![]() They have, for example, fewer dopamine receptors in part of the brain’s reward pathway, so the same reward may bring less pleasure. ![]() In people with addiction, this process in the brain shifts as a consequence or cause of their addiction, or perhaps even both. This pathway evolved to help us survive simplistically, food and sex trigger a dopamine hit in the brain. In particular, GLP-1 analogs affect dopamine pathways in the brain, a.k.a. That these drugs work on the level of the brain-as well as the gut-suggests that they can suppress the urge for other things too. The impulse to eat is just one kind of impulse, though. When Kanoski and his colleagues blocked these receptors in rodents, the first-generation drugs exenatide and liraglutide became less effective at reducing food intake-as if this had eliminated a key mode of action. GLP-1 analogs appear to actually bind to receptors on neurons in several parts of the brain, says Scott Kanoski, a neurobiologist at the University of Southern California. Most intriguing, it also seems to reach and act directly on the brain. The exact mechanism in weight loss is still unclear, but the drugs likely work in multiple ways to suppress hunger, including but not limited to slowing food’s passage through the stomach and preventing ups and downs in blood sugar. Semaglutide has been heralded as a potentially even more potent GLP-1 analog.Įxperts now believe GLP-1 analogs affect more than just the pancreas. And almost immediately, doctors noticed that patients on these drugs also lost weight, an unintended but usually not unwelcome side effect. First-generation GLP-1 analogs-exenatide and liraglutide-have been on the market to treat diabetes for more than a decade. Originally developed for diabetes, semaglutide prompts the pancreas to release insulin by mimicking a hormone called GLP-1, or glucagon-like peptide 1. The history of semaglutide is one of welcome surprises. This drug that so powerfully suppresses the desire to eat could end up suppressing the desire for a whole lot more. At UNC, in fact, Hendershot is now running clinical trials to see whether semaglutide can help people quit drinking alcohol and smoking. The science is still far from settled, though researchers are keen to find out more. But semaglutide could one day be more widely useful, as this class of drug may alter the brain’s fundamental reward circuitry. Treatments available today tend to be specific: methadone for opioids, bupropion for smoking. Semaglutide and its chemical relatives seem to work, at least in animals, against an unusually broad array of addictive drugs, says Christian Hendershot, a psychiatrist at the University of North Carolina at Chapel Hill School of Medicine. For years now, scientists have been testing whether drugs similar to semaglutide can curb the use of alcohol, cocaine, nicotine, and opioids in lab animals-to promising results. And the spate of anecdotes might really be onto something. Not everyone on the drug experiences these positive effects, to be clear, but enough that addiction researchers are paying attention. They have reported losing interest in a whole range of addictive and compulsive behaviors: drinking, smoking, shopping, biting nails, picking at skin. It was like a switch had flipped in her brain.Īs semaglutide has skyrocketed in popularity, patients have been sharing curious effects that go beyond just appetite suppression. For the first time-perhaps the first time in her whole life-all of her cravings and impulses were gone. The desire to drink, extinguished once, did not rush in as a replacement either. But most surprisingly, she walked out of Target one day and realized her cart contained only the four things she came to buy. ![]() (Colloquially, it is often referred to as Ozempic, though that is technically just the brand name for semaglutide that is marketed for diabetes treatment.) Her food thoughts quieted down. When she ran errands at Target, she would impulsively throw extra things-candles, makeup, skin-care products-into her cart.Įarlier this year, she began taking semaglutide, also known as Wegovy, after being prescribed the drug for weight loss. “I couldn’t stop from going to that extreme,” she told me. She would spend $500 on organic groceries, only to have them go bad in her fridge. After she got sober in her early 30s, she replaced drinking with food and shopping, which she thought about constantly. Sign up for it here.Īll her life, Victoria Rutledge thought of herself as someone with an addictive personality. This article was featured in One Story to Read Today, a newsletter in which our editors recommend a single must-read from The Atlantic, Monday through Friday. ![]()
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