{{Short description|Class of anti-diabetic and anti-obesity medication}}
'''Glucagon-like peptide-1''' ('''GLP-1''') '''receptor agonists''', also known as '''GLP-1 agonists''' and '''GLP-1RAs''', are a class of medications that activate the GLP-1 receptor, causing reduced blood sugar, reduced appetite, and reduced energy intake. '''GLP-1 analogs''' are molecules that are structurally almost identical to the endogenous GLP-1 hormone. Incretin mimetics are substances that mimic the actions of incretin hormones such as GLP-1 and GIP.
Originally developed to treat type 2 diabetes, some GLP-1 agonists have been approved to treat obesity. They mimic the actions of the endogenous incretin hormone GLP-1, which is released in the small intestine and can inhibit glucagon release and increase insulin secretion.<ref>{{Cite journal |last1=Ross |first1=Stuart A. |last2=Ekoé |first2=Jean-Marie |date=July 2010 |title=Incretin agents in type 2 diabetes |journal=Canadian Family Physician |volume=56 |issue=7 |pages=639–648 |pmc=2922799 |pmid=20631270}}</ref>
GLP-1 receptor agonists are used to treat type 2 diabetes and obesity, and are under study for treatment of metabolic dysfunction–associated steatotic liver disease, polyendocrine metabolic ovarian syndrome, and diseases of the reward system, such as addictions (especially from ultra-processed foods).<ref>{{Cite web |title=David Kessler on What Doctors and Patients Should Know About GLP-1 Drugs {{!}} Harvard Medicine Magazine |url=https://magazine.hms.harvard.edu/articles/david-kessler-what-doctors-and-patients-should-know-about-glp-1-drugs |access-date=2026-03-08 |website=magazine.hms.harvard.edu |language=en}}</ref>
==Pharmacology== ===Mechanism of action=== GLP-1 agonists work by activating the GLP-1 receptor, which is found all around the body. Some sites are on beta cells in the pancreas and on neurons in the brain. GLP-1 receptor activation slows gastric emptying, inhibits the release of glucagon, and stimulates insulin production, thereby improving glucose homeostasis in people with type 2 diabetes. GLP-1 receptor activation also stimulates satiety, thus reducing food intake, promoting the development of a negative energy balance, and decreasing body weight over time, making GLP-1 agonists a treatment option for obesity.<ref>{{cite journal |last1=Drucker |first1=Daniel J. |author-link=Daniel J. Drucker |date=2022 |title=GLP-1 physiology informs the pharmacotherapy of obesity |journal=Molecular Metabolism |type=Review |volume=57 |article-number=101351 |doi=10.1016/j.molmet.2021.101351 |pmc=8859548 |pmid=34626851 }}</ref> Another class of anti-diabetes drugs, DPP-4 inhibitors, work by reducing the breakdown of endogenous GLP-1, and are generally considered less potent than GLP-1 agonists.<ref>{{cite journal |last=Brunton |first=Stephen |title=GLP-1 Receptor Agonists vs. DPP-4 Inhibitors for Type 2 Diabetes |url= |journal=International Journal of Clinical Practice |date=2014 |type=Review |publisher=Wiley |volume=68 |issue=5 |pages=557–567 |doi=10.1111/ijcp.12361 |pmc=4238422 |pmid=24499291 |doi-access=free}}</ref> Some of the metabolic effects of GLP-1 agonists in rodents are mediated via increased synthesis of fibroblast growth factor 21. Pharmaceutical companies have developed dual GLP-1/FGF21 receptor agonists.<ref>{{cite journal |last1=Shao |first1=Weijuan |last2=Jin |first2=Tianru |year=2022 |title=Hepatic hormone FGF21 and its analogues in clinical trials |url= |journal=Chronic Diseases and Translational Medicine |type=Review |volume=8 |issue=1 |pages=19–25 |doi=10.1016/j.cdtm.2021.08.005 |doi-access=free |pmid=35620160 |pmc=9126297 }}</ref>
===Pharmacokinetics=== The naturally occurring native GLP-1 hormone is considered a peptide hormone. It has a half-life of only about two minutes, because the dipeptidyl peptidase-4 (DPP-4) enzyme rapidly breaks it down.<ref name="Yu" /> As a result, different GLP-1 agonist drugs are modified in various ways to extend the half-life, resulting in drugs that can be dosed daily, weekly, or less often.<ref name="Yu" /> Many commonly used synthetic GLP-1 agonists are delivered weekly by subcutaneous injection, which is a barrier to their use and reason for discontinuation.<ref name="Antza">{{cite journal |last1=Antza |first1=Christina |last2=Nirantharakumar |first2=Krishnarajah |last3=Doundoulakis |first3=Ioannis |last4=Tahrani |first4=Abd A. |last5=Toulis |first5=Konstantinos A. |display-authors= 3 |title=The development of an oral GLP-1 receptor agonist for the management of type 2 diabetes: evidence to date |journal=Drug Design, Development and Therapy |date=2019 |volume=13 |pages=2985–2996 |doi=10.2147/DDDT.S166765 |pmid=31686781 |pmc=6709822 |language=English |doi-access=free }}</ref> Most GLP-1 medications are approved by the FDA and sold as drug-device combination products, which include auto-injecting pens.<ref>{{cite journal |last1=Alhiary |first1=Rasha |last2=Gabriele |first2=Sarah |last3=Kesselheim |first3=Aaron S. |last4=Tu |first4=S. Sean |last5=Feldman |first5=William B. |title=Delivery Device Patents on GLP-1 Receptor Agonists |journal=JAMA |date=5 March 2024 |volume=331 |issue=9 |pages=794–796 |doi=10.1001/jama.2024.0919 |pmid=38315473 |pmc=10845039 }}</ref> Self-injected drugs are especially difficult for people with vision or motor difficulties, which commonly accompany type 2 diabetes.<ref name="Yu" /> Attempts to develop an orally bioavailable GLP-1 agonist, either a modified peptide, as in the case of oral semaglutide,<ref name=Antza/> or a small molecule drug, have produced additional drug candidates.<ref name=Knerr/> Other companies have tested inhaled or transdermal administration.<ref name="Yu" /> An oral semaglutide pill was approved by the FDA in December 2025 and entered mass production in January 2026.<ref>{{Cite web |title=News Details |url=https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html |access-date=2026-01-12 |website=Novo Nordisk |language=en}}</ref>
==Uses==
===Type 2 diabetes=== GLP-1 agonists were initially developed to treat type 2 diabetes.<ref>{{cite journal |last1=Brown |first1=Emily |last2=Heerspink |first2=Hiddo J L |last3=Cuthbertson |first3=Daniel J |last4=Wilding |first4=John P H |title=SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications |journal=The Lancet |date=July 2021 |volume=398 |issue=10296 |pages=262–276 |doi=10.1016/S0140-6736(21)00536-5 |pmid=34216571 }}</ref> The 2025 American Diabetes Association (ADA) standard of care in diabetes include GLP-1 agonists or SGLT2 inhibitors as a first-line pharmacological therapy for type 2 diabetes in people who have or are at high risk for atherosclerotic cardiovascular disease or heart failure.<ref name=ADA2025>{{cite journal |last1=ElSayed |first1=Nuha A. |last2=McCoy |first2=Rozalina G. |last3=Aleppo |first3=Grazia |last4=Bajaj |first4=Mandeep |last5=Balapattabi |first5=Kirthikaa |title=9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 |journal=Diabetes Care |date=2025 |volume=48 |issue=Supplement_1 |pages=S181–S206 |doi=10.2337/dc25-S009 |pmid=39651989 |pmc=11635045 }}</ref> The ADA also recommends GLP-1 agonists for people with both type 2 diabetes and kidney disease. GLP-1 agonists and SGLT2 inhibitors can be combined with metformin, which has shown an enhanced lowering of A1C.<ref name=ADA2025/> GLP-1 receptor agonists are not recommended for use in combination with DPP-4 enzyme inhibitors due to lack of evidence.<ref>{{Cite journal | vauthors=Bando H, Wood M, Ebe K |date=December 2024 |title=The Latest topics of Standards of Care in Diabetes 2025: Focusing on GLP-1RA | journal=Asploro Journal of Biomedical and Clinical Case Reports |doi=10.36502/2024/ASJBCCR.6386 | doi-access=free | title-link=doi |volume=8 |pages=34–37 | type=Commentary }}</ref>
One advantage of GLP-1 agonists over older insulin secretagogues such as sulfonylureas or meglitinides is that they have a lower risk of hypoglycemia, while improving weight and cardiovascular and kidney health.<ref name="ADA2025" /> ADA also recommends use of GLP-1 agonists instead of starting insulin therapy in people with type 2 diabetes who need additional glucose control, except when catabolism, hyperglycemia, or autoimmune diabetes is suspected.<ref name="Nachawi" />
