That’s the question many scientists are asking about the controversial glucagon-like peptide-1 (GLP-1) receptor agonist drug, as some research suggests it may help people age with fewer chronic diseases. The same goes for glucose-dependent insulinotropic peptide (GIP) receptor agonists such as Zepbound and Mounjaro, leading some experts to start looking at them as potential longevity pills and wondering how they could be safely prescribed to more people in the future, especially given Obesity rates continue to rise.
“The most effective and consistent way to prolong the life of animals is through caloric restriction,” says Dr. Douglas Vaughn, professor of medicine at Northwestern University and director of the Potocnak Longevity Institute. “It has been demonstrated to work on everything from worms to flies, mice and monkeys. If you can find a way to get people to chronically reduce their calorie intake, it makes sense that it could have an effect on aging. It’s probably not that simple, and there could be unexpected effects of these drugs that could negate or prevent the anti-aging effects, but it’s an excellent hypothesis and needs to be tested carefully.”
What are GLP-1 and GIP?
Semaglutide and similar drugs were originally developed primarily for the treatment of type 2 diabetes. They work by activating GLP-1 receptors and increasing insulin levels in the body, thereby lowering glucose levels. They can help with appetite suppression and weight loss since GLP-1 receptors exist in the digestive system. Research shows that these drugs delay intestinal motility, slowing the rate at which food is digested and curbing hunger and food cravings.
However, GLP-1 receptors also exist in organ systems throughout the body, such as the kidneys, heart, blood vessels and, of course, the brain. This may be why they appear useful in treating or preventing some other chronic diseases and reducing systemic inflammation, although more research is undoubtedly needed to understand the mechanism of action.
What has research already shown about their benefits?
A wide range of studies of GLP-1 receptor agonists and GIPs have shown that they can combat a range of chronic and age-related diseases, including heart disease, non-alcoholic fatty liver disease, diseases, kidney disease, sleep apnea And polycystic ovary syndrome. Some preliminary studies also suggest that semaglutide, a type of GLP-1 therapy, restored the function of anti-cancer cells known as NK cells in obese people, potentially reduce the risk of developing certain types of cancer.
These drugs also have neuroprotective properties. A little research published in April The New England Journal of Medicine found that lixisenatide, another GLP-1 receptor agonist and a close relative of Vegovi and Ozempic, slows the progression of early-stage Parkison’s disease. Some researchers are also testing whether these drugs can prevent Alzheimer’s disease.
Moreover, compelling preliminary research suggests that these drugs may benefit those being treated for addiction. Animal studies, small human studies and anecdotal reports suggest that these medications may reduce alcohol consumption by curbing cravings—another lifestyle habit strongly associated with shorter lifespan and health span.
Most experts agree that these drugs will need to be studied more thoroughly for each potential indication in order to safely prescribe them outside of their FDA-approved uses, which are currently reserved for the treatment of diabetes, diabetes-related heart disease and obesity.
From a purely statistical point of view, it is likely that the number of people taking GLP-1 receptor agonists and related drugs will continue to increase as by 2030, nearly half of all US adults most likely to be classified as obese. With this comes more chronic diseases. According to the US Centers for Disease Control and Prevention, approximately 4 in 10 adults in the US currently have two or more chronic diseases.
Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine, is studying the possibility of repurposing a number of already FDA-approved drugs to extend lifespan. He recently published an analysis in the journal Medical Research Archive who reviewed existing research on a number of drugs that appear to target twelve signs of aging such as mitochondrial dysfunction, cellular aging and telomere shortening. GLP-1 receptor agonists were shortlisted after SGLT2 inhibitors, metformin and the osteoporosis drug bisphosphonates.
Dr. Barzilai envisions a future in which semaglutide and other drugs become part of a long-term disease prevention plan, much in the same way people take over-the-counter supplements. He notes that healthy people typically take vitamins and supplements that are supposed to slow the effects of aging, especially antioxidants, although studies show they have little impact on health and we don’t know enough about them. their effects.
Risks of treating these drugs as a magic bullet
However, Dr. Barzilai cautions that GLP-1 receptor agonists are not a panacea. “I do not encourage doctors to give these drugs to anyone. I’m just pointing out to them that we test the overall therapeutic effects of these drugs. And we must take them into account, because we can and must, in order to prevent not one disease, but two or three and reduce mortality.”
Doctors like Dr. Kinga Kiszko, an assistant professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai, caution that these medications are not for everyone, especially when it comes to older adults. “Often I see new diabetes medications do more harm than good, which is sometimes simply the result of polypharmacy,” she says. Dr. Kiszko would like to see more well-designed studies that measure the effects of these treatments on older patients. “The older population is so heterogeneous that there are some people we really don’t want to lose weight.”
Dr. Maria Daniela Hurtado Andrade, an assistant professor of medicine and endocrinologist at the Mayo Clinic, already prescribes semaglutide as a treatment to prevent the cascading health effects of weight gain that often leads to early death. Although doctors are advised to reserve these medications for patients with a BMI of 27 or higher, she sometimes gives them to patients whose health is trending alarmingly. They may not currently meet the criteria for being overweight or obese, but they are gaining an average of 10 pounds a year, she says. Waiting another year to start taking medications could harm their health and increase their risk of developing multiple chronic diseases and early death.
“I use my clinical judgment and sometimes do not adhere to recommendations, but consider other aspects. There have been women who didn’t meet the BMI criteria to start these medications, but I start them anyway because I want to prevent the disease, not let it happen,” says Andrade, who is also a co-investigator in the Mayo Precision Medicine for Program. fight obesity. “In my opinion, it is always individual. “I take into account individual medical history, family history of the risks of using these medications, and then I discuss all of those aspects with patients, and at the end of the day, my patients make an informed decision.”