According to the most recent adult obesity facts issued by the CDC, more than 2 in 5 U.S. adults have obesity. That doesn’t factor in those who are overweight but don’t meet the medical criteria to be considered obese.
If you were to ask what bothers people the most about being overweight, their answer would most likely have something to do with aesthetics. But being overweight isn’t just a cosmetic concern; it’s a medical problem. Excess weight puts stress on nearly every organ system. Over time, that pressure can lead to serious health issues.
The scary truth is that weight gain is usually just the beginning…
Obesity rarely happens in isolation. If you’re overweight and you don’t already have an obesity-related health issue, chances are you will. When other health problems show up alongside obesity, they are known as obesity-related comorbidities, and they’re one of the biggest reasons being overweight is about much more than physical appearance.
The encouraging news is that many of these conditions return to healthier ranges after meaningful weight loss and metabolic support, which is something millions of people are achieving thanks to GLP-1 weight loss therapy.
But GLP-1 research is also revealing something even more important than weight loss…
Medications like semaglutide and tirzepatide are increasingly being recognized for their potential to help manage some of the most common complications that occur alongside obesity, like diabetes, high blood pressure, fatty liver disease, and more.
What Are Obesity-Related Comorbidities?
Being overweight doesn’t just increase the number on the scale and make you insecure about your appearance. It increases your risk for a long list of health complications.
When other medical conditions coexist alongside being overweight, these are known as obesity-related comorbidities. They’re common, they’re serious, and in many cases, they develop quietly until symptoms become too big to ignore.
Carrying excess body fat puts physical stress on your joints, disrupts hormones, throws off blood sugar regulation, and increases inflammation throughout the body. Over time, this can trigger a range of health problems and diseases or worsen ones that already exist.
Some of the most common obesity-related comorbidities include:
- Type 2 diabetes
- High blood pressure
- Cardiovascular disease
- Fatty liver disease
- Hormone imbalance and PCOS
- Sleep apnea
- Gastrointestinal disease
- Osteoarthritis and joint pain
- Anxiety, depression, and eating disorders
- Certain cancers
- Fertility issues
- +++ more
The more time your body spends holding on to excess body fat, the greater your risk of developing one or more of these conditions. That’s why addressing obesity early with medical weight loss tools such as GLP-1 weight loss medications is one of the most powerful ways to protect your long-term health.
GLP-1 Medications: More Than Weight Loss Drugs
Most people know GLP-1 medications like semaglutide and tirzepatide as weight loss drugs. While they are incredibly effective for this purpose, emerging research suggests that the benefits of GLP-1 injections extend beyond just appetite suppression, satiety, and a slimmer waistline.
GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally produces to help regulate blood sugar, insulin response, and feelings of fullness after eating. When used as a medication, GLP-1 receptor agonists mimic this hormone to help people eat less, feel satisfied longer, and improve overall metabolic function.
Originally developed to treat type 2 diabetes, these medications quickly soared in popularity for their ability to help people with obesity lose weight consistently and safely. And now, research reveals that GLP-1 medicines are also more than weight loss drugs.
Researchers have been studying the broader potential health benefits of GLP-1s. While still in the early stages of research, initial findings suggest that weight loss medication like semaglutide and tirzepatide may have the potential to improve several key markers associated with obesity-related comorbidities, including blood sugar levels, blood pressure, liver enzymes, and inflammation.
How GLP-1s May Support Common Obesity-Related Comorbidities
We already know that maintaining a healthy weight is one of the most effective ways to prevent, slow, or improve serious health conditions associated with obesity.
We also know that GLP-1 medications are helping people lose that weight. However, it appears that GLP-1 medications might offer additional benefits that go beyond the number on the scale.
Because of their impact on multiple systems in the body, GLP-1s may help support a range of obesity-related conditions by:
- Improving blood sugar regulation and insulin sensitivity
- Reducing appetite and supporting sustainable weight loss
- Lowering blood pressure and improving vascular function
- Positively influencing cholesterol and triglyceride levels
- Supporting cardiovascular health and reducing inflammation
Considering more than 75% of adults with obesity have at least one related comorbidity, the multi-system support that GLP-1s seem to provide could be a game-changer in how we approach chronic disease risk and long-term health.
Obesity-Related Comorbidities Being Studied with GLP-1 Medications
Excess weight raises the risk of developing at least one other chronic health condition. Research is ongoing to understand how GLP-1 medications might help manage some of the most serious complications associated with obesity.