A 2021 meta-analysis reported a 12% reduction in all-cause mortality when GLP-1 agonists are used in the treatment of type 2 diabetes, as well as significant improvements in cardiovascular and renal outcomes relative to nonusers.<ref>{{cite journal |last1=Sattar |first1=Naveed |last2=Lee |first2=Matthew M Y |last3=Kristensen |first3=Søren L |last4=Branch |first4=Kelley R H |last5=Del Prato |first5=Stefano |last6=Khurmi |first6=Nardev S |last7=Lam |first7=Carolyn S P |last8=Lopes |first8=Renato D |last9=McMurray |first9=John J V |last10=Pratley |first10=Richard E |last11=Rosenstock |first11=Julio |last12=Gerstein |first12=Hertzel C |title=Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials |journal=The Lancet Diabetes & Endocrinology |date=October 2021 |volume=9 |issue=10 |pages=653–662 |doi=10.1016/S2213-8587(21)00203-5 |pmid=34425083 }}</ref> A 2023 meta-analysis including 13 cardiovascular outcome trials reported that SGLT2 inhibitors reduce the risk for three-point major adverse cardiovascular events, especially in subjects with an estimated glomerular filtration rate (eGFR) below 60 mL/min, whereas GLP-1 receptor agonists were more beneficial in people with higher eGFRs.<ref name="Sohn_2023">{{cite journal |last1=Sohn |first1=Minji |last2=Dietrich |first2=Johannes W. |last3=Nauck |first3=Michael A. |last4=Lim |first4=Soo |date=2023 |title=Characteristics predicting the efficacy of SGLT-2 inhibitors versus GLP-1 receptor agonists on major adverse cardiovascular events in type 2 diabetes mellitus: a meta-analysis study |journal=Cardiovascular Diabetology |type=Research |publisher=BioMed Central |volume=22 |issue=1 |page=153 |doi=10.1186/s12933-023-01877-6 |pmc=10303335 |pmid=37381019 |doi-access=free}}</ref> Likewise, the relative risk reduction of SGLT-2 inhibitor treatment was larger in populations with a higher proportion of albuminuria, but this relationship was not observed for GLP-1 receptor agonists. This suggests differential use of the two substance classes in people with preserved and reduced renal function or with and without diabetic nephropathy, respectively.<ref name="Sohn_2023" /> GLP-1 agonists and SGLT2 inhibitors work to reduce HbA1c by different mechanisms and can be combined for enhanced effects. They may provide additive cardioprotective effects.<ref>{{cite journal |last1=DeFronzo |first1=Ralph A. |date=2017 |title=Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor |journal=Diabetes, Obesity & Metabolism |type=Review |volume=19 |issue=10 |pages=1353–1362 |doi=10.1111/dom.12982 |pmc=5643008 |pmid=28432726}}</ref>
The US Food and Drug Administration has not approved GLP-1 agonists for type 1 diabetes, but they have been used off-label in addition to insulin.<ref name="Nachawi" />
===Obesity=== GLP-1 agonists are recommended as an add-on therapy to lifestyle intervention (calorie restriction and exercise) in people with a BMI <math>\geq</math>30 kg/m² or with a BMI <math>\geq</math>27 kg/m² with at least one weight-related comorbidity, which can include high blood pressure or high cholesterol.<ref name="Wharton"/> Some GLP-1 agonists are more effective than other weight-loss drugs, but bariatric surgery is still considered the most effective and sustainable way to lose weight.<ref>{{cite journal |last1=Müller |first1=Timo D. |last2=Blüher |first2=Matthias |last3=Tschöp |first3=Matthias H. |author-link3=Matthias Tschöp |last4=DiMarchi |first4=Richard D. |author-link4=Richard DiMarchi |date=March 2022 |title=Anti-obesity drug discovery: advances and challenges |journal=Nature Reviews Drug Discovery |type=Review |volume=21 |issue=3 |pages=201–223 |doi=10.1038/s41573-021-00337-8 |pmc=8609996 |pmid=34815532 |bibcode=2022NRvDD..21..201M |doi-access=free | title-link = doi }}</ref> Genetics is believed to play a role in both GLP-1 weight loss efficacy and side effects.<ref> {{cite journal | last1=Su | first1=Qiaojuan Jane | last2=Ashenhurst | first2=James R. | last3=Xu | first3=Wanwan | last4=Tran | first4=Vinh | last5=Wu | first5=R. Ryanne | last6=Weldon | first6=Catherine H. | last7=Shi | first7=Jingchunzi | last8=Hicks | first8=Barry | last9=Abul-Husn | first9=Noura S. | last10=Aslibekyan | first10=Stella | last11=Holmes | first11=Michael V. | last12=Koelsch | first12=Bertram L. | last13=Auton | first13=Adam | display-authors=6 | collaboration=23andMe Research Team | title=Genetic predictors of GLP1 receptor agonist weight loss and side effects | journal=Nature | date=8 April 2026 | doi=10.1038/s41586-026-10330-z |doi-access=free | pmid=41951734 |issn=1476-4687}}</ref> GLP-1 agonists' weight-reducing effects come from a combination of peripheral effects and activity in the central nervous system.<ref>{{cite journal |last1=Grill |first1=Harvey J |date=2020 |title=A Role for GLP-1 in Treating Hyperphagia and Obesity |journal=Endocrinology |type=Article |publisher=Oxford Academic |volume=161 |issue=8 |article-number=bqaa093 |doi=10.1210/endocr/bqaa093 |pmc=7899438 |pmid=32516384 |doi-access=free | title-link = doi }}</ref> In the brain, GLP-1 agonists reduce weight by crossing the blood–brain barrier, via passive diffusion or receptor mediated transcytosis, and directly activating the satiety hormones in the hypothalamus.<ref>{{Cite journal |last1=Dong |first1=Meiyuan |last2=Wen |first2=Song |last3=Zhou |first3=Ligang |date=2022 |title=The Relationship Between the Blood-Brain-Barrier and the Central Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter-2 Inhibitors |journal=Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy |volume=15 |pages=2583–2597 |doi=10.2147/DMSO.S375559 |doi-access=free | title-link = doi |issn=1178-7007 |pmc=9417299 |pmid=36035518}}</ref>
Three GLP-1 auto-injector medications are approved specifically for weight management: semaglutide (Wegovy),<ref name="Wegovy FDA label">{{cite web | title=Wegovy- semaglutide injection, solution; Wegovy- semaglutide tablet | website=DailyMed | date=30 January 2026 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b | access-date=15 February 2026}}</ref> tirzepatide (Zepbound),<ref name="Zepbound FDA label">{{cite web | title=Zepbound- tirzepatide injection, solution; Zepbound- tirzepatide injection, solution; Zepbound Kwikpen- tirzepatide injection, solution | website=DailyMed | date=20 January 2026 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b | access-date=15 February 2026}}</ref> and liraglutide (Saxenda).<ref name="Saxenda FDA label">{{cite web | title=Saxenda- liraglutide injection, solution | website=DailyMed | date=14 October 2025 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3946d389-0926-4f77-a708-0acb8153b143 | access-date=15 February 2026}}</ref>
Studies reported that on average people regain more than half (50–70%) of the lost weight within a year after stopping any of these medications.<ref>{{cite journal |last1=Quarenghi |first1=Massimo |last2=Capelli |first2=Silvia |last3=Galligani |first3=Giulia |last4=Giana |first4=Arianna |last5=Preatoni |first5=Giorgia |last6=Turri Quarenghi |first6=Rosamaria |title=Weight Regain After Liraglutide, Semaglutide or Tirzepatide Interruption: A Narrative Review of Randomized Studies |journal=Journal of Clinical Medicine |date=28 May 2025 |volume=14 |issue=11 |page=3791 |doi=10.3390/jcm14113791 |doi-access=free | title-link = doi |pmc=12155999 |pmid=40507553}}</ref> People return to their previous weight within a year and a half after stopping these medications.<ref>{{Cite journal |last1=West |first1=Sam |last2=Scragg |first2=Jadine |last3=Aveyard |first3=Paul |last4=Oke |first4=Jason L. |last5=Willis |first5=Lia |last6=Haffner |first6=Stella J. P. |last7=Knight |first7=Heather |last8=Wang |first8=Danni |last9=Morrow |first9=Sarah |last10=Heath |first10=Laura |last11=Jebb |first11=Susan A. |last12=Koutoukidis |first12=Dimitrios A. |date=2026-01-07 |title=Weight regain after cessation of medication for weight management: systematic review and meta-analysis |journal=BMJ |volume=392 |article-number=e085304 |doi=10.1136/bmj-2025-085304 |issn=1756-1833 |pmc=12776922 |pmid=41500720 |doi-access=free}}</ref>
===Metabolic dysfunction–associated steatotic liver disease=== A 2023 systematic review reported that GLP-1 agonists are as effective a treatment for metabolic dysfunction–associated steatotic liver disease (MASLD) as the medications in current use, pioglitazone and vitamin E. It noted a reduction in steatosis, ballooning necrosis, lobular inflammation, and fibrosis.<ref name="Gu">{{cite journal |last1=Gu |first1=Yunpeng |last2=Sun |first2=Lei |last3=He |first3=Yining |last4=Yang |first4=Luping |last5=Deng |first5=Chaohua |last6=Zhou |first6=Run |last7=Kong |first7=Tingting |last8=Zhang |first8=Wei |last9=Chen |first9=Yutong |last10=Li |first10=Jie |last11=Shi |first11=Junping |title=Comparative efficacy of glucagon-like peptide 1 (GLP-1) receptor agonists, pioglitazone and vitamin E for liver histology among patients with nonalcoholic fatty liver disease: systematic review and pilot network meta-analysis of randomized controlled trials |journal=Expert Review of Gastroenterology & Hepatology |date=4 March 2023 |volume=17 |issue=3 |pages=273–282 |doi=10.1080/17474124.2023.2172397 |pmid=36689199 |url=https://figshare.com/articles/journal_contribution/22015822 }}</ref>
Wegovy (semaglutide) is approved by the FDA to treat MASH (metabolic dysfunction-associated steatohepatitis) with stage 2 or stage 3 liver fibrosis. The mechanism of action for this treatment is under investigation, but part 1 of its stage 3 clinical trials saw a 60% reduction in liver inflammation.<ref>{{Cite journal |last=Research |first=Center for Drug Evaluation and |date=2025-08-15 |title=FDA Approves Treatment for Serious Liver Disease Known as 'MASH' |url=https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-serious-liver-disease-known-mash |journal=FDA |language=en}}</ref> Clinical trials are ongoing.
