A wave of anecdotal reports describing unexpected benefits for patients taking GLP-1 receptor agonists – such as weight loss ‘wonder drug’ Semaglutide – is now being followed by a barrage of international headlines confirming significantly reduced cravings for alcohol, smoking and other addictions and compulsive behaviours.
Following US Food and Drug Administration approvals, GLP-1 (glucagon-like peptide-1) receptor agonists – such as type 2 diabetes drug semaglutide – have revolutionised the international weight-loss industry by suddenly offering surprisingly effective obesity treatments.
Now even more unexpectedly, mid-2023 has seen semaglutide (approved in 2017 as Ozempic to treat type 2 diabetes and in 2021 as Wegovy to treat obesity) triggering a whole new series of global headlines, with US excitement summed up by The Atlantic magazine’s bold postulation: ‘Did Scientists Accidentally Invent an Anti-addiction Drug?’
Similarly The New York Times – which had cautiously asked ‘What is Ozempic and why is it getting so much attention?’ in November 2022 – has subsequently published 5 follow-up features between January and June 2023 under increasingly enthusiastic headings such as ‘Some people on Ozempic lose the desire to drink. Scientists are asking why.’
In June alone major US news and health websites joined the semaglutide frenzy with tantalising clickbait including:
- ‘Could semaglutide treat addiction as well as obesity?’ (medscape.com)
- ‘Could the diabetes drug semaglutide also help reduce alcohol use?’ (medicalnewstoday.com)
- ‘Ozempic may help with addiction, shopping habits’ (healthnews.com)
- ‘Weight-loss meds like Ozempic may help curb addictive behaviours’ (cnn.com)
- ‘How semaglutide could help those with addiction disorders’ (abcnews.co.com)
- ‘Semaglutides like Ozempic and Wegovy may treat alcohol addiction’ (joinalfie.com)
- ‘Man who lost 80 pounds on ‘game changer’ weight-loss drug also lost his desire to drink alcohol. Experts say the drug could be a treatment for addiction.’ (insider.com)
- ‘Researchers keep discovering new uses for Ozempic’ (nbcnews.com)
- ‘Ozempic could be ‘accidental’ treatment for addiction’ (nypost.com)
Meanwhile internationally, animal studies have shown GLP-1 agonists suppress alcohol-induced reward, alcohol intake, motivation to consume alcohol, alcohol seeking and relapse drinking of alcohol.
In its latest summation, medscape.com noted: ‘Some patients taking these drugs for type 2 diabetes or weight loss also lost interest in addictive and compulsive behaviours such as drinking alcohol, smoking, shopping, nail biting and skin picking.
‘There is also preliminary research to support these observations.’
And US newsletter Health News trumpeted: ‘Some scientists are thrilled they could have unintentionally discovered using semaglutide as an anti-addiction medication.’
Health News summed up the current state-of-play: ‘An increasing amount of evidence now shows Ozempic and Wegovy may work as anti-addiction drugs, especially for people with drinking disorders.’
It noted one study found semaglutide ‘potently decreased alcohol-seeking and consumption in rats’. Another found semaglutide ‘is effective in reducing alcohol intake and modulating binge-like alcohol drinking in mice’, while a third study ‘examined how lab mice taking different GLP-1 medications can more successfully resist cocaine’.
The findings ‘show GLP-1 medications effectively disrupt important cycles of addiction in the rat brain, which helps them escape the grips of dependency’.
Alcohol down 50% in rats
Swedish scientists recently published a study that found semaglutide significantly curbed alcohol consumption and reduced relapse-drinking behaviours in rats and mice.
Initially they provided alcohol to a group of rats for 3-days-per week over 10 weeks to establish a ‘drinking habit’. Subsequently when they gave some rats semaglutide, those which received the medication exhibited reductions in their alcohol consumption.
Lead author Professor Elisabet Jerlhag Holm at the University of Gothenburg told medicalnewstoday. com: ‘Semaglutide, given once or on several occasions, reduced alcohol intake in both male and female rats. This reduction is over half what they drank before.’
The researchers further tested how semaglutide impacted alcohol drinking after a ‘sobriety’ period and noted, as well as experiencing weight loss, ‘we found semaglutide prevents relapse drinking in both sexes’.
