Weight loss medications could treat addiction

New research shows that weight-loss drugs could treat addiction to alcohol, cigarettes, gambling and drugs.

Experts believe the way the GLP-1 and GIP blockbuster weight loss medications work on the brain’s reward pathway can help reduce cravings for many different substances, not just food.

Mounjaro, a GLP-1 Receptor Agonist that helps aid weight loss

Glucagon-like peptide-1 receptor agonists (GLP-1s), such as Wegovy, and glucose-dependent insulinotropic polypeptide (GIP) like Mounjaro, can help people feel fuller by mimicking the natural hormone released after eating.

Now, a study carried out in the United States has found the medications could help to prevent and treat addiction to substances including alcohol, cannabis, cocaine, nicotine and opioids.

Addiction can come in many forms... from alcohol to cigarettes to gambling to eating

The research found GLP-1s helped prevent substance misuse in those who had no addictions and prevented overdoses and emergency clinical interventions in people already addicted.

The findings were based on 606,434 US veterans with Type 2 diabetes who were monitored for up to three years after commencing onto treatment.

In those with no history of substance abuse, starting a GLP-1 treatment was linked to a 14 per cent reduced risk of associated problems.

Risk of alcohol abuse fell by 18 per cent, cocaine and nicotine addiction fell by 20 per cent, cannabis by 14 per cent, and opioids by 25 per cent, compared with people on other diabetes drugs.

Among those with an existing substance use disorder (SUD), starting a GLP-1 was linked to 31 per cent lower risk of related accident and emergency visits, a 26 per cent reduction in hospital admissions, 50 per cent fewer deaths and 39 per cent fewer overdoses. The drug also reduced the risk of suicidal thoughts or attempted suicides by 25 per cent.

While the study, published in the British Medical Journal, predominantly focused on older men, similar results were found in women.

The researchers concluded: “GLP-1 receptor agonists were associated with lower risks of incident alcohol, cannabis, cocaine, nicotine, opioid and other substance use disorders, suggesting potential preventive effects across a broad range of substances.

“In participants with pre-existing SUDs, GLP-1 receptor agonists were associated with reduced risks of SUD-related emergency department visits, hospital admissions and mortality, and drug overdoses and suicidal behaviours.”

Weight-gain potential?

Meanwhile, a separate study found those on the jabs regained almost two-thirds of the weight lost within a year of coming off the drugs if they did not have healthy habits in place or if they went "cold turkey" when finishing their treatment.

Long term weight change can be difficult to manage without the right support...

However, the period of piling on the pounds post-treatment was likely to plateau, with patients ultimately managing to keep a quarter of the lost weight off.

The University of Cambridge study included six trials involving more than 3,200 people.

The analysis suggests that after stopping the jabs for 52 weeks, people regained 60 per cent of their lost weight.

Researchers said the findings, published in the journal eClinicalMedicine, “indicate that there is significant weight regain following cessation of GLP-1RAs”.

However, by 60 weeks, researchers said the regain started to taper off at 75 per cent of the original lost weight, suggesting 25 per cent may be sustained in the long term.

Brajan Budini, a medical student at the University of Cambridge, said: “Drugs such as Ozempic and Wegovy act like brakes on our appetite, making us feel full sooner, which means we eat less and therefore lose weight.

“When people stop taking them, they are essentially taking their foot off the brake, and this can lead to rapid weight regain.”

This helps support the viewpoint that a longer term maintenance plan is needed for the longer term. Whether that involves pharmacological intervention (longer term maintenance dosing with the medications) or non-pharmacological (healthy habits, exercise and nutritional changes in place), the ability to keep the weight off is encapsulated within a longer term trend for when you reach your target weight.

Our next article will explore a maintenance plan for when you want to reduce your dose or come off the medication, but if you need any advice or support in the meantime, please let us know.

Thanks for reading!