Ozempic as 'a fountain of youth'? What the research says
Key Takeaways
Semaglutide has demonstrated benefits in reducing cardiovascular mortality and improving cardiometabolic health, but its direct effect on slowing aging or extending lifespan is not yet established.
Long-term studies are needed to determine the true impact of semaglutide on longevity and aging biomarkers such as telomere length.
The potential benefits of semaglutide for weight loss and cardiometabolic health must be balanced against the "obesity paradox" in older adults, where a slightly higher BMI may be associated with lower mortality risk.
The potential of GLP-1s, such as Ozempic, is expanding far beyond its initial applications. Recent discussions in the medical community have sparked excitement over its possible roles in managing heart failure, Alzheimer’s disease, and even cancer.
One physician’s provocative speculation (Harlan Krumholz, MD, SM, as quoted in The Independent) that it could be considered “a fountain of youth” highlights the treatment’s promise in not just enhancing quality of life but potentially slowing the aging process itself.[] But does this claim hold any weight?
"It wouldn’t surprise me that improving people’s health this way actually slows down the aging process."
— Harlan Krumholz, MD, SM, August 2024 ESC conference
Lower mortality—but longer life?
In one study (a subanalysis of the SELECT trial), for instance, treatment with semaglutide 2.4 mg was associated with lower rates of all-cause death during the COVID-19 pandemic.[]
The researchers concluded that “the lower rate of non-cardiovascular death with semaglutide was predominantly because of fewer infectious deaths. These findings highlight the effect of semaglutide on mortality across a broad population of patients with CV [cardiovascular disease] and obesity.”[]
Related: Could Ozempic slow Alzheimer’s progression?What the data can't say
Several studies, including those presented at the August 2024 European Society of Cardiology (ESC) meeting, have now shown the benefits of semaglutide in reducing all-cause mortality as well as mortality from CV, including heart failure, in patients with obesity or overweight, both with and without diabetes.[]
“I would say if you’re improving someone’s cardiometabolic health substantially, then you are putting them in a position to live longer and better,” Dr. Krumholz clarified. “It’s not just avoiding heart attacks. These are health promoters.”[]
As you can see, these improvements in cardiometabolic health are being interpreted as “slowing the aging process,” but to date, studies examining the effect of semaglutide on telomere length or actual population longevity are lacking.
Dr. Krumholz’s commentary on the presented studies, of course, is not the same as actual population-based studies over decades showing measurable improvement in longevity or even laboratory-based studies showing an increase in telomere length with semaglutide treatment. As of today, those outcomes are lacking.
Given how recently semaglutide has been introduced into the mainstream market, it will take several more decades to have true longevity data. Regardless, the medical community has reason to remain hopeful.
The obesity paradox
At the same time, there is something to be considered as patients age: Several studies—including a longitudinal study done in China[]—have now shown reduced mortality with a stable BMI in the overweight range of 25 to 27 kg/m(2), as compared with lower BMIs, above the age of 55. This is the very BMI (that is, 27) at which Ozempic is indicated for treatment.
A 2024 Swedish study has confirmed this paradox.[] Regardless of whether they used classic BMI calculations or knee-height BMI, the researchers found that both men and women in the age group 80 years and older who had overweight status had a lower mortality risk as compared with those who were normal/underweight.
Thus, the benefits and safety of Ozempic in older patients are still in question.
What this means for you
While Ozempic (semaglutide) has shown promising results in improving cardiometabolic health and reducing mortality in certain populations, its direct impact on slowing aging or extending lifespan remains unproven. As a physician, it's crucial to weigh the potential benefits against the lack of long-term data on aging's effects (and potential risks), especially in older patients where a slightly higher BMI may be protective.