Do Weight Loss Medications Reduce Inflammation?

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The world was shaken by the news that new drugs were available now to help us lose weight. This article will discuss the effect of Ozempic (semaglutide), Mounjaro, or Zepbound (tirzepatide) on reducing weight, controlling diabetes, and, interestingly, reducing inflammation.

New Research and the Power to Reduce Inflammation

YES!!! New research reveals they might have the power to reduce inflammation throughout the body, from your brain to the liver and possibly the joints.

Understanding GLP-1 Agonist Medications

Everyone talks about GLP-1 (glucagon – like peptide) agonist medications since the FDA approved Monjaro on November 23rd, 2023. But did you know this class of medication called GLP-1 or glucagon-like peptide-1 was actually approved since 2005 for patients with diabetes type 2?

Mechanisms Behind GLP-1 Agonist Medication

GLP-1 agonist medication works through a few mechanisms:

• Increased Insulin Secretion: It increases the secretion of insulin from your pancreas.
• Delayed Stomach Emptying: It delays the emptying of your stomach, keeping you fuller for a longer period.
• Appetite Reduction: Very importantly, these medications will reduce your appetite. The GLP-1 is also known as the HUNGER hormone. When you take these drugs, the drug will activate the GLP-1 receptors in your brain and will decrease your appetite, making your brain believe that you are full. Tricky, right? 
• Change in taste. Some studies even suggest that it may change your taste, leading you to crave less calorie-dense foods over high-fat/high-sugar foods, aiding in weight loss. 
• Boosting metabolism. It appears that it may boost your metabolism by influencing certain areas in the brain that impact metabolism.

Impact on Inflammatory Diseases

Now, what is interesting and particularly of great benefit for patients with autoimmune diseases like Rheumatoid arthritis, Psoriatic arthritis, and patients with Osteoarthritis is that there is new evidence that these drugs might influence and decrease inflammation throughout your whole body.

Studies and Evidence in Humans

Initial studies were published in animals, and now they are starting to appear in humans. One randomized, controlled trial just published in 2023 showed that in patients who used GLP-1 drugs and combined them with exercise resulted in a decrease in inflammatory markers like C-reactive protein, as well as reduced abdominal obesity and improvement in the metabolic syndrome. If you did not know, abdominal obesity is key in increasing cardiovascular risk. Another study in patients with RA also showed a potential benefit of using GLP-1 drugs.

Impact on Brain Inflammation and Neurological Diseases

Studies in animals did show that these drugs do decrease inflammation. Now new evidence shows that it may decrease inflammation in the brain, and this can help people with Parkinson’s or Alzheimer’s, which are diseases linked with inflammation in the brain. There are some small studies that show that it decreases inflammation in the liver.

Obesity, Inflammation, and the Risk of Arthritis 

Obesity is linked with more inflammation, increasing the risk to develop arthritis from Osteoarthritis to Rheumatoid arthritis and psoriasis and Psoriatic arthritis People with psoriasis do have more active disease and more joint disease if they have Psoriatic arthritis; and they often require higher doses of medication if they are obese. I had a patient with psoriasis and psoriasis arthritis where I had to change multiple biologic medications as they were not working. All of them were coming in a fixed dose in a pen, and at some point, I realized it might be best if I change the pen to an infusion and dose the medication based on his weight. That helped a lot, but again, until he was not able to lose some weight, he continued to struggle with his Psoriatic arthritis.

Unanswered Questions and Need for Research

There are many questions that we have at this time:

• What happens when you stop taking the Weight Loss Medications?
• Could inflammation rebound?
• What are the potential side effects?
• Are they safe for long-term use?
• Could they one day replace steroids or immunosuppressants for inflammation?

Only time will tell! We need more research to understand the implications. 

Although we are excited to see more from these drugs and the use expanded into the field of rheumatology, I think we have a few more years to wait and see if they hold the benefit for our diseases. Now be aware that like any drug, there is also a chance of side effects, and people should be aware that they may increase the chance to develop severe nausea, abdominal pain, diarrhea, acute pancreatitis (which is an inflammation of the pancreas), and rarely cancers.

Community Engagement and Insights

If you have Rheumatoid arthritis, Psoriatic arthritis, patients with Osteoarthritis or another inflammatory condition – share your thoughts! Have you tried Ozempic, Mounjaro, or Zepbound? What effects did you notice on inflammation and pain levels? Leave a comment below!

If you want to learn more about autoimmune diseases like RA, PsA, and others, if you want to learn about diet, other lifestyle interventions, and also emerging treatments, subscribe to my newsletter or join my practice, Rheumatologist OnCall.