==Adverse effects== GLP-1 agonists' most common adverse effects are gastrointestinal.<ref name="Wharton"/> These limit the maximum tolerated dose and require gradual dose escalation.<ref name=Knerr/> Nausea, vomiting, diarrhea, and constipation are commonly reported.<ref name="Wharton">{{cite journal |last1=Wharton |first1=Sean |last2=Davies |first2=Melanie |author-link2=Melanie Davies |last3=Dicker |first3=Dror |last4=Lingvay |first4=Ildiko |last5=Mosenzon |first5=Ofri |last6=Rubino |first6=Domenica M. |last7=Pedersen |first7=Sue D. |author-link7=Sue Pedersen |display-authors= 3 |date=2022 |title=Managing the gastrointestinal side effects of GLP-1 receptor agonists in obesity: recommendations for clinical practice |url= |journal=Postgraduate Medicine |type=Commentary |volume=134 |issue=1 |pages=14–19 |doi=10.1080/00325481.2021.2002616 |pmid=34775881 |doi-access=free}}</ref> Nausea is directly related to serum concentration and is reported in up to three-quarters of people using short-acting GLP-1 agonists, but fewer of those using long-acting agonists. Injection site reactions are common, especially with shorter-acting drugs.<ref name="Yu" />
GLP-1 agonists appear to increase the risk of non-arteritic anterior ischemic optic neuropathy.<ref>{{cite journal |last1=Hsu |first1=Alan Y. |last2=Kuo |first2=Hou-Ting |last3=Wang |first3=Yu-Hsun |last4=Lin |first4=Chun-Ju |last5=Shao |first5=Yi-Ching |last6=Chiang |first6=Chun-Chi |last7=Hsia |first7=Ning-Yi |last8=Lai |first8=Chun-Ting |last9=Tseng |first9=Hsin |last10=Wu |first10=Bing-Qi |last11=Chen |first11=Huan-Sheng |last12=Tsai |first12=Yi-Yu |last13=Hsu |first13=Min-Yen |last14=Wei |first14=James Cheng-Chung |title=Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy Risk Among Patients With Diabetes |journal=JAMA Ophthalmology |date=1 May 2025 |volume=143 |issue=5 |pages=400–407 |doi=10.1001/jamaophthalmol.2025.0349 |pmid=40146102 |pmc=11950975 }}</ref>
Some people develop anti-drug antibodies, which are more common with exenatide (the antibodies were detectable in a third or more of people) than other GLP-1 agonists and can decrease efficacy.<ref name="Yu" /> Gallstones may form while attempting to induce rapid weight loss.<ref name="Wharton"/>
The risk of aspiration under anesthesia is higher due to delayed gastric emptying, according to case reports. In 2024, the American Society of Anesthesiologists and others suggested suspending GLP-1 agonist treatment in most people on the day of the procedure for daily dosing or a week before for weekly dosing.<ref>{{Cite journal |last1=Kindel |first1=Tammy L. |last2=Wang |first2=Andrew Y. |last3=Wadhwa |first3=Anupama |last4=Schulman |first4=Allison R. |last5=Sharaiha |first5=Reem Z. |last6=Kroh |first6=Matthew |last7=Ghanem |first7=Omar M. |last8=Levy |first8=Shauna |last9=Joshi |first9=Girish P. |last10=LaMasters |first10=Teresa L. |date=2024 |title=Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period |journal=Surgery for Obesity and Related Diseases |volume=20 |issue=12 |pages=1183–1186 |doi=10.1016/j.soard.2024.08.033 |issn=1550-7289 |doi-access=free |pmid=39482213 }}</ref>
A 2024 study suggested that GLP-1 weight-loss medications do not increase the risk of suicide or suicidal thoughts in children and adolescents, contrary to some previous concerns.<ref>{{cite journal |last1=Kerem |first1=Liya |last2=Stokar |first2=Joshua |title=Risk of Suicidal Ideation or Attempts in Adolescents With Obesity Treated With GLP1 Receptor Agonists |journal=JAMA Pediatrics |date=December 2024 |volume=178 |issue=12 |pages=1307–1315 |doi=10.1001/jamapediatrics.2024.3812 |pmid=39401009 |pmc=11581746 }}</ref> The study included over 54,000 U.S. adolescents and reported a 33% reduction in the risk of suicidal thoughts and attempts among those using the drugs compared to those who did not.<ref>{{Cite web |last=Mundell |first=Ernie |date=2024-10-14 |title=GLP-1 Weight-Loss Meds Won't Raise Teens' Suicide Risk, May Even Lower It |url=https://www.healthday.com/health-news/weight-loss/glp-1-weight-loss-meds-wont-raise-teens-suicide-risk-may-even-lower-it |access-date=2024-10-18 |website=www.healthday.com }}</ref> In January 2026, the US Food and Drug Administration requested removal of suicidal behavior and ideation warnings from glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications.<ref>{{cite web | title=FDA Requests Removal of Suicidal Behavior and Ideation Warning from Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) Medications | website=U.S. Food and Drug Administration (FDA) | date=30 January 2024 | url=https://www.fda.gov/drugs/drug-safety-and-availability/fda-requests-removal-suicidal-behavior-and-ideation-warning-glucagon-peptide-1-receptor-agonist-glp | access-date=15 February 2026}} {{PD-notice}}</ref>
While adolescents taking GLP-1 drugs experienced more gastrointestinal symptoms, they had a lower risk of acute pancreatitis compared to the control group.<ref>{{Cite web |title=GLP-1 therapy may reduce suicidal ideation risk for adolescents with obesity |url=https://www.healio.com/news/endocrinology/20241014/glp1-therapy-may-reduce-suicidal-ideation-risk-for-adolescents-with-obesity |access-date=2024-10-18 |website=www.healio.com }}</ref> A similar study in adults reported similar results for semaglutide.<ref>{{Cite journal |last1=Wang |first1=William |last2=Volkow |first2=Nora D. |last3=Berger |first3=Nathan A. |last4=Davis |first4=Pamela B. |last5=Kaelber |first5=David C. |last6=Xu |first6=Rong |date=January 2024 |title=Association of semaglutide with risk of suicidal ideation in a real-world cohort |journal=Nature Medicine |volume=30 |issue=1 |pages=168–176 |doi=10.1038/s41591-023-02672-2 |pmc=11034947 |pmid=38182782 }}</ref>
A 2025 study suggested that GLP-1 agonists increased risks of hypotension (low blood pressure), syncope (fainting), joint diseases, nephrolithiasis (kidney stones), interstitial nephritis, and acute pancreatitis.<ref name=Xie2025>{{cite journal |last1=Xie |first1=Yan |last2=Choi |first2=Taeyoung |last3=Al-Aly |first3=Ziyad |title=Mapping the effectiveness and risks of GLP-1 receptor agonists |journal=Nature Medicine |date=March 2025 |volume=31 |issue=3 |pages=951–962 |doi=10.1038/s41591-024-03412-w |pmid=39833406 }}</ref>
=== Thyroid cancer === The US Food and Drug Administration requires a boxed warning in the package inserts of GLP-1 agonists due to the risk of thyroid C-cell tumors, including medullary thyroid cancer (MTC). GLP-1 agonists are contraindicated in people with a family or personal history of MTC or multiple endocrine neoplasia type 2.<ref name="Nachawi">{{cite journal |last1=Nachawi |first1=Noura |last2=Rao |first2=Pratibha PR |last3=Makin |first3=Vinni |date=2022 |title=The role of GLP-1 receptor agonists in managing type 2 diabetes |journal=Cleveland Clinic Journal of Medicine |type=Review |volume=89 |issue=8 |pages=457–464 |doi=10.3949/ccjm.89a.21110 |pmid=35914933 |doi-access=free}}</ref> In mice, long-term use of GLP-1 agonists stimulates calcitonin secretion, leading to C-cell hypertrophy and increased risk of thyroid cancer, but no increased secretion of calcitonin has been observed in humans.<ref name="Yu">{{cite journal |last1=Yu |first1=Minzhi |last2=Benjamin |first2=Mason M. |last3=Srinivasan |first3=Santhanakrishnan |last4=Morin |first4=Emily E. |last5=Shishatskaya |first5=Ekaterina I. |last6=Schwendeman |first6=Steven P. |last7=Schwendeman |first7=Anna |display-authors= 3 |title=Battle of GLP-1 delivery technologies |journal=Advanced Drug Delivery Reviews |date=2018 |volume=130 |pages=113–130 |doi=10.1016/j.addr.2018.07.009|pmid=30009885 |pmc=6843995 }}</ref> A retrospective national cohort study in France reported an increased risk of thyroid cancer (all and medullary) after 1-3 years of treatment with GLP-1 agonists for diabetes,<ref>{{Cite journal |last1=Bezin |first1=Julien |last2=Gouverneur |first2=Amandine |last3=Pénichon |first3=Marine |last4=Mathieu |first4=Clément |last5=Garrel |first5=Renaud |last6=Hillaire-Buys |first6=Dominique |last7=Pariente |first7=Antoine |last8=Faillie |first8=Jean-Luc |date=2023-02-01 |title=GLP-1 Receptor Agonists and the Risk of Thyroid Cancer |journal=Diabetes Care |volume=46 |issue=2 |pages=384–390 |doi=10.2337/dc22-1148 |pmid=36356111}}</ref> but other large retrospective studies have not reported a similar association,<ref>{{cite journal |last1=Morales |first1=Daniel R. |last2=Bu |first2=Fan |last3=Viernes |first3=Benjamin |last4=DuVall |first4=Scott L. |last5=Matheny |first5=Michael E. |last6=Simon |first6=Katherine R. |last7=Falconer |first7=Thomas |last8=Richter |first8=Lauren R. |last9=Ostropolets |first9=Anna |last10=Lau |first10=Wallis C.Y. |last11=Man |first11=Kenneth K.C. |last12=Chattopadhyay |first12=Shounak |last13=Mathioudakis |first13=Nestoras |last14=Minty |first14=Evan |last15=Nishimura |first15=Akihiko |last16=Sun |first16=Feng |last17=Yin |first17=Can |last18=Seager |first18=Sarah L. |last19=Chai |first19=Yi |last20=Zhou |first20=Jin J. |last21=Lu |first21=Yuan |last22=Reyes |first22=Carlen |last23=Pistillo |first23=Andrea |last24=Duarte-Salles |first24=Talita |last25=Blacketer |first25=Clair |last26=Schuemie |first26=Martijn J. |last27=Ryan |first27=Patrick B. |last28=Krumholz |first28=Harlan M. |last29=Hripcsak |first29=George |last30=Khera |first30=Rohan |last31=Suchard |first31=Marc A. |title=Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study |journal=Diabetes Care |date=August 2025 |volume=48 |issue=8 |pages=1386–1394 |doi=10.2337/dc25-0154 |pmc=12281980 |pmid=40465422 }}</ref> including with long-term use of GLP-1 agonists and over 10 years of followup.<ref>{{Cite journal |last1=Pollack |first1=Rena |last2=Stokar |first2=Joshua |date=2025 |title=Long-Term Glucagon-Like Peptide 1 Receptor Agonist Use Is Not Associated With Increased Risk of Thyroid Cancer in Adults With Type 2 Diabetes |journal=Diabetes/Metabolism Research and Reviews |volume=41 |issue=8 |article-number=e70104 |doi=10.1002/dmrr.70104 |pmid=41182904 |pmc=12582397 }}</ref>
