Glp-1
Episodes
Dr. Rhonda Patrick discusses nicotinamide riboside, biomarkers, belly fat loss, sex-specific health, curcumin & ashwagandha safety.
In this Aliquot, I discuss how these drugs work, their pros and cons, the latest research, and lifestyle strategies to...
Dr. Rhonda Patrick discusses GLP-1 agonists, alpha-lipoic acid, ubiquinone vs. ubiquinol, calcium needs, and liquid biopsy cancer screening.
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Rhonda Omega-3 Biomarkers Inflammation Curcumin Bone Protein Exercise Epigenetics Aging Glp-1 UbiquinolDr. Rhonda Patrick discusses nicotinamide riboside, biomarkers, belly fat loss, sex-specific health, curcumin & ashwagandha safety.
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In this Aliquot, I discuss how these drugs work, their pros and cons, the latest research, and lifestyle strategies to...
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Rhonda Cancer Epigenetics Diabetes Mitochondria Calcium Dental Weight Loss Microplastics Glp-1 UbiquinolDr. Rhonda Patrick discusses GLP-1 agonists, alpha-lipoic acid, ubiquinone vs. ubiquinol, calcium needs, and liquid biopsy cancer screening.
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In this clip, Dr. Rhonda Patrick explores Ozempic, covering appetite reduction, weight maintenance, muscle loss, efficacy, and side effects.
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Dr. Rhonda Patrick explores creatine, dairy's effect on polyphenols, eggs' health impact, and new weight loss drugs like Ozempic in her latest Q&A.
Topic Pages
News & Publications
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Doctors have long wondered whether the heart benefits of the GLP-1 receptor agonist semaglutide (Ozempic®/Wegovy®) come only from helping people lose weight, or if the drug directly protects the cardiovascular system. An analysis of the SELECT trial explored this question in adults with cardiovascular disease and overweight or obesity, but without diabetes.
The study followed 17,604 participants aged 45 years or older across 41 countries for an average of more than three years. Each person was randomly assigned to once-weekly semaglutide (target dose 2.4 mg) or to placebo. Researchers recorded heart attacks, strokes, and cardiovascular deaths (collectively known as major adverse cardiovascular events, or MACE) and repeatedly measured body weight and waist circumference.
Here is what they found:
- Semaglutide lowered the risk of MACE by about 20% versus placebo.
- Early weight loss at 20 weeks did not predict lower subsequent MACE among those taking semaglutide; people who lost at least 5% of their body weight had similar event rates to those who lost less.
- In contrast, reductions in waist circumference at 20 weeks were associated with fewer subsequent events in the semaglutide group, possibly highlighting the importance of visceral fat loss (fat surrounding abdominal organs) rather than overall weight loss, which can also include lean mass such as muscle.
- Statistical modeling estimated that about one‑third of the treatment effect on MACE was mediated or marked by waist‑circumference reduction, while the remaining two-thirds came from other factors.
The researchers suggest that semaglutide's heart protection likely extends beyond weight or fat loss. By activating the glucagon-like peptide-1 receptor, the drug may directly influence blood vessel function, atherosclerotic processes, inflammation, blood pressure, and lipid metabolism. The authors note that adipose tissue can begin to change biologically before its overall mass declines, which might also help explain the early cardiovascular benefits seen in the trial.
The results show that patients with cardiovascular disease may benefit from semaglutide regardless of how much weight they lose, challenging prescribing rules that rely on body mass index thresholds or weight-loss targets. Future studies are needed to identify which biological processes drive these improvements and to determine whether similar benefits apply to broader populations. In Aliquot #128, I discuss how the new weight loss drugs like Ozempic® and Mounjaro® work, their pros and cons, and lifestyle strategies to optimize their effects for long-term health.
- Semaglutide lowered the risk of MACE by about 20% versus placebo.
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Semaglutide use reduces biological age by 3.1 years on average, with a 9% slower pace of aging as measured by DNA methylation. www.medrxiv.org
The biology of aging is increasingly seen as treatable, and drugs like semaglutide—once solely used for diabetes and weight loss—may be part of the solution. A recent study found that people with HIV who took semaglutide for 32 weeks experienced up to a 4.9-year reduction in biological age, as measured by changes in DNA methylation.
