Ozempic does not slow Alzheimer's, study finds
75 points
3 hours ago
| 5 comments
| semafor.com
| HN
GuB-42
1 hour ago
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Source: https://www.novonordisk.com/news-and-media/news-and-ir-mater...

Ongoing study: https://pubmed.ncbi.nlm.nih.gov/39780249/

Usual rant to news outlets: Cite your damn sources! (if they are public, which is the case here). This is a web page, not printed paper, web pages support links, links are not just for ads!

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OptionOfT
1 hour ago
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But but but we have to keep traffic on our website! Engagement!

That's why when you click on a link you see 1/10th of the article, and then a video, and 3 other irrelevant inlays for other links.

Oh and the video auto plays with sound.

And every word in the article that is remotely a 'tag' links to other parts of the website.

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codedokode
1 hour ago
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> video auto plays with sound.

Without sound in Firefox, I assume?

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megaman821
1 hour ago
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I can't remember the source, but I think this only rules out small-dose, oral. There will still be a trial with large-dose, injectable.
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KittenInABox
2 hours ago
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Why would Ozempic, a chemical affecting a specific receptor found in specific parts of the body, affect alzheimer's? I'm just asking questions here I don't understand what the mechanism of action is that this would be disappointing news.
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foobiekr
2 hours ago
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"Type 3 diabetes" is one of the speculated causes of alzheimer's. The evidence there is not great.
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delichon
2 hours ago
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Fixing type 1 or 2 diabetes does not fix the damage they already did either.
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kens
48 minutes ago
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Semaglutide (Ozempic) has potential therapeutic effects in neurodegenerative disorders through "modulation of neuroinflammation, enhancement of mitochondrial function, and promotion of neurogenesis". It has shown benefits in animal models of Alzheimer's and Parkinson's. So they're not just testing a random drug, but something that could work.

For details, see: https://pubmed.ncbi.nlm.nih.gov/38921025

This diagram shows how Ozempic can produce these results, the various pathways from the GLP-1 receptor to reduce inflammation, protect neurons, and affect mitochondria: https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c0/11202139/72234dd...

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clickety_clack
2 hours ago
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I know we can tell that a chemical does a particular thing in the body, but can we tell that it does not do anything other than that thing? The body is ridiculously complex, and as far as I know we don’t know how every part (or combination of parts) works.

Edit: I mean in the theoretical “this targets the x receptor” kind of way, not in “we tested this and found no causal link” way.

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KittenInABox
2 hours ago
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That's why I'm genuinely asking why this would be disappointing, like what was the evidence that this does affect Alzheimer's. You would expect by X does not affect Y by default, so clearly there had to be a theory why you'd spend 2 years on a study to rule it out.
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FeteCommuniste
43 minutes ago
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Significant, sustained weight loss can prevent or reduce the effects of conditions known to increase the likelihood or hasten the onset of Alzheimer's, like diabetes and high blood pressure.
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twosdai
2 hours ago
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This is anecdotal, I don't have proof but it's something I think is somewhat related. Is that obesity and nuerodegenerative diseases are somewhat related. So that's a guess as to why some people might have though a weight loss drug would potentially be related in some way with alzheimers.

This could just be false though, I can't recall where I heard this information. So do some searching before quoting me.

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FeteCommuniste
40 minutes ago
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Obesity often goes hand in hand with poorly regulated blood sugar and high blood pressure, both known risk factors for Alzheimer's.
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habinero
2 hours ago
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Ozempic is a diabetes drug, and there's a hypothesis that Alzheimer's is really a form of diabetes.
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JoshTriplett
2 hours ago
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As I understand it, one of the reasons GLP-1 agonists seem to affect so many different things is that evolutionarily, it does not seem at all surprising that a huge number of things are hooked on the hungry/full signal.
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SoftTalker
7 minutes ago
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It appears that it might be even more generically the "need/satiated" signal.
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m463
1 hour ago
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I kind of think if it fixes a fundamental issue - too much weight.

Another problem it seems to help with is addictive/impulsive behavior. This might lead to wrong choices in diet or activity.

I suspect that many many functions of the body are degraded or disabled by too much weight or wrong choices, and fixing those problems might let the body cure and maintain itself properly.

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silveraxe93
1 hour ago
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I read this[1] some time ago. Seems relevant now.

- [1] https://www.astralcodexten.com/p/why-does-ozempic-cure-all-d...

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jfarina
2 hours ago
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Maybe because poor diet has been linked to alzheimers?
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red_hare
2 hours ago
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The article describes data showing a correlation between Ozempic use and slowed progression of certain brain conditions. The study aimed to determine whether that effect came from Ozempic itself or simply from weight loss. Once researchers controlled for weight loss, the effect disappeared. In other words, correlation, not causation.
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francisofascii
1 hour ago
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That's an important caveat. But effectively it sounds like Ozempic typically results in a better diet, and a better diet typically results in slowed progression.
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cyberax
1 hour ago
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Since Ozempic was the primary reason for the weight loss, it's still causation. Although indirect.
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devmor
2 hours ago
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It was correlated to lower Dementia rates in a past study. https://journals.sagepub.com/doi/10.1177/13872877251351329
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KittenInABox
2 hours ago
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Thanks, I wasn't aware of this. Do we know how?
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rtkwe
1 hour ago
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Generally this is the answer when there's an announcement like this. Some early paper or analysis showed some (often weak but potentially very interesting) correlation between $new_drug and $scary_disease/$scary_disorder. Doctors and scientists go off and study that in more depth with better controls or more data points and we learn a little more about the world, if you miss the initial paper(s) the follow up can seem a little random.
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SoftTalker
6 minutes ago
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We don't know the "how" in a surprising number of medicines.
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scarmig
2 hours ago
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I don't think there's a confirmed mechanism (or even whether the fact that it does prevent dementia is a confirmed fact).

