Monitoring high-level athletes for drug misuse is nothing new, but the World Anti-Doping Agency (WADA) surprised many people recently by deciding to track the use of GLP-1 drugs, such as the diabetes and obesity treatments Ozempic (semaglutide) and Zepbound (tirzepatide).
Does that mean GLP-1s are banned for Olympic athletes?
What Does It Mean for a Substance to Be in the ‘Monitoring Program’?
Athletes are tested for substances as part of the Monitoring Program during regular doping checks in order to gather data on usage, Fitzgerald explains. Substances included in WADA’s Monitoring Program are separate from those in its Prohibited List.
Elite athletes are categorically banned from using anything on the Prohibited List, which is reviewed each year and can include any substance or method that meets two of these three criteria, Fitzgerald says:
- It has the potential to enhance performance.
- It represents a health risk to the athlete.
- It violates the spirit of sport.
Athletes can still use substances in the Monitoring Program, but WADA has decided to track these items “in order to detect potential patterns of misuse in sport,” Fitzgerald says, and identify whether any of them could enhance performance or pose a health risk.
“Data from the Monitoring Program are then reviewed by the experts of the List Expert Advisory Group before any decision to include or not on the List of Prohibited Substances and Methods is made,” Fitzgerald says.
For the moment, though, Olympic athletes are not banned from taking GLP-1s.
“Since semaglutide and tirzepatide are not prohibited, if found in a sample, it is not reported as an adverse analytical finding, so there are no consequences for the athlete if found,” he says. Instead, this information is simply reported as part of the Monitoring Program.
Can Athletes Gain a Competitive Edge From GLP-1s?
GLP-1 receptor agonist medications are typically used to treat type 2 diabetes and obesity, although their use is expanding to other health conditions.
It’s not clear right now if someone would get a competitive advantage by using these medications, says Bert Mandelbaum, MD, a codirector of the Regenerative Orthobiologic Center at Cedars-Sinai Orthopaedics in Los Angeles.
Dr. Mandelbaum says that given the popularity of GLP-1s it’s important for WADA to gather information about how elite athletes are utilizing these drugs. That means looking at the medications’ use and potential impact across various sports and groups of people, Mandelbaum says.
While athletes in some sports, like figure skating and ski jumping, tend to benefit from a slimmer physique, Mandelbaum says that using a medication like a GLP-1 may not offer all the perks someone would expect. “There’s often decreased muscle mass associated with these,” he says. That can ultimately work against an athlete’s goals, he points out.
Still, if GLP-1s were eventually banned, Mandelbaum says there would likely be “therapeutic use exemptions” for people with certain conditions, like type 2 diabetes.
For now, he says, the jury is out on whether GLP-1s could offer any athletic advantage. “It’s a work in progress,” Mandelbaum says. “We really don’t know the potential impact on performance right now.”