Below is an overview of obesity-related comorbidities for which the data is most promising so far. Although each condition is distinct, GLP-1 medications seem to function through a few key mechanisms that may provide broad health benefits.
Type 2 Diabetes and Prediabetes
Carrying extra weight can put your body on a path toward type 2 diabetes. As body fat increases, insulin resistance usually follows, meaning your body stops properly responding to insulin, and blood sugar stays too high for too long.
GLP-1 medications were initially developed to address this exact problem, so the research behind their use in diabetes management is well-documented. Here are just a few of the most impressive studies available on GLP-1s and diabetes, which is the most common obesity-related comorbidity.
- In one major clinical trial, people with type 2 diabetes who took semaglutide once a week saw their average A1C (a marker of long-term blood sugar) drop by up to 1.8 percentage points over about a year.
That might not sound like a lot, but for many patients, it was the difference between living with uncontrolled diabetes and getting their blood sugar into a safer, more manageable range. Most participants also lost between 5 and 13 pounds, even though weight loss wasn’t the primary goal of the study.
- Another medication in the same class, tirzepatide, has shown even more dramatic results in clinical trials. In the SURPASS studies, people with type 2 diabetes who took tirzepatide lowered their A1C by up to 2.5 percentage points and lost an average of 25 pounds over 40 weeks.
- Maybe the most eye-opening finding came from a separate study on people with prediabetes. After taking tirzepatide for 176 weeks (about three years), 94% of participants avoided progressing to type 2 diabetes compared to a much higher risk in the placebo group. That kind of prevention could completely change the trajectory of someone’s health.
What stands out about this research is that GLP-1s aren’t just helping people manage type 2 diabetes. They’re showing real potential to potentially help prevent it altogether, especially in people with obesity and early signs of metabolic dysfunction.
Takeaway: GLP-1 medications don’t just lower blood sugar. They are shown to address the root of insulin resistance by supporting weight loss, improving insulin sensitivity, and changing how the body processes food. For people living with obesity and blood sugar issues, they offer an opportunity to turn things around. Or, in many cases, stop diabetes before it starts.
High Blood Pressure and Cardiovascular Risk
Obesity places extra strain on the cardiovascular system. As body weight increases, blood volume rises, arteries stiffen, and the heart has to work harder to keep up. Over time, this can lead to chronically elevated blood pressure (hypertension), which is a major risk factor for stroke, heart attack, and other serious cardiovascular complications.
GLP-1 medications weren’t designed as heart drugs, and they still are not FDA-approved for treating cardiovascular disease directly. However, several large clinical trials have shown that GLP-1 medications may offer cardiovascular support and help reduce blood pressure in individuals with obesity and/or increased heart risk, even when blood pressure isn’t the primary focus of treatment.
- In one long-term study, adults who took semaglutide for 68 weeks saw an average drop in systolic blood pressure of about 5 mmHg. That may sound small, but even modest reductions can meaningfully lower the risk of stroke or cardiac events.
- Tirzepatide has shown similar effects. In a 72-week study, participants experienced an average drop of nearly 7 mmHg in systolic pressure and just over 4 mmHg in diastolic pressure. By the end of the trial, almost 60% of people taking tirzepatide reached normal blood pressure levels, compared to just 35% in the placebo group.
- Another study tracked blood pressure around the clock using 24-hour monitoring, considered the gold standard for cardiovascular risk assessment. People taking tirzepatide had sustained reductions throughout the day and night, with systolic readings dropping by as much as 10 mmHg.
- The most significant change may have come from the SELECT trial, which followed over 17,000 adults with obesity and existing cardiovascular disease. The results showed that participants who took semaglutide had a 20% lower risk of experiencing a major cardiovascular event, such as a heart attack, stroke, or cardiovascular-related death, compared to those who received a placebo.
- Tirzepatide is also showing early promise in this area. A meta-analysis of clinical trials found a 20% reduction in major cardiovascular events in people with type 2 diabetes, and separate observational data suggests it may reduce the risk of heart failure hospitalizations.
Takeaway: GLP-1 medications aren’t prescribed specifically for high blood pressure, but early data suggests they may help improve it, especially in people with obesity who are also dealing with metabolic dysfunction. The rate of obesity-related cardiovascular deaths tripled between 1999 and 2020. The combination of weight loss, improved vascular function, and lower blood pressure could offer real protection against one of the most dangerous complications of obesity.