== Society and culture== Influencers and celebrities popularized GLP-1 agonists in the early 2020s, causing many people to seek them for cosmetic or health-based weight loss.<ref>{{cite journal |last1=Han |first1=Sabrina H |last2=Safeek |first2=Rachel |last3=Ockerman |first3=Kyle |last4=Trieu |first4=Nhan |last5=Mars |first5=Patricia |last6=Klenke |first6=Audrey |last7=Furnas |first7=Heather |last8=Sorice-Virk |first8=Sarah |title=Public Interest in the Off-Label Use of Glucagon-like Peptide 1 Agonists (Ozempic) for Cosmetic Weight Loss: A Google Trends Analysis |journal=Aesthetic Surgery Journal |date=14 December 2023 |volume=44 |issue=1 |pages=60–67 |doi=10.1093/asj/sjad211 |pmid=37402640 }}</ref>
===Cost=== GLP-1 agonists are more expensive than other treatments for type 2 diabetes. A study compared the cost-effectiveness of GLP-1 agonists to long-acting insulin in a Taiwanese population with type 2 diabetes. In people with cardiovascular disease (CVD), GLP-1 agonists were estimated to save money due to fewer cardiovascular incidents. In people without CVD, the cost per QALY was $9,093.<ref>{{cite journal |last1=Yang |first1=Chun-Ting |last2=Yao |first2= Wen-Yu |last3=Ou |first3=Huang-Tz |last4=Kuo |first4=Shihchen |title=Value of GLP-1 receptor agonists versus long-acting insulins for type 2 diabetes patients with and without established cardiovascular or chronic kidney diseases: A model-based cost-effectiveness analysis using real-world data |journal= Diabetes Research and Clinical Practice |date=April 2023 |volume=198 |article-number=110625 |doi=10.1016/j.diabres.2023.110625 |pmid=36924833 }}</ref> In the United States, cost is the highest barrier to GLP-1 agonist usage and was reported as the reason for discontinuation in 48.6% of people who stopped using the drugs.<ref>{{cite journal |last1=Moore |first1=Peyton W. |last2=Malone |first2=Kevin |last3=VanValkenburg |first3=Delena |last4=Rando |first4=Lauren L. |last5=Williams |first5=Brooke C. |last6=Matejowsky |first6=Hannah G. |last7=Ahmadzadeh |first7=Shahab |last8=Shekoohi |first8=Sahar |last9=Cornett |first9=Elyse M. |last10=Kaye |first10= Alan D. |display-authors= 3 |title=GLP-1 Agonists for Weight Loss: Pharmacology and Clinical Implications |journal=Advances in Therapy |date=2023 |volume=40 |issue=3 |pages=723–742 |doi=10.1007/s12325-022-02394-w |pmid=36566341 }}</ref> According to a 2023 study, GLP-1 agonists were not cost-effective for pediatric obesity in the U.S.<ref>{{cite journal |last1=Lim |first1=Francesca |last2=Bellows |first2=Brandon K. |last3=Tan |first3=Sarah Xinhui |last4=Aziz |first4=Zainab |last5=Woo Baidal |first5=Jennifer A. |last6=Kelly |first6=Aaron S. |last7=Hur |first7=Chin |display-authors= 3 |title= Cost-Effectiveness of Pharmacotherapy for the Treatment of Obesity in Adolescents |journal=JAMA Network Open |date=2023 |volume=6 |issue=8 |pages=e2329178 |doi=10.1001/jamanetworkopen.2023.29178 |pmid=37651143 |pmc=10472196 }}</ref> As of late 2025, prices had dropped substantially.<ref>{{Cite web |last=Alltucker |first=Ken |title=Drugmaker cuts prices for Ozempic, Wegovy. Here's how much you will pay. |url=https://www.usatoday.com/story/money/2025/11/17/novo-nordisk-cuts-prices-ozempic-wegovy/87269159007/ |access-date=2025-12-28 |website=USA TODAY |language=en-US}}</ref> In 2025 it was estimated that Medicare coverage of GLP-1RA agonists for obesity in the United States would increase federal spending by $69.5 billion over a decade.<ref>{{Cite journal |last1=Hwang |first1=Jennifer H. |last2=Laiteerapong |first2=Neda |last3=Huang |first3=Elbert S. |last4=Mozaffarian |first4=Dariush |last5=Fendrick |first5=A. Mark |last6=Kim |first6=David D. |date=2025-04-25 |title=Fiscal Impact of Expanded Medicare Coverage for GLP-1 Receptor Agonists to Treat Obesity |journal=JAMA Health Forum |language=en |volume=6 |issue=4 |pages=e250905 |doi=10.1001/jamahealthforum.2025.0905 |issn=2689-0186 |pmc=12032556 |pmid=40279111}}</ref>
Mixed results have been found when economic evaluations of glucagon like peptide-1 (GLP-1) receptor agonists have been done, specifically in response to its use for obesity treatment in people without diabetes. A 2026 review concluded that, due to their high acquisition costs, GLP-1 receptor agonists are generally not cost-effective compared to lifestyle interventions or no treatment at all from a healthcare-payer perspective.<ref name=":0">{{Cite journal |last1=Dhippayom |first1=Teerapon |last2=Meraz |first2=Manuel |last3=Lee |first3=Haeseon |last4=Hur |first4=Chin |last5=Inadomi |first5=John M. |last6=Veettil |first6=Sajesh K. |last7=Dunn |first7=Jeffrey D. |last8=Chaiyakunapruk |first8=Nathorn |date=February 2026 |title=GLP-1 receptor agonists for treating obesity without diabetes: A systematic review and meta-analysis of economic evaluations |journal=Diabetes, Obesity and Metabolism |language=en |volume=28 |issue=2 |pages=1339–1349 |doi=10.1111/dom.70322 |issn=1462-8902 |pmc=12803668 |pmid=41365841}}</ref> The analysis also reported that cost-effectiveness outcomes vary drastically depending on assumptions related to treatment duration, long-term weight maintenance, and the time horizon of the specific model. Over longer periods, or populations at high risk of obesity, GLP-1 receptor agonists may have a more favorable cost-effectiveness analysis.<ref name=":0" /> Despite the economic considerations, GLP-1 receptor agonists are included in clinical guidelines for obesity management due to their demonstrated efficacy in weight loss and cardiometabolic risk improvement. The high cost has been identified and is seen as a barrier to access and widespread use in many healthcare systems.<ref name=":0" />
===Health economics and cost effects=== Compared to insulin therapy in patients with type 2 diabetes requiring treatment, GLP-1 RAs may be more cost-effective. In a recent observation of a cohort study using Taiwan's National Health Isurance Reaserch Database, GLP-1 RA therapy was associated with improved clinical outcomes. This includes reductions in mortality and hospitalized hypoglycemia relative to insulin. From an economic perspective, GLP-1 RAs were associated with higher direct drug costs but demonstrated value when evaluated against clinical outcomes. The cost per case prevented was approximately $54,851 for all-cause mortality and $29,115 for hospitalized hypoglycemia from the perspective of a third-party payer. But GLP-1 RA use was associated with net cost savings and reflected a downward movement of healthcare utilization. Studies found that GLP-1 RAs are cost-effective for only some patients. These population groups are limited to long-term cardiovascular and metabolic benefits. Overall, evidence suggests that though these receptor agonists have higher upfront costs, their ability to reduce adverse clinical events may make them a more cost-effective therapy option.<ref>{{Cite journal |last1=Yang |first1=Chen-Yi |last2=Chen |first2=Ying-Ren |last3=Ou |first3=Huang-Tz |last4=Kuo |first4=Shihchen |date=2021-01-19 |title=Cost-effectiveness of GLP-1 receptor agonists versus insulin for the treatment of type 2 diabetes: a real-world study and systematic review |journal=Cardiovascular Diabetology |language=en |volume=20 |issue=1 |pages=21 |doi=10.1186/s12933-020-01211-4 |doi-access=free |issn=1475-2840 |pmc=7816439 |pmid=33468131}}</ref>
