One inescapable phrase dominated biomedicine this 12 months: Ozempic.

Physicians had been amazed on the drug’s efficacy in treating diabetes, for which it’s FDA accepted, and weight problems. Social media propelled it into the 12 months’s zeitgeist as a “miracle” weight-loss drug that may assist folks effortlessly shed kilos—for well being or for vainness.

It’s no marvel. Fat burners have an extended and tumultuous historical past. From amphetamine-laden “rainbow drugs” to the infamous fen-phen and its lethal unwanted effects within the lungs and coronary heart, these drugs have a killer popularity.

Scientists have lengthy looked for a secure and efficient capsule that curbs urge for food with out harmful penalties. Although it isn’t freed from unwanted effects, Ozempic comes a lot nearer to becoming the invoice. It really works its magic by mimicking the physique’s pure response after a satisfying meal—it makes the person really feel full. With out having to withstand fixed starvation, the kilos soften away.

For many individuals fighting weight problems, the drug is a possible lifesaver. Extra weight is related to greater incidences of stroke, coronary heart and liver illness, sleep apnea, joint issues, and a few cancers. A serious medical trial this 12 months in tens of hundreds of obese folks with out diabetes discovered the primary ingredient in Ozempic, semaglutide, lowered the danger of stroke and coronary heart assault, whereas decreasing the probabilities of dying because of cardiovascular issues.

Maybe much more importantly, the drug is steadily altering societal views on weight problems—it’s not because of lack of will energy, however a continual medical situation that may be handled.

However Ozempic and comparable medication—like Wegovy, one other semaglutide-based remedy that has been FDA-approved for weight reduction—are already set for the following chapter: tackling a variety of mind issues, together with Alzheimer’s and Parkinson’s. Scientific trials are underway for dependancy, and the medication are exhibiting early promise battling bipolar dysfunction and melancholy.

Intestine to Mind

Why would medication helpful within the remedy of diabetes and weight reduction additionally show efficient for temper, dependancy, and neurodegenerative illnesses?

It comes right down to how Ozempic and Wegovy work. Each include semaglutide, a chemical that mimics a hormone known as glucagon-like peptide-1, or GLP-1. After a meal, as our intestine senses an inflow of vitamins, cells within the gut launch the hormone. GLP-1 tells the abdomen to decelerate how briskly it’s emptying its contents. It additionally triggers the pancreas to launch extra insulin to maintain blood sugar in verify—sustaining a metabolic state that’s important for mind well being.

However right here’s the crux. GLP-1 doesn’t simply roam the intestine; it additionally simply enters the mind.

Protected by a tight-knit mobile barrier, the mind typically rejects massive molecules that might injury its delicate neurons, nevertheless it readily admits GLP-1. The hormone prompts neurons in a variety of mind areas, together with the “reward middle” and hippocampus, which play important roles within the regulation of temper and reminiscence.

This has neuroscientists questioning: Can GLP-1 tweak mind perform to help neurological or psychological well being?

Dependancy

One tantalizing aspect impact of individuals taking GLP-1-like medication has been that they’re much less fascinated with consuming alcohol and different mind-bending substances. Why this occurs is unclear, nevertheless it’s probably as a result of the hormone dampens reward pathways within the mind.

One examine, for instance, gave alcoholic monkeys (yup, that’s a factor) entry to an open bar for 4 hours a day. These monkeys love their booze. Thriving within the Caribbean, they’re infamous for swiping alcoholic drinks from vacationers. After two to 5 weeks of remedy, these injected with GLP-1-like medication lowered their alcohol consumption even when tempted with all-you-can-drink alcohol. As an alternative, they readily slurped recent water.

GLP-1 mimics can also assist curb smoking dependancy. A small medical trial in 2021 discovered people who smoke, whereas carrying nicotine patches, readily kicked the behavior when injected with a first-generation GLP-1 drug. Practically half of the GLP-1 handled contributors give up smoking—successful price nearly double that of a management group that solely wore nicotine patches.

As with every new drug, the outcomes aren’t minimize and dried. One examine for alcoholism utilizing a first-generation GLP-1 mimic discovered little distinction in folks present process behavioral remedy. Each teams lowered their alcohol consumption, however the GLP-1 drug didn’t additional bolster restoration. A trial utilizing the drug for cocaine abuse additionally discovered negligible results.

That mentioned, semaglutide is much extra environment friendly than first-generation GLP-1 mimics. Scientific trials are within the works, some utilizing brain-imaging to see how the mind reacts to the drug in actual time.

Temper Issues

Melancholy and different temper issues are additionally potential targets for GLP-1 mimics.

Typically thought of purely neurological, temper is tightly linked to different components of the physique, together with the intestine. Folks with melancholy typically expertise adjustments in urge for food and intestine hormone ranges—together with GLP-1.

An evaluation of six trials with over 2,000 contributors discovered GLP-1 mimicking medication eased their melancholy. One other trial involving 29 folks with bipolar dysfunction or melancholy discovered the medication leveled temper swings for no less than six months after remedy.

The medication might work by altering neural connections within the mind.

Neurons look a bit like timber, with large trunks that course of data and branches that “speak” to neighbors. These branches wither in a depressed mind, making it tough for neurons to attach to one another and type wholesome networks. What’s extra, the hippocampus—a mind area important to reminiscence—struggles to delivery new neurons, which assist preserve reminiscence and temper. All these adjustments contribute to temper issues.

Basic antidepressants and newer therapies, together with ketamine, reverse depressive signs by serving to neurons regrow their branches. Preliminary research in mice counsel GLP-1-like medication additionally rewire mind areas that shrivel with melancholy and alleviate manic signs in bipolar mice. Whereas nonetheless preliminary, these outcomes pave the best way for additional testing in people.

Alzheimer’s Illness

Dementia is a grueling journey for these struggling signs and their households. Neurodegenerative issues, akin to Alzheimer’s or Parkinson’s illness, slowly eat away at recollections, reasoning, and ultimately take lives. Continual irritation, which damages neurons and blood vessels and is linked to uncontrolled ranges of blood sugar, is a serious participant.

As a result of Ozempic and comparable medication decrease blood sugar, they may probably additionally dampen irritation within the Alzheimer’s mind and gradual the lack of cognition. Just a few trials are within the works. Novo Nordisk, the Danish pharmaceutical large behind Ozempic and Wegovy, launched two medical trials in 2021 to see if semaglutide slows cognitive decline in Alzheimer’s sufferers. First outcomes are anticipated in 2025. In the meantime, a number of firms, together with Neuraly and Kariya Prescribed drugs, are testing whether or not GLP-1 mimicking medication can restore cognition in Parkinson’s illness.

For now, we don’t absolutely perceive how these medication work within the mind. They might alter ldl cholesterol metabolism—a necessary course of by which neurons construct their protecting sheaths. GLP-1 additionally reworks the best way neurons join with one another to type practical networks, which could possibly be how Ozempic and comparable medication work within the mind.

Whether or not the results final is one other thriller. Early outcomes for weight problems counsel GLP-1 mimics aren’t “without end medication,” in that the sufferers’ weight partly bounces again after discontinuing the every day regime. As for the mind? Solely time will inform.

Picture Credit score: NIH