Do GLP-1 medications (such as Ozempic) help you age more healthily?

GLP-1 medications such as semaglutide (Ozempic, Wegovy) are well known for diabetes and excess weight, but they do more. The strongest evidence concerns the heart and blood vessels: in people with existing cardiovascular disease, they reduce the risk of a heart attack, stroke, or death from cardiovascular disease. The evidence for the kidneys is also solid: they slow the decline in chronic kidney disease and reduce protein loss through the urine. In metabolic-dysfunction-associated fatty liver disease, multiple human studies show clear improvements in the liver tissue itself.

For the brain, the signals are encouraging, but the evidence is still preliminary. Large patient groups with diabetes or cardiovascular disease show that users of these medications develop dementia considerably less often. In animal research, the drugs also reduce inflammation in the brain. However, randomised trials in humans have not yet demonstrated that they genuinely slow cognitive decline in early Alzheimer's disease or mild memory problems. An association in large groups is therefore not the same as a proven causal effect.

There is also a prevailing idea that these medications mimic the effects of caloric restriction, one of the most thoroughly studied strategies for healthy ageing, with positive effects on insulin sensitivity, inflammation, and metabolism. Whether that actually leads to more healthy life years in humans has not yet been demonstrated. They are, however, regarded as one of the eight most promising candidates for slowing ageing, alongside agents such as metformin and NAD+ supplements.

For older adults, there are also serious caveats. Weight loss caused by these medications can take muscle mass along with it. In older adults that is a real risk: less muscle means becoming weaker, falling more often, and losing independence. A small study with twenty people aged 65 and over is under way to investigate this, but results are not yet available. Furthermore, a large Taiwanese study shows that frail older adults with diabetes respond differently from fitter older adults, both in terms of effect and safety. These medications are therefore not equally suitable for everyone over 65.