Dear Dr. Roach: My brother-in-law is a lovely man, but for years, he’s suffered from obesity. He also gambles and drinks alcohol too much. I hesitate to get too involved, but I recently read that the new weight-loss drugs based on GLP-1 agonists are also helpful in reducing alcohol and gambling addictions. This sounds too good to be true. Is it?
— D.N.A.Dear D.N.A.: The evidence is very strong that GLP-1 agonists like tirzepatide (Zepbound) and semaglutide (Wegovy) help people lose weight. About 80% to 90% of people will experience a weight loss of more than 5% of their initial body weight.
For people who are severely obese, people with obesity and metabolic complications (diabetes, prediabetes or metabolic syndrome), and people with other weight-related complications (sleep apnea and arthritis), the benefits of these medicines probably outweigh the risks just for the weight loss.
The evidence for GLP-1 agonists helping with alcohol use disorder is now quite strong, with studies showing significant reductions in alcohol-related hospitalizations and a reduction in problem drinking. The evidence for gambling disorders is preliminary based on the understanding of how these drugs work in the brain. There are no strong clinical data at this time supporting the use of GLP-1 agonists for a gambling disorder.
Still, given the clear benefits in weight reduction and problem drinking, these drugs might be a good choice for your brother-in-law — if both he and his physician agree. It might also help his gambling problem, which I’ve seen take a terrible toll on a person’s social and financial life.
Finally, I was supervising a medical resident yesterday when we discussed the effect of these drugs on heart health. The evidence is also strong that these medications decrease the risk of heart disease — both in people with and without diabetes. Multiple mechanisms have been proposed for this heart protection, but it isn’t exactly clear which ones are the most important.
For those of us who lived through the approval of previous weight-loss drugs, which were later found to cause heart damage, the news about heart protection is welcome. Still, we’ve been using these drugs for less than 10 years, and it’s wise to use them only when there is a clear benefit in doing so.
Dear Dr. Roach: What are the long-term health risks of being exposed to fumes, such as in a hair or nail salon or automobile repair shops? Can these fumes affect your internal organs?
— C.R.C.
Dear C.R.C.: The primary organ affected by fumes during occupational exposure are the lungs. Chest tightness, wheezing and allergic symptoms are common after exposure to benzene, formaldehyde, toluene and other substances that are commonly used in hair and nail salons — often at levels that exceed the safe thresholds. Half of technicians in one study were affected.Auto body and paint workers are also exposed to the same (or very similar) chemicals, and they can develop asthma at a rate that is 80 times higher than the general population. In addition to effects on the lungs, occupational exposure to these chemicals increases the risk of some cancers, especially leukemia (benzene), sinus and nasal cancer (formaldehyde), and nervous system cancers (benzene).
Although personal protection equipment can reduce these exposures, many workers don’t use them regularly. Improved ventilation and less-toxic chemicals are needed to protect workers. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
This article originally appeared on The Detroit News: Dr. Roach: GLP-1 agonists might help obese man with his drinking habit
Reporting by Dr. Keith Roach, To Your Health / The Detroit News
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