Patients claim miracle weight loss jab has very unexpected side effect: it stops all their bad habits – Some have kicked drinking and smoking. Others quit biting their nails. And now intrigued scientists are asking why…
- Semaglutide, or Wegovy, approved on the NHS in March to combat obesity
- It suppresses appetite but some have been saying it stops their bad habits
Top British experts say a new ‘miracle’ weight-loss jab could also help beat debilitating addictions – including alcohol dependency, smoking and even problem gambling.
The pioneering drug, semaglutide, also known as Wegovy, was approved for use by the NHS in March to address the nation’s escalating obesity crisis. It works by suppressing the appetite and in trials has led to patients shedding a fifth of their bodyweight.
But amid mounting evidence by British and international researchers, as well as anecdotal reports from patients, there are now calls for further clinical trials to see if it could help patients combat compulsive behaviour.
Patients taking the drug have described losing interest in drinking alcohol and smoking, while some have reported that lifelong habits such as nail-biting and skin-picking no longer appeal.
One study from researchers at Imperial College London, which has not yet been published, found a similar drug can dampen activity in areas of the brain linked with addiction.
Top British experts say a new ‘miracle’ weight-loss jab could also help beat debilitating addictions – including alcohol dependency, smoking and even problem gambling
This suggests it could make bad habits less appealing and, because semaglutide is more potent than the drug they used, experts say it is likely to have a greater impact.
Dr Tony Goldstone, associate professor in the department of brain sciences at Imperial and who led the research, said: ‘All of the evidence points to the fact [drugs such as this] could treat addiction. We don’t fully know what’s going on. We think these drugs may reduce the amount of the chemical dopamine which is released in the brain in response to certain stimuli, such as smoking or alcohol, or possibly even compulsive behaviours – shopping, internet addiction or gambling. We’re looking at whether it could prevent relapses in people with addictions. Things have to be investigated.’
SURPRISING SIDE EFFECT
Sildenafil citrate, also known as the erectile dysfunction pill Viagra, was developed in 1989 to treat angina chest pain.
Semaglutide, which is injected under the skin using a self-injection pen, was first designed to manage blood sugar levels for type 2 diabetes patients, and was sold under the brand name Ozempic.
But users also lost significant amounts of weight. This spawned an off-label market for the drug among those hoping to use it as an alternative to dieting, making it particularly appealing to Hollywood stars and celebrities. The manufacturer, Danish pharmaceutical company Novo Nordisk, then created Wegovy, which contains a more potent dose of semaglutide as a specific treatment for weight loss. Other drugs that work in a similar way are also available.
Wegovy is licensed in the UK for people who have a body mass index (BMI) of more than 30 – the threshold for obesity – and at least one weight-related condition, such as type 2 diabetes. But as it has grown in popularity, reports have begun to emerge of curious side effects.
Professor Alex Miras, an expert in obesity from Ulster University, said: ‘A small number of patients on these sorts of drugs to have told me they’ve gone off drinking alcohol or smoking. As doctors, it’s not information we routinely ask for, so we’re only hearing it if patients tell us. It means it’s probably happening more than we think. Theoretically, you could take someone with a normal weight and give them these drugs for other forms of addiction, but that hasn’t yet been proven.’
And obesity specialist Dr Spencer Nadolsky, who practices in Maryland in the US, told The Mail on Sunday: ‘Patients report a decreased desire to even reach for any alcohol. Their cravings are diminished. I am hoping this is studied.’
The social media site Reddit has hundreds of people describing how Wegovy has changed their lives in unexpected ways.
One man who claimed to have drunk large amounts of whiskey every night for 20 years said he had barely touched a drop in over two months after taking Wegovy for weight loss. ‘I am able to have a single drink and not have the urge to drink another,’ he wrote.
A woman who had bitten her nails ‘down to the nubs’ for 34 years since she was four had ‘completely stopped’. Others reported losing the craving to smoke, to eat chocolate or shop compulsively.
One Reddit user wrote: ‘I’m on this drug and it really does change some part of your brain. You just feel overly satisfied most of the time. The best way I can think to describe it is like the feeling you have after eating something very rich and decadent.’
One man who spoke to The Mail on Sunday said semaglutide had not only reduced his interest in drinking alcohol, but had also ‘completely stopped’ his teeth-grinding and nail-biting habits.
Patients taking the drug have described losing interest in drinking alcohol and smoking
Some have reported that lifelong habits such as nail-biting and skin-picking no longer appeal
Chad Teixeira started taking it for weight loss five months ago after getting a prescription for Ozempic from a private doctor.
The 27-year-old from London, who runs a celebrity PR agency, says he feels ‘amazing’, losing nearly two-and-a-half stones – 18 per cent of his bodyweight – after a lifetime of fad diets failed to work. But the other effects are ‘just bizarre’, Chad explains.
