Exploding the market for GLP-1 drugs

Investment Analysis Clubs Macro Economic Trends and Risks
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In the beginning, Ozempic was a drug for diabetics. Then its weight-loss indication was noticed so the market expanded to the obese. (Obesity is now defined as a disease.)

It’s one thing if a drug acts on a specific physical process, like insulin allowing glucose to enter a cell. It’s quite another if a drug acts like a switch for a broad range of related issues.

https://www.nature.com/articles/d41586-025-03911-x

Will blockbuster obesity drugs revolutionize addiction treatment?

Scientists are testing whether GLP-1 drugs can help to cut cravings for cigarettes, alcohol and opioids — as well as food.

by Elie Dolgin, Nature, 02 December 2025

…

They describe people taking diabetes and weight-loss drugs such as semaglutide (also marketed as Wegovy) and tirzepatide (sold as Mounjaro or Zepbound) who find themselves suddenly able to shake long-standing addictions to cigarettes, alcohol and other drugs. And now, clinical data are starting to back them up….

Stories like this have been spreading fast in the past few years, through online forums, weight-loss clinics and news headlines. They describe people taking diabetes and weight-loss drugs such as semaglutide (also marketed as Wegovy) and tirzepatide (sold as Mounjaro or Zepbound) who find themselves suddenly able to shake long-standing addictions to cigarettes, alcohol and other drugs. And now, clinical data are starting to back them up.

Earlier this year, a team led by Christian Hendershot, a psychologist now at the University of Southern California in Los Angeles, reported in a landmark randomized trial that weekly injections of semaglutide cut alcohol consumption1 — a key demonstration that GLP-1 drugs can alter addictive behaviour in people with a substance-use disorder. More than a dozen randomized clinical studies testing GLP-1 drugs for addiction are now under way worldwide, with some results expected in the next few months.

Neuroscientists, meanwhile, are working out how the weight-loss drugs suppress addiction by acting on hormone receptors in brain regions that control craving, reward and motivation. They are finding that GLP-1 therapies help to blunt urges for alcohol, opioids, nicotine and cocaine through some of the same brain pathways that also quell hunger cues and overeating. “At the end of the day, the neurobiological system that is activated by rewarding substances — food, sex, drugs, rock and roll — it’s the same system,” says Roger McIntyre, a psychopharmacologist at the University of Toronto in Canada. And some researchers are testing whether, by influencing reward-related brain circuits, the drugs might help with dementia and depression as well…. [end quote]

The market for GLP-1 drugs will explode if they turn out to be “self-control in a bottle.” The mechanism seems to be a dual hit of lowering dopamine in the reward center and also lowering stress hormones in the amygdala.

But using GLP-1 drugs for any indication other than diabetes is an off-label use with risk and liability. It will take time to develop, test and get FDA approval for pills (currently injectable) and get them approved for the many potential currently off-label uses.

https://www.morningstar.com/sustainable-investing/2-companies-poised-capitalize-rise-glp-1-drugs

Wendy

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GLP-1 drugs may be so shockingly potent in bolstering various aspects of human self-control highly adpated to our origins but extremely mal-adapted to our current realities, both social and environmental, as to be radically transformative for everything, only incidentally including macroeconomics.

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@WendyBG

Heard the other day, mother’s voice is in the addiction center of the brain.

What is a brain center? My Dad had a horrible fall 9 weeks ago. He should have been dead. He had bleeding throughout his brain. He has survived and is slowly coming out of his confusion. It will take a year to clear. He is regaining his strength. He has more than a brain center after a career in medicine.

@flyerboys
Looking at self is enough to work with addictions. Most people need to calm down enough to look at self and work with the emotions and thoughts.

Then there is the American way, pop a pill and drink and smoke anyway.

The Irish family are not far behind. My cousin my age is wrinkled from decades of smoking and drinking. Her husband has type II diabetes and is now “bullet proof” after getting two stents. His sugar in EU metric is 100. It should be below 40. My highest reading was 128 which would be 55 roughly in the EU. He is at risk of losing parts in the next 20 years. We had three of my cousins from Ireland for Thanksgiving.