Fatty Liver Disease
Excess body fat doesn’t just affect visible areas of the body. It can also lead to fat buildup in the liver, a condition most commonly known as non-alcoholic fatty liver disease (NAFLD).
In more recent years you might have heard it called MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). Both refer to fatty liver disease, MASLD is just more specific to include focus on metabolic factors that can contribute to the condition.
Over time, fatty liver disease can progress into a more serious form of liver damage called MASH (formerly NASH), which increases the risk of inflammation, fibrosis, and eventually cirrhosis or liver cancer.
A systematic review and meta-analysis found that nearly 60% of patients with obesity have fatty liver disease. Until recently, the only proven method to improve fatty liver disease was through lifestyle changes that lead to significant weight loss.
This approach is still considered the most effective first step, and GLP-1 medications are not approved for the treatment of fatty liver disease or MASH. However, new evidence suggests GLP-1 medications may offer another layer of support.
Early studies show promising reductions in liver fat, inflammation, and fibrosis. While long-term data is still needed, the early results are encouraging.
- In a 72-week phase 2 clinical trial, weekly semaglutide helped resolve liver inflammation in about 63% of people with biopsy-confirmed MASH. Around 37% also showed improvement in liver fibrosis, a key marker of long-term liver damage. For comparison, only 34% and 23% of people in the placebo group saw the same results. Participants taking semaglutide also lost about 10% of their total body weight during the study.
- Other research suggests semaglutide may also help prevent the progression of liver disease. In a large international trial involving nearly 800 adults with moderate to advanced fibrosis, semaglutide slowed or even reversed liver scarring in a significant number of participants.
- Tirzepatide has also shown strong early results in this area. In a phase 2 trial focused on people with obesity, those taking tirzepatide experienced significant reductions in liver fat and inflammation, with early signs of improved liver structure and function.
- A 2023 review of randomized trials concluded that GLP-1 receptor agonists appear to reduce liver fat, lower inflammation, and support healthier liver enzyme levels.
Takeaway: GLP-1 medications are showing strong potential to support liver health in people with obesity. By reducing fat accumulation, calming inflammation, and possibly reversing early scarring, they could offer hope for managing one of the most overlooked obesity-related comorbidities.
PCOS and Hormonal Imbalance
Polycystic ovary syndrome (PCOS) is one of the most common hormone disorders in women of reproductive age. It often brings irregular cycles, acne, facial hair, and stubborn weight gain, along with an increased risk of insulin resistance and infertility.
Obesity and PCOS often go hand in hand. Hormonal imbalance contributes to weight gain and metabolic dysfunction, which then worsens PCOS symptoms. This creates a frustrating cycle that can be hard to break without targeted intervention.
There is encouraging evidence that GLP-1 medications may offer support. Very early studies show that they may improve several symptoms of PCOS in women with obesity or insulin resistance.
- In one study involving women with PCOS and obesity, semaglutide use was associated with significant weight loss, improved insulin sensitivity, and more regular menstrual cycles.
- Other research suggests GLP-1s may help reduce androgen levels (the hormones that cause acne and excess hair growth) and improve ovulation in some women.
- Tirzepatide, though not yet extensively studied for PCOS specifically, has shown strong effects on insulin sensitivity, weight reduction, and metabolic health, all of which are central to managing PCOS symptoms.
Beyond PCOS, obesity is also linked to other hormone imbalances, including elevated estrogen levels, disrupted cortisol patterns, and impaired leptin and insulin signaling. While not always diagnosed as a hormone disorder, hormonal shifts can make it harder to lose weight, regulate appetite, maintain energy, and support fertility.
More research is still needed, but GLP-1 medications have shown promise in helping to rebalance metabolic hormones, such as insulin and leptin, by reducing fat mass and improving cellular sensitivity. These effects may indirectly support broader hormonal regulation in people with obesity-related endocrine dysfunction.
For more, read “Optimize Your Weight Loss Journey: Balancing Hormones for Sustainable Results” and “Balance Your Hormones With Weight Loss & Semaglutide.”
Takeaway: GLP-1 medications aren’t approved treatments for PCOS, but the early research is promising. By addressing insulin resistance, supporting weight loss, and rebalancing key metabolic pathways, GLP-1 weight loss medications may eventually be a tool for women struggling with PCOS and obesity-driven hormonal disruption.
