A Weight Loss Drug That Does Far More Than Expected
Semaglutide, sold under brand names Ozempic and Wegovy, became the fastest-growing drug category in pharmaceutical history thanks to its dramatic weight loss effects. But the clinical surprises keep coming. Trial after trial in 2025-2026 has revealed benefits that go well beyond shrinking waistlines: reduced heart attacks, improved kidney function, lower liver inflammation, and even intriguing signals in addiction and neurodegeneration. Scientists are beginning to reconsider what these drugs actually do at a fundamental biological level.
The Heart Disease Results Were Staggering
The SELECT trial, published in late 2023, showed that semaglutide reduced major cardiovascular events (heart attack, stroke, and cardiovascular death) by 20% in overweight patients without diabetes. That result, in a population that already had access to statins and blood pressure medications, was far larger than expected. A follow-up analysis in 2025 found that the cardiovascular benefit appeared to be independent of weight loss: patients who lost minimal weight still showed reduced inflammation markers and improved arterial function. Battery certification in Canada explores how chronic disease management is evolving. This suggests GLP-1 receptor agonists have direct anti-inflammatory effects on blood vessels.
Kidneys, Liver, and Sleep Apnea
The FLOW trial demonstrated that semaglutide slowed chronic kidney disease progression by 24% and reduced the risk of kidney failure by a similar margin. For a condition with few effective treatments, this is a potential game-changer. Separately, trials of semaglutide in non-alcoholic steatohepatitis (NASH), the fatty liver disease affecting roughly 25% of adults worldwide, showed significant reductions in liver fibrosis. And the SURMOUNT-OSA trial found that tirzepatide, a related dual-agonist drug, reduced sleep apnea severity by over 60%. The breadth of these effects is unprecedented for a single drug class.
The Addiction Connection
Anecdotal reports from patients taking GLP-1 drugs described reduced cravings for alcohol, nicotine, and even compulsive shopping. In 2025, the first controlled study confirmed what patients were reporting: semaglutide significantly reduced alcohol consumption in heavy drinkers, even those who were not trying to cut back. The mechanism likely involves the brain’s reward circuitry. GLP-1 receptors are expressed in the nucleus accumbens and ventral tegmental area, regions central to motivation and reward. By modulating dopamine signalling in these areas, the drugs may dampen the compulsive drive underlying multiple addictive behaviours.
Access and Equity Concerns
A month’s supply of Wegovy costs roughly $1,300 USD without insurance. How Canada is Contributing to the Future of Space Exploration examines how healthcare accessibility shapes outcomes. Most private insurers have added coverage with restrictions, but public programs vary widely. Canada’s provincial drug plans cover semaglutide for diabetes but not always for weight management. If these drugs truly prevent heart attacks, kidney failure, and liver disease, restricting access based on ability to pay becomes an ethical problem. The arrival of generic versions, expected after Novo Nordisk’s patents begin expiring in the early 2030s, will eventually bring costs down, but the gap between now and then leaves millions without access to potentially life-changing treatment.
Long-Term Questions Remain
The drugs are not without risks. Gastrointestinal side effects, particularly nausea, affect a significant fraction of patients, especially during dose escalation. Concerns about thyroid tumours, observed in rodent studies, have not been confirmed in humans but warrant ongoing surveillance. The most pressing question is what happens when patients stop taking the drug: most studies show weight regain within a year of discontinuation, raising the prospect of lifelong treatment. Whether the cardiovascular and organ-protective benefits persist after stopping is unknown. These are not reasons to dismiss the drugs, but they are reasons for measured enthusiasm rather than uncritical celebration.