Professor Elisabet Jerlhag Holm said: ‘Relapse drinking is a huge problem in patients with alcohol use disorder (AUD). They abstain from alcohol, a white period, and then they start drinking more once they start. This is also seen in rodents, but is prevented by semaglutide.’
The study, reported in June in eBioMedicine and thelancet.com, also tested male mice (not used in the alcohol experiments with rats) to examine possible underlying mechanisms in their study.
‘We found semaglutide prevents the reward from alcohol, and this might be the mechanism contributing to the reduced alcohol intake observed,’ said Professor Jerlhag Holm.
‘We also found semaglutide acts via a reward area in the brain called the nucleus accumbens’ – suggesting semaglutide works by decreasing the ‘sense of reward’ typically experienced with alcohol consumption.
In a comment to medscape.com, Professor Holm noted these agents (GLP-1 agonists) also suppress the reward, intake and motivation to consume other addictive drugs like cocaine, amphetamine, nicotine and some opioids.
With these findings suggesting semaglutide works by decreasing the ‘sense of reward’ typically experienced with alcohol consumption, Dr Josh Lichtman, medical director at California’s Neuro Wellness Spa, told medicalnewstoday.com: ‘The findings are potentially very promising when it comes to patient care.
‘Semaglutide could be a potential treatment option for patients with AUDs. It can reduce alcohol consumption, prevent relapse-like drinking during alcohol withdrawal, and attenuate alcohol-related reward responses.’
The drug’s ‘ability to decrease intake and preference for rewarding foods suggests a broader suppressive effect on motivation for rewards, which may be beneficial for individuals with addictive behaviours beyond alcohol.’
Less ‘brain reward’ stimulus
In another new study, Danish scientists examined the effect of exenatide – a first generation GLP-1 agonist approved for type 2 diabetes (under product names Byetta and Bydureon) – on patients with AUD.
Researchers at the University of Copenhagen, whose study was reported in JCI Insight, gave 127 AUD patients exenatide or a placebo once weekly for 26 weeks.
The participants were also shown pictures of alcohol or neutral subjects while undergoing functional magnetic resonance imaging (fMRI) brain scans. Compared with placebo, those who received exenatide had significantly less activation of ‘brain reward centres’ when shown the pictures of alcohol.
Measured by fMRI scans, the exenatide ‘significantly attenuated’ the ‘alcohol cue reactivity in the ventral striatum and septal area, which are crucial brain areas for drug reward and addiction.
‘In addition, dopamine transporter availability was lower in the exenatide group compared with the placebo group.
‘Exploratory analyses revealed exenatide significantly reduced heavy drinking days and total alcohol intake in a subgroup of obese patients.’
Senior author Professor Anders Fink-Jensen told medscape.com: ‘Something is happening in the brain, and activation of the ‘reward centre’ is hampered by the GLP-1 compound.’
And he noted: ‘If patients with AUD already fulfill the criteria for semaglutide (or other GLP-1 analogs) by having type 2 diabetes and/or a Body Mass Index (BMI) over 30kg/m2, they can of course use the compound right now.’
Professor Fink-Jensen’s team is also beginning a study in patients with AUD and a BMI greater than 30 kg/m2 ‘to investigate the effects on alcohol intake of semaglutide up to 2.4 mg weekly’ (the maximum dose currently approved for obesity patients in the US).
He predicted: ‘Based on the potency of exenatide and semaglutide, we expect semaglutide will cause a stronger reduction in alcohol intake’ than exenatide.
Preventing opioid relapse
A recent US study tested whether titration of GLP-1 agonist liraglutide reduced cue- and drug-induced heroin seeking in high drug- taking rats.
Researchers at Pennsylvania’s Penn State College of Medicine noted opioid use disorder (OUD), like other substance-use disorders, is ‘widely understood to be a disorder of persistent relapse’.
They also noted recent evidence ‘suggests GLP-1 receptor agonists may be promising candidates to reduce relapse’.
The researchers were mindful that GLP-1s ‘can cause gastrointestinal malaise, and therefore, in humans, the medication typically is titrated up to full dose when initiating treatment’.
hey used a rodent model to ‘test whether cue- and drug-induced heroin seeking can be reduced by the GLP-1 receptor agonist liraglutide, when the dose is titrated across the abstinence period and prior to test’.
