Do GLP-1 drugs help you live longer?
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In people who already have heart disease and carry extra weight, probably yes. In a trial of 17,604 such adults, semaglutide cut heart attacks, strokes and heart deaths combined by 20%, and fewer people died of any cause. Nobody has tested whether it adds years in healthy people.
What we’d do
If you have heart disease and extra weight, ask your doctor whether a GLP-1 drug fits you, since that’s who the big trial helped. If you’re healthy, don’t take one hoping to live longer, because there’s no evidence for that yet. On any of these drugs, lift weights two or three times a week and eat enough protein to keep your muscle, and never change a dose on your own.
Why the hope runs ahead of the data
GLP-1 drugs like semaglutide (sold as Wegovy and Ozempic) and tirzepatide help people lose a lot of weight, and a big trial found they protect the heart in people at high risk. So it’s natural to wonder whether they’ll turn out to be longevity drugs for everyone. But every big outcome trial so far has been in people who were already sick or at high risk.
The SELECT trial
SELECT enrolled 17,604 adults aged 45 and over who had heart disease, a BMI of 27 or more and no diabetes. Half got weekly semaglutide at 2.4 mg and half a placebo, and they were followed for a little over three years on average.
| Result | Semaglutide against placebo |
|---|---|
| Heart attack, stroke or heart death, combined | 20% lower (6.5% against 8.0%) |
| Death from any cause | 19% lower |
| Death from heart and blood vessel disease | 15% lower, too small to rule out chance |
| Death from other causes | 23% lower |
| Stopped the drug because of side effects | 16.6% against 8.2% |
Death from any cause was a secondary result, measured alongside the main one, so it backs up the main finding but can’t settle the question on its own. Infections were the most common of the other causes of death, and part of the drop came from fewer infection deaths, including from COVID-19, during the pandemic years of the trial.
The simple version
It’s like finding that hearing aids help people with hearing loss. That’s a real and useful result, and it says nothing about whether people with good hearing should wear them.
The muscle question
Big weight loss takes some muscle with it, whatever causes it. In a body scan study within the STEP 1 trial, 140 adults were scanned before and after 68 weeks. On semaglutide, fat mass fell 19.3% and lean mass, which includes muscle, fell 9.7%. Muscle is what gets you off the floor and catches you when you trip, so keeping it is part of the deal.
Lifting is the best-tested way to do that, and it has its own longevity evidence: 90 to 119 minutes a week went with 13% lower risk of dying in 147,374 US adults. See does lifting weights help you live longer, and for more on the drugs and muscle, bodyfat.guide’s do GLP-1 drugs make you lose muscle and the GLP-1 guide.
If you’re healthy and want to start without a drug, how to live longer naturally has the habits with years attached, in order.
4 sources
- Lincoff AM and others, Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes, New England Journal of Medicine, 2023pubmed.ncbi.nlm.nih.gov
- Scirica BM and others, The Effect of Semaglutide on Mortality and COVID-19-Related Deaths: An Analysis From the SELECT Trial, Journal of the American College of Cardiology, 2024pubmed.ncbi.nlm.nih.gov
- Wilding JPH and others, Impact of semaglutide on body composition in adults with overweight or obesity: exploratory analysis of the STEP 1 study, Journal of the Endocrine Society, 2021pmc.ncbi.nlm.nih.gov
- Zhang Y and others, Long-term resistance training with all-cause and cause-specific mortality, British Journal of Sports Medicine, 2026pubmed.ncbi.nlm.nih.gov
