Can GLP-1 Drugs Help People with MS?

Living Well

March 25, 2025

Aviva Patz

Popular drugs might be beneficial for people with MS.

A person injects medication into their arm. — Image: Getty Images/ Caíque De Abreu

Obesity has been linked to worsened symptoms, higher disease severity and poorer outcomes for people with multiple sclerosis. Weight loss drugs such as Ozempic and Wegovy have become increasingly popular, and recent studies show that this class of drugs (known as GLP-1s) can be safe and well-tolerated for people with MS.Extra weight could affect symptoms and disease activity in these ways:

Chronic inflammation: “Extra body fat triggers ongoing, low-level inflammation, releasing chemicals that can worsen inflammation in the brain and spinal cord, potentially making MS symptoms worse,” explains Afsaneh Shirani, MD, neurologist and associate director of Neuroscience Research and Medical Education at Saint Luke’s Marion Bloch Neuroscience Institute, Kansas City, Missouri.
Immune system changes: “Obesity disrupts the balance of the immune system by increasing harmful immune cells, such as pro-inflammatory T cells, and reducing protective ones, such as regulatory T cells,” Shirani says. “This imbalance can potentially lead to more frequent MS relapses and faster disease progression.
Co-existing health conditions: Obesity is often associated with co-existing conditions (also known as comorbidities), such as hypertension, diabetes and cardiovascular disease. “These comorbidities worsen MS outcomes by further compromising neurological health and exacerbating fatigue, mobility issues and cognitive impairment,” Shirani says.

Chronic inflammation: “Extra body fat triggers ongoing, low-level inflammation, releasing chemicals that can worsen inflammation in the brain and spinal cord, potentially making MS symptoms worse,” explains Afsaneh Shirani, MD, neurologist and associate director of Neuroscience Research and Medical Education at Saint Luke’s Marion Bloch Neuroscience Institute, Kansas City, Missouri.
Immune system changes: “Obesity disrupts the balance of the immune system by increasing harmful immune cells, such as pro-inflammatory T cells, and reducing protective ones, such as regulatory T cells,” Shirani says. “This imbalance can potentially lead to more frequent MS relapses and faster disease progression.
Co-existing health conditions: Obesity is often associated with co-existing conditions (also known as comorbidities), such as hypertension, diabetes and cardiovascular disease. “These comorbidities worsen MS outcomes by further compromising neurological health and exacerbating fatigue, mobility issues and cognitive impairment,” Shirani says.

Benefits of Healthy Weight and Nutrition in MS

To a large extent, “the benefits of healthy weight and diet in people with MS are similar to those for anyone else,” says Anne H. Cross, MD, neurologist and neuroimmunologist and the Section Head of Neuroimmunology at Washington University in St. Louis, Missouri.That means less heart disease, less obesity, less obstructive sleep apnea, fewer joint problems, less fatty liver disease, fewer heart attacks and less diabetes — along with fewer health problems associated with diabetes, including metabolic syndrome, kidney disease, peripheral neuropathy, eye disease and stroke, according to Cross.“Maintaining a healthy weight also reduces strain on muscles and joints,” adds Shirani, “helping individuals with MS preserve mobility and delay physical disability.” Good nutrition also boosts energy levels, she says, easing fatigue, a common MS symptom.

Existing Weight Control Treatments

Traditional approaches, such as healthy diet and regular exercise, have long been recommended for weight control for people with MS.In recent years, Cross notes, calorie restriction — including intermittent fasting (time-restricted eating) — has gained favor as a way to lose weight and “possibly achieve other benefits, including enhancement of remyelination (repair of the nerve-insulating myelinthat is damaged in people with MS),” she says. Small studies have found calorie restriction and intermittent fasting to be safe for people with MS, Cross adds.

A man makes a salad. — Plant-based diets consist of fruits, vegetables, nuts, seeds, herbs and spices.

