Are GLP-1’s Longevity Drugs
An article in the New York Times about Glp-1’s and longevity is the inevitable somehow. Longevity and GLP-1 hype collide.
This kind of premature optimism for some sort of drug to universally prolong life drives me crazy. People are so enthusastic about injecting themselves with something ( a much stronger placebo that way) not willing to face the fact that exercise, diet and challenging yourself mentally are the tried and true and safest way to live longer.
One of the biggest questions in longevity medicine is whether GLP-1 drugs such as Ozempic and Zepbound can actually slow aging. The idea has generated enormous excitement, but the science remains surprisingly preliminary.
A recent study in people living with HIV found that eight months of semaglutide treatment appeared to reduce several blood biomarkers associated with biological aging. Because HIV accelerates aging, researchers considered this an ideal group in which to look for early signals. The findings are intriguing—but they are far from proving that these medications extend lifespan or healthspan in healthy people.
Researchers point to several reasons for optimism. GLP-1 drugs improve blood sugar regulation, promote weight loss, reduce cardiovascular risk, improve liver and kidney health, and appear to dampen chronic inflammation, one of the hallmarks of aging. These effects make them attractive candidates for longevity research.
But enthusiasm has raced far ahead of the evidence. There are currently no convincing clinical data showing that GLP-1 medications prolong life or slow aging in metabolically healthy adults. Even animal studies remain limited. At the same time, these drugs are not without risk. Muscle loss, declining bone density, and increased frailty are particular concerns for older adults—the very population most interested in longevity.
This is where Dr. One’s oldest principle remains remarkably relevant: First, do no harm. Good medicine requires balancing potential benefit against known risk. While GLP-1 medications can be life-changing for patients with obesity, diabetes, or metabolic disease, using them solely to pursue longevity is not yet supported by the science. Even one researcher taking a GLP-1 himself openly acknowledged that he would not recommend the practice to healthy patients.
The lesson is simple: exciting hypotheses should inspire careful research—not premature adoption. In longevity medicine, evidence must always come before enthusiasm.
Two of the hottest trends in health — longevity medicine and weight-loss drugs — are colliding.
A theory that GLP-1 medications like Ozempic or Zepbound might help people live longer has been bandied about by biohackers and aging researchers for several years. Online pharmacies already market compounded versions of the drugs to purportedly extend health span. But so far, academic research into the hypothesis has been scant.
One of the first studies putting the idea to the test was published last month. It showed that, among people with H.I.V. and lipohypertrophy (fatty deposits that develop under the skin), taking semaglutide (the drug in Ozempic) for eight months seemed to slow participants’ biological aging, according to blood tests that measure age-related biomarkers. People with H.I.V. experience accelerated aging because of the infection, so they are a good population in which to conduct age-related research, said Michael Corley, an associate professor of medicine at the University of California, San Diego’s Stein Institute for Research on Aging, who led the study.
The trial was preliminary, but it “provided us an opportunity to say, hey, is there any signal here that warrants all the hype?” Dr. Corley said.
Can Ozempic Make You Live Longer?
That hype stems from several lines of evidence. First, there is ample research demonstrating that GLP-1s improve people’s metabolic health by helping to regulate insulin and blood sugar levels and causing weight loss. Several studies show that they also benefit cardiovascular, liver and kidney health.
“GLP-1 agonists decrease the incidence of diseases that are related to aging and are associated with decreasing life span,” said Dr. Nicolas Musi, the director of the Diabetes and Aging Center at Cedars-Sinai in Los Angeles. “One would assume that they’re also potentially going to increase life span and be beneficial for longevity,” he added.
Another reason experts think these drugs might increase longevity is because of how they affect cellular health. Metabolic health and aging are intricately linked, so drugs that alter the mechanisms involved in metabolism may also affect how the body ages.
“Many of these pathways that are modulated by diabetes drugs are also central pathways that control aging and longevity,” Dr. Musi said. (Other drugs that treat diabetes, like metformin and a category known as SGLT2 inhibitors, are similarly being studied for longevity, though the evidence so far has been mixed.)
GLP-1s appear to influence other fundamental cellular changes that occur with aging, most notably inflammation. “We know they have a significant anti-inflammatory effect, and we know inflammation is one of the things that accelerates aging,” said Dr. Thomas Blackwell, a professor of general internal medicine at the University of Texas Medical Branch in Galveston.
How we choose health experts to talk to. Times reporters often spend weeks interviewing doctors, researchers and other health professionals to help report an article. We seek leaders in their fields, watch out for conflicts of interest and try to get a variety of viewpoints.
All of this sounds promising, but researchers say there’s a huge caveat: Currently little to no data exists on whether the drugs will benefit people who are metabolically healthy.
There is not even data available about whether the medications extend life span in healthy rodents. Dr. Richard Miller, a professor of pathology at the University of Michigan, who runs a large program there testing potential anti-aging drugs in mice, said that’s mainly because of logistics. The currently available GLP-1s either don’t work in mice the same way they do in humans, or they can only be delivered via injection, and years of weekly injections in mice aren’t practical.
There are also concerns that GLP-1s negatively affect health in ways that are especially relevant for aging. Most notably, the drugs can cause some muscle loss, a major issue for older adults that is associated with an increased risk of frailty. Rapid weight loss can also lead to a decline in bone density and an increased risk of osteoporosis.
A few clinical trials that are testing GLP-1s on several biomarkers of aging, like inflammation levels and biological age clocks, as well as on functional abilities like strength and walking speed, are finally getting underway. At least one of the studies still will not be conducted on healthy older adults, though, since the participants need to meet the criteria for receiving a prescription for the weight-loss medications, said Dr. Blackwell, who is leading the trial. But he added that those criteria — for example, a body mass index of 27 or greater and a related health condition, like hypertension — reflect “a whole lot of Americans.”
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For now, experts generally don’t recommend taking the medications off label for longevity. “In patients that are otherwise healthy, at this point, I think it’s premature, because there are no data justifying it from preclinical or clinical studies,” Dr. Musi said.
In Dr. Blackwell’s case, the message seemed to be, do as I say, not as I do. He has been taking tirzepatide (the drug in Zepbound) for the past year with the goal of slowing aging.
“Do I know that that’s the right thing? I do not,” he said. “Do I recommend that for patients? I do not.”
“This is my own personal decision,” he added.
Dana G. Smith is a Times reporter covering personal health, particularly aging and brain health.