Their results, published in Brain Research Bulletin, showed ‘this titration regimen is effective in reducing both cue-induced heroin seeking and drug-induced reinstatement of heroin seeking, particularly in rats with a history of high drug-taking’.
They concluded: ‘This treatment regimen had no effect on either circulating glucose or insulin. GLP-1 receptor agonists, then, appear strong candidates for the non-opioid prevention of relapse to opioids.’
Alcohol & nicotine
Another US research group at the University of North Carolina is conducting a clinical trial on 48 AUD participants who are also smokers.
They aim to determine if patients who receive semaglutide at escalating doses over 9 weeks will consume less alcohol (the primary outcome) and smoke less (a secondary outcome) than those who receive a placebo. Their results are expected in October 2023.
The project outline, reported at ClinicalTrials.gov, notes: ‘Among those with AUD, cigarette smokers comprise a sizable and critical subgroup with disproportionally high long-term health risks, making it a key priority to advance therapies for concurrent AUD and cigarette smoking.
‘Recent preclinical evidence indicates glucagon-type peptide-1 (GLP-1), an incretin hormone, impacts both alcohol and nicotine motivation and intake’.
Study lead Professor Christian Hendershot told The New York Times that, while recent findings from animal research often do not translate directly to humans, when patient anecdotes line up with animal data ‘it’s a signal that you’re on to something’.
Responding to enquiries from television network CNN, Professor Hendershot noted: ‘It does seem very clear from people reaching out about our trials that many patients are experiencing some significant secondary benefits from being on these treatments.
‘To see this extent of anecdotal clinical data emerging prior to any human work being published is a relatively unprecedented situation.’
Appetite & desire
Professor Joseph Schacht at the University of Colorado is also preparing to launch a trial ‘looking at whether semaglutide lowers alcohol cravings more than a placebo’.
Schacht told nbcnews.com he first became interested in running a trial when a psychiatrist colleague ‘mentioned some of his patients who’d taken semaglutide for obesity had completely lost interest in alcohol’.
Professor Schacht said: ‘Hearing patients, of their own volition, stop drinking was very striking.
I’ve been working with alcohol use disorder (AUD) for a long time, and there just aren’t a lot of medications that do that.’
Explaining the science behind these drugs, Professor Schacht said that, in normal digestion after someone eats, the small intestine releases the GLP-1 hormone that makes the pancreas release insulin into the blood.
This insulin then lowers blood sugar, sending a signal to the brain saying the body is full and doesn’t need to eat anymore.
The GLP-1 agonist drugs work by mimicking that hormone, helping to lower blood sugar while also making someone feel full.
But interestingly, said ProfessorSchacht, the ‘I’m satisfied’ feeling seems to go to the parts of the brain that regulate not only appetite, but also the desire for alcohol and drugs.
New drugs ‘do their work in brain’
Mainstream US media discussionof additional benefits associated with semaglutide gained significant traction in mid-June, when television network ABC devoted a prime audience segment to the topic.
The national viewership heard the network’s chief medical correspondent Dr Jennifer Ashton ‘break down how diabetes drugs like Ozempic and Wegovy, which contain semaglutide, may help with addiction disorders as well.’
Assessing the latest evidence, Dr Ashton emphasised: ‘Remember, these drugs work in the brain on our reward centre’.
The segment followed the latest major feature in The New York Times that month which trumpeted: ‘What Ozempic Reveals About Desire’.
Stronger versions ‘on their way’
In October 2022, 41-year-old US tech worker Mary Boyer started taking the drug Mounjaro to treat obesity. Mounjaro is a brand name for tirzepatide, an anti-diabetic medication used for treatment of type 2 diabetes.
By June 2023 Boyer had lost 46 pounds (20.9kgs) in 8 months – from 267 to 221 pounds and told The New York Times: ‘I’m losing, like, a pound and a half a week steadily.’
Boyer said that, for decades, she was preoccupied with dieting, hunger and cravings, but now that obsession was gone: ‘I just straight up lost my sweet tooth.’
While she still sometimes turns to pizza or tacos to satisfy emotions, it’s less often, and ‘what happens now is either I get them and have a little bit and I’m satisfied, or I’m just like, ‘You know, I don’t really need that’.’
The NYT explained Mounjaro (like the better-known Ozempic) is one of the ‘new class of diabetes and obesity drugs that work differently from earlier medications in ways not yet fully understood.
