While GLP‑1 receptor agonists may be best known for aiding weight loss and regulating digestion, gastroenterologists are also drawing attention to the therapies’ effect on the brain. Indeed, recent research points to another potential benefit: brain protection.
An April 2025 JAMA Neurology analysis found GLP‑1 use was linked to a 45% lower risk of dementia compared to other glucose-lowering drugs. The findings suggest GLP‑1s may have neuroprotective properties, potentially guarding against cognitive decline through mechanisms independent of weight loss or blood sugar control.
Caroline Apovian, MD, co‑director of the Center for Weight Management and Wellness at Boston‑based Brigham and Women’s Hospital, was among the first physicians to push for obesity to be recognized as a chronic disease, rather than a matter of willpower. She joined Becker’s to discuss why understanding this neurological benefit is crucial.
“GLP‑1, when it is injected, causes satiety in the brain and reduces gastric emptying,” Dr. Apovian said. “It lets food sit longer, and it makes you feel full with less food.”
Imaging research supports this mechanism. A placebo‑controlled functional MRI study published November 2014 in Diabetes found the GLP‑1 agonist exenatide suppressed activity in brain regions tied to appetite and reward — including the insula, amygdala and orbitofrontal cortex — after exposure to food cues, resulting in reduced cravings and lower food intake.
More recent studies have identified GLP‑1 receptor neurons in the hypothalamus that encode early satiety signals before food is consumed.
Beyond appetite control, meta‑analyses have shown GLP‑1 receptor agonists also deliver cardiovascular and kidney benefits, including reduced risk of major adverse cardiac events, heart failure hospitalizations and kidney disease progression in patients with diabetes or obesity.
“Very, very few people with obesity are not at risk,” Dr. Apovian said.
