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Are Weight Loss Drugs Also a Treatment for Addiction?

By now, most people have heard of Wegovy and Ozempic, medications originally developed to control diabetes which are now having tremendous success when prescribed for weight loss. What fewer may have heard of is the exciting potential these drugs may have for the treatment of other addictions such as drug and alcohol abuse, smoking, and even compulsive behaviors such as nail biting.

What are Wegovy and Ozempic?

Wegovy and Ozempic are brand names of semaglutide, and since its widespread introduction for weight loss, patients and doctors have seen that the drug appears to curb addictive tendencies beyond overeating.  Some patients taking semaglutide for weight loss have reported that their cravings for drugs, alcohol and nicotine declined, which has caught the attention of clinical researchers who are now investigating it as a possible treatment for addiction.

It’s an unprecedented situation,” said Christian Hendershot, a University of North Carolina clinical psychologist who is studying semaglutide’s effect on alcohol use.  “The anecdotal reports of people saying these drugs are helping them cut back on drinking or smoking have come much faster than our clinical studies can confirm.”

Semaglutide is a GLP-1 analog which was originally marketed as a diabetes treatment, and earlier versions of the drug have been available for over a decade. Doctors and patients quickly noticed that, even though the medications were prescribed for diabetes, they had the effect of causing weight loss.

Semaglutide likely works in multiple ways to promote weight loss.  It prompts the pancreas to release insulin by mimicking a hormone called GLP-1, or glucagon-like peptide 1. However, experts now believe GLP-1 analogs affect more than just the pancreas. The drug likely also slows the passage of  food through the stomach and prevents fluctuations in blood sugar. Most intriguing, however, is it also seems to act directly on the brain.

How Semaglutide Affects the Brain

GLP-1 analogs appear to bind to receptors on neurons on some parts of the brain.  Specifically, GLP-1 analogs affect the dopamine pathways, or reward circuitry, of the brain.  This reward pathway evolved to help humans survive; in simple terms, food and sex trigger it – it feels good, and we do it again.  People struggling with addiction have fewer dopamine receptors in part of the brain’s reward pathway, so the same reward tends to bring less pleasure, fueling the addiction cycle.

Researchers are still investigating how GLP-1 analogs curb addictive tendencies. Several structures in the brain produce GLP-1 or carry receptors for the hormone—including brain areas that are involved in our reward pathways, which drive us to pursue pleasurable activities, such as eating tasty food or hanging out with friends. Addiction involves “hijacking of the reward pathways in the brain,” says behavioral neuroscientist Patricia Grigson of the Pennsylvania State University College of Medicine. Researchers believe GLP-1 analogs induce weight loss in part by quelling activity of this system, and the same mechanism could explain why people who take the medications report they are less motivated to engage in addictive behaviors such as drinking and smoking.

The other way GLP-1 agonists can impact addictions is by blunting a person’s responsiveness to “cues” for a drug or for alcohol.  Further, there is significant overlap in the systems that regulate pathological overeating and pathological overdrinking.

Addiction research has previously demonstrated that GLP-1 analogs alter the reward pathway in lab animals: mice get less of a dopamine hit from alcohol; rats sought out less cocaine; same for rats and oxycodone. Monkeys drank less alcohol. Most of the animal research was done with first generation GLP-1 drugs, however clinical trials with human subjects using current versions of the drugs are now underway and look promising.

How Wegovy and Ozempic Have Helped Curb Addictive Behaviors

There is already anecdotal evidence from patients who report that they had reduced cravings for alcohol, drugs and nicotine and reduced urges to engage in compulsive behaviors.

One patient, who described herself as having an addictive personality, got sober from alcohol in her early 30s.  However, after quitting drinking, she developed cross-addictions to shopping and compulsive spending.  In 2023, after she began taking Wegovy for weight loss, her food thoughts lessened, and she lost weight.  But to her surprise, she also noticed changes in her shopping and compulsive spending.  She would go into a store and buy only the things on her list, without having the impulse to grab other items to purchase.  This was a significant change for her.  Further, the craving for alcohol did not return.  For the first time in her life, all the cravings and impulses were gone.

Other patients have reported similar effects.  The types of behaviors that patients have seen impacted include both addictions, such as smoking and drinking, and compulsions, such as skin picking and nail biting.  Compulsions are different from addictions in that they involve behaviors that aren’t meant to be pleasurable.  Even though addictions and compulsions differ, both appear to be governed by overlapping reward pathways in the brain, and semaglutide may impact them both in a similar way.

One patient reported that two months after she began taking the drug, she realized the skin on her back, which she had compulsively picked for years, had healed.  She wasn’t even aware that she had stopped picking it after starting the medication.  Previously, she picked her skin so frequently and severely that it bled to the point that she would not wear white.  The fact that she had gone weeks without picking her skin, without even realizing it, astonished her; she reported that the urge to pick had simply “melted away.”

Looking at the Future of Semaglutide

Clinical trials are underway to investigate the potential of semaglutide as a potential treatment for addiction.  It is currently being researched to determine its effectiveness for opioid use disorder, alcohol use disorder and nicotine dependence.

Semaglutide is still in the clinical trial phase and is not yet available for treatment for substance use disorder.  There are, however several medications which are available for treating substance use disorder.  Harmony Place makes the full range of Medication Assisted Treatment (MAT) available to support your recovery.