The study involved 84 adults with HIV-associated lipohypertrophy—a condition marked by excess abdominal fat and faster biological aging. Participants received weekly semaglutide injections or a placebo for 32 weeks. Researchers collected blood samples at the beginning and end of the study and analyzed DNA methylation, a type of molecular tag that shifts predictably with age.
Compared to those on placebo, participants taking semaglutide showed consistent reductions across several established epigenetic clocks, which estimate biological age from DNA patterns. One clock showed an average drop of 3.1 years, while another suggested a 9% slower pace of aging. Aging signals linked to inflammation, brain health, and heart function also declined in the semaglutide group, though measures of overall physical capacity remained unchanged.
These findings suggest that semaglutide influences more than metabolism—it may also target the molecular hallmarks of aging. Learn more about drugs like semaglutide in Aliquot #128: The Expanding Role of Weight Loss Drugs
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Type 2 diabetes and obesity increase a person's risk of developing dementia and other forms of neurodegeneration, particularly when the two conditions occur together. However, newer antidiabetes drugs may mitigate this risk. A recent study found that people taking the antidiabetes drugs semaglutide or tirzepatide were 37% less likely to develop dementia than those taking other diabetes medications.
Researchers analyzed electronic health records from more than 60,000 adults in the United States who had both type 2 diabetes and obesity. All participants began treatment with semaglutide, tirzepatide, or another type of antidiabetic medication between late 2017 and mid-2024. The researchers matched participants in the different treatment groups by age, sex, and health status and tracked their health for up to seven years.
People who took semaglutide or tirzepatide had a 37% lower risk of dementia, a 19% lower risk of stroke, and a 30% lower likelihood of dying during the study period than those on other antidiabetic drugs. These benefits were even greater among people over age 60, women, and those with a body mass index between 30 and 40. However, the risk of Parkinson's disease and brain bleeds did not differ between the groups.
These findings suggest that antidiabetes drugs like semaglutide and tirzepatide offer protection against cognitive decline and stroke, possibly extending life expectancy in people with type 2 diabetes and obesity. Semaglutide and tirzepatide are GLP-1RA drugs. Learn more about this class of medication in Aliquot #128: The Expanding Role of Weight Loss Drugs
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Age-related macular degeneration, the leading cause of irreversible blindness in older adults, affects nearly 200 million people worldwide. This progressive disease erodes central vision, which is critical for reading, driving, and other daily activities. A recent study found that glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic, Wegovy, or others, may double the risk of developing neovascular age-related macular degeneration, the most serious form of the disease.
Researchers analyzed health records from more than 1.1 million people in Ontario, Canada, who had diabetes and were 66 or older. They created a matched study group of about 139,000 people, comparing those who used GLP-1 receptor agonists for at least six months to similar patients who didn’t use the drugs. The researchers tracked new cases of neovascular age-related macular degeneration over three years.
They found that people who used GLP-1 receptor agonists were more than twice as likely to develop neovascular age-related macular degeneration than those who didn’t use the drugs. About 0.2% (93) of the users developed the condition, compared to 0.1% (88) of non-users. Even after accounting for other risk factors, the difference remained consistent.
These findings suggest that while GLP-1 receptor agonists provide considerable health benefits, they may also pose an overlooked risk for serious vision problems. It’s noteworthy that diabetes is an independent risk factor for macular degeneration, and this study identified associations, not a cause-and-effect relationship. Learn more about GLP-1 drugs in Aliquot #128: The Expanding Role of Weight Loss Drugs
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GLP-1 receptor agonists may lower risks for major illnesses like dementia and seizures. www.nature.com
Ozempic, Wegovy, and other glucagon-like peptide-1 (GLP-1) drugs have catapulted into the mainstream of diabetes care, with more than 15 million people in the U.S. currently taking one. Evidence suggests GLP-1 drugs have many off-target effects—both good and bad—but healthcare providers don’t currently know the full extent of the drugs' effects. However, a recent analysis found that GLP-1s may reduce the risk of dementia, seizures, respiratory illnesses, cardiometabolic disorders, and certain infections more effectively than other diabetes drugs and typical care.
