Could a Popular Weight Loss Drug Reduce Pain?
/By Madora Pennington
“When I look around at this room, I can't help but wonder. Is Ozempic right for me?” Jimmy Kimmel quipped to his audience of beautiful people when he hosted the Academy Awards last year.
It seems like everyone is taking Ozempic or drugs like it and losing weight. That class of drugs, known as GLP-1 medications for the hormones they enhance, slow digestion and promote feelings of satiety or fullness. As a result, people eat less and lose weight without the struggle of trying to stick to a diet. You feel fuller more quickly, eat less, and shed pounds.
GLP-1s are proving to have a lot more beneficial effects on the body than just weight loss. A recently published study found that low doses of semaglutide (the active ingredient in Ozempic and Wegovy) reduced alcohol cravings in people diagnosed with alcohol use disorder. When taking the weight-loss drugs, their alcohol intake was less.
In addition to food and alcohol, semaglutides also seem to reduce cravings for nicotine, cocaine, amphetamines and opioids, as well as problematic behaviors like gambling and compulsive shopping. Because the drugs reduce the reward chemical dopamine in the brain, those taking them are less motivated by their own brain signals to have another drink, put another item in their cart, have a hit of a drug, and so on.
Could GLP-1s also help pain patients?
The most obvious way a GLP-1 might reduce pain is through weight loss. Carrying excess weight causes additional wear-and-tear on the back and joints in the lower body. Every extra pound translates to four pounds of force on the knees, so even a modest amount of weight loss has the potential to reduce joint damage and pain.
Excess weight also limits range of motion, restricting joints and making it difficult for a person to exercise. Losing weight can lead to more physical activity, which can lessen pain and help keep the brain, joints and body healthy.
Another benefit of GLP-1 medications is that they lessen inflammation. In a recent study published in The New England Journal of Medicine, semaglutide provided substantial pain relief for patients with obesity and knee osteoarthritis. The exact mechanism of action is unclear, but researchers think its because the drug reduces inflammation and loss of cartilage in the knee joint.
“The findings confirm that substantial weight loss causes an often dramatic reduction in pain. If the effects shown in this trial are mediated by factors other than weight loss alone, new therapeutic avenues may be available,” David Felson, MD, a Professor of Rheumatology at Boston University School of Medicine, wrote in an editorial.
Other studies suggest that semaglutide could be a possible treatment for Alzheimer’s and Parkinson’s disease, as it lowers neuroinflammation, reduces plaque deposits in the brain, and helps generate new neurons. However, it’s only a supposition at this point that GLP-1s could mitigate the damage that chronic pain causes to the brain.
GLP-1s might help modulate pain in other ways. Both humans and animals turn to sweets and fat rich foods when in pain. Because GLP-1s regulate hunger and digestion, it’s possible they can improve pain. Tests on mice indicate that these drugs influence a certain nerve pain receptor. While definite answers and proof are a long way off, this discovery suggests new approaches to treating pain.
Before you run out to try them, be aware that Ozempic and other GLP-1 drugs carry risks. They often cause nausea and vomiting, and rare but serious problems such as pancreatitis, gastroparesis (paralysis of the stomach), and blindness.
They are also expensive. Insurance tends to limit semaglutide coverage to diabetics, so if you pay in cash without any discounts, 2 mg of Ozempic will cost about $1,050. Cheaper, generic semaglutides made overseas are available, as well as compounded versions made in-house by pharmacies. But those formulations have not been evaluated by the FDA and their quality is uncertain.
