Weight-loss medications could play a role in helping people avoid addiction to alcohol, tobacco, and drugs such as cannabis and cocaine, a recent study suggests. They may also lower the risk of overdose, hospitalisation, or death among those already struggling with substance use.
Research published in the British Medical Journal highlights that glucagon-like peptide-1 (GLP-1) receptor agonists—used to treat type 2 diabetes and obesity—may influence the brain’s reward pathways, reducing cravings. These drugs, which include popular treatments like Mounjaro and Ozempic, work by mimicking the natural hormone released after eating, helping patients feel fuller and potentially curbing addictive behaviors.
The US study analysed 606,434 veterans with type 2 diabetes, monitored for up to three years. Results showed that GLP-1 treatments reduced the risk of developing alcohol-related disorders by 18% in patients with no prior substance use. They also lowered the risk of cannabis use by 14%, cocaine use by 20%, nicotine use by 20%, and opioid use by 25% compared with other diabetes medications, such as sodium-glucose cotransporter-2 inhibitors.
Among patients already using substances, GLP-1 medications were associated with a 39% reduction in overdose risk, a 31% lower likelihood of requiring emergency care, and a 50% reduction in death.
“This study adds to emerging research exploring whether GLP-1 medicines may influence brain pathways involved in reward and addiction,” said Prof. Claire Anderson, president of the Royal Pharmaceutical Society. She cautioned, however, that as an observational study, it does not prove that these drugs prevent or treat addiction. “Further research, including clinical trials, will be needed to understand whether GLP-1 medicines have a direct effect,” she added.
Gareth Jones, director of corporate affairs at the National Pharmacy Association, described the findings as “significant,” noting the potential of weight-loss treatments to offer additional therapeutic benefits. He criticized the NHS rollout of GLP-1 medications as “painfully slow,” despite the severe impact of obesity on public health.
However, a separate meta-analysis from Cambridge University, published in eClinical Medicine, reveals long-term challenges with GLP-1 use. The analysis of 48 previous studies found that most patients regain a substantial portion of weight after stopping treatment—about 60% within a year and 75% over the long term. Only roughly 25% of initial weight loss tends to be maintained.
The study also highlighted adherence issues: around half of all users discontinue GLP-1 drugs within a year, and 75% stop within two years, often due to side effects such as nausea and high costs. Additionally, a survey by Simple Online Pharmacy found that two-thirds of patients conceal their GLP-1 use from friends and family to avoid stigma, with 38% reporting criticism for taking “the easy way out.”
These findings underscore the promise of GLP-1 medications beyond weight management while highlighting the practical challenges of long-term use and societal perceptions.
