The buzz around GLP-1 drugs like Ozempic and Wegovy has shifted — and it’s no longer just about shedding pounds. Their potential to treat a wide range of conditions is generating excitement, but also raising serious questions for patients, doctors, and insurers.
Originally developed to manage Type 2 diabetes, GLP-1 drugs have since become blockbuster weight loss treatments. But recent studies suggest they may also help reduce the risk of numerous other conditions — including Alzheimer’s disease, addiction, sleep apnea, seizures, and bacterial infections.
That has sparked a wave of optimism. Yet experts caution that these drugs are far from miracle cures. Many of the benefits may be secondary to their impact on obesity and diabetes, which are major drivers of other health issues. And with monthly price tags exceeding $1,000, the financial strain on the healthcare system is becoming increasingly difficult to ignore — especially when the benefits can vanish if patients stop taking them.
A major turning point came earlier this year with a Veterans Health Administration study of nearly 2 million patient records. It found that GLP-1 use was linked to a 10–20% reduction in the likelihood of several diseases — a modest but potentially meaningful impact, particularly for conditions like dementia that lack effective treatments.
“Given the drugs’ newness and skyrocketing popularity, it is important to systematically examine their effects on all body systems — leaving no stone unturned,” said Dr. Ziyad Al-Aly, the study’s senior author.
Despite the growing body of research, the FDA has only approved GLP-1 drugs for treating obesity, Type 2 diabetes, cardiovascular risk, and — under certain conditions — sleep apnea. That means doctors prescribing them for other conditions are doing so “off-label,” a legal but insurance-sensitive practice.
Insurers often won’t cover off-label use, which is significant when brand-name options like Wegovy and Zepbound cost between $1,000 and $1,350 per month without coverage. (Novo Nordisk, which makes Ozempic and Wegovy, says most insured patients pay less than $25 for Ozempic.)
The intense demand has also led many Americans to turn to telemedicine companies offering brand-name or generic versions, contributing to supply shortages. One recent study found that nearly 40% of GLP-1 prescriptions are for off-label uses.
Meanwhile, access issues persist — especially in marginalized communities where coverage is patchy and counterfeit products are on the rise. Just last week, dozens of lawmakers urged the FDA to crack down on illegal versions of GLP-1 ingredients.
Despite their promise, GLP-1 drugs come with significant side effects, including gastrointestinal problems, low blood pressure, kidney stones, and even pancreatitis. Paradoxically for a weight-loss drug, some patients may experience increased arthritis risk — potentially linked to loss of muscle and bone mass.
Adherence is another challenge: More than 36% of patients stop taking GLP-1s within a year. The high cost and unpleasant side effects are common reasons for quitting.
While the drugs could theoretically reduce future healthcare costs by preventing chronic diseases, expanding Medicare coverage alone could add $48 billion to federal spending over the next decade. They’re also contributing to higher premiums for employer-sponsored insurance plans.
What makes GLP-1s especially intriguing is how they work. In addition to regulating blood sugar and appetite, they seem to reduce inflammation and protect brain cells — mechanisms that may unlock new insights into neurological and psychiatric conditions.
Early research suggests they could help treat substance abuse, suicidal ideation, and even schizophrenia by modulating cravings and feelings of satisfaction. But it’s still early days.
Many researchers and clinicians warn against widespread use until more is understood. “While I’m excited about the future of these drugs’ development, the side effect profile isn’t worth the risk for otherwise healthy patients,” wrote journalist Derek Thompson in a recent analysis of the field.
Pharmaceutical companies are racing to develop oral versions of GLP-1s, which could improve adherence and reduce some side effects. But without additional safety data and formal FDA approvals, insurers are likely to remain hesitant to cover these drugs for anything beyond current indications.
The bottom line: GLP-1 drugs are ushering in a new era of medicine — but their full potential, and their full cost, are still coming into focus.
