Ozempic (a brand name for semaglutide) and similar drugs are all over the news. They were even named 2023’s “breakthrough of the year” by Science magazine. Known as glucagon-like peptide 1 (GLP-1) receptor agonists, this class of drugs was originally approved to treat type 2 diabetes. More recently, some of these drugs gained approval from the U.S. Food and Drug Administration (FDA) as weight loss medications. But can they be safe and effective for those with multiple sclerosis (MS)?

MyMSTeam spoke with Dr. Aaron Boster about GLP-1 receptor agonists and whether they’re a good idea for people with MS. A board-certified neurologist and president of The Boster Center for Multiple Sclerosis in Columbus, Ohio, Dr. Boster also has a YouTube channel covering many aspects of treating and living with MS.

Read on to find out more about GLP-1 receptor agonists and Dr. Boster’s advice for those with MS.

What Are GLP-1 Receptor Agonists?

The first drug in this class was developed in 2005 to treat type 2 diabetes. GLP-1 receptor agonists are believed to work by mimicking a hormone called incretin. Incretin is produced naturally in the small intestine. It has several effects on the body, including:

• Lowering blood glucose (blood sugar)
• Slowing digestion
• Making you feel full after you’ve eaten

Apart from treating type 2 diabetes, GLP-1 agonists may also help some people lower their blood pressure, reduce the risk for heart disease, and improve fatty liver disease.

Some GLP-1 receptor agonists are currently approved as a weight-loss drug to treat people with a body mass index (BMI) score in the overweight or obese range, under certain circumstances. These drugs include:

• Semaglutide (also sold under the brand name Wegovy in addition to Ozempic)
• Liraglutide (known by the brand name Saxenda)

GLP-1 agonists are commonly administered by subcutaneous (under the skin) injection into fatty parts of the body.

Can GLP-1 Agonists Help People With MS Lose Weight Safely?

Research shows that people who have MS and a BMI score in the overweight or obese range tend to report worse disability. Higher body weight can also make some MS symptoms (such as pain and bladder problems) more severe. It’s also associated with developing other health conditions, like heart disease.

According to Dr. Boster, if you and your doctor agree that weight loss is a goal for you, GLP-1 agonists can be a useful part of that effort. However, they are not the whole answer.

“I would love to hear about a medicine like Ozempic being an adjunctive to that conversation, not the center of that conversation,” he said. “It’s not a magic shot. It needs to be considered in conjunction with an exercise program and lifestyle changes in eating and approaching food differently. That’s where you could see someone successfully lose weight and keep weight off.”

The Dangers of Weight Cycling

Dr. Boster warned that it’s important to avoid getting into a cycle of drastic weight changes, which comes with its own health problems.

“There are concerns that are valid about yo-yoing your weight,” he explained. “We go way down and way up and way down, and that’s not healthy for your heart. Someone uses one of these medicines and they lose a bunch of weight, which is great. And then they stop the medicine and gain it all back — it’s not a healthy thing to do.”

Dr. Boster advised working with your health care team to add healthy habits to your overall lifestyle, whether you take GLP-1 agonists or not. “We spend a lot of time in the clinic trying to optimize exercise and nutrition,” he said.

Read more about the Wahls Protocol and the Swank Diet, two nutritional approaches that have been researched for their benefits in those with MS.

Research on GLP-1 Agonists and Multiple Sclerosis

In one small study, 33 people with MS took GLP-1 drugs for weight loss for an average of 15 months. Most were also taking a disease-modifying therapy (DMT) for their MS. No participants had an MS relapse during the study period, although some had new lesions on MRI scans at the end of the study. Around 1 in 4 participants reported gastrointestinal side effects like stomach pain, nausea, and vomiting, although only one person chose to stop taking GLP-1 drugs during the study.

Researchers concluded that GLP-1 agonists seem to be safe and well-tolerated among people with MS and those taking MS treatment, although they noted the need for further studies.

Interestingly, neurology researchers have explored the idea that GLP-1 agonists might be useful in helping people with MS rebuild damaged myelin (the protective shreath around nerves) or slow the process of demyelination. These ideas are in the early stages, and there haven’t been any clinical trials to test them. Much more research is needed before we’ll know how much promise they hold.

Risks of GLP-1 Receptor Agonists

Like all medications, even those sold over the counter, GLP-1 receptor agonists can cause potential side effects. Adverse effects can include:

• Nausea and vomiting
• Reduced appetite
• Diarrhea
• Dizziness
• Headaches
• Indigestion

Rarely, people using GLP-1 agonists have experienced severe pancreas damage.

Find Your Team

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Have you considered taking a GLP-1 receptor agonist? Do you have any questions about them? Share your thoughts in the comments below, or start a conversation on your Activities page.