Taming Problematic Desires for Alcohol as Well as Food

Love, Desire, and DeathThe emergence of advanced medicines for obesity is teaching us a lot about the overlapping mechanisms that drive desires for alcohol, food, and more. Desire, it seems, is more than just a feeling. It is the product of biological processes that our bodies regulate. But those processes can clearly go astray, and desire for food, alcohol, or other things can run amok, causing great suffering.

Research is accumulating to suggest that semaglutide, and perhaps other drugs like it, can restore a more healthy regulation of appetite for more than just food.

Semaglutide and Alcohol Dependence

These insights started out as anecdotal observations. Some patients treated with semaglutide were reporting that they had lost all interest in alcohol. These observations are prompting more careful research into possible mechanisms for these effects.

Then last month, researchers from the University of Gothenburg reported a striking effect in alcohol-dependent rats. One of the authors of this study, Elisabet Jerlhag, explains their findings:

“​We found that semaglutide, given once or at several occasions, reduces alcohol intake in male and female rats. This reduction is over half of what they drank before. All rats have consumed alcohol for over 10 weeks before treatment, indicating that they are “addicted” to alcohol (as much as an animal can be).”

This is a striking effect in a well-established animal model of alcohol dependence. So the next step is a rigorous human study in persons with both alcohol dependence and obesity. Such a study has just begun enrolling patients in Denmark and we expect more will follow.

A Circuitous Path to Understanding Desire

Writing in STAT, Megan Molteni describes how studies of the effects of semaglutide and other GLP-1 agonists are radically expanding the scientific understanding brain circuits responsible for desire and sensations of reward.

Randy Seely, researcher at the University of Michigan, explains that serendipity played a significant role:

“It wasn’t like everyone knew and understood these systems from the outset. We just got really lucky.

“All the weight loss benefits of GLP-1 agonists come from actions directly in the brain.”

Will GLP-1 agonists be only a tool for understanding the biology of desire? Or will they prove to be helpful not only for diabetes and obesity, but also in substance use disorders? Seeley says we still have much to learn:

“It’s entirely possible. But we don’t have enough data yet. The trials will tell us something about whether this is really a phenomenon or not.”

Regardless, these medicines are bringing new insights in neuroscience that are nothing less that amazing.

Click here for the study from Gothenburg, here and here for more reporting on it. For Molteni’s reporting in STAT, click here.

Love, Desire, and Death; woodblock print by George Barbier / WikiArt

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July 11, 2023