But you could speculate that obesity -> cardiovascular issues -> neurological damage, and that could explain things.

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kaonwarb
1 hour ago
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We unfortunate know very little about how dementia / Alzheimer's develop in the first place.
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devmor
1 hour ago
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This new study that did not find a causal link was part of the attempt to find out how. The original study was more of an observation than a deep dive.

You could think of it similar to a study that shows something like "People who don't watch network TV have fewer strokes", which could be an interesting correlation, but the causal effect might be something more like "people who are more health conscious tend to avoid sitting down for extended waking periods" which ultimately has nothing to do with TV.

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temp0826
54 minutes ago
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"Alleged magic cure does not solve all our problems" just isn't as catchy.
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readthenotes1
2 hours ago
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It's disappointing to the manufacturers and consumers because many boomers are taking it already to treat 40+ years of poor and/or indulgent consumption (and more will now that they've negotiated a price reduction).

Glp-1 drugs inhibit drinking and compulsive behaviors and I'm not sure the mechanism of action is known

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paulvnickerson
50 minutes ago
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neither do most things in life
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wonderwonder
2 hours ago
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I would think eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits. Which should be perfectly fine as its valid and results in massive positives in both health and quality of life.
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estearum
2 hours ago
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We already know that's not the case though. A huge portion of the benefits are downstream of obesity, yes, but we already know GLPs have positive effects even without weight loss.
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astura
1 hour ago
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>eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits.

This is not true.

Ozempic appears to affect the brain's rewards system and its known to decreased cravings and urges for a range of unhealthy behaviors, from alcohol consumption and smoking to gambling and shopping to nail biting and skin picking.

Beyond that, Ozempic appears to lower the risk of heart attacks and strokes in overweight people well beyond what weight loss alone would explain. Maybe due to the above (less drinking and smoking) or another unknown mechanism of action.

https://www.scientificamerican.com/article/weight-loss-drug-...

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toraway
25 minutes ago
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I started taking prescription Zepbound (tirzepatide) right when it was approved for about 6 months and lost 30 pounds, later switched to a low dose of much cheaper grey market semaglutide for maintenance. The anti-drinking side effect was unexpected and somewhat shocking to experience. I had heavily drank in the evening for almost a decade to varying degrees and then pretty much stopped overnight once hitting the 5mg dose of Zepbound on the second month. After ending the Zepbound I had a few months where I wasn't taking anything before resuming the maintenance semaglutide, and although food cravings slowly started returning, I still had/have zero interest in drinking whatsoever unless in a social setting where I may have 1-2 drinks (but usually avoid it altogether without requiring any conscious effort).

There is definitely massive variance in the individual psychology/biology that leads to habitual alcohol overuse so I'm sure others might not have the same experience. But for me I'm pretty confident that breaking that deeply engrained habit of starting the first of 6-10 drinks at 6-7pm every day was what did it (without feeling like I was being forced to do something I didn't want). Which was pretty much impossible for me to even envision back when it was such a normal part of my day-to-day coping strategy for stress/depression/etc.

Although I always knew my drinking was excessive and terrible for my health, past my early 20s I was super high functioning and wasn't interfering with my job or life (other than holding me back and probably slowly killing me), and so being an "alcoholic" was never part of my identity (rightly or wrongly), which I kinda think ironically made it easier to just take the win and move on with my life without nagging self-doubt or fixation on whether my "addiction is cured".

But it's been about 2 years now and I hardly ever think about alcohol even when super stressed so something, somewhere in my brain changed thanks to tirzepatide and whatever the mechanism I'm grateful for that happy accident of a positive side effect!

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flir
2 hours ago
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Nah, obesity reduction is itself a downstream effect of messing with neurotransmitters. There have to be other consequences of that - both good and bad.
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estearum
2 hours ago
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There don't have to be any other consequences, certainly not both good and bad ones. Biology doesn't actually have some scale of justice that means good things must be offset by bad things.

But yes, it's very probable (in fact we already know) the drug is doing several things in the body.

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flir
1 hour ago
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I was more thinking that evolved systems rarely have convenient switches you can flip and just get a single outcome. You perturb the system, and you get a cascade of changes. It's not like engineering.

Nothing about justice was implied, so lets say desirable and undesirable instead of good and bad.

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estearum
1 hour ago
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Yes you’re right to be concerned about this, I’m taking issue with your assumption that there must be undesirable effects.
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