‘Unlike stimulants, which can be addictive, these drugs may fight addictions and not just those related to food. Newer, stronger versions are on their way.’
The NYT noted how the new weight loss medications ‘alter appetite and the compulsive behaviour that can be associated with it, could offer new insight into the nature of pleasure and addictions’.
Diabetes patients shun alcohol
As the diabetes drug Ozempic rapidly gained attention for its dramatic weight-loss success, the NYT also reported ‘a surprising side effect has emerged: some people lose the desire to drink.’
Eva Monsen told the newspaper that at the height of her alcohol drinking – during the ‘long slog of the coronavirus pandemic’ – she ‘drained around half a bottle of wine each day’.
Monsen, 24 and living in Seattle, wasn’t a regular drinker before the pandemic, but ‘grew to rely on several glasses of wine to help relax and soften the tension of life during and after lockdown’.
Then in August 2022, Monsen’s endocrinologist prescribed Ozempic to treat her diabetes – and ‘almost immediately, she lost her desire to drink’.
When she poured herself a glass of wine, ‘I felt no pleasure from it at all’; a part of her ‘missed the comforting blur from being tipsy’.
When Monsen tried to drink while on Ozempic, she felt dizzy and nauseated – but not intoxicated.
‘I was just incapable of feeling the buzz,’ she said. Now, she barely drinks at all.
The NYT commented: ‘As Ozempic gains more attention and more people use the diabetes drug off-label to lose weight, doctors say many patients are reporting similar experiences: They start the medication and then stop wanting to drink alcohol.’
Dr Robert Gabbay, chief scientific officer of the American Diabetes Association, confirmed: ‘It’s certainly something I’ve heard many of my patients say, usually in a positive way.’
Distaste for alcohol
The New York Times also cited the case of San Diego museum worker Tina Zarpour, 46, who ‘used to have a glass of wine a few times a week while she cooked dinner’.
After she started taking weight- loss drug Wegovy in 2021, she found herself ‘repelled’ by alcohol.
She would try to have a drink but struggled to finish, explaining: ‘It was like, ugh, I don’t want to.’
She said that during a birthday lunch, the type of social event where she would typically enjoy a cocktail or two, she couldn’t bring herself to drink. She ended up ordering tea.
Less appetite & cravings
Scientists attempting to understand why patients like Tina Zarpour experience this side effect have explained semaglutide belongs to the class of drugs (GLP-1 receptor agonists) which mimic a hormone in our bodies that ‘makes us feel full’.
Professor Janice Jin Hwang from the University of North Carolina told the NYT that semaglutide ‘helps control insulin and blood sugar levels, and can also potentially affect the areas in the brain that regulate our desire for food’.
A joint UK-Denmark study, reported in Diabetes, Obesity & Metabolism, examined the effects of 12 weeks of treatment with once‐ weekly subcutaneous semaglutide (dose‐escalated to 1.0mg) on ‘appetite, energy intake, control of eating, food preference and body weight’ in 30 subjects with obesity.
The scientists (including a team from the University of Leeds) assessed ‘energy intake, ratings of appetite, thirst, nausea and well‐being, control of eating, food preference, resting metabolic rate, body weight and body composition’.
After a standardised breakfast, semaglutide, compared with placebo, led to ‘a lower ad libitum (as much as desired) energy intake during lunch and during the subsequent evening meal and snacks, resulting in a 24% reduction in total energy intake across all ad libitum meals throughout the day’.
The researchers concluded: ‘In addition to reduced energy intake, likely mechanisms for semaglutide‐induced weight loss included less appetite and food cravings, better control of eating and lower relative preference for fatty, energy‐dense foods.’
Less alcohol consumption & desire
Other recent research on GLP-1 receptor agonists and alcohol has been conducted on animals with compounds similar, but not identical, to semaglutide.
A Danish team from the University of Copenhagen specifically investigated the effects of GLP-1 receptor stimulation on alcohol intake in non-human primates by testing ‘GLP-1 receptor agonists exenatide and liraglutide in alcohol-preferring African vervet monkeys with long-term alcohol experience’.
The research, reported in the journal Psychopharmacology, involved 2 streams: in the exenatide experiment, ‘exenatide or vehicle was administered for 5 weeks’, and in the liraglutide experiment, ‘liraglutide or vehicle was administered for 2 weeks’, to obtain steady-state blood levels.
