Neurologists are cautioning that widely used weight-loss medications, such as Ozempic and Wegovy, may have detrimental effects on individuals with neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS).
Jinsy Andrews, MD, a neurologist and director of NYU Langone’s ALS Center, stated that the rapid weight loss these drugs induce can be counterproductive for patients with neuromuscular disorders. While GLP-1 agonists are effective for managing diabetes and obesity, the medical approach shifts when dealing with conditions like ALS.
According to Andrews, these medications, while linked to other protective effects such as reduced cardiovascular disease risk, can accelerate physical decline in ALS patients. For individuals with ALS, losing weight can worsen the condition because the disease's characteristics make it difficult for the body to sustain a caloric deficit. Standard care guidelines for ALS often recommend patients maintain or even gain weight to preserve nerve and muscle function.
"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. "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."
A 2025 case report detailed the experience of a 52-year-old ALS patient prescribed semaglutide for type 2 diabetes. Before starting the medication, her disease progression was on a predictable trajectory. After three months on the drug, she lost 25 pounds and experienced a significant and rapid worsening of her symptoms.
Once the semaglutide was discontinued under medical guidance, the patient's rapid physical decline stabilized. Andrews noted that this case, along with retrospective data from ALS patients with diabetes, suggests clinicians should exercise caution when prescribing GLP-1 receptor agonists.
While these weight-loss medications offer benefits to many, maintaining body weight and muscle mass is crucial for individuals with neurodegenerative diseases.
Novo Nordisk, the maker of Ozempic and Wegovy, stated that patient safety is a priority and the company takes adverse event reports seriously. However, the company noted that ALS and other neurodegenerative diseases are not listed as adverse reactions or warnings in the prescribing information for their semaglutide products.