑1 drugs deliver protection against heart attacks, strokes and premature death over a sustained period of time. Om the other hand, there may be a psychological cost for women losing weight with the drugs, as a Georgetown study found recently.
Emerging studies are also finding some apparent benefits for slowing Alzheimer’s disease through the use of GLP-1 drugs.
It’s an important question since more than 100 million people in America are clinically eligible to use GLP-1 medications and about 18% of U.S. adults are currently using or have previously used a GLP-1 drug.
Cardiovascular effects
Researchers from Anglia Ruskin University (ARU) in the UK analyzed data from more than 90,000 patients enrolled in large-scale international studies and found that people given GLP‑1 were significantly less likely to suffer heart attacks and other major cardiovascular events than those given a placebo.
The review of 11 major cardiovascular outcome trials, published in the journal Cardiovascular Diabetology – Endocrinology Reports showed treatment with GLP‑1 reduced the risk of major cardiovascular events, such as heart attack, stroke and cardiovascular death, by approximately 13% compared with placebo over an average follow‑up of almost three years.
The research is significant because it has focused on the long-term benefits of the drug — only studies with a minimum of one year follow-up were considered. The results are also independent of whether or not a patient is diabetic.
Patients taking the drugs were also less likely to die from any cause, and experienced lower rates of non‑fatal heart attacks, non‑fatal strokes and hospital admissions for heart failure.
The benefits were seen in people already at high cardiovascular risk, including those with type 2 diabetes, obesity or existing heart disease.
No serious safety concerns
The review found no meaningful increase in serious safety concerns, such as severe hypoglycemia or acute pancreatitis, compared with placebo. Gastrointestinal side effects, including nausea and vomiting, were more common, but are already well recognized.
“This is the most comprehensive review to date of long‑term cardiovascular outcome trials for GLP‑1 receptor agonists. We know that one of the factors that weighs on people’s minds when considering going onto these drugs is the potential long-term side effects, said lead author Dr Simon Cork.
“Our results show that, when taken over a prolonged period of at least one year, these medications do much more than help control blood sugar or weight. They significantly reduce the risk of heart attacks, strokes and premature death in people who are already vulnerable,” he said.
Women may be judged more harshly
But while the physical effects may be positive for many users, a new study finds that women who lost weight using GLP-1 medications were judged more harshly than those who lost weight through diet and exercise, with negative reactions driven largely by beliefs that medication-assisted weight loss is a “shortcut.”
The study also found higher levels of stigma when the women in sample scenarios were portrayed as white rather than Black.
The findings, published April 9 in the American Psychological Association’s journal Stigma & Health, highlight how social narratives about “acceptable” weight loss strategies can shape attitudes toward women with obesity, even when the weight loss is clinically significant.
“GLP-1 medications can offer meaningful health benefits for people with obesity, but many patients report feeling shame and guilt for using them,” said social psychologist Stacy Post, PhD.
“Our results show that the ‘easy way out’ perception does more than spark casual criticism. It can translate into measurable stigma, including fat phobia and a desire for social distance.”
For the study, Post and her colleagues recruited 402 U.S. women ages 30 to 49 who identified as Black or white and who also reported being overweight or having obesity. Participants were randomly assigned to read a brief vignette about a woman named Evette who lost 15% of her body weight either through diet and exercise or with a GLP-1 medication.
Evette was depicted as either Black or white using a photo paired with the vignette. The images of Evette were pre-tested to ensure there were no perceptual differences between the two women.
Participants then rated Evette on multiple stigma-related dimensions, including fat phobia, dislike, blame, and desire for social distance, and reported whether they believed she took a weight loss “shortcut.”
Stigma was higher when Evette lost weight with a GLP-1 medication rather than diet and exercise. The researchers found that “shortcut” beliefs were a key driver: perceiving GLP-1–assisted weight loss as an easy way out predicted higher fat phobia, greater dislike, more blame, and more desire for social distance.
More stigma for white women
Unexpectedly, stigma was also higher when Evette was portrayed as a white woman rather than a Black woman. When Evette was portrayed as white and as losing weight with a GLP-1, participants were more likely to endorse shortcut beliefs, which predicted greater stigma.
Interestingly, the race of study participants did not significantly influence stigma outcomes when Evette lost weight with a GLP-1, suggesting that assumptions about GLP-1s as a shortcut may operate similarly across groups.
Weight stigma is associated with harmful health outcomes, including stress, depression and anxiety symptoms, and negative health behaviors. Post and her colleagues say stigma related to GLP-1 medications may discourage people from seeking evidence-based care or may intensify shame for those already managing a chronic condition.
“Having obesity carries many health challenges including increased risk of cancer, diabetes and heart disease,” said Post. “Treatment decisions should be guided by health, not judgments about how someone manages their weight.”