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Diabetes drug Ozempic and weight-loss drug Wegovy seem to curb other cravings

A MARTÍNEZ, HOST:

Prescriptions for Ozempic have skyrocketed in the past year. The drug treats diabetes. It can cause dramatic weight loss. But many people taking this medication have noticed an interesting side effect. Here's Michaeleen Doucleff.

MICHAELEEN DOUCLEFF, BYLINE: During the COVID pandemic, James Paul Grayson felt like his health was crumbling. He gained nearly 40 pounds, got diagnosed with high blood pressure, pre-diabetes and a heart issue.

JAMES PAUL GRAYSON: Man, this sucks (laughter). You know, I got all these meds I never had to take before. So I was actually pretty depressed about my health.

DOUCLEFF: Grayson is 73 years old. He's retired and lives in Clayton, Okla. He didn't want more heart troubles, so he started taking Ozempic. The medication is extremely expensive, but it worked right away.

GRAYSON: Basically, I started losing weight almost immediately.

DOUCLEFF: Then he noticed something else. He went out to dinner, ordered a beer, and...

GRAYSON: I could barely finish it.

DOUCLEFF: It didn't feel or taste good.

GRAYSON: Sometimes, you drink a beer, and it's, like, oh, my God, it tastes so good. Guzzle, guzzle, guzzle, guzzle. Well, I didn't feel like guzzling. I just barely felt like sipping it.

DOUCLEFF: This wasn't like Grayson. While he never thought he had a problem with alcohol, he did like drinking beer and wine.

GRAYSON: You know, I could consume a whole bottle of wine in an evening without trying real hard - along with a bag of chocolates (laughter).

DOUCLEFF: But the medication zapped his motivation for both the chocolate and the wine.

GRAYSON: I'd have wine in the refrigerator or whatever. I'm, like, maybe I should have some wine. And then I just kind of forget about it. I think I just watch more TV.

DOUCLEFF: He might not have realized it, but Grayson was likely experiencing a change in the release of dopamine inside his brain. Dopamine is a chemical that makes us want or crave things. Christian Hendershot is a psychologist at the University of North Carolina. He says that many people taking Ozempic or another version called Wegovy have had similar aversions to alcohol.

CHRISTIAN HENDERSHOT: There's really been a large number of clinical and anecdotal reports coming in - it's really from across the country - just suggesting that people's drinking behaviors are changing and in some instances, pretty substantially.

DOUCLEFF: He's leading one of six clinical trials looking at whether these weight loss medications can help treat alcohol use disorder.

HENDERSHOT: There seems to be almost a satiety effect where people either decide not to initiate drinking or, if they've started, that they don't feel the need to continue.

DOUCLEFF: And here's what's even more surprising - it's not just with alcohol.

HENDERSHOT: The same things have been reported for cigarette smoking.

DOUCLEFF: In other words, Ozempic may curb many different types of cravings, including nicotine and opioids. Although there have been only a few studies in people, scientists have been studying this effect in rats for more than a decade.

ELISABET JERLHAG: So quite a long time now.

DOUCLEFF: That's Elisabet Jerlhag. She's a pharmacologist at the University of Gothenburg in Sweden. She and her colleagues have shown that Ozempic reduces binge drinking in rats and prevents relapses in animals addicted to alcohol.

JERLHAG: We see a reduction on alcohol consumption by over 50%, which is quite dramatic.

DOUCLEFF: So how does a weight loss medication reduce alcohol cravings? Alexandra DiFeliceantonio is a neuroscientist at Virginia Tech. She says the mechanisms in the brain that cause people to overeat overlap with those that cause addiction. In particular, she says, foods with lots of sugar and fat increase dopamine in a specific part of the brain in the center that causes motivation.

ALEXANDRA DIFELICEANTONIO: That increase in dopamine is actually really similar to one that we see after nicotine consumption or after alcohol consumption. All addictive drugs increase dopamine. That really is, like, the hallmark of an addictive drug.

DOUCLEFF: Here's how that dopamine works. Imagine for a second taking a bite of a warm, gooey chocolate chip cookie. That bite triggers a spike of dopamine in your brain, and that spike tells you...

DIFELICEANTONIO: Oh, hey, go do this again.

DOUCLEFF: Take another bite. The same thing happens if you have a gulp of beer. Dopamine spikes and tells you, take another gulp. Have more. But studies in people show that Ozempic-like drugs reduce the dopamine released in both cases - makes the spikes much smaller. So you slow down and end up sipping the beer and taking only one bite of a cookie.

This experience has become so common that some doctors are now prescribing Ozempic to treat alcohol use disorder, even though it's not approved for this. Dr. Lorenzo Leggio is the clinical director of the National Institute of Drug Abuse. He says that's great if a person also has diabetes or obesity.

LORENZO LEGGIO: Absolutely. Speak with your doctor. And if that will help to also curb your drinking, your craving, there will be an added value.

DOUCLEFF: The drugmaker, Novo Nordisk, says it's not conducting any clinical trials to test these medications for addiction-related illness. But one small trial suggests Ozempic might not help with alcohol use if you don't have obesity.

LEGGIO: No medications are going to work for everybody.

DOUCLEFF: Even though it's still early, some people are using these medications with the hopes of curbing alcohol consumption. Meg Johnston is one of them. She's a real estate agent in Washington, D.C., and she recently started taking Ozempic both to lose weight and to reduce her drinking.

MEG JOHNSTON: I really did a lot of research before getting into this, so I was fully expecting that.

DOUCLEFF: She says the medication has caused a lot of rough side effects, which are common.

JOHNSON: Those first couple weeks were very much focused on not vomiting, making sure I continue to have bowel movements.

DOUCLEFF: But nevertheless, the medication immediately reduced her drinking. She says many days, she doesn't even think about having a glass of wine.

JOHNSON: It doesn't sound as appetizing. Additionally, you feel it after a lot harder, too. The hangover or general uneasiness feeling comes a lot quicker.

DOUCLEFF: Like you've lost the taste for it, almost.

JOHNSON: Yes, truly.

DOUCLEFF: Now, she says, the big question is what will happen when she stops taking Ozempic. Many people regain the weight they've lost, but it's still unknown if they will also regain the desire to drink. For NPR News, I'm Michaeleen Doucleff.

(SOUNDBITE OF AUKAI'S "AKAL KI") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Michaeleen Doucleff
Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
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