In both studies, no alcohol was available ‘under up-titration of the study drug’. Alcohol was then reintroduced for 2 weeks, and alcohol intake was recorded while the assigned GLP-1 receptor agonist treatment was continued.
Both GLP-1 receptor agonists ‘reduced alcohol consumption without emetic (vomiting) events’.
Moderate drinkers avoid alcohol
The NYT has also reported that ‘even some people who drank moderately before starting Ozempic find themselves avoiding alcohol’.
Oklahoma man J. Paul Grayson, 73, ‘used to keep a 6-pack of beer tucked in the back of his fridge’. But 3 months after going onto Ozempic, he stopped buying alcohol except when he ate out.
He used to consume 2 beers with dinner but now ‘he can barely sip through the first one’.
Grayson expected his eating habits to change once he began the medication – he ‘became less interested in fatty, sugary foods and found himself eating smaller meals’ – but didn’t anticipate the aversion to alcohol.
He explained: ‘That’s what surprised me. It makes you want to do all the things doctors have told you your whole life.’
Compulsive shopping & nail biting
Meanwhile The Atlantic’s attention-grabbing headline ‘Did Scientists Accidentally Invent an Anti- addiction Drug?’ was followed with the dramatic first sentence: ‘People taking Ozempic for weight loss say they have also stopped drinking, smoking, shopping and even nail biting.’
The magazine reported the case of Victoria Rutledge who ‘all her life, thought of herself as someone with an addictive personality’.
Her first addiction was alcohol. After she regained sobriety in her early 30s, she replaced drinking with food and shopping, which she thought about constantly.
She would spend US$500 on organic groceries, only to have them go bad in her fridge. She explained: ‘I couldn’t stop from going to that extreme.’
When shopping at Target, she would ‘impulsively throw extra things – candles, makeup, skincare products – into her cart’.
Earlier this year she began taking semaglutide, after being prescribed the drug Wegovy for weight loss.
She told The Atlantic her food thoughts quieted down; she lost weight; but most surprisingly, she ‘walked out of Target one day and realised her cart contained only the 4 things she came to buy.
‘I’ve never done that before,’ she declared.
Rutledge’s desire to shop had ‘slipped away’. Her desire to drink, ‘extinguished once, did not rush in as a replacement either’.
For the first time, ‘perhaps the first time in her whole life, all her cravings and impulses were gone. It was like a switch had flipped in her brain.’
The magazine also highlighted the cases of: another patient on Wegovy who reported her obsessive picking of the skin and nail-biting had gone away after she started taking the medication; and writer Jim Melloan who said he experienced a ‘total aversion to alcohol’ while taking semaglutide.
Replacing food, vapes, alcohol
International television network CNN also recently broadcast a special report under the headline: ‘Weight-loss meds like Ozempic may help curb addictive behaviours’. It highlighted the case of UK woman Cheri Ferguson who ‘has traded her vape pen for an Ozempic pen’.
She said that one day, 7 weeks earlier, she thought, ‘you’re doing something about your weight; leave your vape at home’ – and she hasn’t picked it back up since.
Ferguson, who lives in Buckinghamshire, is one of many people ‘taking Ozempic and similar drugs for weight loss who say they’ve also noticed an effect on their interest in addictive behaviours like smoking and alcohol’.
A smoker for most of her life, Ferguson started Ozempic 11 weeks earlier to try to lose about 50 pounds (22.7kg) she’d gained during the Covid-19 pandemic, which had made her pre-diabetic.
She’d switched from cigarettes to vaping last year ‘in hopes of quitting but found vapes even more addictive’. That changed, she told CNN, once she started Ozempic.
‘It’s like someone’s just come along and switched the light on, and you can see the room for what it is,’ Ferguson said. ‘All of these vapes and cigarettes that you’ve had over the years, they don’t look attractive anymore. It’s very, very strange.’
Ferguson also drinks less alcohol on Ozempic. Whereas she would have had multiple drinks in a pub, while watching a football match, she’s now content with just one.
Ferguson told CNN she’s lost 38 pounds (17.2kg) since starting Ozempic. But more important to her ‘is how the drug has helped quieten constant thoughts about food, vaping or alcohol’.
Testing long-term effects
The CNN report highlighted: ‘Some doctors say that when it comes to addictive behaviours, an effect on alcohol use is the most common thing they hear from people taking Ozempic or similar medicines.’
