As the diabetes drug gains more attention, a surprising side effect has emerged.
Source: New York Times
February 26, 2023
At what Eva Monsen calls the height of her drinking – during the long slog of the coronavirus pandemic – she drained around half a bottle of wine each day. Ms. Monsen, 46, wasn’t a regular drinker before the pandemic, but she grew to rely on several glasses of wine to help her relax and soften the tension of life during and after lockdown.
Then, in August 2022, Ms. Monsen’s endocrinologist prescribed Ozempic to treat her diabetes. Almost immediately, she said, she lost her desire to drink. When she poured herself a glass of wine, “I felt no pleasure from it at all,” she said.
A part of her missed the comforting blur from being tipsy. When she tried to drink while on Ozempic, though, she felt dizzy and nauseated – but not intoxicated. “I was just incapable of feeling the buzz,” said Ms. Monsen, who lives in Seattle. Now, she barely drinks at all.
As Ozempic gains more attention and more people use the diabetes drug off-label to lose weight, doctors say that many patients are reporting similar experiences: They start the medication and then stop wanting to drink alcohol.
“It’s certainly something I’ve heard many of my patients say, usually in a positive way,” said Dr. Robert Gabbay, the chief scientific and medical officer of the American Diabetes Association.
Weight Loss Drugs
Ozempic: This semaglutide treatment, originally designed as a diabetes drug, has gained attention as celebrities and TikTok influencers have described taking it to lose weight.
Side Effects: Diabetes treatments used for weight loss like Ozempic can expose those who take them to risks including facial aging, thyroid cancer and kidney failure. Going off the drugs can also take a toll.
Insurance Issues: Many insurance companies are refusing to cover new weight loss drugs that their doctors deem medically necessary.
Childhood Obesity: The American Academy of Pediatrics released new guidelines recommending early and intensive interventions, including the use of weight loss drugs, for children who are overweight or obese.
Tina Zarpour, 46, who works at a museum in San Diego, used to have a glass of wine a few times a week while she cooked dinner. But after she started taking Wegovy – a weight loss drug containing semaglutide, which is the active ingredient in Ozempic – in 2021, she found herself “repelled” by alcohol, she said. She would try to have a drink but struggled to finish. “It was like, ugh, I don’t want to,” she said.
Even during a birthday lunch, the type of social event where she would typically enjoy a cocktail or two, she couldn’t bring herself to drink. She ended up ordering tea. “I just wasn’t expecting it,” she said of her new distaste for alcohol. But she said she was grateful for the push to cut back on drinking.
Scientists are working to understand why people like Ms. Zarpour experience this side effect. There are some clues: Semaglutide belongs to a class of drugs called glucagon-like peptide 1 receptor agonists, which mimic a hormone in our bodies that makes us feel full. Semaglutide helps control insulin and blood sugar levels, and can also potentially affect the areas in the brain that regulate our desire for food, said Dr. Janice Jin Hwang, the division chief of endocrinology and metabolism at the University of North Carolina School of Medicine. Some people taking Ozempic have reported feeling less excited or, in some cases, even disgusted by the foods they once enjoyed. It’s unclear why that reaction may extend to alcohol.
Nearly all of the existing research on GLP-1 receptor agonists and alcohol over the last decade has been conducted on animals and with compounds similar, but not identical, to semaglutide. Rats, mice and monkeys receiving GLP-1 receptor agonists have been shown to consume less alcohol and exhibit less of a desire for it than those that are not given the medication. (Animal studies involving these chemicals and drugs like nicotine, opioids and cocaine have reported similar findings.)
However, findings from animal research often do not translate directly to humans, said Christian Hendershot, an associate professor of psychiatry at UNC School of Medicine who is studying whether semaglutide can affect how much people with alcohol use disorder drink. But when patient anecdotes line up with animal data, “it’s a signal that you’re on to something,” he said.
A few human studies on alcohol and medications like Ozempic are underway. Researchers in Denmark (some of whom previously received research funding from Novo Nordisk, the company that manufactures Ozempic) recently published the results of a clinical trial that tested another GLP-1 receptor agonist in patients with alcohol use disorder. The study included nearly 130 people and examined whether those who received the compound, alongside cognitive behavioral therapy, drank less than those who received a placebo and therapy.
Both groups showed a decrease in alcohol consumption, but patients diagnosed with obesity who were treated with the GLP-1 compound and therapy dramatically reduced the amount they drank, compared with those who only received the placebo and therapy.
The researchers also examined brain scans from some participants to see what would happen when they looked at pictures of alcohol; in those who took the GLP-1 compound, “the areas of the brain involved with addiction lit up to a much lesser extent,” said Anders Fink-Jensen, a psychiatry professor at the University of Copenhagen and a co-author of the study. More research is needed to determine how medications like Ozempic affect alcohol consumption, but scientists say they are encouraged by the findings so far.
“There’s really a dire need for new treatments for substance use disorder,” Dr. Hendershot said.
Until there’s more definitive scientific guidance, people who take Ozempic are left navigating the sometimes unexpected ways that the drug affects them. Even some people who drank moderately before starting Ozempic find themselves avoiding alcohol. J. Paul Grayson, a 73-year-old in Clayton, Okla., used to keep a six-pack of beer tucked in the back of his fridge. But three months after going on Ozempic, he stopped buying alcohol except for when he ate out. He used to have two beers with dinner – one when he first sat down, one about midway through the meal – but now, he said, he can barely sip through the first one.
He had expected his eating habits to change once he began taking the medication – he became less interested in fatty, sugary foods and found himself eating smaller meals – but he didn’t anticipate the aversion to alcohol.
“That’s what surprised me,” he said. “It makes you want to do all the things doctors have told you your whole life.”