Ozempic and similar semaglutide-based medications have been hailed as miracle drugs. Known as GLP-1 (glucagon-like peptide-1) agonists, this class of medications mimics a natural hormone the small intestine releases after you eat. They slow the movement of food through the gut and boost insulin production, increasing the feeling of fullness and suppressing appetite.

GLP-1s have proven effective at helping people lose weight and get their blood sugar under control, potentially reducing the risk of heart attacks, strokes, and other serious health conditions. As a result, prescriptions for GLP-1s have exploded in recent years.

The Food and Drug Administration has approved GLP-1 medications for treating type 2 diabetes and obesity. Some doctors are prescribing these drugs off-label for a variety of addictive disorders. Research is underway on the effectiveness of treating addiction with these medications, and some initial studies have shown promising results.

Anna Lembke, MD, professor of psychiatry and behavioral sciences at Stanford Medicine, treats patients with addiction and wrote the bestselling book on addiction, Dopamine Nation: Finding Balance in the Age of Indulgence.

We asked Lembke to help clarify what scientists have discovered so far about the potential for GLP-1s in addiction treatment. These are the five main takeaways Lembke thinks people should know at this point.

GLP-1s seem to help some people with food addiction

Food addiction is not yet recognized as a psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders, known to many as the DSM-5. Nonetheless, a growing consensus of experts agrees that people can get addicted to food, especially ultraprocessed food with added sugar, salt, fat, and flavorants, leading in some cases to compulsive overconsumption.

GLP-1s are approved to treat type 2 diabetes and weight management in people who are obese. It has also been seen to help with food addiction. “Anecdotally, people with food addiction who find GLP-1s helpful in this regard talk about how the medication turns down the volume of ‘food noise’ in the brain, by which they mean the constant thoughts and cravings for certain types of food,” Lembke said.

Food cravings might return when patients stop taking the medicine, but some people can maintain recovery with proper nutrition and exercise. So, while food addiction might not yet be an official diagnosis, there’s evidence that GLP-1s can have a beneficial effect on treating this addictive behavior.

As an added advantage, GLP-1s are not themselves addictive and don’t trigger withdrawal. But because the FDA hasn’t approved GLP-1s as an addiction treatment, insurance companies often won’t pay for them when prescribed for addiction, keeping them out of reach for some patients who might benefit. 

GLP-1s target the brain’s dopamine reward system

GLP-1s don’t just make people feel full by delaying the movement of food through the stomach. They also help appetite control by targeting the brain’s reward pathway. Specifically, they influence the release of dopamine in the part of the brain linked to motivation, pleasure, and reward.

Dopamine is a neurotransmitter, or chemical messenger, that plays a significant role in addiction. Consuming drugs or alcohol, and participating in any activity that is pleasurable or rewarding, will temporarily increase dopamine firing above baseline in the reward pathway, making this area of the brain a good target for medications to treat addiction.

In addition to food addiction, GLP-1s show promise for opioid, alcohol, and nicotine addiction

Early studies suggest that GLP-1s may be effective in treating opioid, alcohol, and nicotine addiction. In one small study of patients with opioid use disorder, a GLP-1 medication reduced their cravings for opioids by 40% over three weeks. Another study found that people with opioid or alcohol use disorder who took GLP-1s had a 40% lower rate of opioid overdose and a 50% lower rate of alcohol intoxication than people who weren’t on the medications. 

Researchers are examining whether the drugs can also help people who are addicted to gambling, sex, and shopping, among other things. “These molecules demonstrate exciting early promise in stemming the rising tide of addictive disorders,” Lembke said. “But we still need more evidence, including longer-term studies.”

GLP-1s don’t work for everyone

While GLP-1s may prove effective for some people, others may not respond at all. Some individuals will be able to stop the medication and continue their recovery, while others will relapse.

“Interindividual variability in response to medications to treat addiction has always been true and will continue to be true with GLP-1s,” Lembke said.

Every medication has side effects that can vary by individual, and GLP-1s are no exception. In the treatment of diabetes and obesity, patients have reported headaches, upset stomach, dizziness, and increased heart rate. Rarely, serious side effects such as pancreatitis and thyroid cancer can occur. “It’s too early to know whether using GLP-1s to treat addiction comes with additional side effects,” Lembke said.

Addiction experts need more tools, and this could be a powerful one

In a world full of easy access to dopamine triggers, we’re more vulnerable to addiction than ever, Lembke said. Drugs, pornography, shopping, sports betting – they’re all available with the click of the button on a device in our pocket.

Meanwhile, the FDA has approved fewer than 10 medications to treat addiction, despite the fact that the disease affects more than 48 million Americans. In this challenging landscape, GLP-1s could be a formidable addition to treatment providers’ toolkits.

“In order to adapt to this environment, we need all the tools we can find,” Lembke said. “It’s the reality of the world we live in now.”