New research presented at the European Congress on Obesity (ECO) in Malaga, Spain, reveals that some widely used weight loss drugs may do more than just help people shed pounds. First-generation drugs like liraglutide and exenatide appear effective in preventing certain cancers linked to obesity, according to a study published in the journal eClinicalMedicine.
GLP-1 Drugs Compared to Bariatric Surgery
The study compared the effects of first-generation glucagon-like peptide-1 receptor agonists (GLP-1RAs) with bariatric surgery in patients with obesity and type 2 diabetes. Despite bariatric surgery resulting in greater weight loss, rates of obesity-related cancers were similar between the two groups over an average follow-up of eight years.
Dr. Yael Wolff Sagy, co-lead author from Clalit Health Services in Tel Aviv, Israel, explained, “GLP-1RAs have a 41% higher direct effect than surgery in preventing obesity-related cancers in addition to weight loss.” This suggests that GLP-1 drugs provide cancer protection beyond their ability to reduce body weight.
How GLP-1 Receptor Agonists Work
GLP-1RAs mimic a natural hormone that lowers blood sugar and helps people feel full longer. They are widely used to manage type 2 diabetes and aid in weight loss.
Obesity and diabetes increase the risk of various cancers, including postmenopausal breast cancer, colorectal cancer, uterine cancer, and others such as liver, pancreatic, and thyroid cancers.
Large-Scale Study Design and Findings
Researchers analyzed electronic health records of 6,356 patients aged 24 and older with obesity (BMI ≥35) and type 2 diabetes. Patients were either treated with GLP-1 drugs for at least six months or underwent bariatric surgery between 2010 and 2018.
Participants were matched by sex, age, BMI, treatment start date, and smoking status. Follow-up continued until December 2023 to monitor new cancer diagnoses.
During an average follow-up of 7.5 years, 298 participants were diagnosed with an obesity-related cancer. The most common cancers were postmenopausal breast cancer (26%), colorectal cancer (16%), and uterine cancer (15%).
Cancer incidence was nearly equal in both groups: 5.76 cases per 1,000 person-years in the surgery group and 5.64 cases per 1,000 person-years in the GLP-1 group.
Beyond Weight Loss: The Direct Effect on Cancer Risk
When researchers adjusted for the amount of weight lost, they found GLP-1 drugs had a significant direct effect in reducing cancer risk, with a 41% lower relative risk compared to surgery.
Co-first author Dror Dicker, professor at Hasharon Hospital, Rabin Medical Center in Petah Tikva, Israel, noted, “The protective effects of GLP1-RAs against obesity-related cancers may stem from multiple mechanisms, including reduced inflammation.”
He added that newer GLP-1 drugs, which cause more weight loss, might have even greater benefits. However, more studies are needed to confirm these effects and ensure no increased risk of other types of cancers.
Need for Further Research
While these findings are promising, the study is observational. The authors stress that randomized controlled trials and larger prospective studies are necessary to verify the results and better understand how GLP-1 drugs reduce cancer risk.
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