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GLP-1s: More Than a Weight-Loss Drug?
By:
The Woodlands Institute for Health & Wellness - Mila McManus MD
| Published 09/17/2026
What researchers are discovering about the surprising benefits of GLP-1s —and the long-term questions.
When GLP-1 medications first became widely known, the conversation was mostly about one thing: weight loss.
And understandably so. These medications can produce substantial weight loss in people struggling with obesity or metabolic disease.
But as researchers have followed patients longer and looked more closely at the data, something interesting has emerged: GLP-1 medications may be doing more than helping people lose weight.
So what exactly are GLP-1s, and what is the research telling us?
First, what is a GLP-1?
GLP-1 stands for glucagon-like peptide-1. It is a hormone naturally produced in the gut after we eat. It helps regulate blood sugar, stimulates insulin release when glucose is elevated, slows digestion, and sends signals to the brain that help reduce appetite.
Several medications mimic GLP-1, including semaglutide (Ozempic, Wegovy, Rybelsus), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity).
Tirzepatide (Mounjaro, Zepbound) works on both GLP-1 and another hormone called GIP, making it a dual-incretin medication.
Their intended purpose may be diabetes treatment and/or weight management—but researchers are discovering some intriguing effects beyond the scale.
What else might GLP-1s be doing?
Cardiovascular health: One of the strongest findings involves cardiovascular health. In the large SELECT trial, more than 17,000 adults with overweight or obesity and established cardiovascular disease—but without diabetes—received semaglutide or placebo. Semaglutide reduced the risk of cardiovascular death, heart attack, or stroke by about 20%.
The liver: Fatty liver disease is closely connected to insulin resistance, visceral fat and metabolic dysfunction. Newer research shows that GLP-1 therapy can reduce liver fat and improve markers of liver inflammation and disease. Semaglutide has even demonstrated improvements in MASH, a more advanced form of fatty liver disease.
Inflammation: Excess visceral fat is metabolically active and can contribute to chronic inflammation. As GLP-1 medications reduce visceral fat, blood sugar and other metabolic stressors often improve. But researchers are also investigating whether GLP-1 medications have effects on inflammation that go beyond weight loss.
Insulin resistance: This may be the least surprising but one of the most important benefits. GLP-1 medications improve blood sugar regulation, reduce inappropriate glucagon release, slow digestion and decrease appetite. Together, these effects can improve insulin sensitivity and overall metabolic health.
Brain health: This is one of the most fascinating—and least settled—areas of research. Some studies have found associations between GLP-1 use and lower rates of dementia (e.g., Alzheimer’s disease). But we need to be careful here. A major 2026 clinical trial of oral semaglutide in people who already had early Alzheimer’s disease did not show that it slowed disease progression.
So while the research is intriguing, we cannot yet say that GLP-1 medications prevent or treat Alzheimer’s disease.
And what happens when you stop?
This may be one of the most important questions surrounding these medications.
In the STEP 1 extension study, people who stopped semaglutide after 68 weeks regained about two-thirds of the weight they had lost within the following year. Many of their metabolic improvements also moved back toward baseline.
A similar pattern appeared with tirzepatide. In the SURMOUNT-4 trial, people who continued tirzepatide maintained and extended their weight loss, while those who switched to placebo regained a substantial amount of weight.
And when people regained weight after stopping tirzepatide, many of the improvements they had made in blood pressure, cholesterol, waist size and insulin levels also began to fade.
This tells us something important: GLP-1 therapy may need to be viewed as part of a long-term metabolic strategy—not simply a short-term diet.
A different way to think about GLP-1s:
Many of us functional medicine specialists emphasize that these medications work best alongside lifestyle changes, including nutrition and resistance training, rather than viewing the medication as the entire solution.
The research currently tells us that continuing medication is the most reliable way to maintain the weight loss achieved in clinical trials. But it also raises a bigger question:
Can we use the period of weight loss to address the underlying drivers of metabolic dysfunction—nutrition, muscle mass, physical activity, sleep, stress and insulin resistance—so that long-term health becomes less dependent on medication? We certainly hope so! The journey is different for everyone.
The bottom line…
GLP-1 medications began as a powerful tool for controlling blood sugar and reducing weight.
Now researchers are discovering that their effects may extend much further—to cardiovascular health, the liver, inflammation, insulin resistance and possibly brain health.
But these medications aren’t magic, and they aren’t risk-free. We still have important questions about long-term use, side effects, nutritional adequacy, muscle preservation and what happens when treatment is stopped.
The most interesting question may not be:
“How much weight can I lose?”
It may be:
“How can we use this tool to improve my metabolic health for the long term?”
That may be where the next chapter of GLP-1 research becomes especially interesting. Stay tuned and learn more about GLP-1 therapy here.
Be Well!
References
- Lincoff AM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine. 2023. Read the study
- Sanyal AJ, et al. Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis. New England Journal of Medicine. 2025. Read the study
- Plutzky J, et al. Effect of Semaglutide on the Inflammatory Biomarker High-Sensitivity CRP in SELECT. Circulation. 2026. Read the study
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism. 2022. Read the study
- Aronne LJ, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024. Read the study
Note: The Alzheimer’s discussion in the article is supported by the 2026 EVOKE/EVOKE+ phase 3 trials, which are not included in the shortened reference list above. Those trials found no significant slowing of Alzheimer’s disease progression with oral semaglutide.