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@Leap1 I’m sorry to hear about your father. Wishing him a complete recovery even though it will take time.

Wendy

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@WendyBG

Thank you

People have been very caring of my family. I will never forget people’s caring.

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It seems unlikely that GLP-1 only targets urges/rewards for bad stuff. That would really be a miracle drug! I wonder if it also reduces positive feelings more generally, such as for music, art, a beautiful sunset, etc. Perhaps the love for one’s spouse is reduced or the positive feelings of friendships suppressed. Perhaps dulling addiction urges and hunger also reduces other feelings of pleasure and passion.

Those of us who are suspicious of free lunches tend to be a bit cynical about “too good to be true” stories. I suspect that in the end, the positive benefits of GLP-1 will have to be balanced against a more general suppression of a lot of feelings that make life interesting. A healthier life, but also a duller one. There are some indications that this might be the case.

GLP-1 use has been associated with loss of libido and anhedonia (reduced pleasure from previously enjoyable activities). But note that it is a controversial issue:

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Anecdotal response regarding psychoactive drugs. I quit smoking fifteen years ago using Chantix. Side effects included extremely vivid dreams and surprisingly a loss of twenty pounds in the twelve weeks during Chantix use and even after. The systems that control the pleasure centers of the brain seem to affect many different behaviors as opposed to just one.

Jk

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“Ozempic Personality” …. as described in such scholarly resources as The Daily Mail???

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I’m not suggesting it is demonstrated, just a possibility. Two things to consider.

First, given the huge amount of money at stake I would guess there are a lot more funds going into supporting research looking for the benefits of GLP-1 than there are looking for the downsides. The latter is probably mostly coming from federal agencies and we know how they are faring these days.

Second, if GLP-1 modulates dopamine metabolism it seems very likely to me that it will have general impacts on human behavior. Dopamine is after all a common neurotransmitter. It seems unlikely that all the GLP-1 impacts will be favorable.

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@btresist I am absolutely sure that you are correct. An indication of this is the side effects of antidepressants (such as SSRIs) which have not-well-publicized side effects such as loss of libido and sexual response.

Addiction is defined as an urge to use a substance (or do an action) which harms the addict. The cure for the addiction has to be balanced so the cure does less harm than the addiction itself. The addict themself has to be the judge.

The brain is a delicately balanced organ. Some bipolar people who are diagnosed psychotics refuse to take their meds because they miss the excitement of the manic state. An obese person may or may not feel that loss of joie de vivre is more important than loss of weight.

Wendy

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Many bipolar people stop taking meds simply because they feel better. It is hard for them to see in advance how ruinous that is.

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Here’s, IMO, a reasonably cogent summary of the current semaglutide story.

:thinking:
ralph

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HA!….have I got a story to tell here….

He mentions in passing “scientists in the 1980s….” Well, back in 1980, dh was one of about half a dozen young post doc researchers in a lab run by Nobel Laureate Roslyn Yalow at the Bronx VA. “AI overview” will give anyone interested enough a more detailed history, but she was awarded the prize in about 1978 for developing a technique for measuring endogenously produced insulin (radioimmunoassay) along with Solomon Berson. He’d died by the time of the award. The research wasn’t so much to find an appetite suppressing hormone as test further use of RIA in identifying all gut hormones. Husband was one of those young turks….here on year sabbatical (with me in tow) as a Berson fellow. His hormone was secretin. Lots of decent papers from the work…..and with a Nobel Laureate on the papers, plenty of publications in high impact journals.

We made some good friends from that visit and stayed in touch even though we were never intending to return to the US after our return home. Fast forward to a month or so ago, one of those good friends stopped by on his way to Breckenridge. He mentioned another friend from the lab days who’d died recently. The husband happened to ask how John Eng was doing these days and good friend Bill looked at him and laughed. “Don’t you know?”, he asked (Eng wasn’t one of “our” crowd) He clued us in. Eng wasn’t getting very impressive results at the time, but ……… let “AI overview “ tell you the story Bill told us. John Eng and GLP-1 receptor agonists……and the gila monster venom story.

All of a sudden, secretin didn’t look so impressive :face_with_raised_eyebrow:

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