Published Feb 28, 2026 | 7:00 AM ⚊ Updated Feb 28, 2026 | 7:00 AM
GLP-1 drugs. (iStock)
Synopsis: Experts are moving beyond GLP-1 receptor agonists in diabetes and obesity management to a broader focus on protecting vital organs and improving overall metabolic health. Doctors said these drugs are showing benefits for the liver, kidneys, heart and joints.
The role of GLP-1 receptor agonists is expanding rapidly, moving beyond their traditional use in diabetes and obesity management to a broader focus on protecting vital organs and improving overall metabolic health.
Doctors said these drugs are showing benefits for the liver, kidneys, heart and joints, signalling a shift toward treating metabolic disease as a multi-system condition rather than isolated disorders.
With rising rates of obesity, fatty liver disease and cardiovascular illness in India, clinicians are increasingly viewing these therapies as tools that address underlying drivers such as visceral fat, inflammation and insulin resistance.
Experts emphasised that while weight loss remains central, the real impact lies in reducing harmful fat deposits and improving organ function over time.
Doctors said the focus shifted from body weight alone to visceral fat — the hidden fat around organs that drives metabolic disease.
Dr Pradeep Selvaraj, senior diabetologist at Chettinad Hospital and Research Institute, explained that reducing this fat is critical to improving liver health.
“GLP-1 analogues help reduce not just body weight but visceral fat over time,” he told South First, noting that studies have shown fatty liver stages improving after sustained therapy.
He added that metabolic fatty liver disease, unlike alcohol-related disease, can be reversed when inflammation and fat in liver cells decline.
He further noted that fibrosis and inflammatory changes may improve over roughly a year to 18 months of treatment, provided patients are carefully screened and monitored.
According to him, clinicians assess biochemical markers and imaging before initiating therapy to ensure safe and effective outcomes.
Beyond liver benefits, the drugs appear to support kidney health by improving metabolic parameters that contribute to renal damage.
Dr Selvaraj explained that weight loss and improved insulin sensitivity help patients achieve better glycaemic control, which in turn reduces stress on the kidneys.
He stated that early kidney damage, such as microalbuminuria, can improve when multiple risk factors — including blood sugar, blood pressure and salt intake — are controlled alongside treatment.
He emphasised that the drugs act as an adjunct, enhancing the effectiveness of broader diabetes management rather than functioning as a standalone solution.
Sustained benefits, he added, depend on long-term adherence and lifestyle changes.
Improvements in metabolic markers often emerge over 60 to 72 weeks, though stopping therapy abruptly may lead to gradual weight regain, reinforcing the need for tapering and behavioural adaptation.
Cardiologists said the most significant breakthrough may be in heart health. Dr R Venkatakrishnan, consultant cardiologist at Rela Hospital, described GLP-1 analogues as a major addition to cardiovascular risk reduction strategies.
“These agents help reduce heart attacks, strokes and prolong life while improving quality of life,” he told South First, adding that current evidence suggests cardiovascular risk reductions of roughly 15 percent.
He noted that benefits extend beyond blood sugar control, including reduced vascular inflammation and improved blood pressure regulation.
“These drugs reduce visceral and epicardial fat — deposits around the heart that contribute to metabolic dysfunction and arterial blockages,” he added.
According to him, lowering inflammation within blood vessels may slow plaque formation, a key factor in preventing heart attacks and strokes.
Experts said the benefits extend to mobility and joint health, particularly for patients with obesity-related osteoarthritis.
Dr Selvaraj noted that weight loss plays a major role in reducing knee pain, while anti-inflammatory effects help ease metabolic inflammation.
“Many patients experience improved joint mobility and reduced pain, allowing them to become more physically active,” he observed.
Increased activity further supports weight loss and metabolic health, creating a positive cycle that may delay or avoid surgical interventions.
Dr Venkatakrishnan added that improved mobility can indirectly strengthen heart health by enabling patients to exercise.
He explained that patients with severe obesity often struggle with physical activity, but weight reduction can transform a cycle of inactivity into one of progressive fitness and cardiovascular improvement.
Both experts emphasised that GLP-1 therapies represent a shift toward preventive care that addresses the root causes of metabolic disease.
Dr Venkatakrishnan noted that benefits are now being seen even in high-risk patients without diabetes, including reductions in major cardiovascular events.
He said these therapies may help combat metabolic syndrome by reducing visceral fat, improving cholesterol and lowering inflammation — factors that contribute to arterial blockages.
“If used appropriately, they could prevent heart disease and improve long-term survival,” he added.
Dr Selvaraj stressed that sustained results require lifestyle changes alongside medication.
He explained that gradual dose reduction helps patients adapt to healthier habits, ensuring that improvements in liver health, kidney function and mobility are maintained over time.
Dr Vivian Kapil, Consultant Psychiatrist, SRM Prime Hospital, Ramapuram, Chennai, said interest is growing in analysing whether GLP-1 receptor agonists could help manage cravings beyond their established role in diabetes and weight management.
“These drugs act on brain regions involved in reward and impulse control, which are also implicated in behaviours such as binge eating and alcohol use,” he told South First.
As he explained, “GLP-1 receptors are present in brain regions that regulate craving and reward; these drugs may reduce urges,” pointing to a biological basis for their potential role in addiction care.
However, he cautions that the science is still developing. While early findings and theoretical models suggest these medicines may influence dopamine-mediated reward pathways, there are no large-scale clinical trials confirming their effectiveness in treating substance dependence.
Currently, he noted, they cannot be recommended as primary therapy. Instead, they may be considered only as supportive tools alongside established treatments.
In his words, “There are no international guidelines recommending GLP-1 analogues as a standalone treatment for addiction.”
Dr Kapil emphasised that addiction cannot be reduced to a single pathway or symptom. It requires comprehensive care that includes psychotherapy, relapse-prevention strategies, and management of co-existing medical and mental health conditions.
“Viewing addiction purely as a reward-driven problem would be an oversimplification,” he said, stressing the need for a multidisciplinary approach while researchers continue to explore whether these medications could play a meaningful supportive role in the future.
(Edited by Muhammed Fazil.)
