Can GLP-1 Drugs Help Manage Multiple Sclerosis?

Living with multiple sclerosis (MS) often means managing a mix of symptoms that affect daily life, including fatigue, mobility challenges, pain, and changes in strength and endurance.

That’s why researchers are looking at how GLP-1 drugs — medications commonly used for weight loss and diabetes — may help manage MS. Some research suggests that there may be benefits for controlling inflammation and protecting nerve health that go beyond the improvements related to weight loss.

GLP-1 drugs mimic a naturally occurring hormone called glucagon-like peptide-1 (GLP-1), which helps regulate appetite, blood sugar, and digestion.

These medications have these effects:

• Reducing appetite and increasing feelings of fullness
• Slowing how quickly food leaves the stomach
• Improving the body’s response to insulin

Together, these effects help people eat less and lose weight over time. GLP-1 drugs were originally developed to treat type 2 diabetes, but several are now approved for chronic weight management:

• Wegovy (semaglutide), which is available as a pill or injection

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• Zepbound (tirzepatide) injection

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• Saxenda (liraglutide) injection

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“Together, these findings suggest that weight loss may positively influence inflammation and symptoms relevant to MS, even though long-term effects on disease progression are still unclear,” says Ali.

There is growing evidence that body weight may influence how well MS medications work, although this area is still being actively studied, says Ali.

“People with obesity tend to have a poorer response to some disease-modifying therapies, particularly older first-line treatments, compared with people at a healthier weight,” she says.

“Researchers suggested that this difference was likely due to altered drug processing in the body, rather than more aggressive disease alone, raising the possibility that weight normalization could improve treatment effectiveness,” says Ali.

Weight loss may also help indirectly by improving the overall inflammatory environment in which MS treatments work. “Lower inflammation and better physical function may allow disease-modifying therapies to work more effectively, even though this has not yet been directly proven in adults,” she says.

“What makes GLP-1 medications especially interesting is that they may do more than help with weight loss,” says Ali.

But the current evidence is limited: While GLP-1s may be linked to improvements in factors that drive MS disease activity, these are associations — there’s no clear proof that GLP-1s directly slow MS progression, she cautions.

Reduce Inflammation

“In laboratory and animal studies, these drugs appear to reduce inflammation in the brain,” says Ali.

Support Nerve Protection

Most of the strongest evidence linking GLP-1 drugs to potential MS benefits comes from animal and laboratory studies.

“In people, the evidence is much more limited. There are currently no completed randomized, controlled trials testing GLP-1 medications as a treatment for MS itself,” says Ali.

The available human data is mainly from small observational and retrospective studies showing that GLP-1 drugs appear safe and well tolerated in people with MS when used for diabetes or weight loss. But these studies were not designed to measure MS outcomes such as relapses, disability progression, or MRI changes, she says.

“Several clinical trials are now under way examining GLP-1 medications in MS and other neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. Newer compounds, including agents like NLY01 and tirzepatide, are being developed to improve brain penetration and potentially enhance neurological effects,” says Ali.

So far the findings on those newer agents are mixed, underscoring the need for carefully designed human trials, she adds.

Bottom line: The science is promising but not definitive, says Ali. “At this point, there is no conclusive clinical trial evidence that they change the course of MS,” she says.

GLP-1 drugs are not approved to treat MS; they can’t and should not replace MS therapies. However, people with MS who also have obesity or type 2 diabetes may be candidates for GLP-1 therapy, says Alan David Kaye, MD, PhD, a professor and the vice chair of research in the anesthesiology department at LSU Health in Shreveport, Louisiana. Dr. Kaye has published research on GLP-1s in people with MS.

“While weight loss doesn't replace MS drugs, managing weight through diet, exercise, and medications like GLP-1 agonists may lead to fewer relapses, less disability, and better responses to standard drug treatments by reducing systemic inflammation,” he says.

Anyone considering a GLP-1 drug should talk with both their primary care or obesity medicine doctor and their neurologist, says Ali.

Your primary care provider can help you decide if you are a good candidate for a GLP-1 and explain how the medication will fit into your overall care plan. At the same time, your neurologist can evaluate how GLP-1 therapy might fit into your MS care.

“This includes considering the stage of MS, current disease-modifying therapies, potential interactions, and whether any changes in symptoms, relapses, or MRI findings should be monitored more closely,” says Ali.

Future studies are needed to identify which people with MS are most likely to benefit from taking a GLP-1, the safest dosing strategies, and whether these medications have long-term disease-modifying effects in MS, she says. For now, close follow-up and collaboration between primary care and neurology are essential, says Ali.

• Obesity is linked to more active MS, and while weight loss hasn’t been shown to reverse the disease, it may help reduce inflammation and make symptoms easier to manage.
• GLP-1 drugs are not approved MS treatments, but early research suggests that they may affect inflammation and nerve health in ways that could be relevant to MS.
• For people with MS who also have obesity or type 2 diabetes, GLP-1 medications may be worth discussing with a neurologist and primary care provider, though their long-term impact on MS is still unknown.