The Surprising Effects of GLP-1 Medications: Alcohol, Gambling and Beyond

You've probably heard about other effects of these medications in addition to helping people lose weight. People who have previously enjoyed a drink can suddenly, inexplicably, take it or leave it. And it's not just alcohol. One patient who would use cocaine occasionally commented that since being on weight loss injections, she no longer wanted to touch it at all, and another patient who had problems with gambling told me how it had appeared to have cured him.

Now, I should emphasise these are anecdotal reports and these medications are not licensed for use in treating addiction or dependency. However, this effect has made doctors interested that these medications might have a role outside of just weight management.

In a series of case studies, patients who had a problem with alcohol on semaglutide reported that there had been an incidental reduction in their alcohol intake. It was so marked that during follow up, the patients' drinking had changed to the extent that they were no longer classed as having a problem with alcohol.

How can something that helps you lose weight also stop you wanting alcohol? It's a question that intrigued medics and scientists. We know that these medications don't just curb hunger, they also work on the brain reward pathways. This is why foods like cake and chocolate, which stimulate these reward pathways and release the feel good chemical dopamine, lose their appeal for people on these drugs.

Well, it turns out that these reward pathways are also stimulated by alcohol and certain drugs. So not only do foods lose their appeal when on GLP-1 medications, so do other addictive substances and behaviours. It seems that by dampening down the reward pathway, these medications have a knock on effect of reducing people's desire for behaviours that stimulate these pathways.

There are now trials looking at whether these medications could be used to help people with addiction, though at time of writing they are not licensed for this purpose. This is an exciting area of research that underlines just how powerful these medications are, and how much they affect the brain's fundamental reward systems.

This is also why it's so important to do the psychological work whilst on these medications. The reward pathways being dampened down provides an opportunity to develop new, healthier ways of experiencing pleasure and managing difficult emotions. For many people, this unexpected effect on other cravings and addictive behaviours is an added bonus, offering a chance to break free from multiple unhelpful patterns at once and build a healthier, more balanced life.