Studies of the New Weight Loss Drugs

A 2024 study by Shirani, Cross and Olaf Stuve, head of the MS/Neuroimmunology section at the University of Texas Southwestern Medical Center and Chief of Neurology at the Dallas VA Medical Center, published in Therapeutic Advances in Neurological Disorders explored the relationship between weight-loss drugs and reports of MS, using data from the U.S. Food and Drug Administration’s Adverse Event Reporting System.“The goal was to see if certain weight-loss-inducing drugs were linked with fewer reports of MS,” Shirani explains. The findings showed some antidiabetic medications that also promote weight loss were associated with a lower risk of MS, according to Shirani.“While this association does not necessarily indicate a protective effect of these medications against MS, our findings suggest the possibility that these drugs could potentially be repurposed as treatments for MS.However, further research is necessary to confirm these findings,” she says.Limitations of this research are mainly the inability to prove direct cause-and-effect relationships, according to Shirani. “More thorough studies are needed to confirm these findings and assess whether these medications could be effectively repurposed to treat MS,” she says.

How People With MS Can Benefit From These New Drugs

Next Steps for Research

Cross is looking at studies of metformin, which is used to treat type 2 diabetes.She notes that at least 5 studies around the world are investigating whether metformin can improve MS, including by enhancing remyelination. Currently, there are no MS treatments known to repair nerve-insulating myelin.A team at Antwerp University Hospital in Belgium is testing the ability of metformin to stop progression and restore function in people with progressive MS. Findings in animal models show metformin to have properties that can reduce inflammation, protect nerves and promote myelin repair. Led by Barbara Willekens, MD, PhD, a neurologist who specializes in MS, the team will test the effectiveness of metformin compared to placebo in 120 people with progressive MS (who do not have signs of inflammation) for 2 years. Willekens is funded by the National MS Society to conduct this research.If it’s successful, a treatment that’s already approved and known to be safe could become a tool to stop MS progression and restore function in people with progressive MS.

The Importance of a Healthy Diet, Nutrition and Exercise

In general, regular exercise and a balanced diet, plus quitting smoking if you haven’t already, are important steps toward maintaining good health with MS.More specifically, Shirani recommends:

Focusing on whole foods like fruits, vegetables, lean proteins, whole grains and healthy fats, and considering anti-inflammatory diets such as the Mediterranean or plant-based diets.
Staying hydrated by drinking plenty of water and limiting sugary drinks.
Taking adequate vitamin D to support immune and brain health.
Completing regular low-impact exercises, like walking, swimming, yoga or Pilates, along with stretching and strength training to improve mobility and cardiovascular health and reduce fatigue.

“It’s crucial to rest when needed and to set realistic goals to build sustainable habits,” Shirani says. “Collaborating with healthcare providers such as neurologists, primary care physicians, dietitians and physical therapists ensures a personalized plan that accounts for MS symptoms and comorbidities.”

In general, regular exercise and a balanced diet, plus quitting smoking if you haven’t already, are important steps toward maintaining good health with MS.More specifically, Shirani recommends:

Focusing on whole foods like fruits, vegetables, lean proteins, whole grains and healthy fats, and considering anti-inflammatory diets such as the Mediterranean or plant-based diets.
Staying hydrated by drinking plenty of water and limiting sugary drinks.
Taking adequate vitamin D to support immune and brain health.
Completing regular low-impact exercises, like walking, swimming, yoga or Pilates, along with stretching and strength training to improve mobility and cardiovascular health and reduce fatigue.

Learn More About the New Weight-Loss Drugs

Aviva Patz

Aviva Patz is a writer in Montclair, New Jersey.

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Can Weight Loss Drugs Benefit People With MS?

Popular drugs might be beneficial for people with MS.

Benefits of Healthy Weight and Nutrition in MS

Existing Weight Control Treatments

Studies of the New Weight Loss Drugs

How People With MS Can Benefit From These New Drugs

Next Steps for Research

The Importance of a Healthy Diet, Nutrition and Exercise

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