Patients are reporting that the headline-grabbing weight loss and diabetes drug Ozempic has reduced their cravings for alcohol and nicotine and tamped down on compulsive behaviors, raising the possibility that the medication could be a ground-breaking treatment for addiction.
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What is Ozempic?
Ozempic is the brand name of semaglutide, a once-weekly injectable drug developed by Danish pharmaceutical company Novo Nordisk and approved by the FDA for the treatment of Type 2 diabetes in 2017.[1] It works by mimicking a hormone known as glucagon-like peptide-1, naturally produced in the intestines. By binding to receptors on the pancreas, it stimulates it to release insulin, reducing blood sugar levels as needed in diabetics.[2]
Semaglutide also appears to slow food leaving the stomach and prevent spikes and falls in blood sugar, both of which work to reduce hunger.[2][3] People taking Ozempic report that food seems less appealing to them, in some cases even disgusting.[4] This leads to significant weight loss. The FDA subsequently approved a higher dose of semaglutide, marketed as Wegovy, for the treatment of obesity in 2021.[5]
Related article: Experts Discuss: Do Weight Loss Drugs Like Ozempic Hold The Answer to Long-Term Weight Management?
While the drug is technically approved for weight loss in people who are obese or overweight with one weight-related health condition, it’s also being used by people who just want to shed a few pounds, including celebrities and tycoons. Tesla and Twitter CEO Elon Musk says he’s using Wegovy to get “fit, ripped, and healthy,” while comedian Chelsea Handler claimed she “accidentally” took Ozempic after being prescribed it by an anti-aging doctor. Multiple Kardashians have fended off claims that the drug is behind their newly svelte physiques.[6][7]
The popularity of the medication for weight loss has created shortages that have left diabetic patients struggling to fill the prescriptions they need to manage their condition.[8]
Ozempic reportedly reduces cravings for things besides food
As some patients have taken Ozempic and Wegovy for diabetes or weight loss, they’ve found their appetites for other things, from cigarettes to compulsive shopping, have melted away along with the pounds.
People taking Ozempic have reported shaking long-established addictions to nicotine, alcohol, caffeine, and illicit drugs. Ozempic also seems to curb behavioral addictions such as binge eating, shopping, overspending, and even compulsive habits like nail-biting. Users have reported relief from general obsessive thoughts as well.[2][9]
These anecdotal reports have sparked interest in the media and among doctors and researchers about Ozempic as a potentially powerful treatment for addiction.
What does the science say about Ozempic as an addiction treatment?
Researchers have found positive early evidence suggesting that glucagon-like-peptide-1 (GLP-1) analogs like semaglutide may reduce addictive behaviors. This month, a team of researchers, including some at the National Institutes of Health (NIH), published a study showing that semaglutide reduces binge-like and dependence-induced alcohol drinking in rodents.[10] The team is now exploring whether semaglutide could ameliorate fentanyl use disorder.[9]
In animal studies, GLP-1 has previously been found to alter “satiety” signaling and affect reward-related brain changes for multiple drugs of abuse, including cocaine, alcohol, nicotine, and amphetamine.[11] In research, rats given a GLP-1 analog sought out less cocaine or oxycodone, and African vervet monkeys drank less alcohol.[2]
Human clinical trials in humans have been more limited. A Danish study explored the use of exenatide, a first-generation GLP-1 analog, in people with alcohol use disorder. It found that when they were taking the drug, their brain’s reward centers lit up less on fMIRs when they were shown alcohol-related images.[12]
In a study currently being run out of the University of North Carolina at Chapel Hill, semaglutide is being investigated as a treatment for alcohol use disorder and smoking.[13]
Scientists aren’t entirely sure why semaglutide and related GLP-1 analogs moderate addictive behaviors but they have some theories.
Scott Kanoski, a neurobiologist at the University of Southern California, told The Atlantic that GLP-1 analogs don’t just bind to the pancreas but also appear to attach to receptors in the brain, specifically affecting the dopamine pathways that undergird addiction.[2]
Dr. Lorenzo Leggio of the NIH endorsed this theory. “We believe that at least one of the mechanisms of how these drugs reduce alcohol drinking is by reducing the rewarding effects of alcohol, such as those related to a neurotransmitter in our brain, which is dopamine,” he told CNN.[9]
However, the medication may not work for all patients. While the Danish study found that alcoholics treated with exenatide showed brain changes, overall, they didn’t drink less on the drug, with the exception of the subset of patients who were obese.[12] If semaglutide and related drugs are developed for addiction, they’re likely to be more effective for some patients than others.
The development of GLP-1 analogs as anti-addiction medication may also founder on the harsh economics of drug development. Historically, addiction drugs haven't been very profitable for pharmaceutical companies, and those that have been developed, such as disulfiram (Antabuse) for alcoholism haven't been widely used. According to the National Institute on Alcohol Abuse and Alcoholism, in 2021 just 5% of the 29 million Americans with alcohol use disorder took medication for the condition.[14] Currently, no pharmaceutical companies are running trials investigating GLP-1 analogs for addiction.[9]