Professor Jena Shaw Tronieri, from the Center for Weight and Eating Disorders at the University of Pennsylvania, confirmed: ‘I have had a number of patients describe that and ask about it, because they’re curious about ‘hey, I’ve noticed this change; could that be due to this medication?’
She told CNN that in many lifestyle modification trials she’s run, she’s ‘never had participants report this kind of feeling about alcohol’.
But with semaglutide, people describe, ‘I’m just not really interested in alcohol anymore. I don’t feel like drinking.’
As a result, Professor Tronieri is running a clinical trial of semaglutide to better understand its long-term effects on appetite.
Her ‘Stable Weight Loss’ study is a 72-week research project designed to ‘test the long-term effect of the weight loss medication semaglutide on eating behaviour, hunger and food liking, as compared to placebo’.
Lessening addictive ‘rewards’
Meanwhile this year at the US National Institutes of Health in Maryland, Dr Lorenzo Leggio and a team of researchers have been examining ‘growing evidence indicating the GLP-1 system is involved in the neuro-biology of addictive behaviours, and GLP-1 analogues may be used for the treatment of alcohol use disorder (AUD)’.
They have specifically examined ‘the effects of semaglutide on biobehavioural correlates of alcohol use in rodents’ – both male and female mice, as well as male and female rats. The team has just published a study in JCI Insight confirming ‘semaglutide reduces alcohol drinking and modulates central Gamma- aminobutyric acid (GABA) neuro-transmission’ in the rodents.
GABA is an amino acid that functions as the primary inhibitory neurotransmitter for the central nervous system. It functions to reduce neuronal excitability by inhibiting nerve transmission.
The researchers concluded: ‘The GLP-1 analogue semaglutide decreased alcohol intake across different drinking models and species and modulated central GABA neurotransmission, providing support for clinical testing of semaglutide as a potentially novel pharmacotherapy for AUD.’
Dr Leggio told CNN drugs like semaglutide may influence interest in things like alcohol because they have an effect not just in the gut, but in the brain.
He explained: ‘We believe at least one of the mechanisms for how these drugs reduce alcohol drinking is by reducing the rewarding effects of alcohol, such as those related to a neuro-transmitter in our brain, which is dopamine.
‘So these medications are likely to make alcohol less rewarding.’
Dr Leggio emphasised their impact could go beyond alcohol and smoking and revealed his team is also studying whether semaglutide has an effect on fentanyl-use disorder.
And in reference to widespread publicity about numerous other compulsive behaviours, Dr Leggio summed up: ‘There is a lot of overlap in the neuro-biological mechanisms that regulate addictive behaviours in general.
‘So it’s possible that medications like semaglutide, by acting on this specific mechanism in the brain, may help people with a variety of addictive behaviours.’
950 Million Views
Semaglutide – the generic name for diabetes drug Ozempic and weight loss medicine Wegovy – is a glucagon-like peptide-1 (GLP-1) receptor agonist, meaning it mimics GLP-1 hormone.
In diabetes treatment, explained healthnews.com, the drug ‘works by increasing the levels of the hormone incretin, which helps the body produce more insulin when needed’.
When used for weight loss, semaglutide ‘reduces the appetite and slows down the movement of food in the gut, to make patients feel full for longer’.
In a review of the current debate re potential addiction remedies, Health News reported ‘animal studies suggest treatment with semaglutide significantly decreases addictive-like behavioural effects on cocaine, alcohol, and nicotine’.
It noted: ‘Although the FDA has approved Ozempic for type 2 diabetes treatment, many American celebrities, including tech billionaire Elon Musk and comedian Chelsea Handler admitted taking the drug for weight loss.’
Meanwhile Ozempic has swept across the media with the hashtag #ozempic, which (by mid-May) had over 950 million views on TikTok.
However Health News also warned: ‘Using Ozempic does not come without risks. Some patients reported symptoms of eating disorders, such as abnormal eating patterns, meal skipping, and late-night munching.
‘Others lost the elasticity and the collagen in the muscles in the face, which may be a symptom of malnourishment.’
14% of practitioners personally take Ozempic
By June 2023 Health News declared Ozempic ‘has become viral on social media apps like TikTok and is taking the weight loss industry by storm’.
