Dr. Jennifer Ashton: The Truth Behind the Scary GLP-1 Brain Disorder Headlines

Greta Wire

Dr. Jennifer Ashton debunks viral headlines linking GLP-1 weight-loss drugs to a deadly brain disorder, clarifying that the reported cases a

Key takeaways

• The headline linking GLP-1 drugs to Wernicke's encephalopathy is characterized as 'fear mongering' because only 15 cases were identified in a population of millions.
• Wernicke's encephalopathy is caused by thiamine (B1) deficiency, which can occur when reduced food intake on GLP-1 medications leads to nutrient gaps.

Main topics

• GLP-1 weight loss drugs and safety headlines
• Wernicke's encephalopathy and thiamine deficiency

Notable quotes

One word, fear mongering.

Conclusion

The episode serves as a corrective to medical sensationalism, emphasiz

Transcript preview

Speaker 2 (0:00) The Greta Wire podcast is presented by Paramount+. Let Speaker 1 (0:05) chaos reign. Mobland, the hit crime series from the underworld of Guy Ritchie, is now streaming on Paramount+. The Harrigans are on the brink of uncivil war as power plays, fractured loyalties, and reckless decisions collide. Their fixer, Harry, is left to clean up the fallout. Don't miss Mobland, starring Tom Hardy, Piers Brosnan, and Helen Mirren. now streaming on Paramount+. Do Speaker 4 (0:30) you take a GOP one? If you do, this headline may have caught your attention. It says, Popular GOP Weight Loss Drugs Linked to Potentially Deadly Brain Disorder. Yikes. So, I called Dr. Jennifer Ashton because she knows everything about these drugs, everything about obesity. She's board certified. And I asked her, what Speaker 2 (0:52) about this headline? Speaker 4 (0:53) She says, fear mongering. So if you take GLP-1 drugs, you need to watch this Greta Wire. By the way, we also talked about vitamins. Do you take vitamins? There's so much to know about vitamins. And what about stand-up desks? Do you talk about stand-up desks? What about sitting? We talked about so much. Watch this. Speaker 4 (1:23) Dr. Ashton, nice to see you. You too, Greta. Okay, I wanted to talk to you because I read the headline that says popular GLP-1 weight loss drugs linked to potentially deadly brain disorder. That just sounds too good. Speaker 3 (1:37) Right, and I'll tell you what went through my mind when you sent that to me. One word, fear mongering. This is probably the worst medical headline. that I have seen in my career as a medical journalist. And as you know, that's coming up on 20 years soon, real soon. But let's get into it because obviously, you know, with what is it, 12 % estimated of the U.S. population has either tried these drugs or is on one right now. So we're talking about between 30 and 40 million people. OK. Remember that number because we're going to come back to it with a little basic math. That's the study that you're referring to. And there was another one. I printed it out for you right here. Both published this month, one in the journal Obesity, the other one in the journal Clinical Nutrition. People can get online and access at least one of these for free. I didn't pay for the other one, but this one I got for free. I got mine free. I got mine. Well, I didn't get the underlying study. I just got the scary headline. Yeah, exactly. Well, we need to try to get the actual study because in one of them, guess how many case reports they found of this rare, and it is rare, and it is potentially deadly. It's called Wernicke's encephalopathy. Guess how many cases, Greta? Speaker 4 (3:04) I looked it up. You know. 15, 15, 15. But what I can't do is I can't do the mathematics to the 30 or 40 million. I can't do that, but I can do the 15. Speaker 3 (3:13) Exactly. So you always do your homework. So 15 cases, this one in the journal obesity had six cases, six. Okay. Put that number in the numerator, 15 divided by 30 million, 40 million. I don't think we need to be, you know, math geniuses to know that is a very, very small number. All Speaker 4 (3:38) right. Well, the news media picks it up from these medical journals. So shame on the news media for doing that. But why would the medical journals publish anything like that when the numbers are obviously, I mean, because people other than doctors are going to read that. Obviously, whoever read the one that posted the article I saw. Speaker 3 (3:57) Exactly. So let's start with the, it within the medical profession. Number one, even that tiny number of six or 15 generated what's called a safety signal, because that means that in patients on GLP-1 medications, and we're talking about things like Zepban, Manjaro, Ozempic, Semaglutide, that whole class of medications in Cretan class of medications is what they're called. There were more cases of Wernicke's encephalopathy than there are in the general population. Now, this is, I think, the silver lining in this whole inappropriate fear-mongering headline. This is completely preventable, all right? So it comes from a thiamine deficiency. So this is a B-complex family of vitamins. And guess what happens with a lot of people on these medications? They eat less, right? That's how we lose weight in part. Well, when you eat less, you're also taking in fewer micronutrients, B-complex vitamins, calcium, zinc, magnesium, I mean, iron, the list goes on and on. But your brain cannot tolerate vitamin B1 deficiency, thiamine deficiency. So you get these constellation of mental status changes. inability to move and walk, and some eye movement disorders. Some patients don't get those signs until it's too late. And a lot of times this diagnosis is just not detected. It's not on people's radar. So in the medical world, it was a good thing to flag this. What was not a good thing is the headline, which just is inappropriate and lacks the nuance that this is why you and I are talking about it. Speaker 4 (5:47) All right. In