Am J Ophthalmol

GLP-1s may lower cataract risk in adults with overweight, obesity

October 29, 2025

Study details: A retrospective cohort study using the TriNetX Global Collaborative Network included overweight or obese adults aged ≥55 years, excluding those with diabetes or prior cataract. Patients prescribed GLP-1 RAs (semaglutide or liraglutide) were compared with those on other weight loss drugs (OWLD; lorcaserin, setmelanotide, diethylpropion, sibutramine, fenfluramine, mazindol, phentermine, or orlistat) and with a no-drug cohort. Propensity score matching ensured covariate balance.

Results: GLP-1 RA use was associated with markedly reduced risk of age-related cataract compared with OWLD at the following time points (all P<0.0001):

• 5 years: relative risk (RR), 0.278; 95% confidence interval (CI), 0.246-0.314
• 7 years: RR, 0.269; 95% CI, 0.241-0.299
• 10 years: RR, 0.198; 95% CI, 0.176-0.222

Compared with no drug use, GLP-1 RA use was associated with decreased risk at the following time points (all P<0.0001):

• 5 years: RR, 0.605; 95% CI, 0.553-0.661
• 7 years: RR, 0.499; 95% CI, 0.458-0.542
• 10 years: RR, 0.437; 95% CI, 0.403-0.475

OWLD use was associated with increased risk at 5 (RR, 2.142), 7 (RR, 2.093) and 10 (RR, 2.111) years compared with no drug use (all P<0.0001).

Clinical impact: GLP-1 RAs may confer long-term ocular protection against cataract formation in non-diabetic, overweight/obese adults, a novel benefit beyond metabolic effects. Randomized trials and mechanistic studies are warranted to confirm causality and elucidate underlying pathways.

Source:

Ahuja AS, et al. (2025, October 21). Am J Ophthalmol. Glucagon-like Peptide-1 Receptor Agonist Use and Risk of Cataract Development. https://pubmed.ncbi.nlm.nih.gov/41130371/