GLP-1 Drug Use Lowers Cataract Risk in Non-diabetic Patients with Obesity

While GLP-1 agonist use led to a greater reduction in BMI than other weight loss drugs use, this group maintained a higher absolute BMI at all follow-up points. This suggests that the protective effect on cataract risk might extend beyond just weight reduction, and that GLP-1s may exert additional protective effects beyond weight loss. Photo: Gleb Sukhovolskiy, OD. Click image to enlarge. It’s known that systemic diseases such as diabetes and obesity have been previously associated with cataracts. With glucagon-like peptide-1 (GLP-1) receptor agonists now being used for chronic weight management in non-diabetic individuals, researchers sought to evaluate the risk of developing age-related cataract in who are overweight or obese prescribed GLP-1 drugs compared to other weight loss drugs. They found that treatment was associated with a significantly lower risk. The findings were reported this Tuesday in American Journal of Ophthalmology.Over 170 million health records of overweight or obese patients aged 55 and older from the TriNetX Global Collaborative Network were included. Patients with a prior diagnosis of diabetes or age-related cataract were excluded. Patients in the GLP-1 group were prescribed either semaglutide or liraglutide. Patients in the other weight loss drugs group were using lorcaserin, setmelanotide, diethylpropion, sibutramine, fenfluramine, mazindol, phentermine or orlistat. A third cohort included patients not prescribed any weight loss meds.Those using GLP-1s had a significantly reduced risk of cataracts compared to those using other weight-loss drugs or no pharmacological treatment:Relative Risk for Cataract by Medication Status Year 5Year 7Year 10GLP-1 vs. other weight loss drug0.2780.2690.198GLP-1 vs. no med use0.6050.4990.437 The greatest reductions were seen in cortical and posterior subcapsular cataracts, according to the study. This raises the possibility that GLP-1 receptor agonists may differentially influence cataract pathogenesis depending on lens region, although the biological basis for these effects currently remains unclear. GLP-1s “may play a role in modulating the pathophysiological pathways linking elevated BMI to the formation of cortical and posterior subcapsular cataracts,” the authors wrote.Conversely, the study found that other weight loss drugs use was associated with an increased cataract compared to no weight-loss medication use. Because the other weight loss drugs cohort is composed of patients prescribed a variety of drugs, it remains unclear whether a particular agent contributed to this association. “Notably, an FDA drug label reported a higher incidence of cataract in patients treated with lorcaserin compared to placebo among patients diagnosed with diabetes,” the authors explained in their paper.On the other hand the observed increase could reflect residual confounding not fully captured in EHR coding. “For example, other weight loss drugs use may have been more common among patients with lower socioeconomic status or reduced healthcare access, factors that have been independently associated with higher cataract risk and more severe presentation,” the authors wrote in their paper.These findings are in contrast to prior studies among patients with diabetes, where no change in risk of cataract development was noted between GLP-1 agents and either metformin or insulin use. It should be noted that this analysis specifically excluded patients with diabetes, thereby minimizing the influence of glycemic control and diabetic complications on cataract risk. “In contrast, the majority of patients in the prior study had a diagnosis of diabetes, which may have attenuated any protective effect” of GLP-1 therapy on the lens, the authors wrote in their paper.The anti-flammatory properties of GLP-1 drugs are proposed as a possible mechanism, thereby protecting against cataract formation. Notably, this medication class has demonstrated the ability to limit pro-inflammatory cytokine release, a mechanism linked to improved clinical outcomes in immune-mediated diseases, including rheumatoid arthritis and psoriasis. These anti-inflammatory properties “may plausibly similarly mitigate cytokine-driven inflammation within the ocular environment, potentially preventing oxidative injury to lens epithelial cells and thereby offering protection against cataract formation,” the authors explained in their paper.The researchers concluded that these findings support the need for prospective studies to validate this association and to explore potential biological mechanisms that may underlie the observed protective effect.Click here for the journal source. Ahuja AS, Paredes AA, Ahuja SA, Young B. Glucagon-like peptide-1 receptor agonist use and risk of cataract development. Am J Ophthalmol. October 17, 2025. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.