By Carolyn Cao ’28
Over the past few years, Ozempic and Wegovy have become incredibly popular, being used as a “short-cut” for weight loss with prominent public figures like Elon Musk and Andy Cohen promoting it. Though Ozempic and Wegovy were originally created to help treat type 2 diabetes and obesity, new studies indicate that there may be some unintended positive benefits; both may reduce alcohol cravings in people with Alcohol Use Disorder, or AUD.
Ozempic and Wegovy work via their active ingredient, semaglutide, which is highly similar to natural hormone GLP-1, having over 90% sequence homology. (GLP-1 regulates appetite and insulin production in the body.) Due to this structural similarity, semaglutide functions in the human body just like GLP-1: it acts as a GLP-1 receptor agonist that selectively binds to and activates the GLP-1 receptor present in the brain. As such, semaglutide helps amplify the effects of GLP-1 in regulating appetite and caloric intake.
On the other hand, alcohol use disorder is often mischaracterized as just overdrinking, whereas in reality, alcohol fundamentally changes how the brain works. By rewiring dopamine pathways in the nucleus accumbens and ventral tegmental area, two crucial areas of the brain in the processing of motivation and rewards, alcohol stimulates the release and leads to a surge of dopamine in the brain; this produces feelings of euphoria, relaxation, and pleasure. However, chronic alcohol consumption develops tolerance: essentially, the brain requires more alcohol to achieve the same effects, despite the undesirable health consequences. Additionally, stress systems including hormones, like the brain’s amygdala, start to overreact in the absence of alcohol, making individuals crave alcohol more to feel normal.
Promising research showed there is a connection between these two seemingly unrelated pathways. A 2023 study with rats suggests the possibility that semaglutide may help curb alcohol addiction. In both female and male rats, receiving either acute or repeated semaglutide treatments led to a decrease in relapse-like drinking. Scientists theorize that this effect was attributable to how semaglutide affects reward systems; it decreases alcohol’s ability to increase dopamine in the brain, thus reducing the reward and motivation associated with drinking.
The same effect has been observed in humans. A 2024 study of over 800,000 AUD patients or those with a history of AUD had significantly lower rates of alcohol intoxication when they were given prescriptions of semaglutide or other GLP-1 receptor agonists. Although Ozempic and Wegovy are not approved cures for AUD, they importantly could serve as a promising potential treatment or a harm reduction therapy in these patients.
Harm reduction regimens are crucial for the wellbeing of patients with AUD. Every year, 178,000 people die from alcohol-related incidents, and AUD is the second most common mental illness of suicide victims, being involved in roughly 1 of 4 self-inflicted deaths, according to the National Institutes of Health (NIH). Current medications for AUD are limited to naltrexone, acamprosate, disulfiram, to which many patients experience relapse or don’t respond to at all. Ozempic and Wegovy are different because instead of targeting opioid or gamma-aminobutyric systems (systems which regulate relaxation), they target gut-brain systems. This new target can reduce resistance associated with currently ineffective treatment options, and the safety of such treatments is well-assured due to its already widespread usage.
However, there are some limitations of these studies connecting Ozempic and Wegovy to treatment of AUD. Most of these studies are short-term and small-scale, so it could fail to be true when looking at global and long-term perspectives. Additionally, safe dosage is still unclear, and it could vary for those with more moderate or severe cases of AUD. Lastly, the risks of GLP-1, such as pancreatitis in rare cases, could be damaging for people with weakened pancreases from drinking.
That isn’t to say that we should dismiss the potential benefits of Ozempic and Wegovy. Newer studies find that the same dopamine change following semaglutide treatment that helps reduce alcohol cravings may be effective for other addictions, like nicotine and opioid use, binge eating disorders, and more. The existence of semaglutide drugs like Ozempic and Wegovy creates an entirely new perspective on addiction prevention, as investigating the impact gut-brain hormones have on addiction could potentially lead scientists to new therapies that help save and improve the lives of millions.