==== Medicare, Medicaid, and CHIP coverage ==== On April 4, 2025, the Trump administration declined to finalize a proposal from the Biden administration that would have required Medicare, Medicaid, and CHIP to broadly cover GLP-1s for weight loss. Despite the rejection, CMS has indicated that it might cover obesity medication in future rulemaking. But in November 2025, the Trump administration announced TrumpRx, an initiative similar to GoodRx to lower the price of GLP-1s to $245 per month for patients covered by Medicaid and CHIP and $50 month for Medicare patients if states opted in. Coverage for patients with obesity and at least one comorbidity like (elevated LDL-cholesterol, high blood pressure, or MASLD), will be implemented as early as April 1, 2026. The cost will be significantly higher to taxpayers since most health insurance companies do not cover it in their formulary. Before this change, most Medicaid and CHIP patients paid $3 a month, the same price as for brand-name medication.<ref>{{Cite news |title=Think 2025 Was a Big Year for Health News? Fasten Your Seat Belts |url=https://www.bloomberg.com/news/newsletters/2026-01-01/health-metrics-shaping-2026-fda-approvals-measles-trends-insurance-premiums?embedded-checkout=true |access-date=March 7, 2026 |work=Bloomberg}}</ref> In December 2025, CMS announced the Medicare GLP-1 Bridge, a demonstration program running from July 1 to December 31, 2026, giving eligible Medicare Part D beneficiaries access to Wegovy and Zepbound at $50 per month.<ref>{{cite web |title=Medicare GLP-1 Bridge |url=https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge |access-date=April 9, 2026 |website=Centers for Medicare & Medicaid Services}}</ref> A longer-term program, the BALANCE Model, is planned for January 2027.<ref>{{cite web |title=BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model |url=https://www.cms.gov/priorities/innovation/innovation-models/balance |access-date=April 9, 2026 |website=Centers for Medicare & Medicaid Services}}</ref>
===Future coverage in health care plans=== Randomized clinical trials of GLP-1 antagonists found that more than one-third of participants who were overweight or obese lost 20% or more of their weight. Due to substantial weight loss it is predicted that health care spending would decrease for people who are obese or overweight after taking GLP-1 antagonists to lose weight. This creates an incentive for health care plans and Medicare to include weight loss treatments.<ref>{{Cite journal |last1=Thorpe |first1=Kenneth E. |last2=Joski |first2=Peter J. |date=2024-12-05 |title=Estimated Reduction in Health Care Spending Associated With Weight Loss in Adults |journal=JAMA Network Open |language=en |volume=7 |issue=12 |pages=e2449200 |doi=10.1001/jamanetworkopen.2024.49200 |issn=2574-3805 |pmc=11621981 |pmid=39636635}}</ref>
=== Legal status === {{globalize|section|US|date=January 2026}} * liraglutide (Victoza for type 2 diabetes, Saxenda for weight management, manufactured by Novo Nordisk), approved in 2010/2014<ref>{{cite press release |title=FDA Approves New Treatment for Type 2 Diabetes |date=25 January 2010 |publisher=Food and Drug Administration |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm198638.htm |archive-url=https://web.archive.org/web/20100128002155/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm198638.htm |archive-date=28 January 2010 |website=FDA.gov}}</ref> * dulaglutide (Trulicity, manufactured by Eli Lilly), approved in 2014<ref>{{cite press release |title=FDA approves Trulicity to treat type 2 diabetes |date=18 September 2014 |publisher=Food and Drug Administration |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm415180.htm |archive-url=https://web.archive.org/web/20140918235934/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm415180.htm |archive-date=18 September 2014}}</ref> * semaglutide (Ozempic and Rybelsus for diabetes, Wegovy for weight management, manufactured by Novo Nordisk), approved in 2021/2019/2021<ref>{{cite journal |last1=Tibble |first1=Courtney Aavang |last2=Cavaiola |first2=Tricia Santos |last3=Henry |first3=Robert R |title=Longer acting GLP-1 receptor agonists and the potential for improved cardiovascular outcomes: a review of current literature |journal=Expert Review of Endocrinology & Metabolism |date=May 2013 |volume=8 |issue=3 |pages=247–259 |doi=10.1586/eem.13.20 |pmid=30780817 }}</ref> * tirzepatide (a GIP analog with dual GLP-1 receptor and GIP receptor agonism; Mounjaro for diabetes, Zepbound for weight management, manufactured by Eli Lilly), approved in 2022/2024<ref>{{cite journal |display-authors=6 |vauthors=Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, Liu B, Cui X, Brown K |date=August 2021 |title=Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes |journal=The New England Journal of Medicine |volume=385 |issue=6 |pages=503–515 |doi=10.1056/NEJMoa2107519 |pmid=34170647 |doi-access=free}}</ref>
Discontinued: * exenatide (brand names Byetta and Bydureon, manufactured by AstraZeneca), approved 2005/2012,<ref>{{Cite web |title=Drug Approval Package |url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/021773_byettatoc.cfm#:~:text=Approval%20Date:%204/28/2005 |url-status=live |archive-url=https://web.archive.org/web/20250419192041/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/021773_byettatoc.cfm#:~:text=Approval%20Date:%204/28/2005 |archive-date=2025-04-19 |access-date=2025-05-01 |website=www.accessdata.fda.gov}}</ref> discontinued in 2024 * albiglutide (Tanzeum, manufactured by GSK), approved in 2014,<ref>{{cite web |last=Busko |first=Marlene |date=15 April 2014 |title=FDA Approves Weekly Injectable Diabetes Drug: Albiglutide |url=http://www.medscape.com/viewarticle/823645 |url-access=subscription |website=Medscape |type=News, FDA Approvals}}</ref> discontinued in 2017 * lixisenatide (Lyxumia in Europe, Adlyxin in the United States, manufactured by Sanofi), approved in 2016,<ref>{{cite press release |title=FDA approves Adlyxin to treat type 2 diabetes |date=28 July 2016 |publisher=Food and Drug Administration |url=https://www.fda.gov/news-events/press-announcements/fda-approves-adlyxin-treat-type-2-diabetes |archive-url=https://web.archive.org/web/20191211202237/https://www.fda.gov/news-events/press-announcements/fda-approves-adlyxin-treat-type-2-diabetes |archive-date=December 11, 2019}}</ref> discontinued in 2023
===Combination and multiple target drugs=== {{see also|GLP1 poly-agonist peptides}} Some GLP-1 agonists, such as tirzepatide, are also agonists of the GIP receptor, glucagon receptor, and/or amylin receptor. These additional targets are hoped to increase the amount of weight loss the drugs cause.<ref>{{cite journal |last1=Goldenberg |first1=Ronald M. |last2= Gilbert |first2=Jeremy D. |last3=Manjoo |first3=Priya |last4=Pedersen |first4=Sue D. |last5=Woo |first5=Vincent C. |last6=Lovshin |first6=Julie A. |display-authors= 3 |title= Management of type 2 diabetes, obesity, or nonalcoholic steatohepatitis with high-dose GLP-1 receptor agonists and GLP-1 receptor-based co-agonists |journal= Obesity Reviews |date=2024 |volume=25 |issue=3 |article-number=e13663 |doi=10.1111/obr.13663|pmid=37968541 }}</ref><ref name=Knerr>{{cite journal |last1=Knerr |first1=Patrick J. |last2=Mowery |first2=Stephanie A. |last3=Finan |first3=Brian |last4=Perez-Tilve |first4=Diego |last5=Tschöp |first5=Matthias H. |last6=DiMarchi |first6=Richard D. |display-authors= 3 |title=Selection and progression of unimolecular agonists at the GIP, GLP-1, and glucagon receptors as drug candidates |journal=Peptides |date=2020 |volume=125 |article-number=170225 |doi=10.1016/j.peptides.2019.170225 |pmid=31786282 }}</ref>
===Alternatives to approved sources=== Gray market sellers offer unauthorized products they claim are GLP-1 agonists. Some buyers turn to unauthorized retailers if they cannot afford the name-brand drug.<ref>{{cite news |title=Woman says she got less expensive drug for weight loss after being denied by insurance |url=https://abcnews.go.com/GMA/Wellness/high-cost-drugs-weight-loss-ozempic-mounjaro-users/story?id=99424157 | first1= Sarah |last1= Messer |first2= Katie |last2= Kindelan |date= May 18, 2023 |work= abcnews.go.com| publisher= ABC News |language= en |access-date= 31 July 2024 }}</ref><ref>{{cite news |title=Safety worries over copycat versions of Ozempic and Wegovy prompt state crackdowns |url=https://www.nbcnews.com/health/health-news/ozempic-wegovy-weight-loss-compounded-crackdowns-rcna82405 |access-date=26 September 2023 |work= nbcnews.com | first= Berkeley Jr.| last= Lovelace |publisher= NBC News |date= May 3, 2023 |language=en}}</ref><ref>{{cite magazine |last1=Jones |first1=C. T. |title=The FDA Warned Ozempic Users. They Don't Give a F-ck |url= https://www.rollingstone.com/culture/culture-features/ozempic-semaglutide-fda-warning-compound-drug-1234766348/ |access-date=26 September 2023 |magazine= Rolling Stone |date=8 June 2023}}</ref><ref>{{cite news |title=Inside the gold rush to sell cheaper imitations of Ozempic |url= https://www.washingtonpost.com/business/2023/09/19/ozempic-semaglutide-compounding-pharmacies/ | first= Daniel| last= Gilbert |newspaper= Washington Post |date= 19 September 2023 |language=en |access-date= 31 July 2024}}</ref><ref>{{cite news |title=The high price of Ozempic is pushing many to unregulated, copycat drugs for weight loss |url= https://www.nbcnews.com/health/health-news/ozempic-wegovy-semaglutide-compounding-weight-loss-safe-rcna72990 |first1= Berkeley Jr. | last1= Lovelace | first2= Reynolds |last2= Lewis |first3= Marina |last3= Kopf |work= nbcnews.com | publisher= NBC News |date=19 March 2023 |language=en |access-date= 31 July 2024}}</ref> Buyers face risks due to counterfeit or substandard drugs.<ref>{{cite journal |last1= Chiappini |first1=Stefania |last2=Papanti Pelletier |first2=G. Duccio |last3=Vickers-Smith |first3=Rachel |last4=Corkery |first4=John M. |last5= Guirguis |first5=Amira |last6=Martinotti |first6=Giovanni |last7=Schifano |first7=Fabrizio |display-authors= 3 |title=Exploring the nexus of binge eating disorder (BED), New Psychoactive Substances (NPS), and misuse of pharmaceuticals: charting a path forward |journal=Expert Opinion on Pharmacotherapy |date=19 October 2023 |volume=24 |issue=18 |pages=1915–1918 |doi=10.1080/14656566.2023.2271389 |pmid=37853742 |doi-access=free |hdl=2299/26958 |hdl-access=free }}</ref>
