How Ozempic and other GLP-1 agonist drugs reject “food noise” and cravings

When Jenni* began losing weight using a drug called liraglutide, he noticed a change in how he thought about food, not just his appetite.

She suddenly wasn't interested in them as the smell of hot tips on the fly fryer elicited a deep craving for a crunchy and salty snack before.

And her food cravings evaporated.

“It was all blank and cancelled completely, and it was really great,” Jenni says.

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Liraglutide is part of a class of drugs known as GLP-1 receptor agonists. This class of drugs includes tilzepatide (brand name Mounjaro) and Semaglutide (sold as Ozempic and Wegovy).

In Australia, Mounjaro, Wegovy and Saxenda (Liraglaltide) have been approved for weight loss.

People with these medicines report that they do not have a constant, constant idea that is commonly referred to as “food noise” and that their cravings for sweets and fried treats can be eliminated.

And it's not just about seeking hot chips and chocolate that appear to be diminished by these drugs. Some studies have shown that alcohol, other drugs, and even gambling cravings may also be dialed.

So how do these types of drugs have such a profound effect on the brain?

What are GLP-1 receptor agonists?

GLP-1 agonists (also known as GLP-1 receptor agonists or GLP-1 analogs) are injectable drugs that are usually useful in managing blood glucose levels in type 2 diabetic patients.

They do this by mimicking a hormone called glucagon-like peptide 1 or GLP-1. GLP-1 binds to pancreatic receptors and stimulates insulin secretion. Insulin helps shut sugar from the blood to the cells in the body.

In the early 1900s, scientists believed that giving GLP-1 directly to people with diabetes would help control blood sugar levels.

Unfortunately, GLP-1 breaks down in the human body in just a few minutes, so Monash University says it's not useful for long-term glycemic control, which studies anti-obesity drugs and the brain.

The 1980s saw a turning point when molecules similar to GLP-1 were discovered in the saliva of a toxic Gira Monster.Heeloperma is suspicious).

Scientists noticed that the molecule was latched to the same receptor as GLP-1, but it didn't break that quickly. It can lower blood sugar levels for hours in mice and people with type 2 diabetes.

It became a drug called exenatide, and was approved by the US Food and Drug Administration in 2005.

In the 1990s, pharmaceutical companies also worked on their own GLP-1 agonists. For example, Novo Nordisk has developed a daily injection, Liraglatide, a long-acting GLP-1 agonist such as Semaglatide, a weekly injection.

How do Ozempic and other GLP-1 agonists work in the brain?

In addition to increasing insulin from the pancreas, GLP-1 agonists also slow food movement through the intestine.

“In your stomach, there are stretch receptors that tell your brain how full you are and how much you are eating,” Jeffs says.

This slow food movement can explain some of the common gastrointestinal side effects associated with these drugs.

These “satisfaction” signals send the vagus nerve, which conveys information between the brain organs and internal organs.

However, GLP-1 agonists can also act directly on brain cells. They can squeeze out of the blood vessels and enter a part of the brain called the hindbrain, just above the spinal cord.

Hindbrain is partly responsible for what we feel full – It may explain another common side effect, as well as nausea feelings.

Multiple studies Showing the drug of GLP-1 agonist can also eliminate a person's preference for sweets and frying, perhaps due to the effects of the hindbrain and the brain regions it connects to.

However, these connections are complex, and scientists are still elucidating the brain circuits involved in weight loss in GLP-1 agonists, Jeffs says.

“Many areas of the brain interact with each other to cause this overall effect.”

Do GLP-1 agonists help to curb alcohol cravings?

In recent years, animal studies have suggested that GLP-1 agonists can help to suppress cravings for alcohol and other addictive substances.

The drug has also shown to be promising in some human studies.

For example, small studies of American people; It was published in Jama Psychiatry last monthwas given low-dose semaglutide to people with alcohol use disorders for nine weeks each week.

Researchers found that participants with GLP-1 agonists did not crave alcohol more than those with placebo, reducing the number of drinks they consumed on the day they drank alcohol.

People who smoked also reported less smoking.

That said, not all GLP-1 agonist studies have shown a clear reduction in alcohol cravings.

A Danish study from 2022 that administered exenatide – a drug developed from Giramonsters – has been discovered There is no broad difference in cravings and alcohol consumption Between drug people and placebo people.

But what they found was that people with obesity and alcohol use disorders reduced their drinking on average over the course of the 26-week study.

“So it looks like these drugs could … be used for alcohol use disorders,” Jeffs said.

“But our understanding of what drives it [potential alcohol consumption and craving reduction] It's still quite limited. ”

*Last name will be withheld for privacy.

Listen to the full episode of Lab Notes For more information about how GLP-1 agonists work.