Obesity pharmacotherapies and cognition.

GLP-1–based and related obesity pharmacotherapies show mixed cognitive and brain-health effects across cardiometabolic disease, aging, and Alzheimer’s disease, shaped by receptor pharmacology and disease stage.

• Why it matters: The field needs to disentangle whether cognitive changes reflect direct neural-circuit actions, indirect benefits from improved cardiometabolic health, or both, because current findings are inconsistent.
• What they did: This Review synthesizes evidence from preclinical models, observational cohorts, and clinical trials, emphasizing GLP-1–based therapies and combination approaches targeting glucose-dependent insulinotropic polypeptide, glucagon, and amylin pathways.
• The result: Mechanistic clarity about receptor pharmacology, brain exposure, metabolic context, and disease stage could help guide therapies intended to preserve or improve cognition.

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