Who benefits most from GLP-1 drugs?
The people who benefit most are those with type 2 diabetes and obesity, but the benefits extend well beyond weight loss and blood sugar control. A massive 2025 study [5] that mapped 175 health outcomes in over 200,000 diabetes patients found that GLP-1 use was associated with reduced risks of substance use disorders, psychotic disorders, seizures, neurocognitive conditions like Alzheimer's and dementia, and several heart and lung diseases. This means that for a person with diabetes and a history of addiction or cognitive decline, the drug might offer protection beyond what was previously thought.
Another surprising benefit emerged for bone health. A 2026 study [1] of diabetes patients undergoing spinal fusion surgery found that those who used GLP-1 drugs had a 45% lower risk of failed bone fusion at 6 months (7.9% nonfusion vs. 13.6% in nonusers), and this benefit persisted at 2 years (10.0% vs. 15.5%). This suggests that for diabetic patients needing spine surgery, GLP-1 drugs may improve surgical outcomes.
However, the benefits are not universal. The same large analysis [5] also found increased risks of gastrointestinal disorders (nausea, vomiting, diarrhea), hypotension, fainting, arthritis, kidney stones, and drug-induced pancreatitis. A systematic review of case reports [4] confirmed that gastrointestinal problems, especially pancreatitis, were the most frequently reported adverse reactions, with liraglutide and exenatide causing the most issues. So, while many patients benefit, those with a history of pancreatitis or severe gastrointestinal problems may not be ideal candidates.
What about weight loss and body image?
For weight loss, tirzepatide appears to outperform semaglutide, especially for people with type 2 diabetes. A 2025 mega-analysis [3] of over 10,000 trials found that both drugs met the FDA's 5% weight loss threshold, but tirzepatide outperformed semaglutide as the weight loss target increased from 5% to 20%, and had greater effects in people with diabetes. However, the authors caution that faster, greater weight loss is not always better—clinical benefits, safety, and quality of life must be carefully assessed.
Interestingly, a 2025 study [6] on body image found that people most interested in trying GLP-1s for weight loss reported higher body shame, body surveillance, weight concerns, and disordered eating behaviors, as well as lower body appreciation. Body appreciation actually moderated interest—meaning that people who felt better about their bodies were less interested in using the drugs for weight loss. This suggests that the psychological profile of the user matters: those with poor body image may be more motivated to seek the drugs, but may also be at risk for unrealistic expectations or side-effect intolerance.
Are there any mental health risks?
Concerns about suicide risk have been raised, but the evidence here does not support a link. A large 2024 study [2] from Sweden and Denmark tracked over 124,000 GLP-1 users and 174,000 users of a different diabetes drug (SGLT2 inhibitors) for an average of 2.5 years. Suicide deaths were rare in both groups (0.23 vs. 0.18 per 1,000 person-years), and the difference was not statistically significant. The study also found no increased risk of self-harm or depression/anxiety disorders. In fact, the risk of suicide death combined with nonfatal self-harm was actually slightly lower in GLP-1 users (hazard ratio 0.83). This should reassure patients and doctors that the drugs do not appear to increase suicide risk.
About These Sources
This answer is built on 6 peer-reviewed studies — published from 2022 to 2026, 5 from 2024 or later, 5 in Q1 journals, collectively cited 399 times — selected as the most relevant from 7 studies that passed quality screening, drawn from 62 papers retrieved from a database of over 500 million.
Sources used in this answer
Association between glucagon-like peptide-1 receptor agonists and nonfusion risk after single-level anterior cervical discectomy and fusion
In a retrospective cohort study of 1,242 matched diabetes patients undergoing spinal fusion, GLP-1 drug users had 45% lower odds of failed bone fusion at 6 months (7.9% vs. 13.6%), with benefits persisting at 2 years.
GLP-1 Receptor Agonist Use and Risk of Suicide Death
In a large cohort study from Sweden and Denmark (124,517 GLP-1 users vs. 174,036 SGLT2 inhibitor users), GLP-1 use was not associated with increased suicide death (0.23 vs. 0.18 per 1,000 person-years) or self-harm.
Clinical Data Mega-Collection of Obesity and Obesity-Related Trials: Primary Inclusion Criteria from All Studies and Highlights of Clinical Efficacy Analysis of GLP-1 Drugs
A mega-analysis of over 10,000 obesity trials found that tirzepatide outperformed semaglutide for weight loss at higher thresholds (5-20% loss), especially in people with type 2 diabetes, but cautioned that rapid weight loss may not always be beneficial.
Adverse drug reactions of GLP-1 agonists: A systematic review of case reports
A systematic review of 120 case reports found that gastrointestinal disorders (especially pancreatitis) were the most common adverse drug reactions with GLP-1 agonists, most frequently with liraglutide and exenatide.
Mapping the effectiveness and risks of GLP-1 receptor agonists
In a large VA cohort study (215,970 GLP-1 users vs. 1.2 million usual-care controls), GLP-1 use was associated with reduced risks of substance use disorders, seizures, Alzheimer's disease, and cardiometabolic conditions, but increased risks of gastrointestinal disorders, kidney stones, and pancreatitis.
Body image and interest in GLP-1 weight loss medications
In a survey of 225 university students, those most interested in GLP-1s for weight loss reported higher body shame, weight concerns, and disordered eating, while higher body appreciation was a protective factor against interest.