Beyond Weight Loss: Cravings on Ozempic

The Ozempic rush is not showing any signs of slowing down, and emerging anecdotal evidence indicates that its benefits may extend beyond blood sugar and weight management, with more users reporting a lack of desire to consume alcohol and other addictive substances.

Originally manufactured as a drug to help diabetics manage blood sugar levels, Ozempic—and its brand competitors Wegovy and Mounjaro—gained widespread recognition from its weight loss effects. Originally approved by the FDA to help diabetics manage blood sugar levels, Ozempic—and its brand competitors Wegovy and Mounjaro—gained widespread recognition from its weight loss effects. These drugs are designed to mimic the hormone GLP-1, which is released into the intestines after eating. GLP-1 influences how our bodies and brains process food and food cravings.

While these drugs are influencing appetite for food, there is evidence to suggest that they may also influence appetite for alcohol, drugs, and nicotine.

A recent New York Times article chronicles the unexpected impact GLP-1 drugs are having on food, drink, and drug compulsions, noting that new research prompted by patient experiences could unlock insights into how the brain processes desires and addictions (1).

More research is being conducted to study the link behind GLP-1 drugs and a decreased desire to consume addictive substances, and a recent clinical trial examined the impact of GLP-1 on trial participants with alcohol use disorder (2). The trial studied whether or not the administration of GLP-1—in tandem with cognitive behavioral therapy—affects alcohol consumption. The trial of 130 participants included a placebo group who received cognitive behavioral therapy and a GLP-1 group who also received cognitive behavioral therapy. Over the course of the trial the amount of alcohol consumed decreased throughout both groups, but the group who received GLP-1 with cognitive behavioral therapy experienced a dramatic reduction in alcohol consumption. 

During the study researchers also collected brain scans to study how GLP-1 affects the brain’s response when exposed to alcohol. Among the GLP-1 participants, the researchers noticed that areas of the brain associated with addiction did not light up as much after being shown pictures of alcohol. 

How does GLP-1 satiate cravings and alter addictions? 

The findings of the study track with other early analysis of GLP-1’s effect on desire in the brain. Studies have reported that GLP-1 has a regulating effect on dopamine. As dopamine has been shown to be closely related to reward pathways, some researchers believe that the effect of GLP-1 on dopamine regulation may be responsible for its effects on reducing the rewarding effects of consumption in the brain (3). 

Unlike other addiction medications that block dopamine receptors and desire altogether, like antipsychotics, GLP-1 seems to shift attention away from chasing rewards from substances in the first place (1). 

More research is still needed to determine if drugs that mimic GLP-1 can be used to treat substance abuse problems, but early reports indicate that GLP-1 may unlock some key insights into how our brains process cravings and addiction. 

References:

1. Szalavitz, Maia. “What Ozempic Reveals about Desire.” The New York Times, 4 June 2023, www.nytimes.com/2023/06/04/opinion/ozempic-weight-loss-addictions-desire.html. 

2. Klausen, Mette Kruse et al. “Exenatide once weekly for alcohol use disorder investigated in a randomized, placebo-controlled clinical trial.” JCI Insight. 2022;7(19):e159863. https://doi.org/10.1172/jci.insight.159863.

3. Eren-Yazicioglu, Candan Yasemin and Yigit, Arya and Dogruoz, Ramazan Efe and Yapici-Eser, Hale. “Can GLP-1 Be a Target for Reward System Related Disorders? A Qualitative Synthesis and Systematic Review Analysis of Studies on Palatable Food, Drugs of Abuse, and Alcohol.” Frontiers in Behavioral Neuroscience vol 14 (2020). https://doi.org/10.3389/fnbeh.2020.614884