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Comment by surfsvammel | Hacker News Reader

I am on GLP-1 (very low dose), and I’ve found that it seems to help me moderate my alcohol consumption as well. Maybe some thing like that could also be contributing to the effect.

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I hypothesize that the appetite-suppressing effect of GLP-1 agonists contributes to the normalization of dopamine signaling in the brain. By mitigating the exaggerated dopamine fluctuations seen in food and sugar addiction, GLP-1 may promote a return to dopamine homeostasis, thereby reducing compulsive or addiction-like reward-seeking behaviors.

Wonder if it would help compulsive gamblers then.

I think that’s already been shown (at the very least I’ve read news articles with anecdotes).

Same here. There's less wanting it but also, if I do indulge even one small glass of wine, the side effects are awful: broken sleep, acid reflux and a hangover the next day. It really slaps you in the face for indulging

Harsher side-effects to drinking sounds like an effective deterrent (although you'd think people would quit after that one hangover they'll never forget). Works for me with candy, a lot of it gives me tooth pain. My teeth are otherwise healthy, no cavities or anything.

They have a lot of anecdotal, observational, and emerging RCT evidence on their effects on substance consumption and abuse.

The biggest effect and best tested is on alcohol use disorder. Mechanistically we don't know if it's through some complex reward mechanism, or something simpler like "alcohol is a calorie and you consume fewer calories." The JAMA study showed that GLP-1 reduce Heavy Drinking Days (>2 drinks/day), but did not reduce overall drinking days. This would imply the simple mechanism -> it's hard to drink a lot of calories even if you do enjoy a drink.

More anecdotal evidence showing this effect in opiates, but nothing in an RCT yet.

So far, nothing has worked in stimulants. Cocaine and Meth abuse are insanely difficult to manage therapeutically right now.

Is there evidence for addiction tendencies in general? Or is it something specific to alcohol?

I don’t know! Think I’ve seen a headline somewhere, but can’t remember where. Quick search should help you :)

To me, it’s anecdotal, of course, but I have same sense of being in control over alcohol intake as food intake.

Basically makes it much easier for me to avoid binging.

I’m about to go to the cinema so I can’t find you references, but there’s a lot of anecdotal evidence at least of glp1’s curbing all sorts of addictive behaviour. I personally started Mounjaro last week and my coffee cravings have gone way, way down for the first time in my adult life.

I believe there is, I don't recall the source but have read that these drugs work by reducing cravings. So they have shown at least hints that they can work on any addictive behavior, not just overeating.

A Brain Reward Circuit Inhibited By Next-Generation Weight Loss Drugs - https://www.biorxiv.org/content/10.1101/2024.12.12.628169v1.... | https://doi.org/10.1101/2024.12.12.628169 - December 17rd, 2024

Glucagon-like peptide 1 agonist and effects on reward behaviour: A systematic review - https://www.sciencedirect.com/science/article/pii/S003193842... | https://doi.org/10.1016/j.physbeh.2024.114622 - Physiology & Behavior Volume 283, 1 September 2024, 114622

GLP-1 for Addiction: the Medical Evidence for Opioid, Nicotine, and Alcohol Use Disorder - https://recursiveadaptation.com/p/the-growing-scientific-cas... - May 14th, 2024

The central GLP-1: implications for food and drug reward - https://www.frontiersin.org/journals/neuroscience/articles/1... | https://doi.org/10.3389/fnins.2013.00181 - Front. Neurosci., October 13th, 2013

From my friends on GLP-1s, I'm pretty sure that it's mostly that it makes you really sick fairly quickly when you drink even in moderation.

Does the very low dose help with weight management?

It depends on the person, but for some (including me) a low dose is enough.

Conversely, for some (including me) a moderate dose has intolerable side effects.

Would you mind sharing what BMI you had when you started treatment and through whom you went? Curious about the low/micro dose effects.

Same. two drinks and I'm done

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