We’re still figuring out the side effects of GLP-1 weight-loss drugs

EXECUTIVE SUMMARY This week my colleague Antonio Regalado had an interesting update on GLP-1 weight-loss drugs. According to research presented at an aging meeting in Boston, these drugs seem to affect at least some measures of biological age. Overweight and diabetic people who take GLP-1s have a biological age around two to three years younger than similar individuals who take a placebo, according to findings from Eli Lilly and Novo Nordisk, two pharmaceutical companies that make the drugs.

执行摘要：本周，我的同事安东尼奥·雷加拉多（Antonio Regalado）针对GLP-1减肥药发布了一项有趣的最新进展。根据在波士顿举行的一次衰老会议上发表的研究，这些药物似乎至少在某些生物学年龄指标上产生了影响。礼来公司（Eli Lilly）和诺和诺德（Novo Nordisk）这两家生产此类药物的制药公司研究发现，服用GLP-1的超重和糖尿病患者，其生物学年龄比服用安慰剂的类似人群年轻约两到三岁。

I’ve heard people in the aging field describe GLP-1s as longevity drugs for a while now (even if they only benefit people who are overweight or diabetic in the first place). This latest announcement comes after we’ve seen a raft of other benefits associated with taking these drugs. But there are also some weird side effects. So far, GLP-1 agonist drugs—which repress hunger—have been approved for treating diabetes, chronic kidney disease, and obesity, and they can also be prescribed for some people who are overweight or at risk of certain cardiovascular diseases.

我听衰老领域的人士将GLP-1描述为长寿药物已经有一段时间了（尽管它们最初仅对超重或糖尿病患者有益）。在这一最新公告发布之前，我们已经看到了与服用这些药物相关的许多其他益处。但同时也存在一些奇怪的副作用。到目前为止，能够抑制饥饿感的GLP-1受体激动剂药物已被批准用于治疗糖尿病、慢性肾病和肥胖症，也可用于处方给某些超重或有特定心血管疾病风险的人群。

But there is research to suggest they might also help people with substance-use disorders, and they’ve been investigated for potential benefits in neurodegenerative disease and cancer. And a lot of people are taking them. According to a recent Gallup poll, 11% of Americans are taking a GLP-1 drug for weight loss, up from 3% in 2024. And 15% of Americans say they’ve used one for weight loss at some point. They can be incredibly effective. But, like any drug, they can come with side effects. And we’re still figuring out exactly what those might be, and how widespread they are.

但有研究表明，它们或许还能帮助物质使用障碍患者，且人们正在研究其在神经退行性疾病和癌症方面的潜在益处。目前有很多人正在服用这些药物。根据盖洛普（Gallup）最近的一项民意调查，11%的美国人正在服用GLP-1药物减肥，而2024年这一比例为3%。此外，15%的美国人表示他们曾在某个阶段使用过此类药物减肥。它们的效果可能非常显著。但像任何药物一样，它们也可能带来副作用。我们仍在探究这些副作用究竟是什么，以及它们的普遍程度如何。

The most common side effects are gastrointestinal—nausea, vomiting, diarrhea, and constipation. The drugs have also been linked to pancreatitis and gallstone disease. Some claim that, in rare cases, the drugs might cause damage to nerves behind the eye. Dozens of people are suing Novo and Eli Lilly after developing a condition that can lead to sudden vision loss. They’re claiming that their symptoms were brought on by the GLP-1 drugs that these companies manufacture. Both companies dispute the claims. Research into the link is mixed.

最常见的副作用是胃肠道反应，包括恶心、呕吐、腹泻和便秘。这些药物还与胰腺炎和胆结石疾病有关。有人声称，在极少数情况下，这些药物可能会损害眼后神经。数十人在出现可能导致突发性视力丧失的病症后，正在起诉诺和诺德和礼来公司。他们声称自己的症状是由这些公司生产的GLP-1药物引起的。两家公司均对这些指控提出异议。关于这种关联的研究结果尚不统一。

We’re still getting to grips with the effects of weight-loss drugs on hair and nails, too. When Savanna Vidal at the George Washington University School of Medicine and Health Sciences in Washington, DC, and colleagues assessed electronic health data from 67 US health-care organizations, they found that GLP-1 use was associated with an increased risk of hair loss. It’s still not thought to be common, however. And at a conference in Austria last week, another group presented the results of a smaller study suggesting that 66% of GLP-1 users reported at least one nail disorder—in some cases involving nail detachment.

我们对于减肥药对头发和指甲的影响也仍在摸索中。当华盛顿特区乔治华盛顿大学医学与健康科学学院的萨凡纳·维达尔（Savanna Vidal）及其同事评估了来自美国67家医疗机构的电子健康数据时，他们发现使用GLP-1与脱发风险增加有关。不过，这目前仍被认为并不常见。在上周于奥地利举行的一次会议上，另一组研究人员展示了一项小型研究的结果，表明66%的GLP-1使用者报告至少有一种指甲疾病，在某些情况下甚至涉及指甲脱落。

Nail conditions were also fairly common among people who didn’t take the drugs, though. The authors don’t claim that the drugs are causing nails to fall out (as I’m sure 11% of the American population will be relieved to hear). The side effects might look different in children, but there’s not much data on those at the moment. Still, pediatric side effects will be something to watch given that, between 2019 and 2026, there was a 310-fold increase in GLP-1 prescriptions for eight- to 11-year-old children with obesity in the US.

不过，在不服用这些药物的人群中，指甲问题也相当普遍。作者并未声称是药物导致了指甲脱落（我相信11%的美国民众听到这个消息会感到宽慰）。儿童的副作用表现可能有所不同，但目前相关数据并不多。尽管如此，鉴于2019年至2026年间，美国针对8至11岁肥胖儿童的GLP-1处方量增加了310倍，儿科副作用仍将是值得关注的问题。

Child prescriptions are still rare, but they’ve been rising. On Wednesday, the World Health Organization released its first guidelines on managing obesity in children and adolescents. Despite the scale of the issue—the WHO estimates that 70 million children aged five to nine were living with obesity in 2024—the organization explicitly says it does not recommend pharmacological treatment for kids under 10. “This recommendation accounts for the lack of evidence on both benefits and the potential adverse events and consequences of the different medications and/or their active ingredients on normal growth, development, physiological parameters, and mental health,” the guidelines state.

针对儿童的处方虽然仍属罕见，但一直在增加。周三，世界卫生组织发布了首份关于儿童和青少年肥胖管理的指南。尽管问题规模巨大——世卫组织估计2024年有7000万名5至9岁的儿童患有肥胖症——但该组织明确表示，不建议对10岁以下儿童进行药物治疗。指南指出：“这一建议考虑到了目前缺乏关于不同药物和/或其活性成分对正常生长、发育、生理参数和心理健康所带来的益处及潜在不良事件和后果的证据。”

I get press releases about GLP-1s on an almost daily basis. There’s been a ton of research into these drugs, and there are probably hundreds of other studies underway. There will likely be plenty more on this from The Checkup as the evidence evolves. This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

我几乎每天都会收到关于GLP-1的新闻稿。针对这些药物的研究已经非常多，而且可能还有数百项研究正在进行中。随着证据的不断演变，《The Checkup》很可能会对此进行更多报道。本文首次发表于《麻省理工科技评论》的每周生物技术通讯《The Checkup》。如需每周四在收件箱中接收此类通讯并第一时间阅读此类文章，请在此处注册。