Emphasising its incredible impact on both the medical profession and the wider health industry, the newsletter reported ‘a new survey explores the ongoing Ozempic craze in the US’ – and revealed an astounding 14% of US medical practitioners ‘personally take Ozempic’, while 58% said they ‘would recommended Ozempic for weight loss’.
The survey, by Healthcare Software company Tebra, also asked 1,024 Americans and 92 medical practitioners about their thoughts on Ozempic for weight loss.
The survey also asked ‘how Americans are becoming interested in Ozempic’: doctor recommendations accounted for 41%, followed by family or friend recommendations at 27%, social media at 24% and celebrity endorsements at 9%.
But worryingly, nearly 80% of medical practitioners ‘believe celebrity endorsements will lead to Ozempic misuse’.
Tebra spokesperson Jesse Noyes told Health News that while ‘social media is certainly playing a role – and that could lead to some concerning issues or trends – 41% said it was a doctor’s recommendation, demonstrating that despite social media’s increasing influence, the relationship between doctor and patient remains paramount.’
While the survey did not include specific data on ‘any racial disparities in Ozempic usage’ or ‘deep dive into which age group is becoming the most Ozempic obsessed’, Noyes confirmed she ‘does have an idea which generation is becoming the most intrigued by Ozempic’.
She summed up: ‘Our findings suggest social media, frequented mostly by millennials and Generation Z, has played a significant role in increasing interest in drugs like Ozempic for personal use.’
GLP-1 & reward system disorders
Turkish researchers at Istanbul’s Koc University have undertaken a ‘systematic review aimed to analyse the studies on GLP-1 and reward pathways and its currently identified mechanisms’.
Their study, reported in Frontiers in Behavioral Neuroscience, identified 30 clinical and 71 preclinical studies – and data was presented by grouping: rodent studies on palatable food intake, drugs of abuse; and human studies focusing on GLP-1 and reward systems.
The review confirmed ‘GLP-1 receptors are located in reward related areas, and GLP-1, its agonists, and DPP-IV inhibitors are effective in decreasing palatable food intake, along with reducing cocaine, amphetamine, alcohol and nicotine use in animals’.
In addition ‘GLP-1 modulates dopamine levels and glutamatergic neuro-transmission, which results in observed behavioural changes.
‘In humans, GLP-1 alters palatable food intake and improves activity deficits in the insula, hypothalamus, and orbito-frontal cortex (OFC).
‘GLP-1 reduces food cravings partially by decreasing activity to the anticipation of food in the left insula of obese patients with diabetes and may inhibit over- eating by increasing activity to the consumption of food in the right OFC of obese and left insula of obese with diabetes.’
The study concluded: ‘Current preclinical studies support the view that GLP-1 can be a target for reward system related disorders.’
Lost 80 pounds & alcohol urge
Washington state attorney Erin Bradley McAleer became an instant celebrity when insider.com reported him as the ‘man who lost 80 pounds (36.2kg) on a ‘game changer’ weight-loss drug and also lost his desire to drink alcohol. Experts say the drug could be a treatment for addiction.’
McAleer, 43, told how he ‘used to attend work-related sporting events and mixers’ and ‘throw back 8-10 beers almost religiously.’
At 6 feet tall and 320 pounds (145.2kg), he could hold his liquor and declared: ‘If I had one, I had eight.’
But for the past year, McAleer has stopped at 2-3 three drinks – if he attends the gatherings at all. These days ‘going to the gym or spending time with his family is often more appealing’.
McAleer told insider.com he now ‘lacks a physical desire for alcohol’ – an ‘unintentional, though not unwelcome, side effect’ of the weight-loss drug semaglutide and other, similar drugs.
McAleer discovered the drug after waking up one morning in late 2021 with partial vision in one eye; he was diagnosed with an ‘eye stroke’ – and his doctor told McAleer if didn’t lose weight, he risked going blind.
A medical friend initially recommended he try Saxenda (a brand of liraglutide, a weight- loss injectable in the same drug class as semaglutide); soon after he switched to Ozempic, which he could buy on his frequent visits to Mexico, where it’s cheaper.
Since he started taking the drugs, as well as losing over 80 pounds, ‘I’m just not interested in alcohol anymore, after a couple of beers. I’ve never had that before.’
‘Next big thing’ in addiction management
Erin McAleer is typical of many US patients reporting a significant reduction in alcohol consumption after starting semaglutide.
