Semaglutide-based pharmaceuticals like Ozempic and Wegovy are thought to achieve results by counteracting genetic mutations. Many people already regard semaglutide as The Answer to obesity, and there is a new wrinkle in the narrative.
Sarah Zhang, staff writer for The Atlantic, reports on evidence that the new drugs might alleviate not only a bad relationship with eating but some other toxic bonds as well. A significant number of people taking Ozempic (for weight loss, not diabetes) say they have lost interest in such compulsive behaviors as drinking, smoking, shopping, and more.
As we have seen, semaglutide and other GLP-1 agonists can quiet “food noise,” which annoys the brain like tinnitus or the thump of a car’s sound system half a mile away. Patients seeking weight loss, who previously would have replaced food with some other dependency, also apparently have those noises extinguished. One way to describe it is that something flipped a switch in their head.
Other strange effects may show up, not all of them positive. Zhang says,
Patients who undergo bariatric surgery sometimes experience “addiction transfer,” where their impulsive behaviors move from food to alcohol or drugs. Bariatric surgery works, in part, by increasing natural levels of GLP-1, but whether the same transfer can happen with GLP-1 drugs still needs to be studied…
But semaglutide could one day be more widely useful, as this class of drug may alter the brain’s fundamental reward circuitry… This drug that so powerfully suppresses the desire to eat could end up suppressing the desire for a whole lot more.
This is not a new concept in the addiction realm. The notion of a universal compulsion turn-off switch has been something of a holy grail. It’s just that nobody has yet found the magic recipe to pharmaceutically extirpate the detrimental behaviors that people feel compelled to engage in.
The long and short of it is, although nothing ever works for everybody, it presently looks as if food cravings are still the most likely kind to be eliminated by these drugs. At the same time, “The long-term impacts of semaglutide, especially on the brain, remain unknown.” Probably the effect on other body parts will be a surprise, too.
Nobody knows how this will turn out, 10 or 20 years down the line. Another whole area of confusion lies in the fact that…
Unlike addiction, compulsion concerns behaviors that aren’t meant to be pleasurable… Still, addictions and compulsions are likely governed by overlapping reward pathways in the brain, and semaglutide might have an effect on both.
The author mentions a woman whose urge to pick at her skin simply melted away, without even an awareness of slowing down. One day, she just realized she wasn’t doing that anymore. Another female patient stopped skin-picking and nail-biting, and experienced quietness of mind, while others affirmed that their minds “no longer raced in obsessive loops.”
Does semaglutide take the joy out of life? According to those who use it to lose weight, no. They still like what they like, just not in the same quantities as before. So it does not extinguish the pleasure-having ability, only makes it more choosy.
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Source: “Did Scientists Accidentally Invent an Anti-addiction Drug?,” TheAtlantic.com, 05/19/23
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