By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv
GLP-1 and addiction: from obesity and eating to the world of addiction
The link between GLP-1 and addiction is one of the most intriguing directions in medicine today. GLP-1-based drugs have revolutionized the treatment of obesity and diabetes. In recent years, however, it has become clear that their effects reach far beyond metabolic control. A review published in March 2026 in JAMA Psychiatry outlines a new research direction: using these drugs to treat addiction and related mental health conditions as well.
The review was written by two researchers from the U.S. National Institutes of Health, at the institutes for drug abuse and alcohol research. The biological basis for the idea lies in the overlap between the brain’s hunger and satiety mechanisms and its reward systems. The same neural pathways, mainly the dopamine pathways, are also active in addictive behaviors. So it is no surprise that drugs that quiet food noise, the constant thoughts about food, may also affect other urges.
Evidence from laboratory studies: less addictive behavior
The review describes a large body of preclinical research, meaning studies in animals and experimental models. These studies consistently showed that GLP-1 receptor agonists reduce the intake of addictive substances. The results were repeated across different models and different species.
Most of the studies focused on alcohol. However, the researchers also tested nicotine, opioids and stimulants. The key finding is that the effect is repeated and consistent, not random. In other words, these drugs seem to act on the reward system itself.
Clinical evidence: promising data that keep getting stronger
Beyond the lab, evidence is also building in the real world. Cohort studies based on electronic medical records have shown improvements in addiction measures among patients who received GLP-1 drugs for other reasons, mainly obesity and diabetes. On the other hand, studies like these don’t prove cause and effect.
That is why randomized controlled trials (RCTs) matter so much. Here the picture is more complex. In a first controlled trial published in 2025, 48 adults with alcohol use disorder received low-dose semaglutide or placebo for 9 weeks. Semaglutide reduced the amount of alcohol participants drank in the lab, the number of drinks per drinking day and weekly alcohol craving. The number of drinking days, by contrast, did not change. In addition, smokers in the group cut down the number of cigarettes they smoked per day.
The 2026 trial: GLP-1 and alcohol addiction
In April 2026, The Lancet published a large controlled trial in 108 patients with alcohol use disorder and obesity. All participants received cognitive behavioral therapy, plus a weekly injection of semaglutide or placebo for 26 weeks. According to the U.S. National Institutes of Health announcement, heavy drinking days fell by 41.1% in the semaglutide group. The difference in favor of the drug was 13.7% compared with placebo.
Blood tests for alcohol markers supported what participants reported. Body weight and blood pressure also went down. Side effects were mostly digestive, mild and temporary. The number needed to treat for one patient to benefit was 4.3, compared with 7 or more for the drugs currently approved for alcohol use disorder.
Mental health: concerns versus reassuring data
One of the central issues is how GLP-1 drugs affect mental health. Early on, there were concerns about depression, suicidal thoughts or psychiatric worsening. The JAMA Psychiatry review paints a reassuring picture. According to the researchers, there is no evidence that these drugs cause mental health problems or raise the risk of them, including depression and suicidality.
Regulation has been updated, too. In January 2026, the FDA requested removal of the suicidality warning from the labels of Wegovy, Zepbound and Saxenda. The decision was based on an analysis of 91 controlled trials with 107,910 patients, which showed no increased risk.
What’s more, some studies even point to improvements in mental health measures. The improvement may come from fewer cravings, weight loss, a better self-image or a direct effect on the brain. The exact mechanism is still unclear. In any case, it is wise to keep up mental health monitoring during treatment with weight loss injections, as with any long-term therapy.
Open questions about GLP-1 and addiction
Despite the excitement, the research is still in its early days. The review lists several questions that need answers:
- What is the right dose for treating addiction, and how long should treatment continue?
- Does tolerance develop, and what happens after treatment stops?
- Which patients will respond best, and how can we identify them in advance?
- What are the exact mechanisms in the brain, and how do we combine these drugs with psychological therapy?
- How do we ensure reasonable cost, access and equity in treatment?
What GLP-1 research on addiction means for patients today
It is important to be precise: as of October 2026, GLP-1 drugs are not approved to treat addiction. So, for now, using them for this purpose is limited to research settings. Still, many of my patients receive these drugs for obesity or diabetes and tell me about another change. Some describe less desire for alcohol, sweet snacks and even cigarettes.
What should you do with this information? First, don’t start any medication without a doctor, and certainly not with illegal products. Second, if you are dealing with addiction, continue proven treatment: psychological support, support groups and approved medications. Third, if you are taking a GLP-1 drug and notice a change in your cravings, tell your doctor. In such cases, it is worth building a plan together that combines the medication with mental health support.
Looking ahead: a shift in how we treat addiction
The implications of these findings could be dramatic. If large studies confirm that GLP-1 drugs are effective and safe for addiction, we will face a profound shift in thinking. Instead of seeing addiction as a purely behavioral problem, we could treat it as a biological condition that responds to medication. This is a move away from “self-control” toward personalized medicine.
The connection between obesity, eating, addiction and mental health points to a single biological network. Treating one system may affect the others as well. That is why research on GLP-1 and addiction matters even to people who don’t struggle with addiction. It teaches us how the brain regulates craving, pleasure and control, and how we can help it get back into balance. I have also written about the mental health side of treatment in my article on GLP-1 and depression.
The bottom line on GLP-1 and addiction
GLP-1 drugs are opening a new door in the treatment of addiction and related mental health conditions. The evidence from lab studies, the real world and the first trials is promising. However, more large controlled trials are needed to establish effectiveness and safety conclusively. Ultimately, the future of obesity and addiction medicine may be more integrated, biological and precise than ever.
The information in this article is general and does not replace personal medical advice.
References
Prospects of GLP-1 Therapies for Addiction and Mental Health Comorbidities-Quo Vadis?: A Review
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial
Adding weekly GLP-1 to cognitive behavioral therapy further reduces heavy drinking
