UT Health Science Center’s Liza Makowski, PhD, Helps Lead Global Conversation on GLP-1 Drugs and Cancer Risk

Blockbuster drugs like Ozempic, Wegovy, and Zepbound have transformed obesity care for millions of Americans, making them some of the most talked-about medical breakthroughs of the decade. Yet several questions remain, including their long-term effects on cancer risk.

A new commentary co-authored by Professor Liza Makowski, PhD, associate director for Education and Development in the Center for Cancer Research at the University of Tennessee Health Science Center, examines the potential cancer-related consequences of glucagon-like peptide-1 (GLP-1) drugs. The article "Are GLP-1 receptor agonists a 'magic bullet' for cancer?" was published in the highly respected journal Nature Reviews Cancer, placing UT Health Science Center at the forefront of this critical global dialogue.

"GLP-1 receptor targeting drugs have allowed for unprecedented weight loss, which has revolutionized obesity care for many Americans," Dr. Makowski said. "We know that weight loss through bariatric surgery can reduce cancer risk, but it's too soon to know if we will also see these anti-cancer benefits with new GLP drugs."

The review raises two urgent questions: What do these medications mean for long-term metabolic health and cancer risk? And how can clinicians pair them with lifestyle guidance to ensure the best outcomes?

"Millions of people are on GLP-1 drugs, yet we don't fully understand the long-term cancer implications. It is our goal to determine if and how GLP-1 drugs will reduce a patient's chances of getting cancer and even help improve cancer treatments," Dr. Makowski said.

While the commentary is authored by members of a nationwide research consortium funded by the National Cancer Institute, its implications are especially relevant for Tennessee. The state has some of the highest cancer death rates in the country, particularly in the Appalachian regions in the east and the Mid-South in the west. The Makowski Lab ensures local communities are not overlooked but are instead integral to the broader conversation around the links between obesity and cancer.

"We recruit study subjects from patients undergoing weight loss approaches including bariatric surgery or GLP-1 receptor targeting drugs such as Wegovy or Zepbound to our studies," she said. "Not only are we part of a global movement to combine the field of obesity research with cancer discovery, but we are doing this in our own backyard in West Tennessee."

Dr. Makowski has spent much of her career studying how obesity and being overweight can cause metabolic imbalances that contribute to cancer. Her lab has long focused on how weight loss through diet and surgery can reverse those imbalances and reveal potential targets to stop cancer. The rise of GLP-1 drugs has added a new aspect to her work. "Now, for the first time in human history, we have a family of drugs that can profoundly change the metabolic state. That's why understanding links to cancer is urgent," she said.

"Not only are we part of a global movement to combine the field of obesity research with cancer discovery, but we are doing this in our own backyard in West Tennessee."

One of the most important messages from the review is that GLP-1 drugs should not be viewed as a standalone solution. Dr. Makowski said medical providers should help their patients understand these medications are part of a lifestyle change with attention to nutrition and activity, and they should continue to encourage resistance exercise and adequate protein intake.

"The key takeaway is medication should complement, not replace, healthy lifestyle habits," Dr. Makowski said. "In the face of rapid adoption of such a blockbuster drug, which has allowed patients to lose weight effectively, we caution that these 'miracle drugs' should be recommended with the proper nutrition and exercise education from their doctors, just like a diabetes or high blood pressure prescription."

Dr. Makowski is looking ahead to the next phase of research, with an emphasis on the need for long-term studies to understand how GLP-1 drugs affect cancer risk and outcomes. She noted several urgent priorities including population studies, laboratory research on underlying biological mechanisms, and clinical trials to test potential therapeutic targets.

In addition to Dr. Makowski, the collaborators on the recently published work are researchers from the University of South Carolina, including corresponding author James Hébert, ScD, and the University of Utah. Dr. Makowski said she is fortunate her work at the UTHSC Center for Cancer Research has allowed her to serve at the forefront of the fight against cancer.

"If we can understand what leads to cancer, we can prevent it."