GLP-1 Drugs May Quiet Craving Beyond Food

Every year, ? dhruv-khullar notes, tens of thousands of Americans die of opioid overdose. Alcohol-related deaths have more than doubled since the turn of the century. And the FDA has not approved a new medication for alcohol use disorder in two decades.

That is the context for Khullar’s interest in GLP-1 medications such as Ozempic. They are best known as diabetes and obesity drugs. His broader claim is that their most surprising effects may not be in the gut, but in the brain — and specifically in the mental experience of craving.

His central example is “Mary,” a woman who started drinking at 13, eventually could drink 18 beers in a sitting while barely seeming buzzed, and spent her days cycling through intoxication and hangover. She wanted to stop. Alcohol rehab, Alcoholics Anonymous, and Antabuse did not work for her.

The change began when Mary noticed that a friend who also drank heavily was barely touching her drink at a bar. The friend said she had started taking Ozempic and could now barely drink two beers at a time. Mary had understood Ozempic as an obesity medicine, but enrolled in a nearby clinical trial studying whether GLP-1 drugs like Ozempic could help people with alcohol addiction.

Each week, researchers blindfolded her and injected her with either Ozempic or a placebo. Within weeks, she lost her taste for beer, switched to white wine, and then stopped drinking altogether.

Many people taking Ozempic describe a reduction in “food noise”: intrusive, unwanted, repetitive thoughts about eating. Mary described an analogous quieting of “alcohol noise.” The medication did not simply impose a rule against drinking. In Khullar’s account, it made desire less overpowering, turning “an overpowering emotional response into something that could be seen from a distance.” With that mental space, she began exercising, improved her diet, and ended a difficult relationship.

? dhruv-khullar traces GLP-1, or glucagon-like peptide-1, to its discovery in the 1980s, when scientists thought it might be useful for diabetes. The pharmacological problem was that the naturally occurring molecule broke down within minutes, making it hard to turn into a useful drug. The important break came later from research on Gila monsters: a scientist studying the lizards found that their venom contained a similar peptide that could persist for hours. That discovery catalyzed what became the GLP-1 revolution.

For a long time, GLP-1 was understood mainly through digestion. That frame is now too narrow. The medications affect eating, but their most surprising effects may be in the brain. Stories like Mary’s have led scientists to investigate whether GLP-1 medications might help with alcohol, cocaine, gambling, compulsive shopping, smoking, and opioid cravings.

Khullar cites research suggesting that GLP-1s might help people stop smoking, reduce cravings for opioids, and consume fewer drinks. He also points to animal research, currently under review, involving opioid withdrawal. Together, these findings have led some scientists to ask whether GLP-1s act on a common feature of addictive behavior.

He quotes one neuroscientist’s formulation: GLP-1s may be pointing to “some type of universal pathology” in addiction, and may be part of how that pathology is addressed. That is the basis for Khullar’s phrase “moderation molecules.” The wording is important. The claim is not that GLP-1s extinguish desire. It is that they may help keep desire in check.

? dhruv-khullar does not present the mechanism as settled. “No one knows exactly why” GLP-1s might reduce addictive behaviors, he says. But he offers two plausible routes.

The first involves the brain’s mesolimbic pathway, commonly described as the reward system. Alcohol, nicotine, cocaine, and social media all increase dopamine release in that pathway. GLP-1s may limit those dopamine spikes. In mice given cocaine while on the medications, dopamine surges were smaller, while adequate levels of the neurotransmitter otherwise appeared to be maintained.

The second possible mechanism concerns the pain of stopping. Research currently under review has found that animals addicted to opioids and given a GLP-1 showed less activity in a part of the brain involved with withdrawal. If that finding holds, GLP-1s might support moderation not only by making a drug less pleasurable, but also by making abstinence less painful.

The “moderation molecule” frame can easily become too clean. ? dhruv-khullar explicitly warns against that. GLP-1s will not work for everyone. For some people, the moderation effect may look more like a broad dampening of desire. He names the concern directly: some people may lose interest in alcohol, drugs, or food because they lose interest in “pretty much everything,” a condition known as anhedonia.

There are also practical and temporal limits. Addiction is often a lifelong struggle, while many people who start a GLP-1 stop within months because of side effects, cost, or access. Even people who remain on the medications might develop tolerance, with cravings eventually returning.

The evidence Khullar draws on is not all the same kind: Mary’s experience comes from a blinded clinical trial, other claims come from prior addiction research, and the mechanistic discussion relies partly on mouse studies and under-review animal work. Those caveats do not make the drugs irrelevant. They set the level of confidence warranted: promising, biologically plausible, and urgently worth studying, but not a universal cure and not a substitute for the broader work of treating addiction.

For ? dhruv-khullar, the path of GLP-1s — from Gila monster peptide, to diabetes medication, to obesity drug, to possible addiction treatment — illustrates the unpredictability of medical progress. Scientific curiosity that looks obscure or impractical can become the basis for a major clinical shift, and its importance may not be obvious at the beginning.

The deeper implication is about moderation itself. Aristotle treated moderation as central to a well-lived life: courage between cowardice and recklessness, generosity between stinginess and extravagance. Khullar quotes the line often attributed to Aristotle: “It is best to rise from life as though from a banquet, neither drunken nor thirsty.”

But the ancient moral frame is incomplete under modern conditions. Aristotle did not face Doritos, Krispy Kreme, McDonald’s, TikTok, Instagram, algorithms “fracking” attention, or a society beset by fentanyl and oxycodone. Many people now live less with scarcity and boredom than with excess and distraction, in environments and technologies built to exploit basic vulnerabilities.

GLP-1s therefore suggest that moderation is not only a virtue but also a physiological state. Restraint is “not just about character,” in Khullar’s formulation; it is also about biology. That claim does not erase the social causes of addiction. Khullar is explicit that these drugs should not become an excuse to abandon the cultural and political work of building a healthier society or addressing loneliness, trauma, pain, poverty, and exploitation. The drugs are not a social theory. They are a possible tool.

The stakes are visible in the patients ? dhruv-khullar has cared for after addiction had taken almost everything: a young woman whose post-surgery opioid use became heroin addiction and then a fatal heart infection; a father whose liver failed after decades of alcohol use, dying slowly on a transplant list while his children, ages six and eight, asked each morning when their dad could go home.

Mary’s account stays with him because it describes more than abstinence. She told Khullar that GLP-1s enabled her to act not only on her immediate desire to stop drinking, but on a deeper desire to reinvent who she wanted to be — her habits, relationships, and self-understanding. She described gaining freedom to live alongside her desires rather than be ruled by them.

Because alcohol was no longer the issue, Mary told him, she finally had the chance to ask what kind of life she wanted. That is the human version of the scientific claim: if GLP-1s can quiet craving for some people, they may create enough mental space for choices addiction had crowded out.