In the United States, compounding pharmacies may sell custom-made versions of a drug if there is a declared shortage and they obtain the active pharmaceutical ingredient from an FDA-approved facility.<ref>{{cite news |url=https://www.npr.org/2024/05/30/nx-s1-4973307/compounding-pharmacies-are-making-their-own-versions-of-blockbuster-weight-loss-drugs |title=Compounding pharmacies are making their own versions of blockbuster weight loss drugs |date=May 30, 2024 |publisher=NPR |author=Sydney Lupkin}}</ref> The FDA declared shortages of injectable versions of semaglutide, tirzepatide, dulaglutide, liraglutide, and exenatide in 2022. The tirzepatide shortage ended in 2024.<ref>{{Cite web|url=https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize|title=CDER Statement|work=FDA |date=October 3, 2024}}</ref> Al Carter, executive director of the National Association of Boards of Pharmacy, a trade organization for pharmacy regulators, estimated that 95% of online compounding pharmacies were operating illegally in 2024.<ref name="online">{{cite news |url=https://www.npr.org/sections/shots-health-news/2024/06/07/g-s1-3331/wegovy-online-compound-semaglutide-compounding-pharmacies |title=Thinking of buying Wegovy online? Here's what to know about compounding pharmacies |date=June 7, 2024 |author=Sydney Lupkin |publisher=NPR}}</ref> {{As of|January 2026}}, there were up to {{nowrap|1.5 million}} users of compounded GLP-1 receptor agonist drugs in the U.S., according to Novo Nordisk CEO Mike Doustdar.<ref name="Reuters1">{{citation|author1-last=Fick|author1-first=Maggie|author2-last=Roy|author2-first=Mrinalika|title=Novo Nordisk CEO flags 1.5 million US users of compounded GLP-1 drugs|website=Reuters website|date=2026-01-13|url=https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-ceo-flags-15-million-us-users-compounded-glp-1-drugs-2026-01-12/|access-date=2026-01-21}}</ref> He decried the practice of selling what he called "unsafe, knock-off products" while conceding that compounding pharmacies capture price-sensitive consumers in a way that his company, with its more expensive branded offerings, cannot.<ref name="Reuters1" />
===Patents and regulatory exclusions=== GLP-1 drugs are protected by patents and regulatory exclusivities, which delay generic competitors and keep prices high. The drugs have a median of 20 patents.<ref>{{Cite journal |last1=Alhiary |first1=Rasha |last2=Kesselheim |first2=Aaron S. |last3=Gabriele |first3=Sarah |last4=Beall |first4=Reed F. |last5=Tu |first5=S. Sean |last6=Feldman |first6=William B. |date=2023-08-15 |title=Patents and Regulatory Exclusivities on GLP-1 Receptor Agonists |journal=JAMA |language=en |volume=330 |issue=7 |pages=650–657 |doi=10.1001/jama.2023.13872 |issn=0098-7484 |pmc=11457043 |pmid=37505513}}</ref> These patents have protection periods averaging 18 years.<ref>{{Cite journal |last1=Alhiary |first1=Rasha |last2=Kesselheim |first2=Aaron S. |last3=Gabriele |first3=Sarah |last4=Beall |first4=Reed F. |last5=Tu |first5=S. Sean |last6=Feldman |first6=William B. |date=2023-08-15 |title=Patents and Regulatory Exclusivities on GLP-1 Receptor Agonists |journal=JAMA |language=en |volume=330 |issue=7 |pages=650–657 |doi=10.1001/jama.2023.13872 |issn=0098-7484 |pmc=11457043 |pmid=37505513}}</ref> The patents apply not only to the drugs but also to injection devices, delivery systems, and other components. Overlapping patents make it hard for generic manfacturers to enter the market. This creates a tradeoff between short-term affordability and long-term pharmaceutical innovation.<ref>{{Cite journal |last1=Alhiary |first1=Rasha |last2=Kesselheim |first2=Aaron S. |last3=Gabriele |first3=Sarah |last4=Beall |first4=Reed F. |last5=Tu |first5=S. Sean |last6=Feldman |first6=William B. |date=2023-08-15 |title=Patents and Regulatory Exclusivities on GLP-1 Receptor Agonists |journal=JAMA |language=en |volume=330 |issue=7 |pages=650–657 |doi=10.1001/jama.2023.13872 |issn=0098-7484 |pmc=11457043 |pmid=37505513}}</ref>
==History== During the 1980s, Jean-Pierre Raufman worked as a postdoctoral researcher at the National Institutes of Health for John Pisano, a biochemist who specialized in collecting venom from various animals and looking for novel substances that could affect human physiology.<ref name="Molteni">{{cite news |last1=Molteni |first1=Megan |last2=Chen |first2=Elaine |title=GLP-1 drugs are transforming diabetes, obesity and more. Could a Nobel be next? |url=https://www.statnews.com/2023/09/30/weight-loss-ozempic-nobel-prize-science/ |access-date=October 16, 2024 |work=STAT News |date=September 30, 2023}}</ref> In the course of this work, Raufman focused on the Gila monster, because he was curious about its practice of eating once or twice per year.<ref name="Schwarcz">{{cite news |last1=Schwarcz |first1=Joe |title=The Right Chemistry: How the Gila monster assisted weight-loss research |url=https://montrealgazette.com/opinion/columnists/the-right-chemistry-how-the-gila-monster-assisted-weight-loss-research |access-date=October 16, 2024 |work=The Montreal Gazette |date=May 26, 2023}}</ref> He reported that Gila monster venom had biologically active molecules that provoked inflammation of the pancreas in test animals.<ref name="Schwarcz" /><ref name="Winkler">{{cite news |last1=Winkler |first1=Rolfe |last2=Cohen |first2=Ben |title=Monster Diet Drugs Like Ozempic Started With Actual Monsters |url=https://www.wsj.com/articles/ozempic-mounjaro-gila-monster-anglerfish-8c9c1ff2 |access-date=October 16, 2024 |work=The Wall Street Journal |date=June 23, 2023 |url-access=subscription}}</ref>
In 1992, after learning of Raufman's findings, John Eng of the Veterans Administration Medical Center in New York City used radioimmunoassay to isolate a novel substance from Gila monster venom.<ref name="Schwarcz" /><ref name="Molteni" /><ref name="Winkler" /> The new substance, which Eng called exendin-4, was similar to GLP-1 in that it reduced blood glucose in diabetic mice, but exendin-4 had a much longer half-life than GLP-1, whose extremely short half-life had defeated earlier attempts to turn it into a drug.<ref name="Molteni" /><ref name="Winkler" />
Eng filed a patent application for exendin-4 in 1993.<ref name="Molteni" /> He then spent three years searching for a pharmaceutical industry partner interested in commercializing exendin-4.<ref name="Schwarcz" /><ref name="Molteni" /><ref name="Winkler" /> In 1996, Amylin Pharmaceuticals licensed Eng's patent and created a synthetic version of exendin-4 called exenatide.<ref name="Schwarcz" /><ref name="Molteni" /><ref name="Winkler" /> In 2002, Eli Lilly and Company partnered with Amylin to develop exenatide and secure approval to market the drug.<ref name="Pollack">{{cite news |last1=Pollack |first1=Andrew |title=Eli Lilly in Deal For the Rights To a New Drug For Diabetes |url=https://www.nytimes.com/2002/09/21/business/eli-lilly-in-deal-for-the-rights-to-a-new-drug-for-diabetes.html |work=The New York Times |date=September 21, 2002 |page=C1}}</ref> Exenatide's 2005 approval by the U.S. Food and Drug Administration<ref name="Pollack2">{{cite news |last1=Pollack |first1=Andrew |title=Lizard-Derived Diabetes Drug Is Approved by the F.D.A. |url=https://www.nytimes.com/2005/04/30/business/lizardderived-diabetes-drug-is-approved-by-the-fda.html |access-date=November 2, 2024 |work=The New York Times |date=April 30, 2005 |url-access=subscription}}</ref> showed that targeting the GLP-1 receptor was a viable strategy and inspired other pharmaceutical companies to focus on that receptor.<ref name="Molteni" /><ref name="Winkler" />
In 2011, Lilly and Amylin dissolved their partnership, with Amylin keeping the rights to exenatide.<ref name="Staton">{{cite news | vauthors = Staton T |title=Amylin gets Byetta custody in split with Lilly |url=https://www.fiercepharma.com/sponsored/evolving-expanding-integrated-platform-partnerships-drive-access-affordability-outcomes |access-date=November 2, 2024 |work=Fierce Pharma |date=November 8, 2011}}</ref> Lilly continued to develop drugs of the same class.
