For many patients, it feels like for the first time their body isn’t fighting against them.
Sarah H. Finn, MD, section chief of Obesity MedicineA diabetes medication that quickly rose to fame for its weight loss effects has experts exploring how it might help treat everything from heart disease to sleep apnea.
Ozempic, Wegovy, and Zepbound, which belong to a group of drugs called GLP-1 receptor agonists, are showing promise in helping manage several long-term health problems.
“I think we’re all amazed by what these medications can do,” says Joanne B. Hayes, APRN, director of the Diabetes Clinic at Alice Peck Day Memorial Hospital, a member of Dartmouth Health.
But these drugs can also be expensive, cause side effects, and need to be taken long-term to work best. Our experts weigh in on the benefits and challenges of these revolutionary drugs.
How do these medications work?
GLP-1s were initially intended to help control blood sugar in people with Type 2 diabetes. Experts soon figured out GLP-1s are remarkably effective in treating obesity.
The U.S. Food and Drug Administration (FDA) has approved GLP-1 drugs for treating diabetes, metabolic liver disease, and severe sleep apnea. Wegovy recently became the first GLP-1 oral pill to get FDA approval for weight loss.
The medication works like a natural hormone in your body that helps manage blood sugar, slow digestion, release insulin after meals, and send signals to your brain to quiet hunger.
GLP-1 drugs alone can’t treat Type 2 diabetes or obesity. Both conditions also require other approaches, like lifestyle and dietary changes.
“GLP-1s are powerful, evidence-based medications that treat the biology of obesity, not just the symptoms,” says Sarah H. Finn, MD, section chief of Obesity Medicine at the Dartmouth Health Walter and Carole Young Center for Digestive Health. “For many patients, they can finally allow their bodies to respond to healthy changes in a lasting way.”
Do GLP-1s reduce the risk of heart disease?
New studies show that GLP-1s can lower inflammation in the body, which may also help manage cardiovascular disease. A 2025 report from the American College of Cardiology points out that targeting inflammation significantly reduces repeated cardiovascular events like heart attack and stroke.
“We don’t fully understand exactly how GLP-1s are providing heart protection. There are a lot of theories related to inflammation or weight and metabolic changes,” says Mounica Yanamandala, MD, a cardiologist at Dartmouth Hitchcock Medical Center (DHMC). “What we do know is that the benefits are real.”
She explains that as GLP-1s help lower inflammation, your blood vessels become less prone to damage. High blood sugar (or hyperglycemia) causes inflammation all over your body. This can damage the lining of your blood vessels, making them brittle and more susceptible to cholesterol and plaque buildup. This eventually leads to high blood pressure, heart attacks, and strokes.
“By reducing hyperglycemia, we’re not just lowering blood sugar,” says Yanamandala. “We’re also addressing the root cause of inflammation and plaque formation in the arteries.”
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Do GLP-1s treat addiction?
It remains unclear whether GLP-1s can treat addiction.
“These are obviously remarkable medications, but the excitement as far as the treatment of substance use disorders has gotten a bit ahead of the evidence,” says Luke J. Archibald, MD, a psychiatrist who specializes in addiction treatment at DHMC.
Limited research has focused on GLP-1s treating alcohol use disorder and addiction to nicotine and cocaine.
“But a lot of these studies don’t show much improvement for decreasing substance use,” says Shelby S. Olender, MD, an addiction psychiatry fellow at DHMC. “It’s not to say that it’s not possible. I think we just need more evidence.”
What about other chronic conditions?
GLP-1 drugs show promise in chronic conditions beyond diabetes, obesity, and heart disease including liver disease, chronic kidney disease, and obstructive sleep apnea.
Liver disease
Liver disease can inflame, damage, or disrupt your liver's ability to filter toxins, produce bile, and manage metabolism.
GLP-1s help by:
- Decreasing appetite
- Improving insulin sensitivity
- Reducing the delivery of free fatty acids to the liver
- Improving insulin resistance
- Lowering inflammation
- Reducing oxidative stress.
Obstructive sleep apnea
Obstructive sleep apnea can result from excess fat around the neck and organs, blocked airways, insulin resistance, and inflammation.
GLP-1s help by:
- Decreasing appetite, which can lead to weight loss and reduce tongue and neck fat
- Decreasing airway obstruction
- Improving lung volume.
Chronic kidney disease
Chronic kidney disease can mean lasting kidney damage, allowing fluid and waste to build up in the blood.
GLP-1s help by:
- Improving blood sugar
- Lowering blood pressure
- Reducing inflammation and oxidative stress.
Do you need to stay on GLP-1s for the long haul?
Obesity is a long-term disease that affects 40% of Americans. According to Finn, many people do not get enough help from traditional treatments like lifestyle changes or bariatric surgery.
GLP-1s can help with weight loss, but research shows that most Americans stop taking them within a year. The main reasons are high costs and side effects such as vomiting, diarrhea, constipation, and stomach discomfort.
Finn says most insurance plans in the United States do not cover obesity treatment, so many patients cannot afford to pay for it themselves.
“Obesity is a chronic disease, and these are chronic medications,” Finn says. “If you stop the medicine, almost everyone regains the weight, and the cravings come back. It’s not because you failed, it’s because the biology of obesity is still there in your body.”
Finn says that while GLP-1 drugs are not a cure, they can help successfully manage obesity.
“For many patients, it feels like for the first time their body isn’t fighting against them,” she says. “They’re not always hungry, they’re not thinking about food all the time, and the healthy changes they make finally lead to real results.”
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