Using the U.S. Department of Veterans Affairs healthcare databases, researchers identified roughly two million people with diabetes who were using a GLP-1 drug, one of three common anti-diabetes drugs (sulfonylureas, DPP4 inhibitors, or SGLT2 inhibitors), or continuing their usual care without adding new therapies. They tracked the participants' health for about 3.6 years.
They found that GLP-1 use was associated with a reduced risk of dementia (8%), seizures (10%), respiratory illnesses (10% to 25%), cardiometabolic disorders (7% to 22%), and certain infections (12% to 25%). However, the drugs were associated with an increased risk of gastrointestinal issues (5% to 20%), low blood pressure (10%), kidney problems (10% to 15%), arthritic disorders (10% to 16%), and pancreatitis (15% to 20%).
These findings suggest that GLP-1 receptor agonists offer promising benefits for people with diabetes while highlighting potential risks. Further research will illuminate the full range of the drugs' effects. Learn more about GLP-1 drugs in this clip featuring Dr. Rhonda Patrick.
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Appetite control varies widely with different weight-loss interventions. onlinelibrary.wiley.com
The body’s appetite feedback circuit is a sophisticated system that regulates hunger and satiety to maintain energy balance. Suppressing this circuit is essential to successful weight loss before reaching a plateau. A recent study found that weight-loss interventions vary in their capacity to overcome the body’s appetite feedback circuits by as much as threefold.
A researcher used a validated mathematical model to simulate the body’s weight-loss response to calorie restriction, glucagon-like peptide receptor agonists (GLP-1 RAs, a class of drugs primarily used to treat type 2 diabetes and obesity), and bariatric (gastric bypass) surgery. The model predicted how these interventions influenced body weight by simulating changes in caloric intake, energy use, and appetite over time.
He found that weight loss plateaued at around 12 months with calorie restriction and at around 24 months with GLP-1 RAs or gastric bypass surgery. The drugs and surgery were between 40 and 70 percent more effective at suppressing appetite than calorie restriction, aligning with data indicating that most people find calorie restriction challenging to adhere to, especially for an extended period.
These findings suggest that weight-loss interventions vary in their capacity to overcome the body’s appetite feedback circuits, influencing their effectiveness. Unfortunately, many people regain weight after successful weight loss, possibly due to changes in their gut microbiome. Learn more in this episode featuring Dr. Eran Elinav.
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Impairment of associative learning caused by obesity and insulin insensitivity offset by anti-obesity drug liraglutide in recent study www.sciencedaily.com
Associative learning is a psychological process that occurs when two initially unrelated elements, such as objects, sights, sounds, ideas, or behaviors, become linked in the brain. Classic examples include associating pain with touching a hot stove or connecting foodborne illness with eating a particular food. People with obesity and poor insulin sensitivity have impaired associative learning. However, a recent study shows that liraglutide, a drug used to treat type 2 diabetes and obesity, restores associative learning capability in people with obesity.
The study involved 54 adults, half with normal body weight (high insulin sensitivity) and half with obesity (reduced insulin sensitivity). Researchers gave participants either liraglutide or a placebo in the evening and tested their learning abilities the next morning.
They found that people with obesity and reduced insulin sensitivity encountered difficulties when attempting to establish connections between sensory signals, and their brain activity related to learning was weaker than in normal-weight individuals. However, just one dose of liraglutide reversed these issues in people with obesity and reduced insulin sensitivity, exhibiting brain activity comparable to that of normal-weight participants, indicating that the drug improved their learning abilities.
Liraglutide is a glucagon-like peptide 1 receptor agonist (GLP-1RA), a type of drug used to treat type 2 diabetes, overweight, and obesity. GLP-1RA medications work in the pancreas to lower blood glucose levels by promoting the production and release of insulin. They also support beta cells synthesis, growth, and survival while reducing their apoptosis rate.
These findings suggest that liraglutide, an anti-obesity drug, affects brain activity in people with obesity and reduced insulin sensitivity. This study was small, however, so validating the results requires more research.