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Ozempic could hold promise for treating addiction, but many unknowns remain

Insights from Scientific American, The Atlantic, The Conversation, and The New York Times

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Jul 30, 2024, 11:56am EDT
Hollie Adams/File Photo/REUTERS
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The News

Semaglutide, the active ingredient in blockbuster weight-loss and diabetes drugs like Ozempic, may help people quit smoking, a new study suggests.

Researchers found that people taking the drug for diabetes who also smoked were 32% less likely to seek medical care for tobacco addiction than those taking other drugs.

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The study is observational, which means it doesn’t establish a causal link. It’s possible, for example, that the drug makes patients less likely to seek medical care for any issue, rather than making them more likely to quit smoking. But there is other evidence to suggest semaglutide drugs influence will power, addiction, and impulse control, including affecting alcohol consumption and gambling.

But much more research is still needed, and crucially, more understanding of how the drug works.

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Ozempic may curb addictive behavior, but it’s unclear why

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Sources:  
Scientific American, The Atlantic

Anecdotal evidence and a handful of observational studies suggest semaglutide may reduce cravings for alcohol, nicotine, gambling, and other compulsive behaviors like skin picking, Scientific American noted. But exactly why this happens is an open question. The scientists who developed the drug initially thought it affected a gut hormone that signals fullness to the brain, helping reduce hunger and, in turn, cause weight loss. But that has turned out to be not entirely correct, The Atlantic wrote. Now, researchers are starting to understand the process better: The same hormone and its receptor are present in the gut and the brain. It’s possible the drug affects reward centers in the brain, effectively “turning down the dial of want,” Vox wrote.

We need more, bigger, and longer studies

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Sources:  
The Guardian, The Conversation

Most studies into semaglutide’s potential effect on addiction have been conducted in animals; human trials haven’t involved enough people or followed them for enough time to show whether or how it works on reward signaling in the brain, The Guardian wrote. And the findings are mixed, three addiction experts wrote in The Conversation, with some studies suggesting that it is only curbed in people with obesity, rather than in people in general. “These differences in treatment response may come from individual differences that affect addiction, including physical and mental health problems,” the experts wrote. It’s important to find out for another reason: If semaglutide influences reward in the brain, it could be an issue for people with depression, The Guardian added.

Many unknowns over the long-term effects

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Sources:  
CBS News, The New York Times, The Financial Times

Drugs that use semaglutide and similar molecules are relatively new — Ozempic has been on the market for six years — and not much is known about their long-term effects. And because they are posed as a lifelong commitment, doctors have urged caution. “At some point does your body not respond to it anymore? I don’t know,” an endocrinologist told CBS News. In the past, weight loss drugs similarly hailed as miraculous, like fen-phen, turned out to have damaging side effects, and doctors stopped prescribing them, The New York Times added. Questions have already arisen about the potential consequences of semaglutide: Some women have reported unexpected pregnancies, the Financial Times noted, and it’s unclear what impact the drug has on a developing fetus.

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