The 2024 American Diabetes Association conference included presentations on at least 27 GLP-1 receptor agonists then in development.<ref name="Lovelace">{{cite news |last1=Lovelace Jr. |first1=Berkeley |title=Beyond Ozempic: New GLP-1 drugs promise weight loss and health benefits |url=https://www.nbcnews.com/health/health-news/beyond-ozempic-glp-1-drugs-promise-weight-loss-health-benefits-rcna157525 |work=NBC News |date=June 23, 2024}}</ref> By July 2024, Novo Nordisk's semaglutide and Eli Lilly's tirzepatide were ranked among the world's most popular and lucrative drugs.<ref name="Wainer">{{cite news |last1=Wainer |first1=David |title=Rivals Emerge to Ozempic and Zepbound—but With a Lag |url=https://www.wsj.com/health/pharma/rivals-emerge-to-ozempic-and-zepboundbut-with-a-lag-60b555bb |work=The Wall Street Journal |date=July 19, 2024 |url-access=subscription}}</ref> Novo Nordisk's rollout of semaglutide turned it into the most valuable company in Europe in 2024.<ref name="Wass">{{cite news |last1=Wass |first1=Sanne |last2=Kresge |first2=Naomi |title=The Ozempic Effect: How a Weight Loss Wonder Drug Gobbled Up an Entire Economy |url=https://www.bloomberg.com/news/features/2024-04-30/denmark-and-novo-nordisk-ozempic-maker-s-success-makes-huge-impact|work=Bloomberg |date=April 30, 2024 |url-access=subscription}}</ref><ref name="Nelson">{{cite news |last1=Nelson |first1=Eshe |title=How Ozempic Is Transforming a Small Danish Town |url=https://www.nytimes.com/2024/04/20/business/ozempic-denmark-novo-nordisk.html |work=The New York Times |date=April 20, 2024 |url-access=subscription}}</ref> Its market capitalization of $570 billion was larger than the entire economy of its home country of Denmark; its $2.3 billion income tax bill for 2023 made it the country's largest taxpayer; and its rapid growth represented nearly all of Denmark's economic growth.<ref name="Wass" /><ref name="Nelson" /> By October 2024, tirzepatide had turned Eli Lilly into the world's most valuable drug company.<ref name="Barnes">{{cite news |last1=Barnes |first1=Oliver |title=Can Eli Lilly become the first $1tn drugmaker? |url=https://www.ft.com/content/ed81ca79-1fd6-48ea-8e50-246d0849c3f5 |work=Financial Times |date=October 2, 2024 |url-access=subscription}}</ref>
== Research == A retrospective cohort study published in 2025 evaluated GLP-1 agonists' benefits and risks compared to other anti-diabetic medications. The study suggested that GLP-1 agonists reduced risks of substance use and psychotic disorders, seizures, neurocognitive disorders (including Alzheimer's disease and other dementias), coagulation disorders, cardiometabolic disorders, infectious diseases, and several respiratory conditions relative to nonusers.<ref name=Xie2025/>
Under research are GLP1 poly-agonist peptides, dual and triple receptor agonists such as tirzepatide (GLP-1 + GIP) and retatrutide (GLP-1 + GIP + glucagon), and combinations such as cagrilintide/semaglutide, which combines semaglutide with a dual amylin and calcitonin receptor agonist,<ref name="Yu"/><ref>{{cite journal |last1=Castellana |first1=Marco |last2=Cignarelli |first2=Angelo |last3=Brescia |first3=Francesco |last4=Laviola |first4=Luigi |last5=Giorgino |first5= Francesco | display-authors= 3 |title=GLP -1 receptor agonist added to insulin versus basal-plus or basal-bolus insulin therapy in type 2 diabetes: A systematic review and meta-analysis |journal= Diabetes/Metabolism Research and Reviews |date=2019 |volume=35 |issue=1 |article-number=e3082 |doi=10.1002/dmrr.3082 |pmid=30270567 |doi-access=free }}</ref><ref>{{cite journal |last1= Holst |first1=Jens Juul |last2=Jepsen |first2=Sara Lind |last3=Modvig |first3=Ida |title=GLP-1 – Incretin and pleiotropic hormone with pharmacotherapy potential. Increasing secretion of endogenous GLP-1 for diabetes and obesity therapy |journal=Current Opinion in Pharmacology |date=2022 |volume= 63 |article-number=102189 |doi=10.1016/j.coph.2022.102189 |pmid=35231672 |doi-access=free }}</ref> and amycretin, which acts as both a GLP1 and an amylin agonist.<ref>{{Cite journal |last1=Melson |first1=Eka |last2=Ashraf |first2=Uzma |last3=Papamargaritis |first3=Dimitris |last4=Davies |first4=Melanie J. |date=March 2025 |title=What is the pipeline for future medications for obesity? |journal=International Journal of Obesity (2005) |volume=49 |issue=3 |pages=433–451 |doi=10.1038/s41366-024-01473-y |issn=1476-5497 |pmc=11971045 |pmid=38302593}}</ref>
=== Alzheimer's disease === A 2025 study suggested that GLP-1 agonists may reduce risks of neurocognitive disorders, including Alzheimer's disease, pointing to a then-emerging body of research. Hypotheses include that the drugs reduce neuroinflammation, oxidative stress, amyloid β deposition, and tau hyperphosphorylation in animal models.<ref name="Xie2025" />
In November 2025, Novo Nordisk announced<ref>{{Cite news |last=Kolata |first=Gina |date=2025-11-24 |title=GLP-1 Drug Fails to Quell Alzheimer's in Novo Nordisk Trials |url=https://www.nytimes.com/2025/11/24/health/ozempic-wegovy-alzheimers-novo-nordisk.html |access-date=2025-12-21 |work=The New York Times}}</ref> top-line results from two large-scale studies, evoke and evoke+. The studies reported failure to slow the progression of Alzheimer's disease versus placebo.<ref>{{Cite journal |last1=Cummings |first1=Jeffrey L. |last2=Atri |first2=Alireza |last3=Feldman |first3=Howard H. |last4=Hansson |first4=Oskar |last5=Sano |first5=Mary |last6=Knop |first6=Filip K. |last7=Johannsen |first7=Peter |last8=León |first8=Teresa |last9=Scheltens |first9=Philip |date=2025-01-08 |title=evoke and evoke+: design of two large-scale, double-blind, placebo-controlled, phase 3 studies evaluating efficacy, safety, and tolerability of semaglutide in early-stage symptomatic Alzheimer's disease |journal=Alzheimer's Research & Therapy |language=en |volume=17 |issue=1 |page=14 |doi=10.1186/s13195-024-01666-7 |doi-access=free |issn=1758-9193 |pmc=11708093 |pmid=39780249}}</ref>
===Cardiovascular effects=== A 2022 study reported that GLP-1 agonists have cardioprotective effects when used to treat obesity, beyond their primary roles in glycemic control and weight reduction.<ref>{{cite journal |last1=Pedrosa |first1=Maurício Reis |last2=Franco |first2=Denise Reis |last3=Gieremek |first3=Hannah Waisberg |last4=Vidal |first4=Camila Maia |last5=Bronzeri |first5=Fernanda |last6=de Cassia Rocha |first6=Alexia |last7=de Carvalho Cara |first7=Luis Gabriel |last8=Fogo |first8=Sofia Lenzi |last9=Eliaschewitz |first9=Freddy Goldberg |title=GLP-1 Agonist to Treat Obesity and Prevent Cardiovascular Disease: What Have We Achieved so Far? |journal=Current Atherosclerosis Reports |date=November 2022 |volume=24 |issue=11 |pages=867–884 |doi=10.1007/s11883-022-01062-2 |pmid=36044100 }}</ref>
A 2025 study reported that GLP-1 agonists may be beneficial in heart failure with preserved ejection fraction.<ref name="MDPIHF">{{cite journal |last1=Rahmani |first1=Ali Reza |last2=Kalogeropoulos |first2=Andreas P. |date=2025 |title=GLP-1 Receptor Agonists in Heart Failure |journal=Biomolecules |volume=15 |issue=10 |page=1403 |doi=10.3390/biom15101403 |pmid=41154632 |pmc=12562493 |doi-access=free }}</ref>
