Weight-loss drugs beyond weight-loss: The potential of GLP-1 to mitigate cardiovascular disease and other conditions

Weight-loss drugs such as Wegovy are on the rise, driving up the value of the companies, such as Novo Nordisk, that sell them.

While they are predominantly aimed at treating diabetes and obesity, a new perspective, published in the journal Science, suggests that they have a range of other potential benefits. 

How could this impact the food industry? “GLP-1 medicines provide the opportunity to improve glucose control and achieve meaningful weight loss while reducing rates of heart disease, raising new questions as to whether people using these medicines will also shift their dietary preferences and modify their lifestyle in a sustained and positive manner. It is an intriguing question, but the answers are not yet in,” Daniel Drucker, author of the perspective, told FoodNavigator. 

How do GLP-1 drugs help treat obesity and type-2 diabetes?​Glucagon-like peptide-1 (GLP-1) is a hormone that is secreted from cells in the gut after eating, encouraging insulin secretion when blood glucose levels are high.

As a drug, it is mainly used to treat type-2 diabetes. It does this by slowing gastric emptying (the rate at which food moves from the stomach to the small intestine), and slowing the secretion of glucagon, a hormone which raises blood sugar levels.

It is also used to treat obesity. The drug supresses appetite, meaning that those taking it are less likely to overeat and thus, less likely to live with obesity. It does this by activating GLP-1 receptors (GLP-1R) in the brain​. 

However, they have several benefits beyond obesity and type-2 diabetes.

What is the potential of GLP-1 drugs for cardiovascular health?​The leading cause of death worldwide is heart disease. Poor cardiovascular health is often linked to diet. 

GLP-1 drugs can help preserve heart health, according to the perspective, as well as protecting the heart after injury. This is not necessarily linked to weight loss but reducing inflammation. 

The first approved GLP-1 medicines were tested on those with type-2 diabetes and obesity. These studies found that they reduced non-fatal stroke, non-fatal heart attack and cardiovascular death in the people tested. One long-acting GLP-1 therapy known as albiglutide was found to reduce the rate of major adverse cardiovascular events by 22%.

The drugs were found to improve cardiovascular health. Image Source: Getty Images/J StudiosThe link between GLP-1’s reduction of atherosclerosis (when plaque builds in the arteries) and improved blood flow is not, according to the perspective, currently well understood. However, it suggests, they could be linked to reduced inflammation, and independent of GLP-1’s ability to increase weight loss.

How has the food industry responded to weight-loss drugs?GLP-1 weight-loss drugs are booming. The food industry has responded in kind​. For example, Nestlé recently launched a high-fibre, high protein ‘companion’ range called Vital Pursuit aimed at GLP-1 users. The range is ‘portion-aligned’ to reflect smaller desired portion sizes of those using weight-loss drugs.

How can other food manufacturers respond? According to Suketu Patel, global chief medical officer at Havas, which launched its own consultancy around GLP-1, manufacturers should focus on offering smaller pack sizes and lower calorie alternatives, also taking into account research which suggests GLP-1 users are less inclined to consume sugary or high-fat foods. He also suggested products that encourage more mindful eating.

What is the potential of GLP-1 drugs for mitigating liver disease?​Some studies have also suggested that GLP-1 drugs can be used in the treatment of metabolic liver disease. The research has found rare populations of GLP-1R–expressing liver cells which could contribute to GLP-1 having therapeutic benefits on metabolic liver disease.

What is the potential of GLP-1 drugs for mental health?​’More potent’ GLP-1 drugs such as semaglutide and tirzepatide have been examined for their potential to mitigate central nervous system disorders, such as depression, excessive use of narcotics or alcohol, compulsive behaviours, and suicidal ideation.

One study showed that those receiving semaglutide showed lower suicidal ideation than those who were using other glucose-lowering or weight-loss agents. Another data set revealed a lower cannabinoid use in those using GLP-1 drugs than those using non-GLP-1 weight loss tools. However, similar research looking into whether they reduce alcohol consumption is currently inconclusive.

The perspective concludes by speculating that the next decade may bring GLP-1 medicines with the potential to target more health conditions than simply type-2 diabetes and obesity.

Are high-fat foods linked to obesity?The World Health Organisation (WHO) cites high-fat foods as the number one cause of obesity. A new study suggests that they can also increase anxiety.​

They do this by disrupting certain gut bacteria, which, through the gut-brain axis, affects the brain and stimulates anxiety. This was discovered by feeding rats a diet of saturated fats (meaning the findings were linked to saturated fats, not all fats).

Sourced From: Science
‘The benefits of GLP-1 drugs beyond obesity’
Published on: 18 July 2024
Doi: DOI: 10.1126/science.adn4128
Authors: D. Drucker