Ozempic is like a miracle drug. But what does it do to our brains?
It start with anecdotes. There are people who take Ozempic for type 2 diabetes who find that they no longer crave the cigarettes that caused the diabetes. There were those using drugs to treat weight loss who reported that in addition to wanting small portions of food at dinner, they were also satisfied with a small glass of wine next to it.
Nail biting, according to some reports, stopped biting. Compulsive buyers felt less compelled. A man complained to his doctor that when he went fishing he no longer felt the need to drink 18 lagers. He was like that, he cried, “It’s no fun on the beach of the sea.”
It seemed like Ozempic didn’t just change their bodies. Somehow it changed their thinking.
Now lessons came. Laboratory rats were given different drugs – many types of bad human behavior – and then given a new class of weight loss drugs. They stopped being junkies – or, at least, they were less dedicated mice. For people, data is also starting to appear. Just this week, a study found that those with diabetes taking Ozempic were less likely to seek treatment for a tobacco use problem.
The tests we have are early, mostly observational, and some are unclear. But taken together, on balance, they point in the same direction.
“We’re seeing really good results,” said Sue Grigson, of Penn State University, who conducted research showing that a new class of weight-loss drugs appears to help opioid addiction. “The addiction community is really excited and optimistic because we haven’t had a new drug in decades.” And the drugs they have are usually not that good.
It’s been a great journey. Ozempic started out as a powerful diabetes drug. After giving it to thousands of people and following their progress it was found that it was also a powerful drug for weight loss. There is good evidence that, in addition to weight loss, it can prevent heart attacks – and possibly Alzheimer’s.
Now, researchers think it might do something equally powerful: it might be an all-purpose treatment for alcoholism. There is much joy; there is also a caveat. Assuming it actually deals with slavery, how does it do it? And if it can change our desires for bad things, why can’t it also change them for good things?
“That’s a very important question,” Grigson said. “And I don’t think the answer is yet known … Or to, you know, work like a dog to reach a certain time or goal? We need to know what this drug does to our behavior and our thinking and our feelings. ”
Experts are cautiously optimistic about the increased use of drugs
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It doesn’t have to be bad news. It may be that, instead of killing good with evil, it does the opposite. When people lose weight, they gain motivation. When they don’t crave food or cigarettes, they focus. By depressing us for some things, these drugs can motivate us for others.
That is one situation. But that’s just a scenario. Given that, according to some estimates, a fifth of the population may soon be taking these drugs, Grigson thinks it’s time to find out. “We really need real data.”
Ozempic is the most popular of the new class of drugs known as GLP-1 agonists. They trace their origins back to the 1990s, when researchers discovered that they mimic the gut hormone that stimulates insulin production. If you took them, you controlled type 2 diabetes. And you, get them, promote satiety.
But GLP-1 receptors don’t just live in the gut. And so, it was found, drugs do not have an effect only in the intestines. Tony Goldstone, associate professor in the department of brain science at Imperial College London, said: “They seem to lower the reward circuit in the brain – the drive to seek out gratification, whether it’s food or drugs.”
What does this mean? The brain does not have a “bad addiction” circuit. “Remember that the drugs we abuse have shut down our reward systems. We have reward systems designed to help us get food, water, salt and sex. These are evolutionary influences,” said Goldstone.
We know that Ozempic makes us need more food. We also know – although that’s not why its manufacturer Novo Nordisk is worth more than Denmark’s GDP – that it makes us drink less water. On salt and sex, said Goldstone, “there is no data”. And of course, although there is a pharmacological effect that can be more than balanced, it is also a physical one – like the strength of the libido by being thin.
The concern is that Ozempic and similar drugs can create a thin, unhappy, joyless world. “People have been worried that maybe people don’t enjoy anything. Maybe they are getting depressed.” There’s a word for it: anhedonia.
The most convincing argument about that is that, simply, we have good data to show that it doesn’t exist. People have been using these drugs for tens of thousands of years – and we just don’t see it. They don’t quit because they have lost their joie de vivre.
Interestingly, for those who scoff at what’s going on with the nerves, Ozempic people are often still enjoying the food, a little fun. This medicine can give us the light of our mind. “Happiness and motivation can be a little bit different,” Goldstone said. “There can be different cycles.”
So for now, while he and his colleagues wait for better data, for tests that will show if it works, where it works – and how to use it for addiction – there is hope cautious. It won’t be a “wonder drug”, Grigson said. But he is increasingly convinced that, for addiction, it may be a very good thing.
Goldstone is also optimistic, albeit cautiously. As always happens with a new drug, there is a lot of enthusiasm. You go the other way and end up in the middle.” Another concern of his is that addicts—especially alcoholics—are often already malnourished. It may not be a good idea to give them a weak drug. However, he said, “There seems to be a lot of potential benefits without a lot of problems right now.”
However, said Grigson, in the next few years we need to keep an eye on those weaknesses. “Drive and motivation are important.” If, without realizing it, we give a large part of the population a drug that weakens their strength, even a little, that is the issue. “Think of the mountains that people have to climb to solve certain problems. We need them to climb those mountains. And you definitely don’t want to cut them down.”
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