===Cancer=== In a 2024 retrospective study, GLP-1 exposure was associated with lower risks of specific types of obesity-associated cancers compared with insulin or metformin in people with type 2 diabetes. Compared to insulin, GLP-1 agonists showed significant risk reduction in esophageal, colorectal, endometrial, gallbladder, kidney, liver, ovarian, and pancreatic cancer, as well as meningioma and multiple myeloma. Kidney cancers showed an increased risk with GLP-1 treatment relative to those treated with metformin.<ref name="JAMA">{{cite journal |last1=Wang |first1=Lindsey |last2=Xu |first2=Rong |last3=Kaelber |first3=David C. |last4=Berger |first4=Nathan A. |title=Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes |journal=JAMA Network Open |date=5 July 2024 |volume=7 |issue=7 |pages=e2421305 |doi=10.1001/jamanetworkopen.2024.21305|doi-access=free |pmid=38967919 |pmc=11227080 }}</ref>
===Depression=== Studies have reported that GLP-1 agonists have antidepressant and neuroprotective effects and treat the metabolic consequences of second-generation antipsychotics, such as obesity.<ref>{{cite journal |last1=Cooper |first1=Daniel H. |last2=Ramachandra |first2=Ranuk |last3=Ceban |first3=Felicia |last4=Di Vincenzo |first4=Joshua D. |last5=Rhee |first5=Taeho Greg |last6=Mansur |first6=Rodrigo B. |last7=Teopiz |first7=Kayla M. |last8=Gill |first8=Hartej |last9=Ho |first9=Roger |last10=Cao |first10=Bing |last11=Lui |first11=Leanna M.W. |last12=Jawad |first12=Muhammad Youshay |last13=Arsenault |first13=Juliet |last14=Le |first14=Gia Han |last15=Ramachandra |first15=Diluk |last16=Guo |first16=Ziji |last17=McIntyre |first17=Roger S. |title=Glucagon-like peptide 1 (GLP-1) receptor agonists as a protective factor for incident depression in patients with diabetes mellitus: A systematic review |journal=Journal of Psychiatric Research |date=August 2023 |volume=164 |pages=80–89 |doi=10.1016/j.jpsychires.2023.05.041 |pmid=37331261 }}</ref><ref>{{cite journal |last1=Pozzi |first1=Marco |last2=Mazhar |first2=Faizan |last3=Peeters |first3=Gabriëlla G.A.M. |last4=Vantaggiato |first4=Chiara |last5=Nobile |first5=Maria |last6=Clementi |first6=Emilio |last7=Radice |first7=Sonia |last8=Carnovale |first8=Carla |title=A systematic review of the antidepressant effects of glucagon-like peptide 1 (GLP-1) functional agonists: Further link between metabolism and psychopathology |journal=Journal of Affective Disorders |date=October 2019 |volume=257 |pages=774–778 |doi=10.1016/j.jad.2019.05.044 |pmid=31153593 }}</ref>
=== Parkinson's disease === A 2022 UK study failed to find any advantage of using GLP-1 agonists to treat Parkinson's disease.<ref>{{Cite journal |last1=Vijiaratnam |first1=Nirosen |last2=Girges |first2=Christine |last3=Auld |first3=Grace |last4=McComish |first4=Rachel |last5=King |first5=Alexa |last6=Skene |first6=Simon S. |last7=Hibbert |first7=Steve |last8=Wong |first8=Alan |last9=Melander |first9=Sabina |last10=Gibson |first10=Rachel |last11=Matthews |first11=Helen |last12=Dickson |first12=John |last13=Carroll |first13=Camille |last14=Patrick |first14=Abigail |last15=Inches |first15=Jemma |date=2025-02-22 |title=Exenatide once a week versus placebo as a potential disease-modifying treatment for people with Parkinson's disease in the UK: a phase 3, multicentre, double-blind, parallel-group, randomised, placebo-controlled trial |journal=The Lancet |language=English |volume=405 |issue=10479 |pages=627–636 |doi=10.1016/S0140-6736(24)02808-3 |issn=0140-6736 |pmid=39919773|doi-access=free }}</ref>
===Polyendocrine metabolic ovarian syndrome=== GLP-1 agonists are effective in reducing body weight in people with obesity and polyendocrine metabolic ovarian syndrome,<ref>{{Cite journal |last1=Lin |first1=Shike |last2=Deng |first2=Yan |last3=Huang |first3=Jing |last4=Li |first4=Meiyan |last5=Sooranna |first5=Suren Rao |last6=Qin |first6=Minzhen |last7=Tan |first7=Bing |date=2025-05-13 |title=Efficacy and safety of GLP-1 receptor agonists on weight management and metabolic parameters in PCOS women: a meta-analysis of randomized controlled trials |journal=Scientific Reports |language=en |volume=15 |issue=1 |page=16512 |doi=10.1038/s41598-025-99622-4 |issn=2045-2322 |pmc=12075827 |pmid=40360648 |doi-access=free |bibcode=2025NatSR..1516512L }}</ref> but the effectiveness in polyendocrine metabolic ovarian syndrome without obesity is uncertain.<ref>{{Cite journal |last1=Forslund |first1=Maria |last2=Wändell |first2=Per |last3=Forsberg |first3=Lisa |last4=Österberg |first4=Marie |last5=Dagerhamn |first5=Jessica |last6=Wernersson |first6=Emma |last7=Kärrman Fredriksson |first7=Maja |last8=Ringborg |first8=Anna |last9=Lindén Hirschberg |first9=Angelica |date=2026-03-04 |title=GLP-1 receptor agonist treatment in women with polycystic ovary syndrome—a systematic review and meta-analysis |journal=European Journal of Endocrinology |language=en |volume=194 |issue=3 |pages=25–39 |doi=10.1093/ejendo/lvag033 |issn=0804-4643 |doi-access=free |pmid=41701618 }}</ref>
===Reward system disorders=== GLP-1 agonists are under development for substance use disorder, a condition with few pharmacological treatment options. A 2022 study reported reductions in drug and alcohol use in non-human animals.<ref>{{cite journal |last1=Klausen |first1=Mette Kruse |last2=Thomsen |first2=Morgane |last3=Wortwein |first3=Gitta |last4=Fink-Jensen |first4=Anders |date=2022 |title=The role of glucagon-like peptide 1 (GLP-1) in addictive disorders |journal=British Journal of Pharmacology |type=Themed issue review |language=en |publisher=Wiley |volume=179 |issue=4 |pages=625–641 |doi=10.1111/bph.15677 |pmc=8820218 |pmid=34532853 |doi-access=free}}</ref>
GLP-1 agonists are under investigation for the treatment of binge eating disorder.<ref>{{cite journal |last1=Da Porto |first1=Andrea |last2=Casarsa |first2=Viviana |last3=Colussi |first3=Gianluca |last4=Catena |first4=Cristiana |last5=Cavarape |first5=Alessandro |last6=Sechi |first6=Leonardo |display-authors= 3 |title=Dulaglutide reduces binge episodes in type 2 diabetic patients with binge eating disorder: A pilot study |journal=Diabetes & Metabolic Syndrome: Clinical Research & Reviews |date=July 2020 |volume=14 |issue=4 |pages=289–292 |doi=10.1016/j.dsx.2020.03.009 |pmid=32289741 }}</ref><ref>{{cite journal |last1=Richards |first1=Jesse |last2=Bang |first2=Neha |last3=Ratliff |first3=Erin L. |last4=Paszkowiak |first4=Maria A. |last5=Khorgami |first5=Zhamak |last6=Khalsa |first6=Sahib S. |last7=Simmons |first7=W. Kyle |display-authors= 3 |title=Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study |journal=Obesity Pillars |date=September 2023 |volume=7 |article-number=100080 |doi=10.1016/j.obpill.2023.100080 |pmid=37990682 |pmc=10661993 }}</ref>
== References == {{reflist}}
==Further reading== * {{cite journal |last1=Gonzalez-Rellan |first1=Maria J. |last2=Drucker |first2=Daniel J. |title=The expanding benefits of GLP-1 medicines |journal=Cell Reports Medicine |date=July 2025 |volume=6 |issue=7 |article-number=102214 |doi=10.1016/j.xcrm.2025.102214 |pmid=40669447 |pmc=12281309 }}
Category:GLP-1 receptor agonists Category:Anorectics Category:Anti-diabetic drugs