Ozempic has stood at the forefront of a group of drugs known as GLP-1 receptor agonists that have since become a global phenomenon.
Originally developed for the treatment of type 2 diabetes, GLP-1s expanded to the management of obesity, before breaking through clinical boundaries and being adopted as lifestyle drugs that otherwise healthy individuals use for weight loss.
Uptake became so enthusiastic that stock shortages of the major brands (Ozempic, Mounjaro, Wegovy) hit in 2022, when supply couldn’t keep up with social-media-fueled demand. Demand was so high that one man and his brother famously built a billion-dollar telehealth company selling independently formulated versions of the drugs.
We now find ourselves in the middle of a giant, ungoverned sociomedical experiment. The widespread use of these drugs means all the risks and unintended side effects of “cosmetic pharmacology” are now being uncovered at scale.
One important discovery is that these drugs control more appetites than just food.
How GLP-1 drugs suppress appetite
GLP-1 drugs work by mimicking a class of natural peptides called incretins that are released from the gut wall to coordinate the body’s response to feeding. Incretins promote insulin release, slow gastric emptying, and suppress appetite. They shift the body into a state optimised for digestion and absorption of nutrients, and reduce the desire to seek more food.
GLP-1 drugs are synthetic forms of this natural biochemical signal, but they last longer in the body, prolonging the feeling of being sated.
The appetite suppression mechanism is not primarily located in the gut, however. Incretin receptors are found throughout the brain’s reward and motivation systems.
Importantly, these neural systems don’t just regulate physiological responses to food; they also regulate the hedonic pleasure of foods—determining how palatable they are, and how motivated we are to seek them.
Incretins suppress appetite by inhibiting the dopamine-based “wanting” drive that makes us seek out delicious foods, and decreasing the strength of desire we feel for them.
Of course, these reward and motivation pathways in the brain don’t just control desire for food. They regulate many other hedonic drives—including the compulsive desires seen in drug and alcohol addictions (Kenny, 2011). The potential of incretin receptors to moderate cravings has opened up a whole new avenue for the treatment of substance use disorders with GLP-1 drugs.
Preliminary results are encouraging, suggesting that suppression of motivation and reward seeking can reduce substance use severity in addicts (Dawid et al., 2026).
How many desires are suppressed?
It’s becoming clear that GLP-1 drugs can reduce both appetite for food and dysregulated drives like binge-eating, alcohol or drug misuse. Naturally enough, attention is broadening out to their potential for also managing behavioural addictions linked to gambling, shopping, or sex.
A recent paper (Arillotta et al, 2024) searched the same social media ecosystem that promoted uptake of these drugs in the first place to look for clues—analysing Reddit posts on the behavioural changes reported by people taking GLP-1 drugs. The results suggest a reduction in compulsive use of alcohol, caffeine, nicotine and shopping, but a possible increase in libido.
This last point highlights broader concerns about just how many hedonic drives might be affected. Disquiet is growing about the potential wider impact of these drugs on natural rewards, including romantic love.
This is not a baseless concern. A general suppression of desire, of wanting, should impact wanting another person too, and the insatiable desire, euphoric highs, and intrusive thoughts of early love share a lot of similarities with a behavioural addiction.
But love, as has often been observed, is a many-splendored thing. It is not just about reward seeking.
There are layers of psychological and neurobiological complexity in romantic connection: libido, attraction, attachment, bonding, trust, care, affection. How GLP-1 drugs interact with all these factors is largely unknown, and confounded further by the psychological impact that losing weight has on body image, self-confidence, and general health.
Ultimately, we will only learn how all these influences interact to affect love once the results from the uncontrolled social experiment become clear.
From what we know so far, a cautious prediction might be that GLP-1 drugs would have most impact on the insatiable, euphoric, involuntary forms of love—such as limerence—that are driven by reward-seeking behaviour. Or perhaps these drugs will subtly shift the relative contributions of lust, attraction and attachment that compose the complex feelings of love we have for a romantic partner.
At this stage, it remains to be seen how significant any of these secondary psychological consequences of weight loss are for the wellbeing of both individuals and society.
Time will tell.
