All GLP-1 medications have similar gastrointestinal side effects that can contribute to fatigue, but the risk increases with higher doses. And just like insulin, you can get some pretty decent results by giving GLP-1 to people with obesity and/or metabolic syndrome. In other words, the people with access to these drugs had other protective factors against dementia. Prescriptions and spending on Ozempic, approved to help control blood sugar levels for adults with type 2 diabetes in 2017 (Table 1), have grown considerably from 2019 to 2023, nearly doubling every year since 2019. Looking from 2022 to 2023, the latest year of data available, Wegovy (first approved in 2021) and Mounjaro (approved in 2022) also saw substantial growth, with prescriptions and gross spending for both drugs increasing twelvefold or more. The major effect of ghrelin released to the blood is exerted within the central nervous system at the level of the arcuate nucleus where it stimulates the synthesis and release of neuropeptide Y (NPY) and agouti-related protein (AgRP).

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