‘Within three weeks of starting Ozempic, I noticed I also wasn’t interested in drinking alcohol,’ he recalls. ‘It tasted the same, but I didn’t want it – and I’m usually a big drinker.
‘I’ve stopped grinding my teeth and biting my nails. I used to wake up every morning with pain in my jaw and now I don’t.
‘I used to worry about how my nails looked all the time because I’d bite them. Suddenly I realised that, without noticing, I’d stopped doing it.’
Jeff Wilson, 38, a software analyst from North Carolina, started taking Ozempic a year ago when he struggled to tolerate blood sugar lowering drug metformin.
He has lost five stone – but recently realised he’s also stopped biting his nails, a habit he’d had since childhood.
Jeff said: ‘When I read about this possible effect online, I thought, “That’s me”. A lightbulb went on in my head. I’ve always chewed bits off my nails and not thought about it, and haven’t ever tried to stop.
‘But I realised that I’ve been having to cut my nails, with clippers. I had to look for the clippers in the house that my wife and children use. I’d never had to do that before.’
Scientists have not yet worked out what is going on in the brain to prompt this effect. But they all agree it is plausible and there are intriguing clues in how these drugs work.
Semaglutide is part of a family of drugs which mimic a hormone in the intestines called GLP-1. The hormone is released by the body when we eat and sends signals to the brain when we are full.
But some people with obesity may naturally produce less of it, which may partly explain why they eat more, according to Dr Goldstone.
Artificially upping GLP-1 levels may trick the body into feeling full and suppress appetite. But there may also be an effect on the areas of the brain linked with motivation and reward, experts believe.
‘This reward network releases the feel-good chemical dopamine and gives us a pleasant feeling when we do pleasurable things such as eating certain foods, drinking alcohol or even going shopping,’ says Prof Miras. ‘The more pleasant that feeling, the more likely we are to do it again and again.’
In people with addictions, the reward network may over-react, he adds: ‘Most of us get a pleasurable response to these activities, but some people at the extreme end develop compulsive, addictive behaviours.’
The GLP-1 drugs may dull brain activity in those areas, it is believed, causing them to produce less dopamine.
‘Less dopamine means that we may not be as motivated to repeat those behaviours – whether that’s eating, drinking alcohol or some other compulsive act,’ says Dr Goldstone.
Earlier studies found smokers given exenatide, a less potent GLP-1 drug, were twice as likely to quit.
Dr Goldstone’s team looked at brain scans of recent ex-smokers given exenatide and found areas involved in feelings of reward were less active after taking the medication. They hope this means they’ll be less likely to relapse, although the research is ongoing.
‘We hoped to see a similar response in people with alcohol dependence but we didn’t see much of a brain change,’ he adds. ‘But I’d love to do a study on whether these drugs could help beat problem gambling.’
In a separate study, which involved people who were dependent on alcohol, those who were obese at the start reduced their drinking after being given exenatide. For everyone else, though, there was no noticeable difference.
SURPRISING SIDE EFFECT
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The reasons for these discrepancies aren’t clear. There is even less evidence on the effect of the drugs on behaviour which is compulsive – in other words, which isn’t supposed to be pleasurable – such as nail-biting or skin-picking.
While the brain’s reward networks may have some role to play in why these behaviours develop into habits, experts say the mechanisms are more complex to unravel.
Certainly the anecdotal evidence from semaglutide users suggests that not everyone will notice any effect on their behaviour. Prof Miras says: ‘Just as semaglutide doesn’t work for everyone who wants to lose weight, it may not have this other effect on everyone either – or it may be so small that people might not notice it.’
The evidence to date is so tantalising, however, that at least one trial investigating whether semaglutide can help alcoholics and smokers quit their habits is going ahead at the University of North Carolina in the US. The study is recruiting 48 patients – all smokers with a ‘mild to moderate’ dependence on alcohol. Half will be given semaglutide and the rest a placebo injection.
One of the big questions is what happens in the longer term.
Experts agree that, for obesity as well as diabetes, it may be necessary for patients to take semaglutide for life to manage their condition and avoid regaining the weight.
But what about those who are at a normal weight and who may need to take it just to curb an addiction?
‘People dependent on alcohol and drugs may be malnourished already because they don’t eat healthily,’ says Dr Goldstone. ‘You do have to be very careful.’
There are no obvious safety concerns – older versions of the drugs have been used in diabetes patients for a decade without problems.
‘We think, at the moment, that people who are a normal weight taking it for addictions will lose very little weight,’ says Prof Miras. ‘That’s only a hypothesis and it hasn’t been proven.’
Results are expected in November from a large trial looking at whether semaglutide prevents heart attacks and strokes – and all the signs so far are promising.
If it could also help conquer addiction, the demand – and hype – will no doubt reach stratospheric levels.
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