Among multiple users on Reddit (an American social news aggregation and discussion website) one correspondent described how they used to imbibe 2 to 3 alcoholic drinks a night, but taking semaglutide was ‘like a light switch.’
Since then, they’ve had 3 drinks in 3 months. ‘No buzz, no enjoyment,’ they wrote. ‘So I’m a non-drinker now, I guess.’
Another Reddit user posted: ‘I was always confused when I would see people taking all night to finish one drink. Now I can totally relate.’
Ohio metabolic specialist Dr Paul Kolodzik (also board-certified in addiction medicine) told insider.com that while more research is needed on the drug’s potential use as a treatment for alcohol-use disorder, it ‘could be the next big thing in addiction management, certainly related to alcohol.’
Dr Kolodzik confirmed some of his weight-loss patients ‘say they no longer experience alcohol cravings while on semaglutide’, and noted GLP-1 receptor agonists like semaglutide ‘increase satiety, both in your stomach and in your head’ – which can suppress alcohol cravings as well as food cravings.
Similarly Pennsylvania addiction- medication researcher Dr Joseph Volpicelli explained these weight- loss drugs ‘also affect the brain’s reward circuit, dulling the dopamine hit someone might otherwise get from a greasy french fry, hot fudge sundae, or dirty martini’. As a result, ‘things that are pleasurable are no longer so pleasurable.’
But Dr Volpicelli also warned there’s not enough research yet in humans for the US FDA to approve semaglutide as a treatment for alcohol-use disorder. While the potential of semaglutide in addiction medicine is ‘really exciting, we have to do more research, and we have to design the study right.’
Conversely Dr Kolodzok told insider.com he has the evidence he needs to ‘feel comfortable prescribing semaglutide to some patients in his addiction- medicine practice’.
He said one patient, who was originally downing about 45 alcohol drinks a week, had cut her consumption in half by taking naltrexone on the days she drank. When Kolodzik introduced semaglutide, her weekly drinks ‘plunged to just 3 to 5’.
He noted: ‘The way patients describe this is, ‘alcohol used to be the focus of my day, and now I’m just kind of disinterested’.’
However Dr Kolodzik warned potential alcohol addiction patients ‘can’t just inject it and forget it’.
He emphasised ‘just like weight- loss patients need to follow a diet and exercise plan for semaglutide to be most effective, alcohol patients should take the drug as a part of a comprehensive treatment plan that could also include therapy and apps that help track their intake’.
But overall, in Dr Kolodzik’s view ‘the harms of alcohol abuse outweigh the potential harms of off- label semaglutide use’.
He summed up: ‘Medicine changes very slowly, but there are people out there like me who think that if you’re doing no harm, there’s no reason not to try this.’
Ozempic ‘malnourishment’ risk
Using the much-hyped weight loss drug Ozempic – semaglutide’s best-known brand name – does not come without risks.
Hartford HealthCare’s Dr Andrew Wong told healthnews.com: ‘Some patients who have been taking Ozempic for a while have reported symptoms of eating disorders, such as abnormal eating patterns, meal skipping, and late-night munching.
‘Others lost the elasticity and the collagen in the muscles in the face, which may be a symptom of malnourishment.’
Health News noted ‘research says patients see an excessive risk months later when the Ozempic weight reduction frenzy persists’. Dr Wong explained: ‘It slows down digestion, and it sends a signal to the brain to not overeat.’
Health News reported that ‘when on the medication, doctors advise you to maintain a nutritious diet. As the pill often diminishes hunger, it is easy to skip a meal.
‘The FDA has authorised Ozempic, a once-weekly injectable, for treating diabetes but not for weight reduction. It is acceptable to use for obesity, but not for every individual after watching TikTok videos.’
According to the Ozempic website, the most common side effects include nausea, diarrhoea, stomach (abdominal) pain, vomiting and constipation.
And a recent survey by US Healthcare Software company Tebra found the most reported side effects were: nausea (45%); headache (32%); and diarrhoea (31%).
In summarising the current US excitement surrounding Ozempic, Health News emphasised: ‘Ozempic’s role in fighting addiction requires further investigation.
‘While its effects on regulating blood glucose levels and weight loss are well studied, the medication shouldn’t be taken without a doctor’s prescription.’ AMP