Mental Health Conditions and Emotional Wellbeing
Depression and anxiety are both common comorbidities in people who are overweight. Sometimes, mental health conditions show up first and lead to weight gain. Other times, they’re the result of weight gain (and often, it’s both.) Eating disorders also frequently go hand-in-hand with obesity.
GLP-1 medications are not approved treatments for any mental health disorders. More research is needed to confirm these benefits in larger populations, but early data is promising and suggests they may have a positive impact on mood, emotional regulation, and even disordered eating behaviors.
- A 2022 randomized controlled trial published in Diabetes, Obesity and Metabolism found that patients taking semaglutide reported a significant reduction in depressive symptoms compared to the placebo group, with improvements seen as early as week 12 of treatment.
- Other studies suggest that GLP-1 receptor agonists may influence brain regions involved in reward, motivation, and appetite—areas that also play a role in emotional regulation and food-related behaviors.
- In patients with binge eating disorder (BED), early evidence shows that GLP-1s may help reduce binge frequency and improve self-control around food, likely due to their effects on satiety, reward response, and insulin sensitivity.
Takeaway: GLP-1 medications aren’t mental health drugs, but in addition to helping people lose weight, which is a well-known confidence and self-esteem booster, they may also support mood and emotional wellbeing by reducing inflammation, improving metabolic health, and easing food-related distress.
Other Notable Obesity-Related Conditions
While not all obesity-related health issues have been deeply studied in the context of GLP-1 therapy, a few others show compelling early evidence and are worth mentioning.
In 2024, promising results from the SURMOUNT-OSA clinical trial led Eli Lilly to submit tirzepatide (Zepbound) for FDA approval as the first GLP-1-based medication specifically indicated for moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity.
As of the time this article was written, the FDA’s decision is pending. However, early data indicated significant reductions in the number of apnea events per hour, with many participants improving enough to reduce or even discontinue CPAP use.
Joint pain and osteoarthritis also show early promise. In a large phase 3 trial involving 407 adults with obesity and knee osteoarthritis, semaglutide led to an average 14% weight loss and a 42-point drop in WOMAC pain scores over 68 weeks compared to 3% weight loss and a 28-point reduction in the placebo group.
Other conditions such as osteoarthritis, gastrointestinal disease, fertility challenges, and certain obesity-associated cancers are also well-known obesity-related comorbidities but have yet to be studied in direct relation to GLP-1s. As research into obesity-related comorbidities continues to grow, these areas will hopefully become targets for future studies.
Integrating GLP-1 Therapy Into a Comprehensive Care Plan
If it is determined that you are a candidate for GLP-1 weight loss medications, it’s not as simple as getting a shot every week, sitting back, and watching the pounds melt away.
There are a lot of myths about GLP-1 medications. One being that you no longer need to follow a healthy diet or exercise. GLP-1 medications can make weight loss easier, but they’re not a replacement for a healthy lifestyle.
These medications work best when paired with a supportive plan that includes sustainable, healthy habits, such as proper nutrition (especially plenty of protein), regular exercise, effective stress management, and quality sleep.
Additionally, while initial bloodwork is required to assess your baseline health and identify any potential contraindications, follow-up labs and regular appointments with your prescriber are equally important for monitoring your progress and making adjustments as needed to ensure safe support of your goals.
These ongoing check-ins are necessary because not everyone responds the same way to GLP-1 therapy. Factors like underlying health conditions, genetics, and lifestyle can influence outcomes. Your provider may need to adjust dosage, add supportive therapies, or recommend temporary pauses based on how your body responds.
At Relive Health, our team doesn’t just prescribe GLP-1 medications and send you on your way. Your GLP-1 treatment plan is personalized just for you. Then, once your program begins, we provide continued medical oversight to ensure safety, progress, and long-term success.
Conclusion
It is well-studied and documented that GLP-1 medications (even in small doses) have a positive influence on many of the hormonal, metabolic, and neurological pathways that contribute to weight gain. And while all the science is still unfolding and more clinical studies are needed, it appears that the potential health benefits of GLP-1 medications extend far beyond weight loss.
When used as part of a comprehensive care plan, GLP-1 medications show great promise in managing common obesity-related comorbidities such as diabetes, high blood pressure, fatty liver disease, hormone disorders, mental health issues, and more.
If you’re curious about whether GLP-1 therapy is right for you, our team at Relive Health is here to help. Visit our clinic locator to find a Relive Health location near you and schedule your consultation today.