NEW YORK — Doctors are warning that popular GLP-1 medications used for diabetes and weight loss, including drugs such as Ozempic and Wegovy, may pose serious risks for some patients with neurodegenerative diseases, particularly those with amyotrophic lateral sclerosis, or ALS.
Neurologists say the same effect that makes these medications effective for many people — significant weight loss — could potentially accelerate physical decline in ALS patients, whose bodies often require careful management of calories and muscle mass.
Jinsy Andrews, M.D., a neurologist and director of the ALS Center at NYU Langone, said the medical approach changes when GLP-1 receptor agonists are used in patients with neuromuscular disorders.
GLP-1 medications have become widely used for managing obesity and type 2 diabetes, and research has linked them to benefits including reduced risks of cardiovascular disease, stroke and certain metabolic conditions.
But Andrews said those benefits do not necessarily translate to patients with ALS, an incurable disease that progressively damages nerve cells responsible for muscle movement.
For people with ALS, maintaining weight can be an important part of care. Doctors often encourage patients to avoid weight loss and, in some cases, gain weight to help preserve remaining muscle function and slow the effects of the disease.
“In certain conditions where hypermetabolism is something that negatively affects the disease […] losing weight actually makes the disease worse and move faster,” Andrews told Fox News Digital.
She said that for someone with ALS, using GLP-1 medications may create additional concerns, even if the patient also has diabetes.
“So, in the setting of a person with ALS — whether they have diabetes or not — using GLP-1s may actually worsen the disease and make for a rapid progression,” Andrews said.
Researchers have pointed to a 2025 case report published in the medical journal Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration involving a 52-year-old ALS patient who was prescribed semaglutide, the active ingredient in medications including Ozempic and Wegovy, to help manage type 2 diabetes.
According to the report, the patient had been experiencing a predictable pattern of decline before starting the medication. After losing approximately 25 pounds over three months, doctors observed a significant acceleration in her physical deterioration.
The report said the patient’s rapid decline stabilized after semaglutide was discontinued under medical guidance.
Andrews said the case report, along with other observational data involving ALS patients with diabetes, suggests healthcare providers should carefully consider the risks and benefits before prescribing GLP-1 medications to people with underlying neurodegenerative conditions.
Experts emphasize that GLP-1 drugs remain an important treatment option for many patients dealing with obesity and diabetes. However, doctors say treatment decisions should account for an individual’s overall health, disease status and nutritional needs.
For patients with ALS and other disorders that affect muscle function, maintaining body weight and preventing excessive loss of muscle mass can be a critical part of medical care.
